Neuroimaging the neural correlates of increased risk for substance use disorders in attention-deficit/hyperactivity disorder-A systematic review: Neuroimaging ADHD at High Risk for SUD
Abstract
BACKGROUND/OBJECTIVES: Children with attention-deficit/hyperactivity disorder (ADHD) are nearly three times more likely to develop substance use disorders (SUD) than their typically developing peers. Our objective was to review the existing neuroimaging research on high-risk ADHD (ie, ADHD with disruptive behavior disorders, familial SUD and/or early substance use), focusing on impulsivity as one possible mechanism underlying SUD risk. METHODS: A PubMed literature search was conducted using combinations of the keywords "ADHD," "substance use," "substance use disorder," "SUD," "addiction," "dependence," "abuse," "risk," "brain" "MRI," "imaging" and "neuroimaging." Studies had to include cohorts that met diagnostic criteria for ADHD; studies of individuals with ADHD who all met criteria for SUD were excluded. Eight studies met the search criteria. RESULTS: Individuals with high-risk ADHD have hyperactivation in the motivation-reward processing brain network during tasks of impulsive choice, emotion processing, and risky decision-making. During response inhibition tasks, they have hypoactivation in the inhibitory control brain network. However, studies focusing on this latter circuit found hypoactivation during inhibitory control tasks, decreased white matter microstructure coherence and reduced cortical thickness in ADHD independent of substance use history. DISCUSSION/CONCLUSIONS: An exaggerated imbalance between the inhibitory control network and the motivation-reward processing network is theorized to distinguish individuals with high-risk ADHD. Preliminary findings suggest that an exaggerated aberrant reward processing network may be the driving neural correlate of increased SUD risk in ADHD. SCIENTIFIC SIGNIFICANCE: Neural biomarkers of increased SUD risk in ADHD could help clinicians identify which patients may benefit most from SUD prevention. Thus, more neuroimaging research on this vulnerable population is needed. (Am J Addict 2017;26:99-111).
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The co-occurrence of ADHD and SUD can be partly explained by dysfunctions in the inhibitory and reward system in the brain.
“and (associated) dysfunctions in the inhibitory and reward system in the brain [10,11]”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [11]
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ICASA Consensus Group (2020) · VUBIR (Vrije Universiteit Brussel)
- Authors
- Adisetiyo, V., & Gray, K. M.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Adisetiyo, Vitria
- Venue
- The American Journal on Addictions
- Publisher
- Wiley
- Published
- 2017-01-20
- Volume
- 26
- Issue
- 2
- Pages
- 99-111
- ISSN
- 1055-0496 (ISSN-L)
- OpenAlex
- W2572683392
- Cited by
- 49
- References
- 80
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 4 · 2018: 3 · 2017: 2
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal on Addictions (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Klingenstein Third Generation Foundation Fellowship in Child and Adolescent ADHD
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, substance use disorders, impulsivity, reward processing, inhibitory control, response inhibition, white matter microstructure, cortical thickness, neural markers, substance use prevention, children
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Humans, Prognosis, Psychopathology, Risk Assessment, Substance-Related Disorders, Neuroimaging
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