1. ADHD Symptoms in Children Slideshow Pictures
2. Take the ADHD Quiz
3. ADHD in Adults Slideshow Pictures

Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The pathogenesis (cause) of ADHD has not been totally defined. One theory springs from observations regarding variations in functional brain-imaging studies between those with and without symptoms. Similar variations have been shown in studies of the structure of the brain of affected and nonaffected individuals. Animal studies have demonstrated differences in the chemistry of brain transmitters involved with judgment, impulse control, alertness, planning, and mental flexibility. A genetic predisposition has been demonstrated in (identical) twin and sibling studies. If one identical twin is diagnosed with ADHD, there is a 92% probability of the same diagnosis in the twin sibling. When comparing nonidentical twin sibling subjects, the probability falls to 33%. Overall population incidence is felt to be 8%-10%.

Genes that control the relative levels of chemicals in the brain called neurotransmitters seem to be different in ADHD, and levels of these neurotransmitters are out of normal balance.

• MRI and other imaging studies suggest that these imbalances occur in parts of the brain that control certain types of movement and executive functions.
• These areas of the brain may be smaller and/or less active in people with ADHD.

The six major tasks of executive function that are most commonly distorted with ADHD are the following:

• Shifting from one mind-set or strategy to another (that is, flexibility)
• Organization (for example, anticipating both needs and problems)
• Planning (for example, goal setting)
• Working memory (that is, receiving, storing, then retrieving information within short-term memory)
• Separating emotions from reason
• Regulating speech and movements appropriately

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