Towards conceptualizing a neural systems-based anatomy of attention-deficit/hyperactivity disorder

Abstract

Convergent data from neuroimaging, neuropsychological, genetic and neurochemical studies in attention-deficit/hyperactivity disorder (ADHD) have implicated dysfunction of the dorsolateral prefrontal cortex (DLPFC) and dorsal anterior cingulate cortex (dACC), which form the cortical arm of the frontostriatal network supporting executive functions. Furthermore, besides the DLPFC and dACC, structural and functional imaging studies have shown abnormalities in key brain regions within distributed cortical networks supporting attention. The conceptualization of neural systems biology in ADHD aims at the understanding of what organizing principles have been altered during development within the brain of a person with ADHD.Characterizing these neural systems using neuroimaging could be critical for the description of structural endophenotypes, and may provide the capability of in vivo categorization and correlation with behavior and genes.

Fig. 1

Conceptual framework of the pathophysiology and etiology of ADHD.

Fig. 2

Functional neuroanatomy of circuits involved in the pathophysiology of ADHD. A = Amygdala; ACC = anterior cingulate cortex; AFP = amygdalofugal pathway; C = caudate nucleus; CBL = cerebellum; Ccspl = splenium of corpus callosum (including isthmus); FEF = frontal eye field; HT = hypothalamus; ILF = inferior longitudinal fascicle; IPL = inferior parietal lobule; LB = limbic brainstem; LFS = local fiber system; LN = lenticular nucleus; MFB = medial forebrain bundle; N = nucleus accumbens; OC = occipital cortex; P = pons; PCC = posterior cingulate cortex; SGC = subgenual cingulate cortex; SLF = superior longitudinal fascicle; SMA = supplementary motor area; SPL = superior parietal lobule; THA = thalamus; TOP = temporo-occipito-parietal junction; UF = uncinate fascicle.

Fig. 3

Conceptual model of the neuroanatomical substrates of ADHD. AMF = Amygdalo-fugal pathway; MB = Muratoff bundle; LFS = local fiber system; SLF II = superior longitudinal fascicle; ICal = internal capsule anterior limb; TOP = temporo-occipito-parietal junction.

Fig. 4

Neural systems biology acts as an interface between behavior and the genome.