Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T01:38:19.445Z Has data issue: false hasContentIssue false
  • English
  • Français

A Review of Adult ADHD: A Neuropsychological and Neuroimaging Perspective

Published online by Cambridge University Press:  07 November 2014

Richard F. Kaplan  and
Michael C. Stevens
Get access Rights & Permissions [Opens in a new window]

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder which effects an estimated 3% to 5% of children. Despite estimates that ADHD persists in 30% to 70% of adults having had the disorder in childhood, ADHD in adulthood remains controversial. This report summarizes current thinking in the diagnosis and etiology of adult ADHD. Most theories posit that ADHD is related to anomalies in frontal lobe function and dopaminergic transmission. However, there is debate as to whether ADHD is a unitary disorder with different manifestations, a syndrome, or multiple disorders. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classifies ADHD into inattention, hyperactivity-impulsivity, and combined subtypes. Although problems with cognition are core ADHD symptoms, self reporting has not been a reliable predictor of neuropsychological test performance. Nevertheless, we suggest that a performance-based diagnosis, including empirically derived, age-sensitive neuropsychological tests, provides the best hope of dissociating ADHD from psychiatric disorders with similar symptoms. We also describe the promise of new neuroimaging technologies, such as functional magnetic resonance imaging, in elucidating the pathophysiology of ADHD and similar psychiatric disorders.

Type
Original Research
Information
CNS Spectrums , Volume 7 , Issue 5 , May 2002 , pp. 355 - 362
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Bellak, L, Black, RB. Attention-deficit hyperactivity disorder in adults. Clin Ther. 1992;14:138–147.Google ScholarPubMed
2.Faraone, SV, Biederman, J, Spencer, T, et al.Attention-deficit/hyperactivity disorder in adults: an overview. Biol Psychiatry. 2000;48:9–20.CrossRefGoogle ScholarPubMed
3.Hechtman, L. Subgroups of adult outcome of attention-deficit/hyperactivity disorder. In: TE, Brown, ed. Attention-Deficit Disorders and Comorbidities in Children, Adolescents, and Adults. Washington, DC: American Psychiatric Press, Inc; 2000:231–298.Google Scholar
4.Mannuzza, S, Klein, RG. Adolescent and adult outcomes in Attention-Deficit/Hyperactivity Disorder. In: HC, Quay, Hogan, AE, eds. Handbook of Disruptive Behavior Disorders. New York, NY: Kluwer Academic/Plenum Publishers; 1999::279–284.CrossRefGoogle Scholar
5.Barkley, RA. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 2nd ed. New York, NY:Guilford Press; 1998.CrossRefGoogle Scholar
6.Brown, TE. Emerging understandings of Attention-Deficit Disorders and comorbidities. In TE, Brown, ed. Attention-Deficit Disorders and Comorbidities in Children, Adolescents, and Adults. Washington, DC: American Psychiatric Press, Inc; 2000:3–56.Google Scholar
7.Tannock, R. Attention deficit hyperactivity disorder: advances in cognitive, neurobiological, and genetic research. J Child Psychol Psychiatry. 1998;39:65–99.CrossRefGoogle ScholarPubMed
8.Brown, TE. Differential diagnosis of ADD versus ADHD in adults. In: Nadeau, KG, ed. A Comprehensive Guide to Attention Deficit Disorder in Adults. New York, NY: Brunner/Mazel; 1995.Google Scholar
9.Denny, CB, Rapport, M. The cognitive pharmacology of stimulants in children with ADHD. In: Solanto, MV, Arnsten, AFT, Castellanos, FX, eds. Stimulant Drugs and ADHD: Basic and Clinical Neuroscience. New York, NY: Oxford University Press; 2001.Google Scholar
10.Sergeant, JA, Oosterlaan, J, van der Meere, J. Information processing and energetic factors in attention deficit/hyperactivity disorder. In: Quay, HC, Hogan, AE, eds. Handbook of Disruptive Behavior Disorders. New York, NY: Kluwer Academic/Plenum Publishers; 1999:75–104.Google Scholar
11.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
12.Carlson, CL, Mann, M. Attention-deficit/hyperactivity disorder, predominantly inattentive subtype. Child Adolesc Psychiatr Clin N Am. 2000;9:499–510.CrossRefGoogle ScholarPubMed
13.Lahey, BB, Applegate, B, McBurnett, K, Biederman, J. DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents. Am J Psychiatry. 1994;151:1673–1685.Google ScholarPubMed
14.Denckla, MB. Attention deficit hyperactivity disorder-residual type. J Child Neurol. 1991;6(suppl):S44–S50.CrossRefGoogle ScholarPubMed
15.Taylor, CJ, Miller, DC. Neuropsychological assessment of attention in ADHD adults. J Att Disord. 1997;2:77–88.CrossRefGoogle Scholar
16.Riordan, HJ, Flashman, LA. AJ, Saykin. SA, Frutiger, Carroll, KE, Huey, L. Neuropsychological correlates of methylphenidate treatment in adult ADHD with and without depression. Arch Clin Neuropsychol. 1999;14:217–233.CrossRefGoogle ScholarPubMed
17.Biederman, J, Faraone, SV, Spencer, T, Wilens, T, et al.Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150:1792–1798.Google ScholarPubMed
18.Bradley, C. The behavior of children receiving benzedrine. Am J Psychiatry. 1937;94:577–585.CrossRefGoogle Scholar
19.DuPaul, GJ, Barkley, RA, Connor, DF. Stimulants. In: RA, Barkley, ed. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 2nd ed. New York, NY: Guilford Press; 1998.Google Scholar
20.Spencer, T, Biederman, J, Wilens, THarding, M, O'Donnell, D, Griffin, S. Pharmacology of attention deficit disorder across the life cycle. J Am Acad Child Adolesc Psychiatry. 1996;34:409–432.CrossRefGoogle Scholar
21.Jensen, PS, Hinshaw, SP, Swanson, JM, et al.Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22:60–73.CrossRefGoogle Scholar
22.Levy, F, Hay, DA, McStephne, M, Wood, C, Waldman, I. Attention-deficit hyperactivity disorder: a category or a continuum? J Am Acad Child Adolesc Psychiatry. 1997;36:737–744.CrossRefGoogle ScholarPubMed
23.Sherman, DK, Iacono, WG, McGue, MK. Attention-deficit hyperactivity disorder dimensions: a twin study of inattention and impulsivity-hyperactivity. J Am Acad Child Adolesc Psychiatry. 1997;36:745–753.CrossRefGoogle ScholarPubMed
24.Gjone, H, Stevenson, J, Sundet, JM. Genetic influence on parent-reported attention-related problems in a Norwegian general population twin sample. J Am Acad Child Adolesc Psychiatry. 1996;35:588–596.CrossRefGoogle Scholar
25.Neuman, RJ, Todd, RD, Heath, AC, et al.Evaluation of ADHD typology in three contrasting samples: a latent class approach. J Am Acad Child Adolesc Psychiatry. 1999;38:25–33.CrossRefGoogle ScholarPubMed
26.Goodman, R, Stevenson, J. A twin study of hyperactivity--II. The aetological role of genes family relationships and perinatal adversity. J Child Psychol Psychiatry. 1989;30:691–609.CrossRefGoogle Scholar
27.Faraone, SV, Biederman, J, Weiffenbach, B, et al.Dopamine D4 gene 7-repeat allele and attention deficit hyperactivity disorder. Am J Psychiatry. 1999;156:768–770.CrossRefGoogle ScholarPubMed
28.Cook, EH, Stein, MA, Krasowski, MD, et al.Association of attention-deficit disorder and the dopamine transporter gene. Am J Hum Genet. 1995;56:993–998.Google ScholarPubMed
29.Daly, G, Hawi, Z, Fitzgerald, M, Gill, M. Mapping susceptibility loci in attention deficit hyperactivity disorder: preferential transmission of parental alleles at DAT1, DBH, and DRD5 to affected children. Mol Psychiatry. 1999;4:192–196.CrossRefGoogle ScholarPubMed
30.Castellanos, FX, Giedd, JN, Marsh, WK, et al.Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. Arch Gen Psychiatry. 1996;53:607–616.CrossRefGoogle ScholarPubMed
31.Filipek, PA, Semrud-Clikeman, M, Steingard, RJ, Renshaw, PF, Kennedy, DN, Biederman, J. Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls. Neurology. 1997;48:589–601.CrossRefGoogle ScholarPubMed
32.Castellanos, FX, Giedd, JN, Eckburg, P, Marsh, WL, et al.Quantitative morphology of the caudate nucleus in attention deficit hyperactivity disorder. Am J Psychiatry. 1994;151:1791–1796.Google ScholarPubMed
33.Hynd, GW, Hern, KL, Novey, ES, Eliopulos, D, et al.Attention deficit-hyperactivity disorder and asymmetry of the caudate nucleus. J Child Neurol. 1993;8:339–347.CrossRefGoogle ScholarPubMed
34.Mataro, M, Garcia-Sanchez, C, Junque, C, Estevez-Gonzalez, A, Pujol, J. Magnetic resonance imaging measurement of the caudate nucleus in adolescents with attention-deficit hyperactivity disorder and its relationship with neuropsychological and behavioral measures. Arch Neurol. 1997;54:963–968.CrossRefGoogle ScholarPubMed
35.Hynd, GW, Semrud-Clikeman, M, Lorys Alison, R, Novey, ES, et al.Corpus callosum morphology in attention deficit-hyperactivity disorder: morphometric analysis of MRI. J Learn Disabil. 1991;24:141–146.CrossRefGoogle ScholarPubMed
36.Lyoo, K, Noam, CG, Lee, CK, Lee, HK, Kennedy, BP, Renshaw, PF. The corpus callosum and lateral ventricles in children with attention-deficit hyperactivity disorder: a brain magnetic resonance imaging study. Biol Psychiatry. 1996;40:1060–1063.CrossRefGoogle ScholarPubMed
37.Semrud-Clikeman, M, Filipek, PA, Biederman, J, Steingard, R, et al.Attention-deficit hyperactivity disorder: magnetic resonance imaging morphometric analysis of the corpus callosum. J Am Acad Child Adolesc Psychiatry. 1994;33:875–881.CrossRefGoogle ScholarPubMed
38.Mostofsky, SH, Reiss, AL, Lockhart, P, Denckla, MB. Evaluation of cerebellar size in attention-deficit hyperactivity disorder. J Child Neurol. 1998;13:434–439.CrossRefGoogle ScholarPubMed
39.Jonkman, LM, Kemner, C, Verbaten, MN, et al.Event-related potentials and performance of attention-deficit hyperactivity disorder: children and normal controls in auditory and visual selective attention tasks. Biol Psychiatry. 1997;41:595–611.CrossRefGoogle ScholarPubMed
40.Jonkman, LM, Kemner, C, Verbaten, MN, et al.Effects of methylphenidate on event-related potentials and performance of attention-deficit hyperactivity disorder children in auditory and visual selective attention tasks. Biol Psychiatry. 1997;41:690–702.CrossRefGoogle ScholarPubMed
41.Kemner, C, Verbaten, MN, Koelega, HS, et al.Event-related brain potentials in children with attention-deficit and hyperactivity disorder: effects of stimulus deviancy and task relevance in the visual and auditory modality. Biol Psychiatry. 1996;40:522–534.CrossRefGoogle ScholarPubMed
42.Klorman, R, Brumaghim, JT, Fitzpatrick, PA, Borgstedt, AD. Methylphendiate speeds evaluation processes of attention deficit disorder adolescents during a continuous performance test. J Abnorm Child Psychol. 1991;19:263–283.CrossRefGoogle Scholar
43.Strandburg, RJ, Marsh, JT, Brown, WS, et al.Continuous-processing-related event-related potentials in children with attention deficit hyperactivity disorder. Biol Psychiatry. 1996;40:964–980.CrossRefGoogle ScholarPubMed
44.Zametkin, AJ, Nordahl, TE, Gross, M, et al.Cerebral glucose metabolism in adults with hyperactivity of childhood onset. N Engl J Med. 1990;323:1361–1366.CrossRefGoogle ScholarPubMed
45.Zametkin, AJ, Liebenauer, LL, Fitzgerald, GA, King, AC, et al.Brain metabolism in teenagers with attention-deficit hyperactivity disorder. Arch Gen Psychiatry. 1993;50:333–340.CrossRefGoogle ScholarPubMed
46.Schweitzer, JB, Faber, TL, Grafton, ST, Tune, LE, Hoffman, JM, Kilts, CD. Alterations in the functional anatomy of working memory in adult attention deficit hyperactivity disorder. Am J Psychiatry. 2000;157:278–280.CrossRefGoogle ScholarPubMed
47.Rubia, K, Overmery, S, Taylor, E, et al.Functional frontalisation with age: mapping neurodevelopmental trajectories with fMRI. Neurosci Biobehav Rev. 1999;24:13–19.CrossRefGoogle Scholar
48.Vaidya, CJ, Austin, G, Kirkorian, G, et al.Selective effects of methylphenidate in attention deficit hyperactivity disorder: a functional magnetic resonance study. Neurobiology. 1998;95:14494–14499.Google ScholarPubMed
49.Bush, G, Frazier, JA, Rauch, SL, et al.Anterior cingulate cortex dysfunction in attention-deficit/hyperactivity disorder revealed by fMRI and the counting Stroop. Biol Psychiatry. 1999;45:1542–1552.CrossRefGoogle ScholarPubMed
50.Ernst, M, Zametkin, AJ, Matochik, JAPH, Jons, Cohen, RM. DOPA decarboxylase activity in attention deficit hyperactivity disorder adults. A [flourine 18]fluorodopa positron emission tomographic study. J Neurosci. 1998:18:5901–5907.CrossRefGoogle ScholarPubMed
51.Sunohara, GA, Malone, MA, Rovet, J, Humphries, T, Roberts, W, Taylor, MJ. Effect of methylphenidate on attention in children with attention deficit hyperactivity disorder (ADHD): ERP evidence. Neuropsychopharmacology. 1999;21:218–228.CrossRefGoogle ScholarPubMed
52.Winsberg, BG, Javitt, DC, Shanahan-Silipo, G. Electrophysiological indicies of information processing in methylphenidate responders. Biol Psychiatry. 1997;42:434–445.CrossRefGoogle Scholar
53.Zillessen, KE, Scheuerpflug, P, Fallgatter, AJ, Strik, WK, Warnke, A. Changes of the brain electrical fields during the continuous performance test in attention-deficit hyperactivity disorder-boys depending on methylphenidate medication. Clin Neurophysiol. 2001;112:1166–1173.CrossRefGoogle ScholarPubMed
54.Cummings, JL. Frontal-subcortical circuits and human behavior. Arch Neurol. 1993;50:873–880.CrossRefGoogle ScholarPubMed
55.Volkow, ND, Wang, G, Fowler, JS, et al.Therapeutic doses of oral methylphenidate significant increase extracellular dopamine in the human brain. J Neurosci. 2001;21:RC121.CrossRefGoogle ScholarPubMed
56.Andersen, SL, Teicher, MH. Sex differences in dopamine receptors and their relevance to ADHD. Neurosci Biobehav Rev. 2000;24:137–141.CrossRefGoogle ScholarPubMed
57.Castellanos, FX. Neuroimaging studies of ADHD. In: Solanto, MV, Arnsten, AFT, Castellanos, FX, eds. Stimulant Drugs and ADHD: Basic and Clinical Neuroscience. Oxford, England: Oxford University Press; 2001:243–258.Google Scholar
58.Hebb, DO. A Textbook of Psychology. Philadelphia, Penn: Saunders; 1958.CrossRefGoogle Scholar
59.Mirsky, AF, Anthony, BJ, Duncan, CC, Aheam, MB, Kellam, SG. Analysis of the elements of attention: a neuropsychological approach. Neuropsychol Rev. 1991;2:109–145.CrossRefGoogle ScholarPubMed
60.Fuster, JM. The Prefrontal Cortex: Anatomy, Physiology, and Neuropsychology of the Frontal Lobe. Philadelphia, Penn: Lippincott-Raven; 1997.Google Scholar
61.Reader, MJ, Harris, HL, Schuerholz, LJ, Dencla, MB. Attention deficit hyperactivity disorder and executive dysfunction. Dev Neuropsychol. 1994;10:493–512.CrossRefGoogle Scholar
62.Holdnack, JA, Moberg, PJ, Arold, SE, Gur, RC, Gur, RE. Speed of processing and verbal deficits in adults diagnosed with attention deficit disorder. Neuropsychiatry Neuropsychol Behav Neurol. 1995;8:282–292.Google Scholar
63.Seidman, LJ, Biederman, J, Weber, W, Hatch, M, Farone, SV. Neuropsychological function in adults with attention deficit hyperactivity disorder. Biol Psyhiatry. 1998;44:260–268.CrossRefGoogle ScholarPubMed
64.Corbett, B, Stanczak, DE. Neuropsychological performance of adults evidencing attention-deficit hyperactivity disorder. Arch Clin Neuropsychol. 1999;14:373–387.CrossRefGoogle ScholarPubMed
65.Grodzinsky, GM, Diamond, R. Frontal lobe functioning in boys with attention-deficit hyperactivity disorder. Dev Neuropsychol. 1992;8:427–445.CrossRefGoogle Scholar
66.Jenkins, M, Cohen, R, Malloy, P, Sallowy, S, Johnson, EG. Neuropsychological measures which discriminate among adults with residual symptoms of attention deficit disorder and other attentional complaints. Clinl Neuropsychol. 1998;12:74–83.CrossRefGoogle Scholar
67.Epstein, JN, Johnson, DE, Varia, IM, Conners, CK. Neuropsychological assessment of response inhibition in adults with ADHD. J Clin Exp Neuropsychol. 2001;23:362–371.CrossRefGoogle ScholarPubMed
68.Clark, VP, Fannon, S, Lai, S, Benson, R, Bauer, L. Responses to rare visual target and distractor stimuli using event-related fMRI. J Neurophysiol. 2000;83:3133–3139.CrossRefGoogle ScholarPubMed
69.Weyandt, LL, Roce, JA, Linterman, I, Mitzlaff, L, Emert, E. Neuropsychological performance of a sample of adults with ADHD, developmental reading disorder, and controls. Dev Neuropsychol. 1998;14:643–656.CrossRefGoogle Scholar
70.Kaplan, RF, Jones-Woodward, L, Workman, K, Steere, AC, Logigian, EL, M-E, Meadows. Neuropsychological deficits in Lyme disease with and without other evidence of central nervous system pathology. Appl Neuropschol. 1999;6:3–11.CrossRefGoogle ScholarPubMed
71.Bolla, KI, Lingren, KN, Bonaccorsy, C, Bleecker, ML. Memory complaints in older adults fact or fiction? Arch Neurol. 1991;48:61–64.CrossRefGoogle ScholarPubMed
72.Larrabee, GL, Levin, HS. Memory self-ratings and objective memory test performance in a normal elderly sample. J Clin Exp Neuropsychol. 1986:8:275–284.CrossRefGoogle Scholar
73.Milner, B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull. 1971;27:272–277.CrossRefGoogle ScholarPubMed
74.Stuss, DT, Benson, DF. The Frontal Lobes. New York, NY: Raven Press; 1986.Google Scholar
75.PS, Goldman-Rakic. Topography of cognition: parallel distributed networks in primate association cortex. Annu Rev Neurosci. 1988;11:137–156.Google Scholar
76.Pribram, KH, McGuinness, D. Arousal, activation, and effort in the control of attention. Psychol Rev. 1975;82:116–149.CrossRefGoogle ScholarPubMed
77.Cassens, G, Wolfe, L, Zola, M. The neuropsychology of depressions. J Neuropsychiatry Clin Neurosci. 1990;2:202–213.Google ScholarPubMed
78.Landro, NI, Stiles, TC, Sletvold, H. Neurological function in nonpsychotic unipolar major depression. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14:233–240.Google Scholar
79.Morgan, AB, Lilienfeld, SO. A meta-analytic review of the relation between antisocial behavior and neuropsychological measures of executive function. Clin Psychol Rev. 2000;20:113–136.CrossRefGoogle ScholarPubMed
80.Moritz, S, Birkner, C, Kloss, M, et al.Impact of comorbid depressive symptoms on neuropsychological performance in obsessive-compulsive disorder. J Ab Psychol. 2001;110:653–657.CrossRefGoogle ScholarPubMed
81.Pennington, BF, Ozonoff, S. Executive functions and developmental psychopathology. J Child Psychol Psychiatry. 1996;37:51–87.CrossRefGoogle ScholarPubMed
82.Morris, JC, Heyman, A, Mohs, RC, Hughs, JP, van Belle, G, et al.The consortium to establish a registry for Alzheimer's disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology. 1989;39:1159–1165.Google Scholar