Differentiating frontostriatal and fronto-cerebellar circuits in attention-deficit/hyperactivity disorder.
Attention-deficit/hyperactivity disorder (ADHD) has long been conceptualized as a neurobiological disorder of the prefrontal cortex and its connections. Circuits with the prefrontal cortex relevant to ADHD include dorsal frontostriatal, orbitofronto-striatal, and fronto-cerebellar circuits. Dorsal frontostriatal circuitry has been linked to cognitive control, whereas orbitofronto-striatal loops have been related to reward processing. Fronto-cerebellar circuits have been implicated in timing. Neurobiological dysfunction in any of these circuits could lead to symptoms of ADHD, as behavioral control could be disturbed by: 1) deficits in the prefrontal cortex itself; or 2) problems in the circuits relaying information to the prefrontal cortex, leading to reduced signaling for control. This article suggests a model for differentiating between interlinked reciprocal circuits with the prefrontal cortex in ADHD. If such a differentiation can be achieved, it might permit a neurobiological subtyping of ADHD, perhaps by defining "dorsal fronto-striatal," "orbitofronto-striatal," or "fronto-cerebellar" subtypes of ADHD. This could be useful as a template for investigating the neurobiology of ADHD and, ultimately, clinically.
Durston
Sarah
S
Neuroimaging Laboratory, Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. S.Durston@umcutrecht.nl
van Belle
Janna
J
de Zeeuw
Patrick
P
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D002531:Cerebellum / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology; D003342:Corpus Striatum / Q000503:physiopathology*; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008962:Models, Theoretical; D009434:Neural Pathways / Q000033:anatomy & histology / Q000503:physiopathology