NDLI: Brain functional domains inform therapeutic interventions in attention-deficit/hyperactivity disorder and pediatric bipolar disorder.

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Brain functional domains inform therapeutic interventions in attention-deficit/hyperactivity disorder and pediatric bipolar disorder.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Passarotti, Alessandra M. Pavuluri, Mani N.
Description	Country affiliation: United States Author Affiliation: Passarotti AM ( Pediatric BRAIN Center, Institute for Juvenile Research, University of Illinois at Chicago, 1747, West Roosevelt Road, M/C 747, Chicago, IL 60612, USA. apassarotti@psych.uic.edu)
Abstract	A deeper understanding of how the relationships between impulsivity, reward systems and executive function deficits may be similar or different in attention-deficit/hyperactivity disorder (ADHD) and pediatric bipolar disorder (PBD) is fundamental for better defining phenotypy in these two developmental illnesses, and moving towards improved treatment and intervention. We focus our article on recent neurocognitive and neuroimaging data examining the behavioral and neural aspects of poor behavior regulation, response inhibition and reward systems in ADHD and PBD. In light of recent research evidence, we propose that the common behavioral manifestations of impulsivity in ADHD and PBD may indeed originate from different neural mechanisms mediated by altered reward systems. In order to define and differentiate these mechanisms, unlike previous approaches, our theoretical model examines the interface of the dorsal frontostriatal circuit, involved in behavior regulation, and the ventral frontostriatal circuit, which is involved in reward-related and affect processes. Preliminary evidence suggests that the neural systems involved in impulsivity, reward systems and executive function engage differently in the two illnesses. In PBD, 'emotional impulsivity' is predominantly 'bottom-up' and emotionally/motivationally driven, and stems from ventral frontostriatal circuitry dysfunction. By contrast, in ADHD 'cognitive impulsivity' is predominantly 'top-down' and more 'cognitively driven', and stems from dorsal frontostriatal dysfunction. We discuss this evidence in view of clinically relevant questions and implications for illness-based intervention. We conclude that the reward-related mechanisms underlying the interactions between executive function, behavior regulation and impulsivity in PBD and ADHD may be differentially compromised, and in accordance differently shape the clinical symptoms of impulsivity and goal-directed behavior.
File Format	HTM / HTML
ISSN	14737175
e-ISSN	17448360
DOI	10.1586/ern.11.71
Journal	Expert Review of Neurotherapeutics
Issue Number	6
Volume Number	11
Language	English
Publisher	Taylor & Francis
Publisher Date	2011-06-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Therapeutics Discipline Neurology Attention Deficit Disorder With Hyperactivity Physiopathology Bipolar Disorder Brain Phenotype
Content Type	Text
Resource Type	Article
Subject	Neuroscience Neurology (clinical) Pharmacology (medical)

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