ADHD Neurology: How Does ADHD Affect the Brain?

When we think about Attention Deficit Hyperactivity Disorder, ADHD, many of us visualize the external symptoms: hyperactivity, impulsivity, or a child struggling to focus in class. In fact, many people would describe ADHD as an attention and behavior problem.  However, investigating ADHD neurology demonstrates key physical ADHD effects on the brain, and sheds light on the complex nature of ADHD and the widespread impact it can have on many aspects of life beyond attention and behaviors

How does ADHD affect the brain? Below, we delve into the neuroscience of the ADHD brain, its effects on brain development, and the combination of development, environmental, and genetic factors that contribute to the disorder. We'll also provide resources and strategies for supporting the brain health and development of individuals with ADHD.

The Neuroscience Behind ADHD's Effect on the Brain

ADHD’s effects on the brain are very real. How does ADHD affect the brain? There are both developmental and structural differences in the brain in both kids and adults with ADHD. The result of these differences does not reduce a person’s intelligence, but it can make daily activities involved in learning, planning, regulating mood, and executing tasks more difficult.

Brain Networks and Regions Impacted in ADHD

From a structural standpoint, ADHD neurology reveals unique differences in brain structure and connectivity in multiple brain regions, which sheds important light on understanding why ADHD presents challenges in such a broad array of actions, emotions, and behaviors The following are examples of differences in critical brain regions shown to be different in people with ADHD:

• Prefrontal Cortex: The prefrontal cortex is the front portion of the brain, and is a highly evolved brain region allowing us to accomplish complex tasks. This brain region is responsible for the ability to direct and sustain attention, for reasoning and logic, and to guide goal-oriented behaviors, known as executive functions. Neuroimaging studies have indicated a reduction in prefrontal cortex size and functionality in those with ADHD, which directly impacts these abilities. 
• Basal Ganglia: The basal ganglia is a group of nuclei found deep in the center of the brain and is involved in many functions including starting and stopping body movements and actions. The basal ganglia is involved in motor learning, executive functions, behaviors and emotions. Research indicates dysfunctions in the circuits connecting this area of the brain to other regions and differences in the volume and structure of the basal ganglia. These differences can result in altered control of actions including increased impulsivity, and can negatively impact cognition including attention and learning. 
• Amygdala: The amygdala is a part of the brain involved in processing emotions, including fear and anxiety. This can result in differences in patterns of emotional-related reactivity. Studies have shown a reduction in the amygdala volume. This difference in brain region volume is present in adults with ADHD. Individuals with ADHD can experience heightened emotions and may find themselves at the point of meltdown or frustration more frequently than their peers. This can present as more frequent tears, or increased anger-related reactions.
• Default Mode Network: The Default Mode Network has been found to have atypical connectivity and is more active in individuals with ADHD. The Default Mode Network pathways are active when a person is resting, or engaged in self-directed thought and are utilized when daydreaming or during idle times. These pathways contribute to forming memories, processing events and experiences in life, brainstorming, and creative thinking. In people with ADHD these pathways are more active, demonstrating less time spent in focused attention where your mind is actively engaged, such as listening to the teacher in the classroom. The result is less time spent with directing and sustaining attention, especially on topics that are less interesting to the individual. 
  
  • The Default Mode Network guides your thoughts from the past to the present and future, which can result in remembering past experiences, or worries about the future, which may contribute to an increase in rumation or repition of negative thoughts, worries, and anxiety. 
• Cerebellum: The cerebellum sits at the base of the brain and is responsible for many automated functions and coordinating sensory input with motor responses. Brain imaging illustrates differences in the motor circuitry in ADHD and other developmental disorders which contributes to increased challenges in motor coordination, as well as the development that contributes to the maturation of attentional control over time. This can result in delays or challenges with complex physical coordination such as learning to ride a bike, or athletics. It is important to note that there not all individuals with ADHD experience the same degree of motor coordination challenges, as there are many professional athletes with ADHD. 

Overall, brain scans of people with ADHD have consistently found many differences including a reduced density of gray matter, alterations in the composition of white matter, and even a slight decrease in total brain volume. The maturation of the cortical areas, vital for attention, has been observed to be slower in those with ADHD, leading to attentional challenges. There's also differences in the activity of neural network activation and coordination. Certain regions are underactive, leading to the primary symptoms, while others are overactive, further compounding the challenge.

These structural and functional brain differences have been correlated with delays in development, which can contribute to an individually appearing younger, or more immature with certain behaviors and actions, such as the ability to stay on task without redirection, and the ability to regulate mood and emotions during times of stress. 

Developmental Challenges Faced by Children with ADHD

We’ve seen how ADHD affects the brain. Now, let’s see how it affects the child. 

ADHD is classified as a neurodevelopmental disorder, as there are developmental differences and delays in the formation of brain networks and structures. These developmental delays result in differences in the ability to direct and sustain attention, regulate mood and behaviors, and start and complete a task without additional support and guidance. All of these differences can result in disruptions to both academic and social-emotional learning. ADHD is not a choice or a behavior, but a structural and developmental difference that creates additional hurdles both in the classroom and at home. 

Children with ADHD aren't just daydreamers or high-energy kids. They face many developmental challenges that extend far beyond the classroom walls. Their unique ADHD neurology means that they process information differently, which can lead to a series of obstacles in their formative years that have been shown to persist into adulthood. 

Firstly, academic challenges are prevalent. A reduced ability to direct and sustain attention can interfere with listening and learning in the classroom, as well as staying on task to complete assignments and study - especially if the topic is not one of personal interest. People with ADHD experience increased challenges with executive functions - which are goal-oriented actions. This can impact a person’s ability to organize, manage time, plan, and complete tasks. This can result in struggles to start and complete an assignment, follow multiple-step instructions, or to turn in assignments on time. Parents and teachers may see missing or incomplete assignments and reduced attention. This can easily be interpreted to mean that the student doesn’t care, or isn’t trying, when in fact they may be working harder than their peers yet still coming up short. These disruptions are no indicator of the student’s intelligence but can be indicators of immature brain functions associated with ADHD that interfere with learning and grades. 

Social challenges also arise, as children with ADHD often misinterpret social cues or act impulsively, leading to misunderstandings and, in some cases, social isolation. Emotionally, they may grapple with having low self-esteem, feeling different, or even internalizing their struggles as personal failures. There is a greater tendency to reach the point of frustration, meltdown or upset more quickly, and have a harder time moving on from the upset. A child or adult with ADHD can seem more immature than their peers in how they react to frustrations and upsets, which is a reflection of brain development making it harder for this person to control their responses in times of heightened stress.

The additional movements correlated with the hyperactive aspect of ADHD can be disruptive, even though those additional movements may help to support development and attention. Increased physical activity and movement can be related to immature aspects of development contributing to ADHD and can be misinterpreted as disruptive behavior. Engaging the muscles helps to increase the brain’s level of alertness through a system called the Reticular Activating System which is involved in the brain’s level of alertness. By moving, it helps to engage this system, increasing the brain’s level of arousal. As the brain matures the ability to control movements allows us to become more efficeint - saving energy resources for more important tasks, and providing an increased ability to remain focused without the need to move. 

Psychologically, ADHD's effects on the brain can negatively impact health as a result of behaviors and actions. ADHD has been linked to eating disorders, increased rates of addictive behaviors, and higher-risk behaviors.

It's crucial to understand that the challenges associated with ADHD aren't due to a lack of intelligence or lack of effort but a brain that's simply wired differently.

Strategies for Supporting Brain Health in ADHD

Understanding what ADHD does to the brain can help parents respond to challenges with compassion, support, and a proactive strategy. It’s more than just responding to challenging symptoms. It involves promoting optimal brain health and development to mature brain regions and pathways that contribute to the ability to direct and sustain attention, regulate mood and emotions and improve impulsivity and control. While working towards improving developmental maturity and brain function over time, you can also implement daily strategies to help maximize current abilities and minimize ADHD complications.

Daily Habits and Strategies to Minimize ADHD Symptoms:

•  Dietary Adjustments: Increasing healthy foods, and minimizing foods high in added sugars, dyes, and preservatives can reduce inflammation and minimize disruptions in mood and attention. Consuming a balanced diet rich in omega-3 fatty acids, zinc, iron, and magnesium can play a role in managing ADHD symptoms. These nutrients support neural function and can enhance focus and cognitive abilities.
  
• Regular Physical Activity: Aerobic activities like swimming, cycling, or even brisk walking can promote blood flow to the brain, enhancing cognitive function and reducing hyperactivity. Implementing physical activity prior to times of focus can help to increase the level of alertness in the brain, which can help to extend periods of focused attention. 
• Sleep Hygiene: A tired brain has a harder time completing complex tasks and will reduce the ability to sustain attention, block out distractions, and regulate mood and emotions. Sleep hygeine is considered a pattern of healthy sleep habits which include going to bed and waking up at a consistent time each day, sleeping for the recommended number of hours based on age and development, avoiding screens in the hour before beditme (to reduce the blue light that signals wakefulness to the brain), and avoiding sugar and caffeine several hours prior to bed. 
• Minimizing Screen Time: While technology provides many helpful tools and resources when and how you utilize screen time can have a big impact on your attention and self-regulation abilities. Activities such as gaming, and scrolling social media can be more tiring to the brain than you realize, and a tired brain has a harder time with control and regulation. Saving screentime for after important tasks such as homework or studying, but prior to bedtime is key to save the best attentional and control resources for when they are needed most. 
• Cognitive Behavioral Therapy (CBT): This therapeutic approach can assist children in understanding their thought processes, developing coping mechanisms, and building self-awareness.
• Routine and Structure: Establishing a consistent routine can help children with ADHD manage their time and tasks more effectively. Knowing what to expect can help to reduce stress, and increase the ability to plan and be prepared. Providing kids with structure when they struggle to implement structure and routine can help them learn daily habits for organization and time management. 

Strategies to Mature the Brain and Development to Support Increased Attention and Control

• The Brain Balance Program: A multi-modal, integrative program designed to exercise and strengthen brain pathways to improve development has demonstrated significant gains in development and in improving ADHD. The improvements were reported by parents, teachers, and clinicians in various studies, and shown to have a high level of reliability in consistently driving improvements in ADHD. 
• Mindfulness and Meditation: These practices can help children with ADHD improve their attention span, learn to direct attention, and improve self-awareness and emotional regulation. Breathing exercises or guided meditations can be a great starting point.
  
• Participation in After School Activities including Sports and Music: The ability to coordinate the body to play a sport or a musical instrument requires the coordination and timing of complex networks within the brain. Exercising these pathways repeatedly over time helps to improve the ability to sustain attention and improve inhibitory control. 

Environmental and Genetic Factors in ADHD Development

Science has learned a great deal about how ADHD affects the brain. The cause of ADHD, however, is a balance between genetics and environment. Genetically, there's compelling evidence pointing to the role of epigenetics in ADHD development. Family patterns reinforce this, with ADHD frequently observed running in families.

Environmentally, a host of factors can increase ADHD risk. Prenatal exposures to smoking or alcohol use have been linked to a higher occurrence. Childhood exposure to toxins, especially lead, can also contribute. Traumatic experiences and early life stress can further predispose an individual to ADHD.

It's essential to recognize the interplay between these elements and understand that family history, life experiences, and environment play a role in ADHD.

Regardless of how or why ADHD presents in a child, know that the brain is able to change. The challenges related to ADHD you see today can be minimized to improve outcomes for learning, social interactions, and self-confidence.

Resources and Support for Parents and Educators

We are learning a great deal about how ADHD affects the brain and what causes the condition. Best of all, we’re learning how minimize the impact of ADHD while doing  better supporting those with ADHD.

If you or someone you love struggles with ADHD, the drug-free Brain Balance program can help. Our holistic approach builds and strengthens the brain, improving the ability to sustain attention, block out distractions, and regulate mood and behavior.  The combination of healthy daily habits combined with purposeful exercises to strengthen the brain can make a meaningful impact on daily life. 

Visit your local Brain Balance center or contact us. We can help.

Sources:

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