Alertness and feeding behaviors in ADHD: Does the hypocretin/orexin system play a role?
Abstract
Increasing evidence has suggested that patients with attention-deficit/hyperactivity disorder (ADHD) may present with a deficit of alertness and sleep disturbances. Recent studies have also pointed out a previously underestimated association between ADHD and abnormal eating behaviors, including binge eating. Since sleep/alertness disturbances and eating disorders may significantly increase the functional impairment of ADHD, gaining insight into their pathophysiology as well as into their treatment is of relevance to provide a better clinical management of patients suffering from ADHD. The hypocretin/orexin system comprises two distinct peptides, located in the hypothalamus, which are involved in several homeostatic functions. In particular, it has been suggested that hypocretin/orexin neurons located in perifornical and dorsomedial hypothalamic nuclei increase arousal, whereas those located in the lateral hypothalamus are primarily implicated in reward processing, stimulating feeding and other reward seeking behaviors. Given the involvement of the hypocretin/orexin system in the control of alertness and reward seeking (including feeding), we hypothesize that hypocretin/orexin neurons located in perifornical and dorsomedial hypothalamic areas are hypoactivated, while those located in the lateral hypothalamus are overactivated in patients with ADHD. If confirmed by further neurophysiological, imaging, and genetics studies, our hypothesis may help us progress in the understandin…
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Sleep disturbances and deficit of alertness have been found to be linked to abnormal eating behaviours, including binge eating, which is a common ADHD comorbidity; this link is hypothesized to involve the hypocretin/orexin system through hypoactivation of hypocretin/orexin neurons from perifornical and dorsomedial hypothalamic neurons and overactivation of hypocretin/orexin neurons from lateral
“Sleep disturbances and deficit of alertness have also been found to be linked to abnormal eating behaviours, including binge eating, which is a common ADHD comorbidity; this link is hypothesized to involve the hypocretin/orexin system through hypoactivation of hypocretin/orexin neurons from perifornical and dorsomedial hypothalamic neurons (involved in arousal) and overactivation of hypocretin/ore”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [119]
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References 32 · Cited by 68
- Authors
- Cortese, S., Konofal, E., & Lecendreux, M.
- Affiliations
- University of Verona (IT)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Cortese, Samuele
- Venue
- Medical Hypotheses
- Publisher
- Elsevier BV
- Published
- 2008-11
- Volume
- 71
- Issue
- 5
- Pages
- 770-775
- ISSN
- 0306-9877 (ISSN-L)
- OpenAlex
- W1994249945
- Cited by
- 68
- References
- 32
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 5 · 2022: 9 · 2021: 2 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 5
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Hypotheses (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- attention deficit hyperactivity disorder, hypocretin/orexin system, alertness, sleep disorders, feeding behavior, binge eating, reward seeking, hypothalamic nuclei, arousal, histamine H3 receptor antagonists, ADHD pathophysiology
- MeSH terms
- Orexins, Animals, Arousal, Attention Deficit Disorder with Hyperactivity, Feeding Behavior, Homeostasis, Humans, Hypothalamus, Models, Biological, Models, Theoretical, Neuropeptides, Peptides, Quality of Life, Intracellular Signaling Peptides and Proteins
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