ADHD brain function

Abstract

ADHD patients appear to have complex multisystem impairments in several cognitive-domain dissociated inferior, dorsolateral, and medial fronto-striato-parietal and frontocerebellar neural networks during inhibition, attention, working memory, and timing functions. There is emerging evidence for abnormalities in motivation and affect control regions, most prominently in ventral striatum, but also orbital/ventromedial frontolimbic areas. Furthermore, there is an immature interrelationship between hypoengaged task-positive cognitive control networks and a poorly ‘switched off’ default mode network, both of which impact performance. Stimulant medication enhances the activation of inferior frontostriatal systems, while atomoxetine appears to have more pronounced effects on the dorsal attention network. More studies are needed to understand the neurofunctional correlates of the effects of age, gender, ADHD subtypes, and comorbidities with other psychiatric conditions. The use of pattern recognition analyses applied to imaging to make individual diagnostic or prognostic predictions are promising and will be the challenge over the next decade.