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Revisiting the role of the prefrontal cortex in the pathophysiology of attention-deficit/hyperactivity disorder.
Abstract
Most neural models for the pathophysiology of attention-deficit/hyperactivity disorder (ADHD) have centered on the prefrontal cortex and its interconnections with the striatum and other subcortical structures. However, research only partially supports these models, and they do not correspond with the development of the prefrontal cortex and its interrelated neurocircuitry. The neural and functional development of the prefrontal cortex more closely parallels recovery from ADHD as indicated by the developmental remission of symptomatology. The authors hypothesize that ADHD is due to noncortical dysfunction that manifests early in ontogeny, remains static throughout the lifetime, and is not associated with the remission of symptomatology. Data supporting this neurodevelopmental model of prefrontal cortex function in ADHD are reviewed. Research and treatment implications are discussed.
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In the citing paper
“they hypothesized that ADHD is caused by non-cortical neural dysfunction that is present early in ontogeny and remains relatively static throughout life.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Halperin et al., 2006
In the citing paper
“Halperin and colleagues (Halperin et al., 2006; Halperin, Marks, & Schulz, 2008) have posited distinct neurocognitive mechanisms for the etiology of and relative recovery from ADHD.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Halperin et al., 2006
In the citing paper
“investigators have increasingly embraced the notion that ADHD is best viewed within the context of a developmental trajectory rather than that of a static medical condition (Halperin et al., 2006; Sagvolden, Johansen, Aase, & Russell, 2005; Sonuga-Barke & Halperin, 2009; Taylor, 1999)”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Halperin et al., 2006
In the citing paper
“they posited that the reduction of symptoms oftentimes seen over development are at least partially accounted for by the degree to which prefrontally-mediated EFs and other higher cortical functions, which emerge throughout childhood and adolescence, can compensate for these more primary and enduring subcortical deficits.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Halperin et al., 2006
In the citing paper
“This intervention is relevant to ADHD given the noted difficulties that many children with ADHD have with EFs (Doyle, 2006; Willcutt et al., 2005) and the notion that improved EF over development should reduce the severity of ADHD symptoms and impairments (Halperin and Schulz, 2006).”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Halperin and Schulz, 2006
In the citing paper
“The prefrontal recovery hypothesis [73] postulates that the reduction of ADHD symptoms during adolescence is related to the degree in which prefrontal cognitive control functions (‘cold’ decision-making) compensate for primary and persistent subcortical deficits (‘hot’ decision-making).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [73]
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Connaughton, M., O’Hanlon, E., Silk, T. J., Paterson, J., O’Neill, A., Anderson, V. A., Whelan, R., & McGrath, J. (2023) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2023.10.005 · Cited by 30
Robinson, T. P., & Tripp, G. (2013) · Japanese Psychological Research · doi:10.1111/jpr.12005 · Cited by 24
van Lieshout, M., Luman, M., Schweren, L., Twisk, J. W. R., Faraone, S. V., Heslenfeld, D. J., Hartman, C. A., Hoekstra, P. J., Franke, B., Buitelaar, J. K., et al. (2018) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-018-0449-z · Cited by 27
“An extension is postulated by Halperin and Schulz (2006), who specifically focused on longitudinal aspects and differentiated between different types of neurocognitive functions.”
BackgroundInfluentialPritchard, V. E., Neumann, E., & Rucklidge, J. J. (2008) · Brain and Cognition · doi:10.1016/j.bandc.2008.02.002 · Cited by 24
The Power of Planning: Self-Control by Effective Goal-striving
Gollwitzer, P. M., Gawrilow, C., & Oettingen, G. (2010) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195391381.003.0015 · Cited by 25
Smaller volumes of caudate nuclei in prepubertal children with ADHD: Impact of age
Carrey, N., Bernier, D., Emms, M., Gunde, E., Sparkes, S., MacMaster, F. P., & Rusak, B. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.04.025 · Cited by 22
“Hyperactive/impulsive symptoms inyounger children may reflect basal ganglia disruption during a developmental period where cortical regions (especially prefrontal cortex) are not fully functional (Halperin & Schulz, 2006; Soliva et al., 2010).”
BackgroundAttention-Deficit/Hyperactivity Disorder and Correctional Health Care
Eme, R. (2009) · Journal of correctional health care · doi:10.1177/1078345808326617 · Cited by 31
“…brain circuits and therefore deficits in the executive functions that these circuits subserve (Biederman, 2006a, 2006b; Biederman & Farone, 2005; Halperin & Schultz, 2006; Krain & Castellanos, 2006; Neuman et al., 2007; Nigg, 2006; Seidman et al., 2006; Valera, Farone, Murray, & Seidman, 2007).”
BackgroundMassat, I., Slama, H., Villemonteix, T., Mary, A., Baijot, S., Sáenz, A. A., Balériaux, D., Metens, T., Kavec, M., & Peigneux, P. (2016) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2016.1237040 · Cited by 24
“The right IFG has been considered as a key node for RI itself and/or for attentional detection of the stop signal (Halperin & Schulz 2006; Swick et al. 2008; Aron et al. 2014).”
BackgroundMiranda, A., Diago, C. C., Andrés, M. I. F., Herrero, M. J. P., & Miranda, B. R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0128325 · Cited by 28
“These findings do not support the Halperin and Schulz model [33], which suggests a maturation of more consciously controlled neurocognitive functions in ADHD remitters.”
ResultEquit, M., Becker, A., Khatib, D. E., Rubly, M., Becker, N., & von Gontard, A. (2014) · Acta Paediatrica · doi:10.1111/apa.12676 · Cited by 22
“In bladder control, the periaqueductal grey, thalamus, insula, anterior cingulate gyrus and prefrontal cortex are involved (4), whereas in ADHD neural pathways including dorsal anterior midcingulate cortex, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, parietal cortex as well as striatum, premotor a…”
BackgroundLange, S. M. (2017) · Contemporary School Psychology · doi:10.1007/s40688-017-0122-5 · Cited by 28
Lan, Y.-T., Liu, X., & Fang, H.-S. (2018) · Applied Neuropsychology Child · doi:10.1080/21622965.2018.1509003 · Cited by 22
“For example, Halperin & Schulz (2006) revealed a decrease in ADHD symptoms, which was rated by parents after EF training.”
BackgroundKakuszi, B., Szuromi, B., Bitter, I., & Czobor, P. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.03.011 · Cited by 27
Ivanov, I., & Yehuda, R. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.23894 · Cited by 22
“One developmental model of ADHD suggests that ADHD symptoms are related to non-cortical (i.e., limbic system) dysfunction that manifests early in life and persists throughout a lifetime (Halperin & Schulz, 2006).”
BackgroundLin, Y., Chen, W. J., & Gau, S. S. (2013) · Psychological Medicine · doi:10.1017/s0033291713002390 · Cited by 22
“The improvement in ADHD symptoms during adolescence seems to correspond chronologically to the maturation of the prefrontal cortex and frontosubcortical networks (Halperin & Schulz, 2006), which are thought to serve EFs (Fuster, 2002).”
BackgroundResultTarle, S. J., Alderson, R. M., Patros, C. H. G., Arrington, E. F., & Roberts, D. K. (2018) · Child Neuropsychology · doi:10.1080/09297049.2018.1519068 · Cited by 22
Brain Games as a Potential Nonpharmaceutical Alternative for the Treatment of ADHD
Wegrzyn, S. C., Hearrington, D., Martin, T., & Randolph, A. B. (2012) · Journal of Research on Technology in Education · doi:10.1080/15391523.2012.10782599 · Cited by 23
“As a result, children with ADHD do not perform as well as controls in tests of their executive functions, which are the mental processes that control thinking, emotions, and behavior (Adler, Spencer, Stein, & Newcorn, 2008; Halperin & Schulz, 2006; Mares, McLuckie, Schwartz, & Saini, 2007).”
BackgroundGivón, T. (2020) · John Benjamins Publishing Company eBooks · doi:10.1075/z.230 · Cited by 21
Attention-Deficit/Hyperactivity Disorder and the Juvenile Justice System
Eme, R. (2008) · Journal of Forensic Psychology Practice · doi:10.1080/15228930801963994 · Cited by 20
Development of endogenous orienting of attention in school-age children
Leclercq, V., & Siéroff, É. (2012) · Child Neuropsychology · doi:10.1080/09297049.2012.682568 · Cited by 21
“According to Halperin and Schulz (2006 ), the developmental remission of attention deficit/hyperactivity disorder (ADHD) symptoms during childhood and adolescence should follow the time course of prefrontal changes.”
BackgroundAutomatic Processing of Duration in Children with Attention-Deficit/Hyperactivity Disorder
Gomes, H., Duff, M., Flores, A., & Halperin, J. M. (2013) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617713000258 · Cited by 21
“…2001), specifically the basal ganglia, have been identified as being dysfunctional in individuals with ADHD (Durston, van Belle, & de Zeeuw, 2011; Halperin & Schulz, 2006); (3) studies in individuals with cerebellar damage, another brain area implicated in ADHD (Castellanos et al., 2002), show…”
BackgroundSelf-citationKofler, M. J., Sarver, D. E., & Wells, E. L. (2020) · Journal of Attention Disorders · doi:10.1177/1087054715608439 · Cited by 20
Lifespan associations of resting-state brain functional networks with ADHD symptoms
Wang, R., Fan, Y., Wu, Y., Zang, Y., & Zhou, C. (2022) · iScience · doi:10.1016/j.isci.2022.104673 · Cited by 21
“According to neurodevelopmental theory (Halperin and Schulz, 2006), ADHD remission is driven by improved prefrontal top-down control.”
BackgroundSleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder
Lunsford‐Avery, J. R., Carskadon, M. A., Kollins, S. H., & Krystal, A. D. (2024) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2024.03.005 · Cited by 21
Henríquez, M., Zamorano, F. J., Engel, F. R., & Domínguez, F. A. (2010) · Revista de Neurología · doi:10.33588/rn.5002.2009082 · Cited by 19
“En una línea similar, Halperin y Shultz han planteado que las alteraciones anatómicas y funcionales del circuito estriadotalamocortical descritas en pacientes con TDAH no serían necesariamente parte central en la etiopatogenia del síndrome, sino epifenómenos asociados a la expresión clínica de la sintomatología y a la…”
BackgroundImpaired Visual Habituation in Adults With ADHD
Massa, J., & O’Desky, I. H. (2011) · Journal of Attention Disorders · doi:10.1177/1087054711423621 · Cited by 22
“These theories range from dysfunction in lower level brain regions (Halperin & Schulz, 2006; Sergeant, 1996; Sergeant, Geurts, Huijbregts, Scheres, & Oosterlaan, 2003) to dysfunctional top-down executive control (Barkley, 1998).”
BackgroundOpenneer, T. J. C., Forde, N. J., Akkermans, S. E. A., Naaijen, J., Buitelaar, J. K., Hoekstra, P. J., & Dietrich, A. (2019) · Cortex · doi:10.1016/j.cortex.2019.11.007 · Cited by 20
Executive Function Deficits in Adolescents With ADHD: Untangling Possible Sources of Heterogeneity
Molitor, S. J., Oddo, L. E., Eadeh, H., & Langberg, J. M. (2018) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426618763125 · Cited by 23
Merkt, J., Siniatchkin, M., & Petermann, F. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716629741 · Cited by 19
“There are theoretical assumptions that ADHD symptoms appear if a deficit within the hot-emotional response system is not compensated for by the regulation in the cold-cognitive control system (Halperin & Schulz, 2006; Johnson, 2012).”
BackgroundZhi, J., Zhang, S., Huang, M., Qin, H., He, X., Chang, Q., & Wang, Y. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1494272 · Cited by 19
Zhao, C., Xu, Y., Li, R., Li, H., & Zhang, M. (2025) · Frontiers in Artificial Intelligence · doi:10.3389/frai.2025.1624485 · Cited by 23
“Longitudinal study designs are crucial for understanding developmental trajectories of ADHD and the long-term effects of interventions, while cross-sectional studies provide snapshots of differences at specific ages (Halperin and Schulz, 2006).”
Yang, Y., Yang, B., Zhang, L., Peng, G., & Fang, D. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.648143 · Cited by 18
“Halperin and Schulz (2006) believe that the structure and function of the PFC are intimately involved in the manifestation of ADHD symptoms.”
BackgroundBollmann, S., Ghisleni, C., Poil, S., Martin, E., Ball, J., Eich‐Höchli, D., Klaver, P., Tuura, R., Michels, L., & Brandeis, D. (2015) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2015.1112034 · Cited by 19
Pre-attention and Working Memory in ADHD: A 25-Year Follow-Up Study
Torgalsbøen, B. R., Zeiner, P., & Øie, M. G. (2019) · Journal of Attention Disorders · doi:10.1177/1087054719879491 · Cited by 21
“It may also reflect a “catching up” in the executive domain, possibly resulting from a fine-tuning of neural connectivity (Carlson, Zelazo, & Faja, 2013) or a more efficient use of neuropsychological resources (Halperin & Schulz, 2006).”
BackgroundThe Association Between Parkinson’s Disease and Attention-Deficit Hyperactivity Disorder
Fan, H., Chang, Y., Tsai, J., Chiang, K.-L., Shih, J., Yeh, K.-Y., Ma, K., & Li, I. (2020) · Cell Transplantation · doi:10.1177/0963689720947416 · Cited by 18
Coll‐Martín, T., Carretero‐Dios, H., & Lupiáñez, J. (2021) · British Journal of Psychology · doi:10.1111/bjop.12513 · Cited by 16
Ortuño-Miró, S., Molina‐Rodríguez, S., Belmonte, C., & Ibáñez-Ballesteros, J. (2023) · Journal of Neural Engineering · doi:10.1088/1741-2552/acad2b · Cited by 19
Linderkamp, F., & Lauth, G. W. (2011) · Verhaltenstherapie · doi:10.1159/000332429 · Cited by 18
Sørensen, L., Eichele, T., van Wageningen, H., Plessen, K. J., & Stevens, M. C. G. (2016) · NeuroImage Clinical · doi:10.1016/j.nicl.2016.08.007 · Cited by 18
“Alternatively, impairments in state regulation, arousal, or learning/ motivational processes may give rise to behavioral IIV in ADHD (Halperin and Schulz, 2006; Halperin et al., 2008; Sagvolden et al., 2005; Sergeant, 2005).”
Goetz, M., Schwabová, J. P., Hlávka, Z., Ptáček, R., Zumrová, A., Hort, V., & Doyle, R. (2014) · Journal of Attention Disorders · doi:10.1177/1087054713517745 · Cited by 18
“Several hypotheses explaining the neurological basis of RT variability in ADHD have been formulated, suggesting deficits in cortical and subcortical processing (Halperin & Schulz, 2006; Sergeant, 2000).”
BackgroundNeurocognitive and Symptom Trajectories of ADHD from Childhood to Early Adolescence
Murray, A. L., Robinson, T. P., & Tripp, G. (2017) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000476 · Cited by 20
“This may reflect a “catching up” in the executive domain, possibly resulting from fine-tuning of neural connectivity(46) or more efficient use of cognitive resources.(15) Some improvement may also reflect previous exposure to the tasks, i.”
BackgroundHwang-Gu, S.-L., Chen, Y., Liang, S. H., Ni, H., Lin, H., Lin, C.-F., & Gau, S. S. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-018-00508-z · Cited by 17
Krieger, V., & Amador-Campos, J. A. (2021) · Child Neuropsychology · doi:10.1080/09297049.2021.1917530 · Cited by 16
“Thus, as suggested by Halperin and Schulz (2006), the prefrontal cortex and its functional measures are closely related to the course and severity of ADHD symptoms, especially in adolescence and adulthood.”
BackgroundADHD: Volumetry, Motor, and Oculomotor Functions
Mahone, E. M. (2011) · Current topics in behavioral neurosciences · doi:10.1007/7854_2011_146 · Cited by 17
“2004), more recent research has argued that other brain regions (particularly subcortical) may provide answers to the early neurobiological unfolding of ADHD (Valera et al. 2006; Halperin and Schulz 2006).”
BackgroundInfluentialAssociation Between Pubertal Onset and Symptoms of ADHD in Female University Students
Ostojic, D., & Miller, C. J. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714535249 · Cited by 18
“Notably, these brain regions are associated with catecholamine neurotransmitter systems (e.g., dopamine) that have also been linked to ADHD and have been the target of stimulant medication (Biederman et al., 2005; Halperin & Schulz, 2006).”
BackgroundThe Use of fMRI Regional Analysis to Automatically Detect ADHD Through a 3D CNN-Based Approach
Gülhan, P. G., & Özmen, G. (2024) · Journal of Imaging Informatics in Medicine · doi:10.1007/s10278-024-01189-5 · Cited by 15
“The prefrontal cortex plays an important role in regulating higher-level cognitive functions, such as attention control, impulse control, planning, and decision-making [10].”
Engelhardt, P. E., Veld, S. N., Nigg, J. T., & Ferreira, F. (2012) · Cognitive Neuropsychology · doi:10.1080/02643294.2012.712957 · Cited by 16
“Turning now to theories of ADHD, Halperin et al. (2008) argued that symptom remission in ADHD is driven primarily by improvements in effortful control.”
Kidwell, K. M., Hankey, M., Nelson, J. M., Espy, K. A., & Nelson, T. D. (2017) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx071 · Cited by 15
de Lacy, N., Kodish, I. M., Rachakonda, S., & Calhoun, V. D. (2018) · Human Brain Mapping · doi:10.1002/hbm.24187 · Cited by 15
“…without involvement of anticorrelated circuits, these three frontal network effects are consistent with findings suggesting remission of ADHD symptoms arises from prefrontal maturation (Halperin & Schulz, 2006) and the dominance of fronto-parietal involvement in adult ADHD (Cortese et al., 2012).”
Blomberg, R., Capusan, A. J., Signoret, C., Danielsson, H., & Rönnberg, J. (2021) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2021.771711 · Cited by 17
“…subcortical (basal ganglia and cerebellum) dysfunction, and that agerelated reductions in neurocognitive deficits in some cases are attributable to a healthy maturation of frontal lobes and the improved ability to issue cognitive control over subcortical systems (Halperin and Schulz, 2006).”
BackgroundDamatac, C., Soheili-Nezhad, S., Freches, G. B., Zwiers, M., de Bruijn, S., Ikde, S., Portengen, C., Abelmann, A. C., Dammers, J. T., van Rooij, D., et al. (2021) · bioRxiv · doi:10.1016/j.nicl.2022.103057 · Cited by 13
“37 In a double dissociative neurodevelopmental model of ADHD, the underlying neural mechanisms that 38 control onset are distinct from those that drive remission [5].”
BackgroundPauli‐Pott, U., Roller, A., Heinzel‐Gutenbrunner, M., Mingebach, T., Dalir, S., & Becker, K. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12230 · Cited by 16
Soleimani, R., Salehi, Z., Soltanipour, S., Hasandokht, T., & Jalali, M. M. (2017) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32613 · Cited by 15
“Halperin and Schulz (2006) proposed that the neural and cognitive mechanisms associated with the development and amelioration or recovery of ADHD are, at least partially, separable.”
BackgroundMichelini, G., Lenartowicz, A., Vera, J. D., Bilder, R. M., McGough, J. J., McCracken, J. T., & Loo, S. K. (2022) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2022.08.001 · Cited by 15
“Conclusion: We identified treatment-specific and shared predictors of response to different pharmacotherapies in children with ADHD.”
BackgroundResultInfluentialTrampush, J. W., Jacobs, M. M., Hurd, Y., Newcorn, J., & Halperin, J. (2014) · Developmental Science · doi:10.1111/desc.12131 · Cited by 14
“…development (Halperin et al., 2008), (ii) dopamine D1 receptors in the prefrontal cortex being critical to working memory (Paspalas & Goldman-Rakic, 2005), and (iii) the prefrontal cortex being one of the last cortical regions to mature during development (Andersen, 2003; Halperin & Schulz, 2006).”
InfluentialSelf-citationLuo, Y., Schulz, K. P., Alvarez, T. L., Halperin, J. M., & Li, X. (2018) · Cortex · doi:10.1016/j.cortex.2018.09.013 · Cited by 14
Self-citationJiang, W., Duan, K., Rootes-Murdy, K., Hoekstra, P. J., Hartman, C. A., Oosterlaan, J., Heslenfeld, D. J., Franke, B., Buitelaar, J. K., Vásquez, A. A., et al. (2020) · NeuroImage Clinical · doi:10.1016/j.nicl.2020.102273 · Cited by 14
“Structural brain alterations associated with ADHD have been reported consistently across cortical and subcortical regions (EllisonWright et al., 2008; Halperin and Schulz, 2006; Hoogman et al., 2017).”
Gao, F., Klinedinst, D. K., Fernandez, F., Cheng, B., Savonenko, A. V., Devenney, B., Li, Y., Wu, D., Pomper, M. G., & Reeves, R. H. (2021) · Acta Neuropathologica Communications · doi:10.1186/s40478-021-01237-z · Cited by 14
Longitudinal Temperament Pathways to ADHD Between Childhood and Adolescence
Martel, M. M., Elkins, A. R., Eng, A. G., Goh, P. K., Bansal, P. S., Smith, T. E., Thaxton, M. H., Ryabinin, P., Mooney, M. A., Gustafsson, H., et al. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00902-8 · Cited by 13
“It may be mediated by maturation of subcortical and limbic neural circuits, potentially operating through effects on subcortical and limbic regions of the brain (Halperin & Schulz, 2006).”
BackgroundBaboli, R., Cao, M., Halperin, J. M., & Li, X. (2022) · Brain Sciences · doi:10.3390/brainsci13010046 · Cited by 13
Self-citationMethylphenidate for attention problems in epilepsy patients: Safety and efficacy
Leeman-Markowski, B. A., Adams, J., Martin, S. P., Devinsky, O., & Meador, K. J. (2020) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2020.107627 · Cited by 15
“, deficits in planning, problem-solving, and cognitive flexibility/set-shifting) [79], findings are mixed and task-dependent [1,3,4,33,59].”
BackgroundCai, B., Cai, S., He, H., He, L., Chen, Y., & Wang, A. (2022) · Brain Sciences · doi:10.3390/brainsci13010066 · Cited by 18
“Neuroimaging studies have shown that children with ADHD exhibit abnormal activation of these brain regions specifically during demanding tasks associated with inhibitory control [45,66,67].”
BackgroundA framework of psychological compensation in attention deficit hyperactivity disorder
Merkt, J., Reinelt, T., & Petermann, F. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01580 · Cited by 13
“For example, if compensation by the prefrontal cortex is successful, an individual will not show ADHD symptoms anymore, although a deficit in subcortical functions remains (Halperin and Schulz, 2006).”
BackgroundMethodInfluentialADHD and the Disruptive Behavior Disorders
Metcalf, E. (2016) · Springer eBooks · doi:10.1007/978-1-4939-2528-5_18 · Cited by 15
Zarka, D., Cebolla, A. M., Cevallos, C., Palmero‐Soler, E., Dan, B., & Cheron, G. A. (2021) · European Journal of Neuroscience · doi:10.1111/ejn.15198 · Cited by 15
“…of the caudate nucleus corresponding to the GO- P3 component in the ADHD group and not in TDC support the neurodevelopmental model of (Halperin and Schulz 2006) promoting that ADHD is related to early alterations in “bottom- up” cognitive processing performed by the striato- thalamic…”
MethodFriedman, L. M., Rapport, M. D., & Fabrikant-Abzug, G. (2022) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-022-09967-7 · Cited by 15
“…or noise, heterogeneity in cognitive performance is considered a causal mechanism/core deficit of ADHD-related symptoms (Castellanos et al., 2006; Halperin & Schulz, 2006; Russell et al., 2006; Sonuga-Barke & Castellanos, 2007) or correlated outcome of underlying factors (Barkley, 1997;…”
BackgroundLinks between excessive daytime sleepiness and EEG power and activation in two subtypes of ADHD
McCabe, L. E., Johnstone, S. J., Jiang, H., Sun, L., & Zhang, D. (2023) · Biological Psychology · doi:10.1016/j.biopsycho.2023.108504 · Cited by 12
Feng, M., Xu, J., Zhai, M., Wu, Q., Chu, K., Xie, L., Luo, R., Li, H., Xu, Q., Xu, X., et al. (2023) · Behavioural Neurology · doi:10.1155/2023/3735634 · Cited by 12
“This decisive phase presents a distinctive opportunity for interventions, such as those targeting conditions like ADHD, to instigate profound and enduring effects on disease progression, given the concurrent evolution of the brain’s functional networks [16].”
BackgroundLi, X., Motwani, C., Cao, M., Martin, E., & Halperin, J. M. (2023) · Brain Sciences · doi:10.3390/brainsci13101469 · Cited by 12
“…cognitive/behavioral profiles, comorbidities, developmental stages and trajectories, and neural correlates (underlying neural mechanisms associated with the given cognitive function), likely due to the heterogeneity in etiological factors (i.e., biological and environmental risk factors) [1,6–8].”
BackgroundSelf-citationMiller, C. J., Miller, S. R., Healey, D. M., Marshall, K., & Halperin, J. M. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.759116 · Cited by 13
“Rapid attentional shifts and motor preparation have been linked more closely to ascending subcortical pathways (Halperin & Schulz, 2006) and the parietal cortex (Corbetta & Shulman, 2002).”
BackgroundSelf-citationCampez, M., Raiker, J. S., Sarver, D. E., Friedman, L. M., Orban, S. A., & Rapport, M. D. (2019) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-019-09762-x · Cited by 12
“In contrast, the cognitive-energetic (Sergeant 2000) and neurodevelopmental models (Halperin and Schulz 2006) propose that the interplay between neurocognitive abilities results in the emergence of behavioral difficulties, which would indicate that executive functions and motivational processes have associations with…”
BackgroundLessons Learned in Enhancing Behavioral Parent Training for High-Risk Families of Youth with ADHD
Chacko, A., Uderman, J. Z., & Zwilling, A. L. (2013) · The ADHD Report · doi:10.1521/adhd.2013.21.4.6 · Cited by 12
“…that reduction of ADHD symptoms frequently seen in adolescents and young adults is accounted for, at least in part, by the development of higher order cortical control mechanisms, which can compensate for early subcortical neural deficits via topdown regulatory control (Halperin & Schulz, 2006).”
BackgroundLeenders, A. E. M., Damatac, C. G., Soheili‐Nezhad, S., Chauvin, R. J., Mennes, M., Zwiers, M. P., van Rooij, D., Akkermans, S. E. A., Naaijen, J., Franke, B., et al. (2021) · JCPP Advances · doi:10.1002/jcv2.12040 · Cited by 11
“The underlying neural mechanisms that drive symptom remission may be distinct from those that drive ADHD onset, thus the brains of remitted individuals could be methodologically differentiated from those of people who were never diagnosed with ADHD (Halperin & Schulz, 2006).”
BackgroundATTENTION DEFICIT HYPERACTIVITY DISORDER AND THE FAMILY COURT
Eme, R. (2009) · Family Court Review · doi:10.1111/j.1744-1617.2009.01279.x · Cited by 12
Cognitive Control in Attention Deficit Hyperactivity Disorder
de Zeeuw, P., & Durston, S. (2017) · Wiley eBooks · doi:10.1002/9781118920497.ch33 · Cited by 12
Li, Q., Cao, M., Stein, D. J., Sahakian, B. J., Jia, T., Langley, C., Gu, Z., Hou, W., Han, L., Cao, L., et al. (2025) · Molecular Psychiatry · doi:10.1038/s41380-025-02912-6 · Cited by 11
Münger, M., Sele, S., Candrian, G., Kasper, J., Rehim, H. A., Eich‐Höchli, D., Müller, A. F., & Jäncke, L. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.767789 · Cited by 17
Dietrich, A., Althaus, M., Hartman, C. A., Buitelaar, J. K., Mindera, R. B., van den Hoofdakker, B. J., & Hoekstra, P. J. (2012) · Biological Psychology · doi:10.1016/j.biopsycho.2012.03.008 · Cited by 11
Attention‐deficit hyperactivity disorder reduces automatic attention in young adults
Sable, J. J., Knopf, K. L., Kyle, M. R., Schully, L. T., Brooks, M. M., Parry, K. H., Thompson, I. A., Suna, E. B., Stowe, R., Flink, L. A., et al. (2013) · Psychophysiology · doi:10.1111/psyp.12012 · Cited by 11
Size at Birth and Motor Activity During Stress in Children Aged 7 to 9 Years
Schlotz, W., Jones, A., Phillips, N. M. M., Godfrey, K. M., & Phillips, D. I. W. (2007) · PEDIATRICS · doi:10.1542/peds.2006-3277 · Cited by 11
“473b 0 58 (47) 31 (25) 27 (22) 1 45 (37) 23 (19) 22 (18) 2 12 (10) 5 (4) 7 (6) 3 8 (7) 2 (2) 6 (5) Smoking during pregnancy, n (%) .”
Developing ADHD in preschool: Testing the dual pathway model of temperament
Koerner, J. K. A., Gust, N., & Petermann, F. (2017) · Applied Neuropsychology Child · doi:10.1080/21622965.2017.1347509 · Cited by 11
“Furthermore, the prefrontal cortex, which has been linked to inhibition and effortful control, shows strong development during preschool (Halperin & Schulz, 2006; Rothbart et al., 2011).”
BackgroundMethodResultInfluentialCortico-striatal differences in the epigenome in attention-deficit/ hyperactivity disorder
Shastri, G. G., Sudre, G. P., Ahn, K., Jung, B., Kolachana, B. S., Auluck, P. K., Elnitski, L. L., Marenco, S., & Shaw, P. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-02896-x · Cited by 11
The Development of Selective Attention and Inhibition in NICU Graduates During the Preschool Years
Kittler, P. M., Gardner, J. M., Lennon, E. M., Flory, M. J., Mayes, L. C., & Karmel, B. Z. (2011) · Developmental Neuropsychology · doi:10.1080/87565641.2011.588762 · Cited by 9
“This especially seems possible considering evidence indicating brainstem-mediated effects on attention, and the proposal that early brainstem, midbrain, and cerebellar mechanisms may be at the core of understanding the development of ADHD ( Halperin & Schultz, 2006 ).”
BackgroundDeveloping attention in typical children related to disabilities
Posner, M. I., Rothbart, M. K., & Ghassemzadeh, H. (2020) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64150-2.00019-8 · Cited by 11
Magnetic Resonance Spectroscopy Studies of Attention Deficit Hyperactivity Disorder
O’Neill, J., Levitt, J. G., & Alger, J. R. (2012) · Springer eBooks · doi:10.1007/978-1-4419-5864-8_18 · Cited by 9
Parenting and Human Brain Development
Posner, M. I., & Rothbart, M. K. (2018) · Springer eBooks · doi:10.1007/978-3-319-94598-9_8 · Cited by 10
Halperin, J. M. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12551 · Cited by 9
Self-citationZhu, Z., Lei, D., Qin, K., Li, X., Li, W., Tallman, M. J., Patino, L. R., Fleck, D. E., Aghera, V., Gong, Q., et al. (2023) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.220209 · Cited by 8
“12 Although alterations in the frontotemporal cortex and subcortical regions have been observed among youth at high genetic risk of BD-I, 13,14 little research has attempted to identify distinguishing brain features in youth with ADHD, with and without familial risk of BD-I.”
BackgroundDezfouli, R. A., Hosseinpour, A., Ketabforoush, S., & Daneshzad, E. (2024) · Middle East Current Psychiatry · doi:10.1186/s43045-024-00400-1 · Cited by 9
“On the other hand, abnormalities in the prefrontal cortex, caudate nuclei, and cerebellum [61, 62], which are involved in regulating attention and behavior, have been linked to ADHD.”
BackgroundMohamed, S. M. H., Börger, N. A., Geuze, R. H., & van der Meere, J. J. (2016) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2016.1167174 · Cited by 10
“It has been proposed that as a function of age there is improvement in executive neuropsychological functioning, but compromised lower order functioning, such as a state regulation deficit, remains stable over time (Halperin & Schulz, 2006; Halperin, Trampush, Miller, Marks, & Newcorn, 2008).”
BackgroundBen‐Shachar, M. S., Shmueli, M., Jacobson, S. W., Meintjes, E. M., Molteno, C. D., Jacobson, J. L., & Berger, A. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14244 · Cited by 8
“Reliance on alternative brain regions to compensate for inefficient processing in neural networks specialized for a given brain function has been reported extensively in the fMRI literature (see e.g., Halperin and Schulz, 2006).”
BackgroundAltered interaction of physiological activity and behavior affects risky decision-making in ADHD
Halbe, E., Kolf, F., Heger, A. S., Hüpen, P., Bergmann, M., Aslan, B., Harrison, B. J., Davey, C. G., Philipsen, A., & Lux, S. (2023) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2023.1147329 · Cited by 8
“Additionally, based on the prefrontal recovery hypothesis (Halperin and Schulz, 2006), it has been shown that developmental improvements in cognitive control functions may favor a reduction in behavioral disturbances in adult ADHD (Groen et al.”
BackgroundThe Neural and Neurocognitive Determinants of ADHD
Gopin, C. B., & Healey, D. M. (2011) · Journal of Infant Child and Adolescent Psychotherapy · doi:10.1080/15289168.2011.575700 · Cited by 9
“Halperin and Schulz (2006) recently hypothesized that ADHD is the direct result of noncortical neural dysfunction that is first manifest early in the ontogenetic process.”
BackgroundInfluentialNewcorn, J. H., Ivanov, I., Krone, B., Li, X., Duhoux, S., White, S., Schulz, K. P., Bédard, A.-C. V., Pedraza, J., Adler, L., et al. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.11.037 · Cited by 7
Self-citationDynamic Seat Assessment for Enabled Restlessness of Children with Learning Difficulties
Stanić, V., Žnidarič, T., Repovš, G., & Geršak, G. (2022) · Sensors · doi:10.3390/s22093170 · Cited by 7
“Start of schooling coincides with the period of typically the most intense symptoms of ADHD [3].”
BackgroundCurrent Perspectives on Attention-deficit Hyperactivity Disorder
Shafiullah, S., & Dhaneshwar, S. S. (2023) · Current Molecular Medicine · doi:10.2174/1566524023666230522145950 · Cited by 9
Binocular rivalry transitions predict inattention symptom severity in adult ADHD
Jusyte, A., Zaretskaya, N., Höhnle, N. M., Bartels, A., & Schönenberg, M. (2017) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-017-0790-1 · Cited by 10
“Specifically, established models assume that ADHD symptoms stem from a subcortical dysfunction, which is alleviated and compensated through maturation processes in prefrontal regions [64].”
BackgroundHong, Y. N., Hwang, H., Hong, J. S., & Han, D. H. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.03.021 · Cited by 9
Chua, R. N., Hau, Y. W., Tiew, C. M., & Hau, W. L. (2019) · IEEE Access · doi:10.1109/access.2019.2938095 · Cited by 7
Öztekin, I., Garic, D., Bayat, M., Hernandez, M. L., Finlayson, M. A., Graziano, P. A., & Dick, A. S. (2022) · European Journal of Neuroscience · doi:10.1111/ejn.15842 · Cited by 8
“…of such ER deficits are in line with theories of ADHD that have suggested that EF-related effects might not emerge in the young age range evaluated in the current study and that subcortical regions that support ER might be crucially important for the early onset of ADHD (Halperin & Schulz, 2006).”
Background
Metadata
- Authors
- Halperin, J. M., & Schulz, K. P.
- Affiliations
- Queens College, CUNY (US)
- Icahn School of Medicine at Mount Sinai (US)
- Venue
- Psychological Bulletin
- Published
- 2006
- Volume
- 132
- Issue
- 4
- Pages
- 560-581
- ISSN
- 0033-2909 (ISSN-L)
- 1939-1455
- OpenAlex
- W2139377807
- Semantic Scholar
- 9b63dbee33341e428d6c3a9a7c386b7dd42c7191
- Cited by
- 446
- References
- 298
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 21 · 2023: 14 · 2022: 22 · 2021: 21 · 2020: 34 · 2019: 14 · 2018: 18 · 2017: 26 · 2016: 30 · 2015: 25 · 2014: 30 · 2013: 35 · 2012: 25
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Bulletin (publishedVersion)
- PubMed (publishedVersion)
- Funders
- William T. Grant Foundation (97183497)
- National Institute of Mental Health (RO1 MH60698; RO1 MH068206; R21 MH066360)
- 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, prefrontal cortex, neurodevelopmental model, striatum, symptom remission, ADHD pathophysiology
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Humans, Prefrontal Cortex
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