The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): What every clinician should know
Abstract
This review, addressed mainly to clinicians, considers commonly asked questions related to the neuroimaging, neurophysiology, neurochemistry and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD). It provides answers based on the most recent meta-analyses and systematic reviews, as well as additional relevant original studies. Empirical findings from neurobiological research into ADHD reflect a shift in the conceptualisation of this disorder from simple theoretical views of a few isolated dysfunctions to more complex models integrating the heterogeneity of the clinical manifestations of ADHD. Thus, findings from structural and functional neuroimaging suggest the involvement of developmentally abnormal brain networks related to cognition, attention, emotion and sensorimotor functions. Brain functioning alterations are confirmed by neurophysiological findings, showing that individuals with ADHD have elevated theta/beta power ratios, and less pronounced responses and longer latencies of event-related potentials, compared with controls. At a molecular level, alterations in any single neurotransmitter system are unlikely to explain the complexity of ADHD; rather, the disorder has been linked to dysfunctions in several systems, including the dopaminergic, adrenergic, serotoninergic and cholinergic pathways. Genetic studies showing a heritability of ∼60-75% suggest that a plethora of genes, each one with a small but significant effect, interact with environmental factors to…
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In ADHD, dysfunction in the dopamine and norepinephrine systems, which are essential for normal cortical and striatal function, likely accounts for some of the pathophysiology of ADHD.
“In ADHD, dysfunction in the DA and NE systems, which are critical to proper cortical and striatal function, likely account for some of the pathophysiology of ADHD (10, 11, 206).”
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- Authors
- Cortese, S.
- Affiliations
- Université de Tours (FR)
- Corresponding author
- Cortese, Samuele
- ORCID
- Cortese, Samuele
- Venue
- European Journal of Paediatric Neurology
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 16
- Issue
- 5
- Pages
- 422-433
- ISSN
- 1090-3798 (ISSN-L)
- OpenAlex
- W2109413825
- Cited by
- 335
- References
- 28
- Citations by year
- 2026: 17 · 2025: 30 · 2024: 20 · 2023: 21 · 2022: 29 · 2021: 23 · 2020: 24 · 2019: 20 · 2018: 20 · 2017: 20 · 2016: 33 · 2015: 24 · 2014: 27 · 2013: 21 · 2012: 6
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Paediatric Neurology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, neurobiology of ADHD, ADHD genetics, heritability, neuroimaging, functional neuroimaging, neurophysiology, event-related potentials, neurotransmitter systems, dopaminergic system, adrenergic system, serotonin, cholinergic system, brain networks, gene-environment interaction, clinical implications
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Brain, Evoked Potentials, Humans, Neuroimaging
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