ADHD - An Illustrated historical overview

ured cerebral glucose metabolism in a group of 25 hyperactive adults and 50 control subjects and found a signifi- cant decrease of metabolic activity in frontal and striatal regions. Also at the beginning of the 1990s, researchers deployed magnetic reso- nance imaging (MRI), together with its related procedure functional MRI (fMRI) a widely used technique based on the work of Raymond Damadian, Paul Lauterbur and Peter Mansfield in the 1970s. The first studies were per- formed by Hynd and colleagues and aimed to observe deviations in pat- terns of brain asymmetry. Since these initial efforts, various stud- ies have produced seminal results for the understanding of ADHD by sug- gesting that frontostriatal dysfunc- tion is central to pathophysiology, that abnormalities of frontostriatal circuits, modulated by dopamine, exist, that structural abnormalities observed in children in frontal, striatal, parietal and cerebellar regions may be due to a de- lay in structural brain maturation and that widespread neural deficits in mul- tiple interconnected systems of the brain are present. More research, how- ever, is necessary to find out if non- frontostriatal regions are affected, too, what their contribution to the disorder may be and if brain stimulation tech- niques may serve as additional non- pharmacological treatment options for ADHD patients. Exemplary iodine-123-beta-CIT SPECT-imaging measuring striatal dopamine transporter density (yel- low: highest density, black: lowest density). Unpub- lished data (Romanos et al., in preparation).