What is ADHD?

      ADHD is a real problem for many kids and parent!  So why the controvery?

      I have watched the evolution of our conception of this “mental disorder” from the time was called Minimum Brain Dysfunction to the current DSM-5 definition of ADHD (attention-deficit/hyperactivity disorder) with 3 sub-types ie combined presentation; predominantly inattentive presentation and predominantly hyperactive/impulsive presentaton prior to age 12.  

     Our understanding of the neurobiology has progress with functional MRI and  diffusion MRI studies.  Some studies suggest that the inattentive form is different from the hyperactive form by being a primary deficit in working memory.  There is evidence to suggest that there are abnormalities of white matter pathways identifying a specific sensory processing disorder (SPD) not recognized in the DSM-5.  

     There is co-morbidity of SPD with attention deficit hyperactivity disorder (ADHD) and autism and there are ofter many other co-morbidities with ADHD including anxiety, learning disorders, and mood disorders.  It is obvious then the these diagnoses reflect complex heterogenous abnormalities of neurobiology in the child dynamic developing brain/mind.  

     Until we can unravel the complex neurobiology we will be like the blind men and the elephant.  And we must approach each child as unique and therefore tailor treatment accordingly always remembering:  “Even the term ‘mental disorder’ implies a mind-body dichotomy that is outmoded and not embraced  by most present day basic neuroscientists and developmental neurobiologists.”  Peter Jensen et al.  

    No wonder there is so much controversy about treatment!Image

 

8 thoughts on “What is ADHD?

  1. Studies of ADHD by Diffusion tensor imaging (DTI) revealed widespread alterations in white matter integrity most consistently so in the right anterior corona radiata, right forceps minor, bilateral internal capsule, and left cerebellum, areas previously implicated in the pathophysiology of the ADHD and providing a major clue to the neurobiology of ADHD. These white matter connections are called connectomes.

  2. Connectome studies of ADHD reveal wide spread white matter alterations most consistently so in the right anterior corona radiata, right forceps minor, bilateral internal capsule, and left cerebellum, areas previously implicated in the pathophysiology of the disorder. Such studies should help us better understand the neurobiology of ADHD.

      • Much of brain development occurs before birth but the first 6 months after birth is a period of most rapid development therefore the importance of healthy attachment. Major maturation of the brain continues until age 25 especially that of the mid prefrontal lobes. Understanding any disorder such as ADHD requires a developmental perspective. The human brain remains plastic through out life with connections between the 100 billions neurons continuing to form. See connectome video http://youtu.be/HA7GwKXfJB0
        Parents literally shape the structure and function of their child’s brain.

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