title: The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.
abstract: Through neuromodulatory influences over fronto-striato-cerebellar circuits, dopamine and noradrenaline play important roles in high-level executive functions often reported to be impaired in attention-deficit/hyperactivity disorder (ADHD). Medications used in the treatment of ADHD (including methylphenidate, dextroamphetamine and atomoxetine) act to increase brain catecholamine levels. However, the precise prefrontal cortical and subcortical mechanisms by which these agents exert their therapeutic effects remain to be fully specified. Herein, we review and discuss the present state of knowledge regarding the roles of dopamine (DA) and noradrenaline in the regulation of corticostriatal circuits, with a focus on the molecular neuroimaging literature (both in ADHD patients and in healthy subjects). Recent positron emission tomography evidence has highlighted the utility of quantifying DA markers, at baseline or following drug administration, in striatal subregions governed by differential cortical connectivity. This approach opens the possibility of characterizing the neurobiological underpinnings of ADHD (and associated cognitive dysfunction) and its treatment by targeting specific neural circuits. It is anticipated that the application of refined and novel positron emission tomography methodology will help to disentangle the overlapping and dissociable contributions of DA and noradrenaline in the prefrontal cortex, thereby aiding our understanding of ADHD and facilitating new treatments.
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom. nd290@cam.ac.uk
authors.forename: Natalia
authors.initials: N
authors.lastname: Del Campo
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Chamberlain
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sahakian
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Robbins
mesh_terms: D000818:Animals; D001289:Attention Deficit Disorder with Hyperactivity / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D000697:Central Nervous System Stimulants / Q000494:pharmacology* / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D004298:Dopamine / Q000502:physiology*; D006801:Humans; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D009638:Norepinephrine / Q000502:physiology*; D049268:Positron-Emission Tomography / Q000379:methods*; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology
chemical_list: D000697:Central Nervous System Stimulants; D004298:Dopamine; D009638:Norepinephrine