Le déficit d'attention
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Attention-deficit disorder (attention-deficit/
hyperactivity disorder without hyperactivity): a
neurobiologically and behaviorally distinct disorder from
attention-deficit/hyperactivity disorder (with hyperactivity).
Diamond A.
Department of Psychiatry, University of British Columbia,
Vancouver, Canada. adele.diamond@ubc.ca
Most studies of attention-deficit/hyperactivity disorder
(ADHD) have focused on the combined type and emphasized a
core problem in response inhibition. It is proposed here
that the core problem in the truly inattentive type of ADHD
(not simply the subthreshold combined type) is in working
memory. It is further proposed that laboratory measures,
such as complex-span and dual-task dichotic listening tasks,
can detect this. Children with the truly inattentive type of
ADHD, rather than being distractible, may instead be easily
bored, their problem being more in motivation (underarousal)
than in inhibitory control. Much converging evidence points
to a primary disturbance in the striatum (a frontal-striatal
loop) in the combined type of ADHD. It is proposed here that
the primary disturbance in truly inattentive-type ADHD (ADD)
is in the cortex (a frontal-parietal loop). Finally, it is
posited that these are not two different types of ADHD, but
two different disorders with different cognitive and
behavioral profiles, different patterns of comorbidities,
different responses to medication, and different underlying
neurobiologies.
Publication Types:
PMID: 16262993 [PubMed - indexed for MEDLINE]
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