The neurobiological basis of ADHD

Ital J Pediatr. 2010 Dec 22;36(1):79. doi: 10.1186/1824-7288-36-79.


Attention-Deficit/Hyperactivity Disorder is not a single pathophysiological entity and appears to have a complex etiology. There are multiple genetic and environmental risk factors with small individual effect that act in concert to create a spectrum of neurobiological liability. Structural imaging studies show that brains of children with Attention-Deficit/Hyperactivity Disorder are significantly smaller than unaffected controls. The prefrontal cortex, basal ganglia and cerebellum are differentially affected and evidence indicating reduced connectivity in white matter tracts in key brain areas is emerging. Genetic, pharmacological, imaging, and animal models highlight the important role of dopamine dysregulation in the neurobiology of Attention-Deficit/Hyperactivity Disorder. To date, stimulants are the most effective psychopharmacological treatments available for Attention-Deficit/Hyperactivity Disorder. Currently only immediate release methylphenidate and atomoxetine are approved for the treatment of ADHD in Italy. Drug treatment should always be part of a comprehensive plan that includes psychosocial, behavioural and educational advice and interventions.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Atomoxetine Hydrochloride
  • Attention Deficit Disorder with Hyperactivity / metabolism
  • Attention Deficit Disorder with Hyperactivity / pathology
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / therapy
  • Basal Ganglia / physiopathology
  • Behavior Therapy
  • Brain / drug effects
  • Brain / metabolism
  • Brain / pathology
  • Brain / physiopathology*
  • Central Nervous System Stimulants / therapeutic use
  • Cerebellum / physiopathology
  • Dopamine / metabolism
  • Dopamine Agents / metabolism
  • Dopamine Uptake Inhibitors / therapeutic use
  • Drug Therapy, Combination
  • Evidence-Based Medicine
  • Humans
  • Italy
  • Methylphenidate / therapeutic use
  • Prefrontal Cortex / physiopathology
  • Propylamines / therapeutic use
  • Risk Factors
  • Treatment Outcome


  • Central Nervous System Stimulants
  • Dopamine Agents
  • Dopamine Uptake Inhibitors
  • Propylamines
  • Methylphenidate
  • Atomoxetine Hydrochloride
  • Dopamine