Linking ADHD, Impulsivity, and Drug Abuse: A Neuropsychological Perspective

Chapter
Part of the Current Topics in Behavioral Neurosciences book series (CTBN, volume 9)

Abstract

In this chapter, we consider the relevance of impulsivity as both a psychological construct and endophenotype underlying attention-deficit/hyperactivity disorder (ADHD) and drug addiction. The case for executive dysfunction in ADHD and drug addiction is critically reviewed in the context of dissociable cognitive control processes mediated by the dorsolateral prefrontal cortex (DLPFC), the orbital and ventral medial prefrontal cortex (VMPFC). We argue that such neuroanatomical divisions within the prefrontal cortex are likely to account for the multidimensional basis of impulsivity conceptually categorized in terms of “motoric” and “choice” impulsivity. The relevance of this distinction for the etiology of ADHD and drug addiction is integrated within a novel theoretical framework. This scheme embraces animal learning theory to help explain the heterogeneity of impulse control disorders, which are exemplified by ADHD as a vulnerability disorder for drug addiction.

Keywords

Addiction ADHD Basal ganglia Discounting Dopamine Hot and cold cognition Impulsivity Learning Limbic system Motor inhibition Prefrontal cortex 

Abbreviations

5-CSRTT

5-Choice serial reaction time task

5-HT

5-Hydroxytryptamine (serotonin)

ADHD

Attention deficit hyperactivity disorder

CR

Conditioned reinforcer

DA

Dopamine

DAT

Dopamine transporter

DLPFC

Dorsolateral prefrontal cortex

DRL

Differential response to low rates of reinforcement

fMRI

Functional magnetic resonance imaging

IFG

Inferior frontal gyrus

IL

Infralimbic (cortex)

mPFC

Medial prefrontal cortex

NAcb

Nucleus accumbens

O

Outcome

OFC

Orbitofrontal cortex

PET

Positron emission tomography

PIT

Pavlovian to instrumental transfer

R

Response

RD

Response followed by a delayed outcome

RI

Response followed by an immediate outcome

S

Stimulus

SN

Substantia nigra

SSRT

Stop-signal reaction time

SST

Stop-signal task

TMS

Transcranial magnetic stimulation

VMPFC

Ventromedial prefrontal cortex

VTA

Ventral tegmental area

Notes

Acknowledgments

This research was supported by a Wellcome Trust Programme Grant (089589/Z/09/Z) awarded to T.W. Robbins, B. J. Everitt, A. C. Roberts, B.J. Sahakian, and JWD, MRC grants to B.J. Everitt (G0600196) and JWD (G0401068, G0701500) and by the European Community’s Sixth Framework Programme (“Imagen” LSNM-CT-2007-037286). GPU was supported by a Marie Curie Intra-European Fellowship (PIEF-GA-2009-237608) awarded by the European Commission. This review reflects only the authors’ views and the European Community is not liable for any use that may be made of the information contained therein. The authors thank Andrea Bari for insightful discussions. Figure 1 was adapted from best-lemming, brain, Google SketchUp 3D warehouse, http://sketchup.google.com/3dwarehouse/details?mid=bdde6508945af6e2a4dd6527f4a3f142 (accessed 8 July, 2010).

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© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Behavioural and Clinical Neuroscience Institute, Department of Experimental PsychologyUniversity of CambridgeCambridgeUK
  2. 2.Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology & Department of PsychiatryUniversity of CambridgeCambridgeUK

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