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Neurobiology and Genetics of ADHD in Adults

Published online by Cambridge University Press:  07 November 2014

Thomas J. Spencer
Thomas J. Spencer*
Affiliation:
Dr. Spencer is associate professor of psychiatry at Harvard Medical School and associate director of the Clinical and Research Program in Pediatric Psychopharmacology at, Massachusetts General Hospital, in Boston
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Abstract

Treatment of attention-deficit/hyperactivity disorder (ADHD) may positively impact the neurobiology of adult patients with ADHD. Treatment may also minimize impairment from core symptoms and may alter the course of co-morbid disorders such as depression and substance use disorder. However, much of the information on stimulant use in adult ADHD comes from studies conducted in children, and it remains unclear whether there is a difference between children and adults when it comes to the side effects and tolerability of ADHD treatments. It is known that clinical presentation differs between adults and children, with adults demonstrating a higher percentage of mood disorders. Current treatments for adult ADHD include psychosocial therapies and pharmacologic therapies, the latter of which include the stimulants d-methylphenidate extended release (XR), OROS methylphenidate, lisdexamfetamine, and mixed amphetamine salts XR; and the nonstimulant atomoxetine, a selective norepinephrine reuptake inhibitor. There is need for additional study of treatment strategies for adult ADHD. Although all classes of ADHD medications are approved in adults, there are fewer approved formulations for adults than for children. Efficacy in adults is more subjective than in children, which may affect how efficacy rates for adult treatments are calculated. Adults also present a greater diversion risk than children. In addition, there are several new and emerging medication treatments worth considering.

This Expert Roundtable Supplement represents part 2 of a 3-part supplement series on adult ADHD led by Lenard A. Adler, MD. In this activity, Thomas J. Spencer, MD, discusses the neurobiology and genetics of adult ADHD; Mark A. Stein, PhD, discusses stimulant therapy; and Jeffrey H. Newcorn, MD, reviews nonstimulants and psychosocial treatments.

Type
Research Article
Information
CNS Spectrums , Volume 13 , Issue S13 , 2008 , pp. 5 - 7
Copyright
Copyright © Cambridge University Press 2008

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References

1.Mick, E, Biederman, J, Prince, J, Fischer, MJ, Faraone, SV. Impact of low birth weight on attention-deficit hyperactivity disorder. J Dev Behav Pediatr. 2002;23(1):16–22.CrossRefGoogle ScholarPubMed
2.Castellanos, FX, Lee, PP, Sharp, W, et al.Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA. 2002;288(14):1740–1748.Google Scholar
3.Shaw, P, Eckstrand, K, Sharp, W, et al.Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci U S A. 2007;104(49):19649–19654.Google Scholar
4.Makris, N, Biederman, J, Valera, EM, et al.Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder. Cereb Cortex. 2007;17(6):1364–1375.Google Scholar
5.Seidman, LJ, Valera, EM, Makris, N, et al.Dorsolateral prefrontal and anterior cingulate cortex volumetric abnormalities in adults with attention-deficit/hyperactivity disorder identified by magnetic resonance imaging. Biol Psychiatry. 2006;60(10):1071–1080.Google Scholar
6.Epstein, JN, Casey, BJ, Tonev, ST, et al.ADHD- and medication-related brain activation effects in concordantly affected parent-child dyads with ADHD. J Child Psychol Psychiatry. 2007;48(9):899–913.Google Scholar
7.Valera, EM, Faraone, SV, Biederman, J, Poldrack, RA, Seidman, LJ. Abstract Functional neuroanatomy of working memory in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(5):439–447.CrossRefGoogle Scholar
8.Casey, BJ, Durston, S. From behavior to cognition to the brain and back: what have we learned from functional imaging studies of attention deficit hyperactivity disorder? Am J Psychiatry. 2006;163(6):957–960.CrossRefGoogle Scholar
9.Sonuga-Barke, EJ. The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics. Neurosci Biobehav Rev. 2003;27(7):593–604.Google Scholar
10.Cummings, JL. Frontal-subcortical circuits and human behavior. Arch Neurol. 1993;50(8):873–880.CrossRefGoogle ScholarPubMed
11.Bush, G, Frazier, JA, Rauch, SL, et al.Anterior cingulate cortex dysfunction in attention-deficit/hyperactivity disorder revealed by fMRI and the Counting Stroop. Biol Psychiatry. 1999;45(12):1542–1552.Google Scholar
12.Faraone, SV, Perlis, RH, Doyle, AE, et al.Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1313–1323.CrossRefGoogle ScholarPubMed