A behavioral neuroenergetics theory of ADHD

Killeen, Peter R.; Russell, Vivienne A.; Sergeant, Joseph A.

doi:10.1016/j.neubiorev.2013.02.011

Cited by 97Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesNeurotransmitter Receptor Influence on Behavior

A behavioral neuroenergetics theory of ADHD

Killeen, Peter R., Russell, Vivienne A., Sergeant, Joseph A.·2013·Neuroscience & Biobehavioral Reviews

DOI 10.1016/j.neubiorev.2013.02.011

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Abstract

Energetic insufficiency in neurons due to inadequate lactate supply is implicated in several neuropathologies, including attention-deficit/hyperactivity disorder (ADHD). By formalizing the mechanism and implications of such constraints on function, the behavioral Neuroenergetics Theory (NeT) predicts the results of many neuropsychological tasks involving individuals with ADHD and kindred dysfunctions, and entails many novel predictions. The associated diffusion model predicts that response times will follow a mixture of Wald distributions from the attentive state, and ex-Wald distributions after attentional lapses. It is inferred from the model that ADHD participants can bring only 75-85% of the neurocognitive energy to bear on tasks, and allocate only about 85% of the cognitive resources of comparison groups. Parameters derived from the model in specific tasks predict performance in other tasks, and in clinical conditions often associated with ADHD. The primary action of therapeutic stimulants is to increase norepinephrine in active regions of the brain. This activates glial adrenoceptors, increasing the release of lactate from astrocytes to fuel depleted neurons. The theory is aligned with other approaches and integrated with more general theories of ADHD. Therapeutic implications are explored.

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While mechanistic hypotheses have been proposed for behavioral features of ADHD, empirical research validating these frameworks remains elusive.
“While mechanistic hypotheses have been proposed for behavioral features of ADHD (e.g. [75]), empirical research validating these frameworks remains elusive.”
From Linking ADHD to the Neural Circuitry of Attention (2017) · cites this paper as [75]

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Ziegler, S., Pedersen, M. L., Mowinckel, A. M., & Biele, G. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.09.002 · Cited by 110 · see citing works
Is hyperactivity ubiquitous in ADHD or dependent on environmental demands? Evidence from meta-analysis
Kofler, M. J., Raiker, J. S., Sarver, D. E., Wells, E. L., & Soto, E. F. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.004 · Cited by 88 · see citing works
Task-general efficiency of evidence accumulation as a computationally defined neurocognitive trait: implications for clinical neuroscience
Weigard, A., & Sripada, C. (2021) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2021.02.001 · Cited by 43 · see citing works
Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions
Kofler, M. J., Groves, N. B., Chan, E. S. M., Marsh, C. L., Cole, A. M., Gaye, F., Cibrian, E., Tatsuki, M. O., & Singh, L. J. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1277583 · Cited by 35 · see citing works
“Sergeant (35); Killeen et al. (36); Killeen (37)”
Working Memory and Increased Activity Level (Hyperactivity) in ADHD: Experimental Evidence for a Functional Relation
Kofler, M. J., Sarver, D. E., & Wells, E. L. (2020) · Journal of Attention Disorders · doi:10.1177/1087054715608439 · Cited by 20 · see citing works
Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder
Hanna, G. L., Liu, Y., Hanna, B. S., Arnold, P. D., & Gehring, W. J. (2026) · Psychophysiology · doi:10.1111/psyp.70403
“Further research on RTV and neural indices of performance monitoring using Ex-Gaussian decomposition and other computational methods may lead to more detailed and testable mechanistic models of ADHD and OCD (Killeen et al. 2013; Naze et al. 2025; Pine and Leibenluft 2015; Tamm et al. 2025; Ziegler et al. 2016).”
Influential

Authors: Killeen, P. R., Russell, V. A., & Sergeant, J. A.
Affiliations: Arizona State University (US)
University of Cape Town (ZA)
Vrije Universiteit Amsterdam (NL)
Corresponding author: Killeen, Peter R.
ORCID: Killeen, Peter R.
Russell, Vivienne A.
Sergeant, Joseph A.
Venue: Neuroscience & Biobehavioral Reviews
Publisher: Elsevier BV
Published: 2013-05
Volume: 37
Issue: 4
Pages: 625-657
ISSN: 0149-7634 (ISSN-L)
DOI: 10.1016/j.neubiorev.2013.02.011
OpenAlex: W2017350194
Semantic Scholar: 19f65730acefaef5feea0a5531eae0c1a48556c2
Cited by: 97
References: 79
Citations by year: 2026: 6 · 2025: 9 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 4 · 2018: 9 · 2017: 8 · 2016: 11 · 2015: 10 · 2014: 8 · 2013: 1
FWCI: 1.36
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Neuroscience & Biobehavioral Reviews (publishedVersion)
PubMed (publishedVersion)
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, norepinephrine, stimulant medication, cognitive resource allocation, response time distribution, attentional lapses, diffusion models
MeSH terms: Attention, Attention Deficit Disorder with Hyperactivity, Energy Metabolism, Female, Humans, Male, Memory, Short-Term, Norepinephrine, Psychomotor Performance, Receptors, Adrenergic, Lactic Acid

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A behavioral neuroenergetics theory of ADHD

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