Cortical ChangesCortical Changes

In In

Attention Deficit Attention Deficit Hyperactivity DisorderHyperactivity Disorder

(ADHD)(ADHD)

This Presentation Will Help YouThis Presentation Will Help YouUnderstand the brain anatomy associated

with ADHDUnderstand some of the causes of ADHDUnderstand some of the symptoms of

ADHD

Other Power Point Presentations on this Site Will Give You More Basic Understanding

About Learning Differences

ADHDADHDIs often referred to as ADDHas a symptom pattern that is evident

before age 7 yearsHas a life long influence on the individual

This presentation will help you understand the cortical (brain) differences that have

been found with this syndrome.

SyndromeSyndromeA syndrome is a condition which has a

specific set of symptoms.These symptoms are well documented.With ADHD, symptoms are documented

in the DSM IV which is a reference book compiled by psychiatrists for conditions that affect mental health.

Syndromes are organic, that is, they relate to how the body functions.

Let’s Look At Difference In The Let’s Look At Difference In The Cerebral Cortex That Have Been Cerebral Cortex That Have Been Found In Individuals With ADHD.Found In Individuals With ADHD.

There Are Several Studies That There Are Several Studies That Explore Anatomical Differences In Explore Anatomical Differences In

ADHD Individuals. ADHD Individuals.

These Changes Include:These Changes Include:

Overall brain size The frontal lobe is responsible for

– executive functioning – regulating impulse control – attention– other thought processes

Frontal lobe

The brain of ADHD children was found to be 3% smaller in volume compared to those of normal children.

Brain size differences remained relatively the same (allowing for growth) through a child's development, suggesting that differences are fixed.

Pet Scans Also Show Distinct Pet Scans Also Show Distinct Differences In Cortical Size With Differences In Cortical Size With

ADHD.ADHD.

Speculation As To The Reasons For Speculation As To The Reasons For Decreased Cortical Size…Decreased Cortical Size…

Include many factors, but one has been ruled-out.

Some scientists speculated that brain size was affected by cortical stimulants, such as Ritalin or Adderall, which were routinely prescribed for ADHD individuals.

However, research has proven otherwise.

Medication To Help ADHD Does Not Medication To Help ADHD Does Not Affect Brain SizeAffect Brain Size

Brain differences among ADHD children who took medication such as Ritalin, and those who did not take medication were similar.

This suggests that medication does not cause changes in brain development, as some researchers have suggested.

Lack Of Change In The Physiology Of Cortical Lack Of Change In The Physiology Of Cortical Size Supports Congenital EtiologySize Supports Congenital Etiology

The fact that the brain differences remain largely unchanged after ten or more years suggests that the cause of ADHD occurs prenatally.

ADHD could be genetic, occur during the birth process, or occur early in life.

This gives researchers directions to examine regarding the causes of ADHD and variations of the disorder.

In Addition To In Addition To SizeSize, Brain , Brain ChemistryChemistry Is Affected In ADHDIs Affected In ADHD

Neurotransmitters Are Affected In Neurotransmitters Are Affected In ADHD IndividualsADHD Individuals

Children in the ADHD group seemed to have decreased levels of GABA, which might explain poor impulse control

And higher levels of glutamate, which is excitatory

and can be toxic to nerve cells in high amounts.

Both GABA and glutamate are neurotransmitters, or brain chemical messengers.

In addition to having brains which are slightly smaller than normal, there are other cortical differences in children with ADHD.

Researchers have long suspected that the disorder is caused by a dysfunction in the frontal lobes of the brain which control emotions and impulses.

The frontal lobe is thought to be the seat of emotion in the individual. Many ADHD individuals have angry outbursts and are easily irritated.

It is postulated that emotional outbursts are also due to easy fatigability.

ADHD individuals use an enormous amount of energy paying attention, even when they are on medication.

Therefore…Therefore… They are more easily

fatigued More easily irritated And tend to have

difficulty controlling behavior.

ALSO…ALSO…

Studies have shown that ADHD individuals often have lower levels of dopamine, a neurotransmitter that is implicated in depression.

This finding, as well as the genetic connection, may help explain why parents, particularly mothers, of ADHD individuals are often diagnosed with recurrent depression.

Frontal Lobe involvement…Frontal Lobe involvement…

explains why ADHD individuals have difficulty modulating both emotion and attention.

Their irritability is not only due to fatigue, but also to a compromised ability to control emotions.

..Children and teenagers with ADHD

have less tissue in parts of the brain's prefrontal and temporal lobes than those without attentional disorders.

This was reported by neurologist Elizabeth R. Sowell of the University of California, Los Angeles School of Medicine and her coworkers.

Children with ADHD display an excessive density of the neuron-rich tissue known as gray matter in regions of the cortex

toward the back of the brain.

Brain Differences In ADHD Are Well Brain Differences In ADHD Are Well Documented.Documented.

Changes in brain physiology for ADHD and Reading Disorders have been documented by several researchers.

But not all disorders

have brain changes that are easy to identify.

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LaSalle College High School

This Presentation Was Compiled By:This Presentation Was Compiled By:

Jo Ann Curcio Cohen, Ph.D.Licensed Psychologist

Learning Specialist

The David Program