The neurobiological basis of ADHD
Open accessAbstract
Attention-Deficit/Hyperactivity Disorder is not a single pathophysiological entity and appears to have a complex etiology. There are multiple genetic and environmental risk factors with small individual effect that act in concert to create a spectrum of neurobiological liability. Structural imaging studies show that brains of children with Attention-Deficit/Hyperactivity Disorder are significantly smaller than unaffected controls. The prefrontal cortex, basal ganglia and cerebellum are differentially affected and evidence indicating reduced connectivity in white matter tracts in key brain areas is emerging. Genetic, pharmacological, imaging, and animal models highlight the important role of dopamine dysregulation in the neurobiology of Attention-Deficit/Hyperactivity Disorder. To date, stimulants are the most effective psychopharmacological treatments available for Attention-Deficit/Hyperactivity Disorder. Currently only immediate release methylphenidate and atomoxetine are approved for the treatment of ADHD in Italy. Drug treatment should always be part of a comprehensive plan that includes psychosocial, behavioural and educational advice and interventions.
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Reduced maternal thyroid capacity, poor maternal wellness, maternal age, post-maturity of the foetus, long working hours, maternal stress, foetal stress, prenatal exposure to alcohol and tobacco, and antepartum haemorrhage are prenatal factors that could influence ADHD development.
“Reduced maternal thyroid capacity, poor maternal wellness, maternal age, post-maturity of the foetus, long working hours, maternal stress, foetal stress, prenatal exposure to alcohol and tobacco, and antepartum haemorrhage are prenatal factors that could influence ADHD development [54, 58, 65].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [54]
The Introduction’s “The environmental basis of ADHD” section links prenatal alcohol exposure and maternal smoking to ADHD-related outcomes, and mentions pregnancy and birth complications generally. It does not identify reduced thyroid capacity, poor maternal wellness, maternal age, post-maturity, long working hours, maternal or foetal stress, or antepartum haemorrhage as factors. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPrenatal, perinatal and postnatal difficulties, psychological adversities, exposure to chemical contaminants, or iron deficiency are factors that increase the probability of developing ADHD.
“highlighting prenatal, perinatal and postnatal difficulties, psychological adversities, exposure to chemical contaminants, or iron deficiency as factors that increase the probability of developing ADHD [54]”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [54]
The Introduction’s “environmental basis of ADHD” section (page unavailable) links prenatal and perinatal factors to ADHD and identifies postnatal social deprivation and iron deficiency as possible contributors. It does not identify exposure to chemical contaminants as an ADHD risk factor, and its statements about social deprivation and iron deficiency are narrower and more tentative than the citing sentence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredADHD aetiology is complex, involving multiple genetic and environmental factors acting together and creating a spectrum of neurobiological responsibility.
“The ADHD aetiology is complex with a multiple pathophysiological entity involving multiple genetic and environmental factors, acting together, and creating a spectrum of neurobiological responsibility [54]”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [54]
Genetics has a great weight in ADHD, with a heritability ranging from 60% to 90% according to twin studies.
“Genetics has a great weight in ADHD, with a heritability ranging from 60% to 90% according to several studies carried out in twins [54, 56].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [54]
Dysregulation of the dopaminergic system is related to ADHD symptoms and signs.
“Dysregulation of the dopaminergic system is related to the ADHD symptoms and signs [54].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [54]
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- Authors
- Curatolo, P., D'Agati, E., & Moavero, R.
- Affiliations
- University of Rome Tor Vergata (IT)
- Corresponding author
- Curatolo, Paolo
- Venue
- Italian Journal of Pediatrics
- Published
- 2010
- Volume
- 36
- Issue
- 1
- Pages
- 79
- ISSN
- 1720-8424 (ISSN-L)
- 1824-7288
- PMC
- PMC3016271
- OpenAlex
- W2163811629
- Cited by
- 189
- References
- 91
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 18 · 2023: 9 · 2022: 16 · 2021: 14 · 2020: 13 · 2019: 18 · 2018: 11 · 2017: 6 · 2016: 9 · 2015: 11 · 2014: 12 · 2013: 15 · 2012: 9
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- The Italian Journal of Pediatrics/Italian journal of pediatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, ADHD pathophysiology, neurobiology of ADHD, genetic risk factors, environmental risk factors, structural brain abnormalities, prefrontal cortex, basal ganglia, cerebellum, white matter connectivity, dopamine dysregulation, stimulant pharmacotherapy, methylphenidate, atomoxetine, psychosocial interventions
- MeSH terms
- Atomoxetine Hydrochloride, Central Nervous System Stimulants, Animals, Attention Deficit Disorder with Hyperactivity, Basal Ganglia, Behavior Therapy, Brain, Cerebellum, Dopamine, Drug Therapy, Combination, Humans, Italy, Methylphenidate, Propylamines, Risk Factors, Dopamine Agents, Treatment Outcome, Prefrontal Cortex, Dopamine Uptake Inhibitors, Evidence-Based Medicine
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