Front and center: Maturational dysregulation of frontal lobe functional neuroanatomic connections in attention deficit hyperactivity disorder

Gerry Leisman, Robert Melillo

Research output: Contribution to journalArticlepeer-review

Abstract

Frontal lobe function may not universally explain all forms of attention deficit hyperactivity disorder (ADHD) but the frontal lobe hypothesis described supports an internally consistent model for integrating the numerous behaviors associated with ADHD. The paper examines the developmental trajectories of frontal and prefrontal lobe development, framing ADHD as maturational dysregulation concluding that the cognitive, motor, and behavioral abilities of the presumptive majority of ADHD children may not primarily be disordered or dysfunctional but reflect maturational dysregulation that is inconsistent with the psychomotor and cognitive expectations for the child’s chronological and mental age. ADHD children demonstrate decreased activation of the right and middle prefrontal cortex. Prefrontal and frontal lobe regions have an exuberant network of shared pathways with the diencephalic region, also having a regulatory function in arousal as well as with the ascending reticular formation which has a capacity for response suppression to task-irrelevant stimuli. Prefrontal lesions oftentimes are associated with the regulatory breakdown of goal-directed activity and impulsivity. In conclusion, a presumptive majority of childhood ADHD may result from maturational dysregulation of the frontal lobes with effects on the direct, indirect and/or, hyperdirect pathways.

Original languageEnglish
Article number936025
JournalFrontiers in Neuroanatomy
Volume16
DOIs
StatePublished - 23 Aug 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Leisman and Melillo.

Keywords

  • ADHD
  • direct pathway
  • frontal lobe
  • hyperdirect pathway
  • indirect pathway
  • prefrontal cortex

ASJC Scopus subject areas

  • Cellular and Molecular Neuroscience
  • Neuroscience (miscellaneous)
  • Anatomy

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