Precision Medicine Care in ADHD: The Case for Neural Excitation and Inhibition

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current...

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Vydané v:Brain sciences Ročník 11; číslo 1; s. 91
Hlavní autori: Mamiya, Ping, Arnett, Anne, Stein, Mark
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland MDPI AG 13.01.2021
MDPI
Predmet:
amphetamine
Amphetamines
Anatomy
Attention deficit hyperactivity disorder
Biomarkers
Brain research
Catecholamines
Children
Dopamine
Electrophysiology
executive function
Hyperactivity
inhibitory control
Life span
Magnetic resonance spectroscopy
methylphenidate
Neostriatum
Neurobiology
Neurodevelopmental disorders
norepinephrine
Precision medicine
Scalp
Teenagers
γ-Aminobutyric acid
United States > US
norepinephrine
amphetamine
methylphenidate
dopamine
inhibitory control
executive function
ISSN:2076-3425, 2076-3425
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Abstract Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.
AbstractList Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.
Author Stein, Mark
Arnett, Anne
Mamiya, Ping
AuthorAffiliation 2 Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; arnettab@uw.edu (A.B.A.); mark.stein@seattlechildrens.org (M.A.S.)
1 Institute for Learning and Brain Sciences, University of Washington, Seattle, WA 98195, USA
AuthorAffiliation_xml – name: 2 Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; arnettab@uw.edu (A.B.A.); mark.stein@seattlechildrens.org (M.A.S.)
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  fullname: Stein, Mark
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33450814$$D View this record in MEDLINE/PubMed
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Keywords norepinephrine
amphetamine
methylphenidate
dopamine
inhibitory control
executive function
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Snippet Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including...
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SubjectTerms amphetamine
Amphetamines
Anatomy
Attention deficit hyperactivity disorder
Biomarkers
Brain research
Catecholamines
Children
Dopamine
Electrophysiology
executive function
Hyperactivity
inhibitory control
Life span
Magnetic resonance spectroscopy
methylphenidate
Neostriatum
Neurobiology
Neurodevelopmental disorders
norepinephrine
Precision medicine
Scalp
Teenagers
γ-Aminobutyric acid
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