Six Unknown Facts About the ADHD Brain

The attention deficit brain’s functioning is described by two leading authorities on ADHD, along with several reasons why it is not always operating at its best.



How does the ADHD brain process stimulants?

The first-line stimulant drugs have an easily measurable stimulant component, but it is unclear how and why this stimulation helps with attention deficit disorder (ADD or ADHD). Currently on the market, 43 drugs stimulate similarly to amphetamine and methylphenidate, however only three of those drugs effectively treat ADHD. It gets worse with the others. A medicine cannot function in an ADHD brain by itself; it needs to be more than just a stimulant.


A PET scan investigation was conducted to track the location of a specifically formulated methylphenidate solution in the human brain. It was widely anticipated that it would travel to either a dopamine or adrenaline-rich region in the fronto-parietal cortex. No, it didn’t. Rather, it was actively extracted from the circulation and concentrated in the corpus striatum, a single region in the precise center of the brain.


Adrenaline and dopamine are not active in the striatum. You have an executive assistant in the striatum. It looks through every thought, emotion, and experience you have and delivers the most significant thing to your cortex for consideration. Everything else is managed in the background.


The striatum functions 99 percent of the same as it does in neurotypical brains, according to the current hypothesis of ADHD. It transmits five or six items to the frontal cortex, with no specific weight assigned to any one of them, instead of just one significant item. Untreated ADHD is characterized by five items that constantly race through your mind for no apparent reason. The striatum functions as intended with the assistance of the ADHD drugs. —Mr. William Dodson, Jr.



Can stimulants be safely used on an ADHD brain?

A long time ago, people were unjustly afraid of the long-term repercussions on the brain of taking drugs in the stimulant class every day for the rest of their lives. We are aware of the response. The initial data originate from the application of stimulants in the management of narcolepsy, a sleep disease. Studies on patients who have used the same daily drugs for ADHD for 40–50 years have not identified a single long-term issue. The Milwaukee Study, which has been studying ADHD for almost 28 years, is the longest. So far, the only risk factor linked to ADHD has been not using medication to treat the problem rather than the drug itself. —William Dodson, M.D.



Why are methylphenidate and amphetamine ineffective for my child or me?

Over time, it has become apparent that the appropriate chemical, at the appropriate amount, for each distinct child or adult should offer significant advantages with almost no adverse effects. Nevertheless, a lot of parents discovered that their kid did not respond well to the two stimulant drugs, amphetamine (Adderall, Vyvanse, etc.) and methylphenidate (Ritalin, Concerta, etc.). We now understand why.


It turns out that only roughly half of patients benefit from the first-line stimulant drug dose ranges that the FDA has approved. Six to eight percent of individuals experience their best reaction at dosages below the lowest amounts that are produced. These patients are already overdosed and may experience the Starbuck’s syndrome (being excessively energized, having a fast heartbeat, and becoming agitated) or the Zombie syndrome (emotional blunting, lethargy) if they begin at the lowest dose that is available. When the dosages are reduced, the patients respond well.


On the other hand, roughly 40% of individuals see their best results at doses greater than the FDA-approved maximum strengths. They experiment with medication, but they are unable to get a dosage that produces noticeable results. Up to half of patients now respond better to medicine due to the discovery of a wider range of appropriate doses. —Mr. William Dodson, Jr.



What makes the brain of an ADHD sufferer lose interest in work?

Chemicals that activate reward-recognizing circuits in the brain tend to bind on much fewer receptor sites in the brains of persons with ADHD than in the healthy comparison group, according to PET imaging examinations of the brains of these individuals. These and other imaging studies could contribute to the understanding of why individuals with ADHD typically exhibit lower levels of satisfaction or anticipation of pleasure when working on tasks that take longer to complete than their peers. One significant consequence is that they struggle greatly to motivate themselves to begin things that they find uninteresting and to persevere through jobs for which there are no immediate benefits. —From Smart But Stuck, Thomas E. Brown, Ph.D.



What causes the emotion-overloading of the ADHD brain?

Emotions are important in two main aspects when it comes to the ongoing problems that individuals with ADHD face. Both are associated with working memory impairments, which refer to a person’s restricted ability to retain and apply several emotionally charged pieces of information simultaneously. A person with ADHD may occasionally experience a flash of intense emotion that overwhelms them, making it difficult for them to focus on other feelings, information, or memories that are connected to that flash of emotion due to working memory problems in the brain.


Sometimes an individual with ADHD has trouble keeping other pertinent information in mind or incorporating it into their appraisal of the situation, which results in an inadequate sensitivity to the significance of a given feeling. —from Thomas E. Brown, Ph.D.’s book, Intelligent But Stuck


Why is it that the brain of someone with ADHD does not always relate?

When comparing persons with ADHD to most others, it is common for the networks that convey information about emotion and other elements of brain functioning to be considerably more constrained. Many years ago, the majority of scientists believed that the prefrontal cortex and other specific brain regions were the main source of abnormalities associated with ADHD. However, recent research has indicated that some of the deficits observed in individuals with ADHD may have more to do with the networks of fibers that provide interactive connection across different brain regions. “White matter” connections are one way that different brain regions communicate with each other. The white matter structure of the brains of children, adolescents, and adults with ADHD has been found to be aberrant in imaging investigations.


Some of the challenges these people face—keeping one thing in mind while doing something else—may be explained by such abnormalities. According to one study, methylphenidate, an ADHD medication, helps normalize children with ADHD’s connection impairments in their reward and motivation networks when they are completing certain prescribed tasks. —From Smart But Stuck, Thomas E. Brown, Ph.D.

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