What is it about?

Neuroanatomical differences in ADHD is one of the most investigated topics for several decades, with over 100 reviews, that provide support for several, yet inconclusive large-scale brain network implications and models. Given this volume of scientific information, we aimed to identify the neuroanatomical differences in ADHD through the first published systematic overview of systematic reviews, using Cochrane guidelines and PRISMA criteria.

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Why is it important?

This paper proposes an hypothesis that ADHD presents itself as an unbalanced multi-network neurofunctioning that is clearly suggested to go beyond the frontoparietal network and dopaminergic system. This hypothesis is also consistent with a variety of skills that can be compromised in ADHD and that have been extensively reported, such as cognitive, emotional regulation, motor, sensory-perceptual and social skills. This highlights not also the importance of a first level multidisciplinary diagnostic and treatment approach (focused in the core symptoms of attention and hyperactivity) but also supports the existence of a second level multidisciplinary assessment of how these core symptoms impact functional and occupational performance.

Perspectives

This was a neuroscience investigation with neuroanatomical results that need to be interpreted into a practice/investigation level. As an Occupational Therapist, two key-points, that were out of the scope of this paper, are clearly consistent with its main conclusions: 1) For practice: it creates the scientific evidence that Occupational Therapists should be integrated in primary care teams - as an Occupational therapist have training and expertise in the assessment of functional/occupational performance and its relation to cognitive, emotional regulation, motor, sensory-perceptual and social skills; 2) For investigation: this paper supports etiological theories that conceptualize a systemic implication of the central nervous system in ADHD.

Bruno Vieira de Melo
Higher School of Health, Polytechnic Institute of Porto

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This page is a summary of: Systematic overview of neuroanatomical differences in ADHD: Definitive evidence, Developmental Neuropsychology, December 2017, Taylor & Francis,
DOI: 10.1080/87565641.2017.1414821.
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