Neurobiology of attention-deficit hyperactivity disorder: historical challenges and emerging frontiers

IF 34.7 1区 医学 Q1 Neuroscience Nature Reviews Neuroscience Pub Date : 2024-10-24 DOI:10.1038/s41583-024-00869-z
Sanju Koirala, Gracie Grimsrud, Michael A. Mooney, Bart Larsen, Eric Feczko, Jed T. Elison, Steven M. Nelson, Joel T. Nigg, Brenden Tervo-Clemmens, Damien A. Fair
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Abstract

Extensive investigations spanning multiple levels of inquiry, from genetic to behavioural studies, have sought to unravel the mechanistic foundations of attention-deficit hyperactivity disorder (ADHD), with the aspiration of developing efficacious treatments for this condition. Despite these efforts, the pathogenesis of ADHD remains elusive. In this Review, we reflect on what has been learned about ADHD while also providing a framework that may serve as a roadmap for future investigations. We emphasize that ADHD is a highly heterogeneous disorder with multiple aetiologies that necessitates a multifactorial dimensional phenotype, rather than a fixed dichotomous conceptualization. We highlight new findings that suggest a more brain-wide, ‘global’ view of the disorder, rather than the traditional localizationist framework, which asserts that a limited set of brain regions or networks underlie ADHD. Last, we underscore how underpowered studies that have aimed to associate neurobiology with ADHD phenotypes have long precluded the field from making progress. However, a new age of ADHD research with refined phenotypes, advanced methods, creative study designs and adequately powered investigations is beginning to put the field on a good footing. Indeed, the field is at a promising juncture to advance the neurobiological understanding of ADHD and fulfil the promise of clinical utility.

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注意缺陷多动障碍的神经生物学:历史挑战与新兴前沿
从遗传学到行为学研究等多个层面的广泛调查试图揭示注意力缺陷多动障碍(ADHD)的机理基础,以期开发出有效的治疗方法。尽管做出了这些努力,但注意力缺陷多动障碍(ADHD)的发病机制仍然难以捉摸。在这篇综述中,我们回顾了已了解到的有关多动症的知识,同时还提供了一个框架,可作为未来研究的路线图。我们强调,ADHD 是一种具有多种病因的高度异质性疾病,因此需要一种多因素维度表型,而不是一种固定的二分法概念。我们强调了一些新发现,这些新发现表明,应从更加全脑、"全局 "的角度来看待多动症,而不是传统的局部化框架,后者认为多动症是由一组有限的大脑区域或网络引起的。最后,我们强调,长期以来,那些旨在将神经生物学与多动症表型联系起来的研究一直未能取得进展。然而,ADHD 研究进入了一个新时代,其表型的完善、方法的先进、研究设计的创新以及研究力量的充足,正开始为这一领域奠定良好的基础。事实上,该领域正处于一个大有希望的关口,可以推进对多动症的神经生物学理解,并实现临床应用的承诺。
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来源期刊
Nature Reviews Neuroscience
Nature Reviews Neuroscience 医学-神经科学
CiteScore
35.00
自引率
0.60%
发文量
104
审稿时长
6-12 weeks
期刊介绍: Nature Reviews Neuroscience is a journal that is part of the Nature Reviews portfolio. It focuses on the multidisciplinary science of neuroscience, which aims to provide a complete understanding of the structure and function of the central nervous system. Advances in molecular, developmental, and cognitive neuroscience have made it possible to tackle longstanding neurobiological questions. However, the wealth of knowledge generated by these advancements has created a need for new tools to organize and communicate this information efficiently. Nature Reviews Neuroscience aims to fulfill this need by offering an authoritative, accessible, topical, and engaging resource for scientists interested in all aspects of neuroscience. The journal covers subjects such as cellular and molecular neuroscience, development of the nervous system, sensory and motor systems, behavior, regulatory systems, higher cognition and language, computational neuroscience, and disorders of the brain. Editorial decisions for the journal are made by a team of full-time professional editors who are PhD-level scientists.
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