Current concepts on the neurobiology of Attention-Deficit/Hyperactivity Disorder

Journal of Attention Disorders - Tập 6 Số 1_suppl - Trang 7-16 - 2002
Joseph Biederman1, Stephen V. Faraone2
1Pediatric Psychopharmacology Unit of the Child Psychiatry Service, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
2Pediatric Psychopharmacology Unit of the Child Psychiatry Service, Massachusetts General Hospital and Harvard Medical School.

Tóm tắt

Attention-Deficit/Hyperactivity Disorder (ADHD) is an early onset, clinically heterogeneous disorder of inattention, hyperactivity, and impulsivity. In contrast to the widespread acceptance of ADHD as a childhood diagnosis, its prevalence in adults and its implications for clinical practice remain a source of controversy. Throughout the lifecycle, a key clinical feature observed in ADHD patients is comorbidity with Conduct, Depressive, Bipolar, and Anxiety disorders. Family studies consistently support the assertion that ADHD runs in families. Heritabillty data from twin studies of ADHD attribute about 80 percent of the etiology of ADHD to genetic factors. Adoption studies of ADHD also implicate genes in its etiology. Molecular genetic data are bolstered by considerations suggesting that DRD4 and DAT genes may be relevant for ADHD. Independently of genes, prenatal exposure to nicotine and psychosocial adversity have also been identified as risk factors for ADHD. Structural and functional Imaging studies consistently implicate catecholamine-rich fronto-subcortical systems in the pathophysiology of ADHD.

The effectiveness of stimulants, along with animal models of hyperactivity, point to catecholamine disruption as at least one source of ADHD brain dysfunction. Although not entirely sufficient, changes in dopaminergic and noradrenergic function appear necessary for the clinical efficacy of pharmacological treatments for ADHD, providing support for the hypothesis that alteration of monoaminergic transmission in critical brain regions may be the basis for therapeutic action in ADHD.

Từ khóa


Tài liệu tham khảo

10.1111/j.1939-0025.1986.tb03473.x

10.1146/annurev.ne.09.030186.002041

10.1001/archpsyc.1987.01800130081010

10.1046/j.1471-4159.1995.65031157.x

10.1007/BF00916547

10.1016/S0006-3223(00)01053-2

10.1001/archpsyc.1992.01820090056010

10.1097/00004583-199007000-00004

Biederman J., 1991, American Journal of Psychiatry, 148, 251

10.1001/archpsyc.1991.01810310051009

10.1176/ajp.152.3.431

10.1097/00004583-199511000-00017

10.1001/archpsyc.1995.03950180050007

10.1176/ajp.148.5.564

10.1001/archpsyc.1988.01800360068010

10.1111/j.1469-7610.1991.tb01921.x

10.1097/00002826-198409000-00002

10.1001/archpsyc.1972.01750270114018

10.1111/j.1469-7610.1975.tb01275.x

10.1111/j.1469-7610.1991.tb00350.x

10.1007/978-1-4684-3686-0

Conners C. K., 1992, Conners’ Continuous Performance Test.

Cook E. H., 1995, American Journal of Human Genetics, 56, 993

10.1001/archneur.1993.00540080076020

10.1016/0014-2999(94)90323-9

10.1016/S0140-6736(99)04030-1

10.1038/clpt.1990.118

10.1097/00041444-199210000-00004

10.1176/ajp.150.6.891

10.1017/S0033291700014707

10.1097/00004583-199710000-00020

10.1176/appi.ajp.157.7.1077

10.1002/(SICI)1098-2272(200001)18:1<1::AID-GEPI1>3.0.CO;2-X

10.1016/S0165-0327(00)00213-5

10.1016/S1056-4993(18)30059-2

10.1176/appi.ajp.158.7.1052

Faraone S. V., 1995, Textbook in Psychiatric Epidemiology, 81

10.1207/s15374424jccp2004_14

10.1016/0091-3057(89)90419-X

10.1016/S0165-0173(97)00063-5

10.1038/379606a0

10.1111/j.1469-7610.1989.tb00782.x

10.1016/0736-5748(85)90046-2

10.1056/NEJM199304083281403

Hetherington E. M., 1982, Non-traditional families, 223

Institute of Medicine, 1989, Research on Children and Adolescents with Mental, Behavioral and Developmental Disorders.

Johns J. M., 1982, Nenrobehavioral Toxicology and Teratology, 4, 365

10.1016/S0304-3940(00)01040-5

LaHoste G. J., 1996, Molecular Psychiatry, 1, 121

10.1046/j.1471-4159.1997.68020804.x

10.1037/1064-1297.9.1.83

10.1007/BF02246281

Manshadi M., 1983, Journal of Clinical Psychiatry, 44, 379

Marks M. J., 1993, Journal of Pharmacology and Experimental Therapeutics, 266, 1268

10.1523/JNEUROSCI.12-07-02765.1992

10.1016/0010-440X(80)90017-6

10.1097/00004583-199701000-00015

Morrison J. R., 1971, Biological Psychiatry, 3, 189

10.1001/archpsyc.1973.01750360098015

10.1017/S0033291700055550

10.1016/S0893-133X(98)00115-8

Pauls D. L., 1983, Annals of Neurology, 14, 363

10.1016/0899-3289(95)90030-6

10.1097/00004583-199401000-00005

10.1192/bjp.126.6.493

10.1111/j.1469-8986.1971.tb00450.x

10.1111/j.1469-7610.1990.tb01576.x

10.1002/(SICI)1097-0193(1996)4:3<174::AID-HBM3>3.0.CO;2-0

10.1016/S0022-3476(78)80001-8

10.1016/0361-9230(93)90224-Y

10.1016/S1056-4993(18)30136-6

10.3109/10673229409017099

10.1097/00004583-200011000-00018

10.1097/00004583-199309000-00023

10.1016/0091-3057(94)90293-3

Van Tol H. H., 1992, Nature, 555, 149

10.1016/S0022-3476(05)80947-3

Weiss R. E., 1994, Journal of Clinical Endocrinology and Metabolism, 78, 1525

10.1097/00005053-197708000-00004

Wilens T. E., 1999, American Journal of Psychiatry, 156, 1931, 10.1176/ajp.156.12.1931

10.1001/jama.1995.03530200053037

10.1097/00004583-199512000-00007

Zametkin A. J., 1987, Psychopharmacology: The third generation of progress, 837

Thông tin
Thông tin xuất bản

Journal of Attention Disorders

Tập 6 Số 1_suppl

7-16

Thông tin tác giả