期刊
BIOLOGICAL PSYCHIATRY
卷 72, 期 2, 页码 126-133出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2012.04.004
关键词
ADHD; decision making; dopamine; dorsolateral prefrontal cortex; medial prefrontal cortex; neuroeconomics; orbitofrontal cortex; planning; reinforcement; reward; utility; value; ventral striatum
资金
- University of Southampton
- Janssen Cilag
- Shire
- Qbtech
- Flynn Pharma
Psychiatric neuroeconomics offers an alternative approach to understanding mental disorders by studying the way disorder-related neurobiological alterations constrain economic agency, as revealed through decisions about choices between future goods. In this article, we apply this perspective to understand suboptimal decision making in attention-deficit/ hyperactivity disorder (ADHD) by integrating recent advances in the neuroscience of decision making and studies of the pathophysiology of ADHD. We identify three brain networks as candidates for further study and develop specific hypotheses about how these could be implicated in ADHD. First, we postulate that altered patterns of connectivity within a network linking medial prefrontal cortex and posterior cingulate cortex (i.e., the default mode network) disrupts ordering of utilities, prospection about desired future states, setting of future goals, and implementation of aims. Second, we hypothesize that deficits in dorsal frontostriatal networks, including the dorsolateral prefrontal cortex and dorsal striatum, produce executive dysfunction-mediated impairments in the ability to compare outcome options and make choices. Third, we propose that dopaminergic dysregulation in a ventral frontostriatal network encompassing the orbitofrontal cortex, ventral striatum, and amygdala disrupts processing of cues of future utility, evaluation of experienced outcomes (feedback), and learning of associations between cues and outcomes. Finally, we extend this perspective to consider three contemporary themes in ADHD research.
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