Dopamine Reward Pathway in Adult ADHD
- Samuele Cortese, MD, PhDDepartment of PsychiatryTours UniversityTours, France;
- F. Xavier Castellanos, MD francisco.castellanos@nyumc.orgPhyllis Green and Randolph Cowen Institute for Pediatric NeuroscienceNew York University Child Study CenterNew York
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY
- DIAGNOSIS
- DOPAMINE
- HYPOTHALAMIC DISEASES
- NEURAL PATHWAYS
- SEX FACTORS
- SYNAPTIC TRANSMISSION
To the Editor: Dr Volkow and colleagues1 reported measures of dopamine synaptic markers in a sample of adults with ADHD and in healthy controls. As the authors noted, significantly lower dopamine D2/D3 receptor availability in the hypothalamus of ADHD participants might provide a neurobiological basis for often overlooked associations between ADHD and somatic alterations suggestive of hypothalamic dysfunction, such as sleep/arousal disturbances, obesity/overweight, and abnormal stress responses (via altered hypothalamic-pituitary-adrenal axis).
Hypothalamic abnormalities might also underlie other dysfunctions that have recently begun to be addressed in ADHD. Besides its roles in sleep, appetite, and stress response regulation, the hypothalamus is involved in the control of the autonomic system.2 Preliminary data suggest that children with ADHD exhibit dysfunction in cardiac autonomic regulation.3 The hypothalamus contributes to regulation of water balance and thirst,2 and thirst has been reported in a significantly higher proportion of children …
