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.
Neuroimaging Laboratory, Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. S.Durston@umcutrecht.nl
Sarah
S
Durston
Janna
J
van Belle
Patrick
P
de Zeeuw
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