Brain abnormality found in boys with attention deficit hyperactivity disorder

March 18, 2009

Researchers trying to uncover the mechanisms that cause attention deficit hyperactivity disorder and conduct disorder have found an abnormality in the brains of adolescent boys suffering from the conditions, but not where they expected to find it.

Boys with either or both of these disorders exhibited a different pattern of brain activity than normally developing boys when they played a simple game that sometimes gave them a monetary reward for correct answers, according to a new study by a University of Washington research team.

The research focused on two brain areas, the striatum and anterior cingulate cortex. The striatal region is a network of structures in the mid brain that motivates people to engage in pleasurable or rewarding behavior. The anterior cingulate is higher in the brain and normally activates when an expected reward stops. However, this process, called extinction, doesn't occur, at least as quickly, in boys with attention deficit hyperactivity or conduct disorders. Instead, the striatal region continues to be activated, said Theodore Beauchaine, a UW associate professor of psychology and senior author of the paper.

"When children engage in impulsive behavior they are looking to stimulate themselves and have fun. Children with attention deficit hyperactivity disorder are always looking to have fun and that is what gets them in trouble," he said. "A behavior should stop when the reward stops. When you stop the reward for children with these disorders, they continue to focus on the reward long afterward and the anterior cingulate does not appear to become activated."

Attention deficit hyperactivity disorder is one of the most common mental disorders among children, affecting between 3 and 5 percent of school-age youngsters, or an estimated 2 million.

The researchers used functional magnetic resonance imaging to compare brain activity in 19 boys with either or both disorders and 11 normally developing boys. The adolescents ranged in age from 12 to 16.

Their brains were scanned while they played the game. The boys looked at a screen and there was a button under each of their thumbs. When a light flashed on the left or right side of the screen they were instructed to press the button on that side. The screen lit up very fast, up to 100 times a minute. The boys received five cents for each correct response and could win up to $50. They were not penalized for wrong answers and their accumulated winnings showed up on the screen.

Each boy had four five-minute blocks of trials. The first and third trials involved opportunities to earn money. The second and fourth trials did not involve winning money, but the boys were told to keep playing the game because the game would change at some point.

Beauchaine said there was no difference in the accuracy or speed - the behavioral response - between the two groups. But there was a difference in brain activation. When the non-reward blocks came up the anterior cingulate lit up for normally developing boys, but those with either of the disorders, which frequently co-occur, continued to only show activation in the striatum.

"This shows there is an abnormality, but not in the place we expected to find it. We expected to find a difference in the way the striatum functions, but instead found it in anterior cingulate functioning," said Beauchaine.

University of Washington

---

---

	Parenting ADD/ADHD Children: The Definitive Guide for Parents Raising a Child with Attention Deficit Hyperactivity Disorder by Positive Steps Publishing In this Book, Experienced Children's Medical and Developmental Researcher Elizabeth Miles Teaches You: ✓ What ADHD IS and IS NOT ✓ What is Potential Causing your child's ADHD ✓ Whether drugs are the right option, the side effects and the alternatives ✓ What nutritionists will tell you about ADHD that your doctor won't ✓ How to overcome the feeling of being powerless and channel your parental instincts constructively ✓ What you can do to help your ADHD child succeed academically ✓ How to use exercise to burn off excess energy and improve focus ✓ How to improve behavior at home and lead a calmer, stress-free home life ✓ Which simple diet and nutrition changes could dramatically improve your child's life ✓ And much,...
	What Does Everybody Else Know That I Don't?: Social Skills Help for Adults with Attention Deficit/Hyperactivity Disorder by Michele Novotni PhD (Author), Randy Petersen (Author) Focusing on social skills training for adults with attention deficit/hyperactivity disorders (AD/HD), this book offers solutions for tackling behavior that is often inattentive, impulsive, and hyperactive. Advice is given on how to handle common social problems such as manners, etiquette, communication, subtext, listening, and interpersonal relationships. The format of the book is designed for AD/HD learning styles and includes true stories, practical exercises, and tips that keep those with AD/HD reading. Adults with AD/HD learn how to identify behaviors in themselves that can cause problems in social relationships.
	Attention-Deficit Hyperactivity Disorder, Third Edition: A Handbook for Diagnosis and Treatment by Russell A. Barkley PhD ABPP ABCN (Author) This handbook presents extensive knowledge on the nature, diagnosis, assessment, and treatment of ADHD. Provided are authoritative guidelines for understanding and managing the challenges ADHD poses to children, adolescents, and adults in a range of settings. All chapters conclude with user-friendly Key Clinical Points. Note: Practitioners wishing to implement the assessment and treatment recommendations in the Handbook are advised to purchase the companion Workbook, which contains a full set of forms, questionnaires, and handouts, in a large-size format with permission to photocopy. (20080101)
	Attention-Deficit Hyperactivity Disorder, Third Edition: A Clinical Workbook by Russell A. Barkley PhD ABPP ABCN (Author), Kevin R. Murphy PhD (Author) This user-friendly workbook provides a master set of the assessment and treatment forms, questionnaires, and handouts recommended by Barkley in the third edition of the Handbook. Formatted for easy photocopying, many of these materials are available from no other source. Featured are interview forms and rating scales for use with parents, teachers, and adult clients; helpful checklists and fact sheets; daily school report cards for monitoring academic progress; and more.
	100 Questions & Answers About Attention Deficit Hyperactivity Disorder (ADHD) in Women and Girls by Dr. Patricia Quinn (Author) If you are a woman who has been diagnosed with attention-deficit hyperactivity disorder (ADHD), or the parent of a girl with the condition, this book offers help. 100 Questions & Answers About Attention-Deficit Hyperactivity Disorder (ADHD) in Women and Girls provides authoritative, practical answers to common questions about this disorder. Written by a renowned ADHD specialist, this book presents important information about common symptoms, the diagnosis process, management, and sources of support for women and girls with ADHD. An invaluable resource, this book provides the necessary tools for anyone coping with the emotional turmoil caused by ADHD.
	Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, Second Edition by Russell A. Barkley (Author), Kevin R. Murphy (Author) This 8.5 x 11 comb-bound workbook provides a master set of the assessment and treatment forms, questionnaires, and handouts recommended by Barkley in Attention-Deficit Hyperactivity Disorder:A Handbook for Diagnosis and Treatment, Second Edition. Formatted for easy photocopying, many of these materials are available from no other source. All child and adult interview forms and rating scales have been completely revised for DSM-IV and new norms for many of the scales have been provided. Also included are a fact sheet for parents and teachers of children with ADHD, as well as ADHD-diagnosed adults; daily school report cards for monitoring academic progress; and more.
	Understanding A.D.H.D.: A Parent's Guide to Attention Deficit Hyperactivity Disorder in Children by Christopher Green (Author) In his typically freindly and clear style, the ever-popular Dr Chris Green, with Dr Kit Chee, explains the causes and treatments of this distressing condition which affects the learning and behaviour of up to 1 in 10 children in this country. Fully revised to take account of the latest developments in the treatment and diagnosis of ADHD, this book for parents, teachers and health professionals dispels the myths and gives a clear overview of ADHD: the causes, the behaviours and the treatments. It is full of well-tried, practical strategies to help cope with common problems such as inattention, underachievement and impulsiveness. Topics covered include: 1. The causes, how to help improve behaviour at home and at school. 2. Making the diagnosis, medication and alternative therapies. 3. Hints...
	Scattered Minds: Hope and Help for Adults with Attention Deficit Hyperactivity Disorder by Lenard Adler (Author), Mari Florence (Author) A practical, authoritative book on an increasingly talked-about condition that affects more than 8 million American adults. Dr. Lenard Adler, director of the Adult ADHD Program at New York University School of Medicine, presents the latest findings on Attention Deficit Hyperactivity Disorder. In Scattered Minds, he reveals hidden warning signs, debunks common misconceptions, and offers information on obtaining an accurate diagnosis, along with treatment options that include cutting-edge medications and proven coping strategies. Includes a screening quiz.
	Understanding My Attention-Deficit/Hyperactivity Disorder by Kara T Tamanini (Author) Understanding my ADHD, is written as an introduction for children who are being evaluated for ADHD or who have recently been diagnosed with ADHD. The book is a story about a child named Tommy, who is struggling in school and who always seems to be in trouble. The author's story explains the symptoms of ADHD in kid-friendly language and offers hope and encouragement to a child that with work things can get better. "Young children always have questions, but those questions may not always be easy to answer. In her new kid-friendly book, Understanding My Attention Deficit Hyperactivity Disorder, Kara Tamanini has made that process much simpler. In this sensitive book, easily understood by even preschoolers, Mr. Timmons, a kindly shop owner, shares his childhood experiences with Tommy, a...
	ADHD: Attention-Deficit Hyperactivity Disorder in Children, Adolescents, and Adults by Paul H. Wender (Author) Paul Wender began his career treating children with ADHD 37 years ago and has treated adults with the disorder for almost 30 years. His exhaustive research and insight gained from clinical practice led to the first book about ADHD in children (Minimal Brain Dysfunction in Children, 1971). Continuing research revealed that in many instances ADHD persisted into adult life, and that adult ADHD included symptoms that were not present in childhood. These findings resulted in his 1995 book Attention Deficit Hyperactivity Disorder in Adults. He also authored the first book for the parents of children with ADHD, The Hyperactive Child in 1974. Now, in this revised and updated edition of ADHD he presents the definitive resource on Attention Deficit Hyperactivity Disorder. In his discussion...