51. The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics
- Author
-
Edmund J.S. Sonuga-Barke
- Subjects
Cognitive Neuroscience ,Models, Neurological ,Dopaminergic ,Ventral striatum ,Mesolimbic pathway ,Models, Psychological ,Nucleus accumbens ,medicine.disease ,Behavioral Neuroscience ,Mental Processes ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,Attention Deficit Disorder with Hyperactivity ,Dopamine ,Neural Pathways ,medicine ,Humans ,Attention deficit hyperactivity disorder ,Cognition Disorders ,Prefrontal cortex ,Psychology ,Reinforcement, Psychology ,Neuroscience ,Executive dysfunction ,medicine.drug - Abstract
The currently dominant neuro-cognitive model of Attention Deficit Hyperactivity Disorder (AD/HD) presents the condition as executive dysfunction (EDF) underpinned by disturbances in the fronto-dorsal striatal circuit and associated dopaminergic branches (e.g. meso-cortical). In contrast, motivationally-based accounts focus on altered reward processes and implicate fronto-ventral striatal reward circuits and those meso-limbic branches that terminate in the ventral striatum especially the nucleus accumbens. One such account, delay aversion (DEL), presents AD/HD as a motivational style-characterised by attempts to escape or avoid delay-arising from fundamental disturbances in these reward centres. While traditionally regarded as competing, EDF and DEL models have recently been presented as complimentary accounts of two psycho-patho-physiological subtypes of AD/HD with different developmental pathways, underpinned by different cortico-striatal circuits and modulated by different branches of the dopamine system. In the current paper we describe the development of this model in more detail. We elaborate on the neuro-circuitry possibly underpinning these two pathways and explore their developmental significance within a neuro-ecological framework.
- Published
- 2003