ADHD overview and integration

1. ATTENTION DEFICIT
HYPERACTIVITY DISORDER
PAT YANCEY

2. ADHD OVERVIEW
• Neurobehavioral condition
• Three primary characteristics
• Impulsivity
• Inattention
• Hyperactivity
• Boys diagnosed more often than girls
• Incidence increasing

3. ADHD OVERVIEW CONTINUED
• Diagnostic Criteria –
• Six or more symptoms of inattention, impulsivity, or
hyperactivity
• Present in more than one setting
• Present for more than 6 months
• Negatively impact socially or academically

4. PATHOGENESIS
• No single definitive cause
• Genetic component
• Neurochemical reactions
• Brain development and function
• Environmental influences
• Diet not generally implicated (zinc is exception)

5. IMPACT
Child
Society
Parent
Child:
Academically
Socially
Family Relationships
Adolescents:
Unplanned pregnancies
Accidents
Criminal Activity
School Drop Out
Adults:
Personally
Professionally
Society
Economically
Healthcare
Costs
Criminality
Comorbidities
Consequences
of academic
failure
Addiction
Employers
Employees
Relationships

6. DIAGNOSIS TREATMENT
• No Specific Tests
• Clinical Evaluation
• Subjective Information from
patient, parents, teachers
• Questionnaires and screening
tools
• Evaluate/Treat/Rule Out
Comorbidities
• Behavior modification
• Cognitive therapy
• Academic support
• Pharmacologic measures
stimulants,
nonstimulants, and
antidepressants
• Routine and consistency

7. INTEGRATION
• NEUROCHEMICAL ETIOLOGY
• Dopamine and
norepinephrine imbalances
• BRAIN DEVELOPMENT AND
FUNCTION
• Structural and functional
differences
https://www.google.com/search?q=images+of+brain+and+functions+adam&biw=1152&bih=447&source=lnms&tbm=is
ch&sa=X&ved=0CAYQ_AUoAWoVChMI3KSOqaibyQIVhMo-
Ch2XqQfD#tbm=isch&tbs=rimg%3ACVAl8vYZpXQzIjgMVSZEsl61AZpfQIbWfsfPqtES3snez4jEHGIsnOlfWUH6I6tMOvDCPvOuQ
ov6ozriRQEQbXusoSoSCQxVJkSyXrUBERBUqHKxZZjvKhIJml9AhtZ-
x88RY4UgCYl4i40qEgmq0RLeyd7PiBHiIkdYmT4mxSoSCcQcYiyc6V9ZEe0iDCFjAdpiKhIJQfojq0w68MIR-NgI0rjuD1oqEgk-
865Ci_1qjOhGddbZ6rmjNYCoSCeJFARBte6yhETPmaMuUZ_1JT&q=images%20of%20brain%20and%20functions%20adam&img
dii=bEwuiQw0dcQ6NM%3A%3BbEwuiQw0dcQ6NM%3A%3Bgac-qOykZBk2sM%3A&imgrc=bEwuiQw0dcQ6NM%3A

8. DOPAMINE AND NOREPINEPHRINE
IMBALANCE
Dopamine
• Neurotransmitter
• Frontal Lobe/prefrontal
cortex
• Controls flow of information
from other areas of the brain
• Imbalance affects neurocognitive
functions:
• Memory
• Attention
• Problem-solving
• Norepinephrine
• Neurotransmitter/
Neuromodulator
• Forebrain neuronal activity
• Collects and processes sensory
information
• Effort/Motivation
• Increasing focus/sustaining thought
• Modulates information in cortical and
subcortical regions responsible for
attention and energy
http://www.news-medical.net/health/Dopamine-Functions.aspx
http://www.medscape.org/viewarticle/523887

9. STRUCTURAL DIFFERENCES
WITH ADHD
• Smaller cerebral and cerebellar
volume
• Smaller prefrontal cortical volumes
• Smaller posterior corpus callosum
regions
• Reduced thickness of the anterior
cingulate cortex
• Cortical thinning in bilateral
superior frontal brain regions
• Increased gray matter in posterior
temporal and inferior parietal
• https://www.google.com/search?q=brain+functions&biw=1165&bih=526&tbm=isch&imgil=zxyFufS
HlakqiM%253A%253B4iU6WclLgoCStM%253Bhttp%25253A%25252F%25252Fwww.alzheimerstreatment
.space%25252Ftag%25252Fparts-of-the-brain-and-their-
function&source=iu&pf=m&fir=zxyFufSHlakqiM%253A%252C4iU6WclLgoCStM%252C_&usg=__TtWWg
yKTn54fXN5-LHp5cpJU15k%3D&ved=0CC0QyjdqFQoTCNywlsbG_8gCFYpsPgodm9UCUw&ei=uJQ-
Vtz0A4rZ-
QGbq4uYBQ#tbm=isch&q=brain+functions+adam&imgdii=cSYkjejOqcgVrM%3A%3BcSYkjejOqcgVrM%
3A%3BUKCp0ol1xbG0tM%3A&imgrc=cSYkjejOqcgVrM%3A

10. FUNCTIONAL DIFFERENCES WITH ADHD
:
•Brain Imaging
• Reduced local and global activation of basal ganglia
• Reduced activation of anterior frontal lobe
•Brain Mapping
• Bilaterally reduced brain size of:
• Anterior temporal cortices
• Inferior portion of the prefrontal cortices
• Prominent grey matter in posterior temporal and inferior parietal
cortices