Neurobiology of ADHD. Neuropharmacology. 2009;57:579-589. [PMID: 19627998 DOI: 10.1016/j.neuropharm.2009.07.026]

Attention-deficit/hyperactivity phenotype in mice lacking the cyclin-dependent kinase 5 cofactor p35

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) may result from delayed establishment of corticolimbic circuitry or perturbed dopamine (DA) neurotransmission. Despite the widespread use of stimulants to treat ADHD, little is known regarding their long-term effects on neurotransmitter levels and metabolism. Cyclin-dependent kinase 5 (Cdk5) regulates DA signaling through control of synthesis, postsynaptic responses, and vesicle release. Mice lacking the Cdk5-activating cofactor p35 are deficient in cortical lamination, suggesting altered motor/reward circuitry.

METHODS

We employed mice lacking p35 to study the effect of altered circuitry in vivo. Positron emission tomography measured glucose metabolism in the cerebral cortex using 2-deoxy-2-[¹⁸F] fluoro-d-glucose as the radiotracer. Retrograde dye tracing and tyrosine hydroxylase immunostains assessed the effect of p35 knockout on the medial prefrontal cortex (PFC), especially in relation to mesolimbic circuit formation. We defined the influence of Cdk5/p35 activity on catecholaminergic neurotransmission and motor activity via examination of locomotor responses to psychostimulants, monoamine neurotransmitter levels, and DA signal transduction.

RESULTS

Here, we report that mice deficient in p35 display increased glucose uptake in the cerebral cortex, basal hyperactivity, and paradoxical decreased locomotion in response to chronic injection of cocaine or methylphenidate. Knockout mice also exhibited an increased susceptibility to changes in PFC neurotransmitter content after chronic methylphenidate exposure and altered basal DAergic activity in acute striatal and PFC slices.

CONCLUSIONS

Our findings suggest that dysregulation of Cdk5/p35 activity during development may contribute to ADHD pathology, as indicated by the behavioral phenotype, improperly established mesolimbic circuitry, and aberrations in striatal and PFC catecholaminergic signaling in p35 knockout mice.

Oxidative imbalance in child and adolescent patients with attention-deficit/hyperactivity disorder

Various psychological, social, genetic, and biochemical factors are thought to be involved in the aetiology of attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated the biochemical basis of ADHD. In the present study, we evaluate whether levels of nitric oxide pool (NO+NO(2)(-)) and malondialdehyde (MDA) oxidants as well as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) antioxidant enzyme activities are associated with ADHD. The sample population consisted of thirty-five child or adolescent patients diagnosed with ADHD according to DSM-IV-TR criteria. Thirty-five healthy subjects also were included in the study as controls. Venous blood samples were collected, and NO pool and MDA levels as well as SOD, GSH-Px, and CAT activities were measured. NO and MDA levels of the patients were significantly higher than the controls. GSH-Px activities of the patients were significantly lower than the controls. CAT activities of the patients were higher than the controls; however, the difference was not statistically significant. There were no significant differences in SOD activity between the patient and control groups. Remarkably high levels of NO pool and MDA oxidants as well as low GSH-Px activities suggest an oxidative imbalance in paediatric patients with ADHD. CAT activities may be increased in response to increased oxidant levels.

Contributions of the orbitofrontal cortex to impulsive choice: interactions with basal levels of impulsivity, dopamine signalling, and reward-related cues

RATIONALE

Individual differences in impulsive decision-making may be critical determinants of vulnerability to impulse control disorders and substance abuse, yet little is known of their biological or behavioural basis. The orbitofrontal cortex (OFC) has been heavily implicated in the regulation of impulsive decision-making. However, lesions of the OFC in rats have both increased and decreased impulsivity in delay-discounting paradigms, where impulsive choice is defined as the selection of small immediate over larger delayed rewards.

OBJECTIVES

Reviewing the different methods used, we hypothesized that the effects of OFC inactivation on delay discounting may be critically affected by both subjects' baseline level of impulsive choice and the presence or absence of a cue to bridge the delay between selection and delivery of the large reward.

RESULTS

Here, we show that OFC inactivation increased impulsive choice in less impulsive rats when the delay was cued, but decreased impulsive choice in highly impulsive rats in an uncued condition.

CONCLUSIONS

Providing explicit environmental cues to signal the delay-to-reinforcement appears to change the way in which the OFC is recruited in the decision-making process in a baseline-dependent fashion. This change may reflect activation of the dopamine system, as intra-OFC infusions of dopamine receptor antagonists increased impulsive choice but only when the delay was cued.

Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both highly heritable neurodevelopmental disorders. Evidence indicates both disorders co-occur with a high frequency, in 20-50% of children with ADHD meeting criteria for ASD and in 30-80% of ASD children meeting criteria for ADHD. This review will provide an overview on all available studies [family based, twin, candidate gene, linkage, and genome wide association (GWA) studies] shedding light on the role of shared genetic underpinnings of ADHD and ASD. It is concluded that family and twin studies do provide support for the hypothesis that ADHD and ASD originate from partly similar familial/genetic factors. Only a few candidate gene studies, linkage studies and GWA studies have specifically addressed this co-occurrence, pinpointing to some promising pleiotropic genes, loci and single nucleotide polymorphisms (SNPs), but the research field is in urgent need for better designed and powered studies to tackle this complex issue. We propose that future studies examining shared familial etiological factors for ADHD and ASD use a family-based design in which the same phenotypic (ADHD and ASD), candidate endophenotypic, and environmental measurements are obtained from all family members. Multivariate multi-level models are probably best suited for the statistical analysis.

Identifying the neurobiology of altered reinforcement sensitivity in ADHD: a review and research agenda

ADHD is associated with altered reinforcement sensitivity, despite a number of inconsistent findings. This review focuses on the overlap and differences between seven neurobiologically valid models and lists 15 predictions assessing reinforcement sensitivity in ADHD. When comparing the models it becomes clear that there are great differences in the level of explanation. For example, some models try to explain a single core deficit in terms lower-level reinforcement systems, such as the dopamine transfer to reward back in time. Other models explain multiple deficits, by describing higher-level systems, such as impaired bottom-up prefrontal activation. When reviewing the available experimental evidence in support of the predictions, most experimental studies have been focusing on behavioral changes in the face of reward and response cost over no-reward, and on delay discounting. There is currently a lack in studies that focus on explaining underlying cognitive or neural mechanisms of altered reinforcement sensitivity in ADHD. Additionally, there is a lack in studies that try to understand what subgroup of children with ADHD shows alterations in reinforcement sensitivity. The scarcity in studies testing the neurobiological predictions is explained partly by a lack in knowledge how to test some of these predictions in humans. Nevertheless, we believe that these predictions can serve as a useful guide to the systematic evaluation of altered reinforcement sensitivity in ADHD.