Is there evidence for neural compensation in attention deficit hyperactivity disorder? A review of the functional neuroimaging literature
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This article reviews evidence for the presence of a compensatory, alternative, neural system and its possible link to associated processing strategies in children and adults with attention deficit hyperactivity disorder (ADHD). The article presents findings on a region by region basis that suggests ADHD should be characterized not only by neural hypo-activity, as it is commonly thought but neural hyperactivity as well, in regions of the brain that may relate to compensatory brain and behavioral functioning. In this context studies from the functional neuroimaging literature are reviewed. We hypothesize that impaired prefrontal (PFC) and anterior cingulate (ACC) cortex function in ADHD reduces the ability to optimally recruit subsidiary brain regions and strategies to perform cognitive tasks. The authors conclude that healthy individuals can recruit brain regions using visual, spatial or verbal rehearsal for tasks as needed. In contrast, individuals with ADHD may be less able to engage higher order executive systems to flexibly recruit brain regions to match given task demands. This may result in greater reliance on neuroanatomy that is associated with visual, spatial, and motoric processing rather than verbal strategies. The authors speculate that this impaired flexibility in recruiting brain regions and associated strategies limits adaptation to new cognitive demands as they present and may require more effortful processing.
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Neuroimaging studies show abnormal prefrontal and parietal cortex functioning in children with ADHD during working memory tasks.
“Neuroimaging studies reveal abnormal PFC and parietal cortex functioning in children with ADHD during WM tasks [5-9, 39, 40].”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [9]
Reviews concluded that ADHD children may rely on brain functions based on visual and motor processing associated with performance strategies to compensate for deficits in executive functions.
“Reviews of the literature (Dickstein et al, 2006;Fassbender and Schweitzer, 2006) concluded that ADHD children may rely on brain functions based on visual and motor processing of information associated with performance strategies that allow them to compensate for deficits in executive functions.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Fassbender and Schweitzer, 2006
Fassbender and Schweitzer found the ADHD group had greater intraindividual variability, which was negatively correlated with activity in the posterior cingulate cortex.
“The ADHD group also showed greater intraindividual variability, which was negatively correlated with activity in the PCC.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Fassbender and Schweitzer (2006)
Fassbender and Schweitzer 2006 found that during the most demanding visual search task, the ADHD group showed less deactivation of the medial prefrontal cortex than the control group.
“The groups differed in the degree of deactivation of the DMN: during performance of the most demanding (visual search), the ADHD group showed less deactivation of the medial PFC than the control group.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Fassbender and Schweitzer (2006)
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- Authors
- Fassbender, C., & Schweitzer, J. B.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Schweitzer, Julie B.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2006-08
- Volume
- 26
- Issue
- 4
- Pages
- 445-465
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC2677014
- OpenAlex
- W2137654107
- Cited by
- 214
- References
- 178
- Citations by year
- 2026: 13 · 2025: 7 · 2024: 9 · 2023: 14 · 2022: 10 · 2021: 4 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 14 · 2016: 9 · 2015: 17 · 2014: 19 · 2013: 11 · 2012: 13
- FWCI
- 6.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Brandeis University
- National Institute of Mental Health (R01MH066310, MH066310)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, neural compensation, neural hyperactivity, prefrontal cortex, anterior cingulate cortex, executive function, cognitive flexibility, processing strategies, functional neuroimaging
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Brain, Child, Cognition Disorders, Humans, Impulsive Behavior, Magnetic Resonance Imaging, Nerve Net
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