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Cited by 819Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesNeurotransmitter Receptor Influence on Behavior

The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics

Sonuga-Barke, Edmund J.S·2003·Neuroscience & Biobehavioral Reviews
DOI 10.1016/j.neubiorev.2003.08.005
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Abstract

The currently dominant neuro-cognitive model of Attention Deficit Hyperactivity Disorder (AD/HD) presents the condition as executive dysfunction (EDF) underpinned by disturbances in the fronto-dorsal striatal circuit and associated dopaminergic branches (e.g. meso-cortical). In contrast, motivationally-based accounts focus on altered reward processes and implicate fronto-ventral striatal reward circuits and those meso-limbic branches that terminate in the ventral striatum especially the nucleus accumbens. One such account, delay aversion (DEL), presents AD/HD as a motivational style-characterised by attempts to escape or avoid delay-arising from fundamental disturbances in these reward centres. While traditionally regarded as competing, EDF and DEL models have recently been presented as complimentary accounts of two psycho-patho-physiological subtypes of AD/HD with different developmental pathways, underpinned by different cortico-striatal circuits and modulated by different branches of the dopamine system. In the current paper we describe the development of this model in more detail. We elaborate on the neuro-circuitry possibly underpinning these two pathways and explore their developmental significance within a neuro-ecological framework.

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Crossref · 10.1016/j.neubiorev.2003.08.005

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  • Children with ADHD show a failure to delay gratification, impaired responses to partial schedules of reinforcement, and preference for small immediate rewards over larger delayed rewards.

    “they also show a failure to delay gratification, have impaired responses to partial schedules of reinforcement, and preference for small immediate rewards over larger delayed rewards 6 , 7 .”

    From Motivation Deficit in ADHD is Associated with Dysfunction of the Dopamine Reward Pathway (2011) · cites this paper as [6]

  • The observation of a deficit in the DA reward pathway is further evidence that deficits in motivation may be contributing to impairment in ADHD adults.

    “The observation of a deficit in the DA reward pathway is further evidence that deficits in motivation may be contributing to impairment in ADHD adults 6 .”

    From Motivation Deficit in ADHD is Associated with Dysfunction of the Dopamine Reward Pathway (2011) · cites this paper as [6]

  • There is considerable heterogeneity in cognitive impairments in ADHD, with some patients not showing impairments or only in some cognitive domains.

    “Last, there is considerable heterogeneity in cognitive impairments, with some patients not showing impairments or only in some cognitive domains, which may be underpinned by different pathophysiological pathways (Sonuga-Barke, 2003; Nigg et al., 2005; Sonuga-Barke et al., 2010).”

    From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Sonuga-Barke, 2003

  • There is substantial heterogeneity among identified cognitive domains, leading to variable characterizations of ADHD as a predominant disorder of inhibition, delay aversion, or temporal processing.

    “However, this is countered by substantial heterogeneity among the identified domains, leading to variable characterizations of ADHD as a predominant disorder of inhibition (e.g. [13]), delay aversion [14] or temporal processing [15], among others (e.g. [16]).”

    From Linking ADHD to the Neural Circuitry of Attention (2017) · cites this paper as [14]

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Research works printed but not linked: 1

  1. Scarr, 1983, How people make their own environments: a theory of person—environmental effects, Child Dev, 54, 424

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Authors
Sonuga-Barke, E. J. S.
Affiliations
University of Southampton (GB)
Corresponding author
Sonuga-Barke, Edmund J.S
ORCID
Sonuga-Barke, Edmund J.S
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2003-11
Volume
27
Issue
7
Pages
593-604
ISSN
0149-7634 (ISSN-L)
DOI
10.1016/j.neubiorev.2003.08.005
OpenAlex
W2064260924
Cited by
816
References
105
Citations by year
2026: 33 · 2025: 29 · 2024: 38 · 2023: 43 · 2022: 41 · 2021: 35 · 2020: 50 · 2019: 23 · 2018: 32 · 2017: 35 · 2016: 49 · 2015: 32 · 2014: 46 · 2013: 41 · 2012: 47
FWCI
3.38
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
attention deficit hyperactivity disorder, executive dysfunction, delay aversion, reward processing, dopaminergic system, mesocortical pathway, mesolimbic system, nucleus accumbens, ventral striatum, motivational styles
MeSH terms
Attention Deficit Disorder with Hyperactivity, Cognition Disorders, Humans, Mental Processes, Models, Neurological, Models, Psychological, Neural Pathways, Reinforcement, Psychology

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