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Attention deficit/hyperactivity disorder: characteristics, interventions and models.
M G Paule1, A S Rowland, S A Ferguson
1Behavioral Toxicology Laboratory, Division of Neurotoxicology, HFT-132, National Center for Toxicological Research, 3900 NCTR Road, Jefferson, AR 72079-9502, USA. mpaule@nctr.fda.gov
Neurotoxicology and Teratology
|December 7, 2000
Summary
Attention Deficit/Hyperactivity Disorder (ADHD) may be more prevalent than previously thought, with frequent under and overdiagnosis. Animal models and neuroimaging studies offer insights into ADHD traits and treatment effectiveness.
Area of Science:
- Neuroscience
- Psychiatry
- Genetics
Background:
- Epidemiological data suggest Attention Deficit/Hyperactivity Disorder (ADHD) prevalence may be 2-3 times higher than the commonly cited 3-5%.
- Both underdiagnosis and overdiagnosis of ADHD are frequently observed.
- Existing ADHD research often presumes intact perceptual abilities, a notion challenged by recent findings.
Purpose of the Study:
- To review current understanding of Attention Deficit/Hyperactivity Disorder (ADHD) epidemiology, animal models, behavioral tasks, and neurobiological underpinnings.
- To evaluate the efficacy of multimodal and pharmacological interventions for ADHD.
- To explore the role of time perception deficits in ADHD.
Main Methods:
- Review of epidemiological data on ADHD prevalence.
- Analysis of findings from rodent and mouse models of ADHD (e.g., SHR, Coloboma).
- Examination of behavioral operant tasks and methylphenidate effects.
- Evaluation of data from the Multimodality Treatment Study of ADHD (MTA).
- Review of neuroimaging studies (structural and functional) in children with ADHD.
Main Results:
- ADHD prevalence may be significantly underestimated, with frequent diagnostic errors.
- Animal models like SHR exhibit ADHD-like traits, aiding research.
- Methylphenidate can normalize performance in specific ADHD-related behavioral tasks.
- Multimodal and pharmacological interventions, including frequent follow-up, show superior long-term benefits compared to standard care.
- Neuroimaging reveals structural differences (e.g., reduced corpus callosum, white matter, cerebellar volumes) and functional alterations (e.g., prefrontal cortex/striatum blood flow, catecholamine dysregulation) in ADHD.
Conclusions:
- ADHD diagnosis and prevalence require re-evaluation.
- Animal models and specific behavioral tasks are valuable tools for ADHD research.
- Effective ADHD treatment involves multimodal approaches, combining medication with intensive parent/teacher follow-up.
- Neurobiological abnormalities in specific brain regions and neurotransmitter systems are implicated in ADHD.