Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder. This means there are differences in the ADHD brain that affect a child’s development. ADHD does not influence intelligence. It does, however, affect a person’s ability to regulate attention and emotions, and it results in hyperactivity and impulsivity as well as organization problems.
“Take a deep breath and press the following buttons on your activity thermostat” makes sense if the wiring is standard, but not if the wires are connected differently, as they are in children and adults with ADHD. The most current research on brain imaging is starting to let us trace the wiring, so we can untangle the misconceptions that experts, as well as those with ADHD, have about the disorder and the brain. Our new understanding of the brain promises to change the way we treat ADHD.
Dopamine is a neurotransmitter that contributes to essential skills such as motivation and decision-making. In children with ADHD, some dopamine pathways are thought to be disrupted, leading to lower levels of dopamine. This could cause some of the typical characteristics associated with the disorder.
- The ADHD vs. Non-ADHD Brain
- The Brain Up Close
- Face It — People with ADHD Are Wired Differently
- How Is the ADHD Brain Different
- Brain Structure
- How Is ADHD Tested and Diagnosed?
- Differences in the ADHD Brain
- Video for “What does an adhd brain look like?”
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The ADHD vs. Non-ADHD Brain
Researchers at Cambridge, England, and Oulu, Finland, followed 49 adolescents diagnosed with ADHD at age 16 and examined their brain structure and memory function in young adulthood (between 20 to 24 years old), compared to a control group of 34 young adults. The results showed that the group diagnosed in adolescence had reduced brain volume as adults, leading to poorer memory function, even if they no longer met the diagnostic checklist criteria for ADHD. Researchers saw reduced gray matter in a region deep within the brain known as the caudate nucleus, the brain region that integrates information across different parts of the brain and supports cognitive functions, including memory.
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The Brain Up Close
Alex wasn’t asking Dr. Mason to quote studies, just to help him reach some of his goals. Dr. Mason was about to say “50-50,” to emphasize that the effects of medication and non-medication therapies are both important, but what came out was, “They’re both essential. It’s 100-100. Neither of them matters much without the other.”
Serving as our control center, the brain needs to both send and receive electrical signals or “messages” throughout the body. The brain is able to do this via nerve cells (neurons). However, there are gaps between neurons. Neurotransmitters are the chemical messengers that fill the gap and allow for messages to be passed along.
Face It — People with ADHD Are Wired Differently
Many of the characteristics of ADHD are related to executive functioning. This refers to a set of mental skills that include working memory, emotional control, and complex problem-solving. Essentially, executive functions are the skills we all use to manage day-to-day tasks, such as time management, staying organized, and planning. While there are several different parts of the brain that contribute to executive functioning, the prefrontal cortex is especially important in regulating these skills.
On a hot summer day in my new office, my client and I were shivering cold. “The air conditioning is hyperactive, maybe?” I jokingly wondered as we pulled on sweaters. I turned the thermostat up to 76 degrees, then 80, but the cold air wouldn’t stop.
Another interesting finding was that the amygdala and hippocampus are smaller in the brains of people with ADHD. These areas are responsible for emotional processing and impulsivity and had previously not been definitively connected to ADHD.
How Is the ADHD Brain Different
One study published in 2010 found that children with ADHD do not have the same connections between the frontal cortex of the brain and the visual processing area. This suggests that the ADHD brain processes information differently than a non-ADHD brain.
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“Our HVAC system seems overactive,” I explained later to my husband. “Could it be too big for the office space?”
How Is ADHD Tested and Diagnosed?
Aron Janssen, MD is board certified in child, adolescent, and adult psychiatry and is the vice chair of child and adolescent psychiatry Northwestern University.
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Differences in the ADHD Brain
What this means is ADHD is not a difference in behavioral preference. Instead, ADHD appears to be partially attributed to a difference in how the brain is structured. What may look like behavioral choices — laziness, sloppiness, and forgetfulness — are likely due to differences in brain structure.
Ever since it was first diagnosed in the 1960s, ADHD (attention-deficit hyperactivity disorder) has been a controversial topic. Even experts often debate over how the disorder should be defined and what causes it.