Fundamentals of attention-deficit/hyperactivity disorder: circuits and pathways.

摘要: Neuropsychological and imaging studies have shown that attention-deficit/hyperactivity disorder (ADHD) is associated with alterations in prefrontal cortex (PFC) its connections to striatum cerebellum. Research animals, combination observations of patients cortical lesions, has the PFC critical for regulation behavior, attention, affect using representational knowledge. The important sustaining attention over a delay, inhibiting distraction, dividing while more posterior areas are essential perception allocation attentional resources. right hemisphere especially behavioral inhibition. Lesions produce profile distractibility, forgetfulness, impulsivity, poor planning, locomotor hyperactivity. very sensitive neurochemical environment, optimal levels norepinephrine dopamine needed proper control behavior attention. Recent electrophysiologic animals suggest enhances "signals" through postsynaptic alpha2A-adrenoceptors PFC, decreases "noise" modest D1-receptor stimulation. Blockade alpha2-receptors monkey re-creates symptoms ADHD, resulting impaired working memory, increased Genetic catecholamine pathways may contribute dysregulation circuits this disorder. Stimulant medications some their therapeutic effects by increasing endogenous stimulation D1-receptors optimizing