Drumroll Please! And the Cause of ADHD Is…

Big neuroscience news!! Some important research is in. Things that you thought you knew about ADHD have changed.

Close inspection reveals that this is not an ad for a home exercise program.

Close inspection reveals that this is not an ad for a home exercise program.

Because I’m an ADHD nerd, I like to read studies about ADHD. You are entirely forgiven if you, in fact, know better than to do this. NOT liking to read research defines ‘normal’. The following sentence from a study that I found fascinating will demonstrate why you should NOT read most research literature:

 “The functional data series of each participant from each stimulation task were preprocessed for the mean intensity adjustment, slice scan time correction (correction with sinc interpolation, slice scanning order ascending interleaved), three-dimensional …” (1)

Never mind.  That sentence isn’t even halfway done yet.

The first reason I read stuff like this instead of watching “Game of Thrones” is to understand ADHD better and the second is to explain it better to others. The third reason is that we don’t get HBO.

I rarely write about a single study, because our knowledge base depends on multiple studies that approach a topic from many angles until a consistent picture emerges. Research is a lot like trying to figure out what’s on TV when you can only observe one square inch at a time. Each “study” might report a one-inch perspective which is hard to interpret until you assemble all the small views and realize that you’ve been studying an infomercial for P90-X and need to change channels to see Game of Thrones.

Also, not an exercise video.

Also, not an exercise video.

Recently, a review of multiple studies was completed by some of the most knowledgeable ADHD experts in the world. They pored through dozens of studies involving the brain scans of hundreds of people with ADHD. Their report on this “study of studies” included the following sentence which you really ought to wade through, because is literally earth-shaking, at least to ADHD nerds and anyone still with me after that first quote.

“…therapeutic oral doses of stimulants decrease alterations in brain structure and function in subjects with ADHD relative to unmedicated subjects and controls. These medication-associated brain effects parallel, and may underlie, the well-established clinical benefits.”  (2)

You may have missed the explosive news there, so let me restate it.

  1. We are beginning to understand the causes of ADHD. ADHD is a condition that involves abnormal brain function.
  2. Specifically, normal folk have capabilities in their brains that ADHD folk don’t. So far, the reverse hasn’t been seen.
  3. Stimulant medications restore (at least some) normalcy to brain function. They are not–as they are sometimes described–giving ‘speed’ to normal brains. They bring normal brain function to people who were born without it.
  4. These findings have been so consistent across multiple studies, that they can be considered “scientifically proven”.
This yoga position is  actually a scene from Game of Thrones, not an exercise video.

This yoga position is actually a scene from Game of Thrones, not an exercise video.

This study doesn’t mean that we have ADHD entirely figured out, but that there is an explanation. The picture was too fuzzy to interpret until recently, but now is coming into focus. We know what show we’re watching, and it’s not an infomercial for exercise videos.

Going forward, we will be able to research treatments that address the causes and separate those which are really just a Band-Aid.  We may even see the development of a definitive test in the next decade! The science of ADHD has reached a significant milepost.

At the end of the last century, leading scientists properly said, “We don’t know what causes ADHD.” Anyone who says that now has fallen too far behind the times to be helpful.

 

  1. Karakaş S Functional MRI compliance in children with attention deficit hyperactivity disorder.  Diagn Interv Radiol. 2014 Dec 17.
  2. Spencer T, et al. Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies. J Clin Psychiatry. 2013 Sep;74(9):902-17

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

Posted in ADHD
10 comments on “Drumroll Please! And the Cause of ADHD Is…
  1. Elias Sarkis says:

    Nice summary! Thanks.
    Elias

    Like

    • Elias, since meeting you in DC Reagan, my wife refers to you as one of my ‘nerd friends’ as in “I hope you have fun at your meeting with your ADD nerd friends.” I believe this to be a compliment, as she expressed warm feelings for you after that. Just sayin’…

      Like

  2. JM says:

    Thank you for your translation! I still hate reading research literature, as a graduate student with ADHD, reading research was like torture. I’m glad to hear about their findings.

    Like

  3. Doug Puryear says:

    Dr. Mason – thank you for this great post. I have taken the liberty of quoting from it, and also linking to it. I admire both your humor and you clear thinking.
    Best wishes
    Doug

    Like

  4. Gert Manthey says:

    Thank you, Dr. Mason – nice way of breaking down the scientific lingo – my own opinions (you may call them hunches) are gaining some
    validation and backup from this – i hope, i will be able to read the cited publications – i also would like to link to your post!

    GMy

    Like

  5. […] Dr. Mason’s post is worth reading, shedding light not only on ADD ADHD but also on the scienti… […]

    Like

  6. Cassie says:

    Did I miss something in the article? Where in this article does it say the cause of ADHD lies. We understand better what it is, but do we understand how it’s caused yet?

    Like

    • You correctly note that I didn’t elaborate on the cause, just pointed out that “we are beginning to understand the causes…”. I say that to rebut the oft-repeated “we don’t know what causes ADHD…” which is now scientifically incorrect and to mark this watershed in the advancing science of ADHD.

      Much work remains to be able to tell the full story of the cause of ADHD, but the outline of the story is this: Genetic settings determine both structural and neurochemical differences, some that are determinative and some that cause susceptibilities only. Some environmental and/or experiential triggers magnify the differences. These differences decrease function in cognitive brain systems. The cognitive workload must either be reduced or shifted to emotional systems which are not as adept at managing, directing, organizing and deploying executive function.

      The fact that we can “see” this all play out with current scanning methods is very exciting, if you’re a nerd like me. The fact that ADHD medications normalize function should be a relief to millions of ADHD patients and parents who have chosen medication as part of their treatment.

      Like

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Oren Mason MD
Oren Mason MD

Oren Mason MD

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

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