Telepsicologiainfantil

Cerebral cortex development in ADHD

Posted on noviembre 12, 2013 Actualizado enn octubre 6, 2014

Children with ADHD continue to have symptomatology as adults. Hyperactivity and impulsivity tend to decrease but attentional problems remain persistent over the years. Incidence of ADHD in adulthood is near 2,5% of the population and ADHD in adult age is linked with underemployment, poor relationships and underachievement (Pingault et al., 2011; Simon et al., 2009). Cerebral regions that are important for cognitive control and attention are the cingulate cortex, the dorsolateral prefrontal cortex, and posterior cortical regions of the precuneus and cuneus (Seidman et al., 2006; Proal et al., 2011). Trajectories of cerebral cortex development are associated with the development of ADHD across the ages. Cortical thinning of medial regions is associated with symptomatology in adult ADHD. Decrease activation on frontoparietal networks is found in ADHD and tend to persist in adulthood. Adults with ADHD tend to have problems in goal-directed behavior and cognitive control. They have poor inhibition responses in front of stimuli. In fact, Barkley shows that adults with ADHD tend to have more car accidents and drive faster than control adults. Cortical thinning is not a biomarker but it shows a correlation with ADHD symptomatology across the years. One of the hypothesis for the remission in ADHD is the cortex functional normalization. However larger studies are needed to test this kind of hypothesis, because variables of the samples used, as high IQ, could be a confunding factor. In conclusion, the study of Shaw et al., 2013 is a good starting point to study the developmental trajectories of cortical components of networks supporting attention, cognitive control and the default mode network.

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 References

Pingault, J.-B., Tremblay, R. E., Vitaro, F., Carbonneau, R., Genolini, C., Falissard, B., & Côté, S. M. (2011). Childhood trajectories of inattention and hyperactivity and prediction of educational attainment in early adulthood: A 16-year longitudinal population-based study. American Journal of Psychiatry, 168(11), 1164-1170. doi:10.1176/appi.ajp.2011.10121732

Proal E, Reiss PT, Klein RG, & et al. (2011). BRain gray matter deficits at 33-year follow-up in adults with attention-deficit/hyperactivity disorder established in childhood. Archives of General Psychiatry, 68(11), 1122-1134. doi:10.1001/archgenpsychiatry.2011.117

Seidman, L. J., Valera, E. M., Makris, N., Monuteaux, M. C., Boriel, D. L., Kelkar, K., … Biederman, J. (2006). Dorsolateral Prefrontal and Anterior Cingulate Cortex Volumetric Abnormalities in Adults with Attention-Deficit/Hyperactivity Disorder Identified by Magnetic Resonance Imaging. Biological Psychiatry, 60(10), 1071-1080. doi:10.1016/j.biopsych.2006.04.031

Shaw, P., Malek, M., Watson, B., Greenstein, D., de Rossi, P., & Sharp, W. (2013). Trajectories of Cerebral Cortical Development in Childhood and Adolescence and Adult Attention-Deficit/Hyperactivity Disorder. Biological Psychiatry, 74(8), 599-606. doi:10.1016/j.biopsych.2013.04.007

Simon, V., Czobor, P., Bálint, S., Mészáros, Á., & Bitter, I. (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. The British Journal of Psychiatry, 194(3), 204-211. doi:10.1192/bjp.bp.107.048827