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      Reduced dopamine transporter availability in drug‐naive adult attention‐deficit/hyperactivity disorder

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          Abstract

          Aim

          This study aimed to clarify the abnormalities in dopamine transporter (DAT) availability in drug‐naive adult patients with attention‐deficit/hyperactivity disorder (ADHD) and the relationship between ADHD symptoms and abnormalities in DAT availability.

          Methods

          Single‐photon emission tomography (SPECT) was performed using iodine‐123‐β‐carbomethoxy‐3β‐(4‐iodophenyltropane) (I‐123 β CIT) as a tracer to measure in vivo DAT availability in 20 drug‐naive patients with ADHD [mean age ± standard deviation (SD)]: 25 ± 3.44 years; male:female = 11:9] and 20 age‐ and sex‐matched healthy controls (HCs) (mean age ± SD: 23.9 ± 2.27 years). Comparisons of DAT availability between HCs and adult patients with ADHD and the association between symptom severity and DAT availability within the ADHD group were analyzed using Statistical Parametric Mapping 12.

          Results

          Drug‐naive adults with ADHD showed significantly reduced DAT availability in the bilateral nucleus accumbens compared with HCs. Correlation analyses revealed a negative correlation between the severity of inattentive symptoms in adult patients with ADHD and DAT availability in the bilateral heads of the caudate nucleus, indicating the association between severe inattentive symptoms and lower DAT availability in the caudate nucleus.

          Conclusion

          In drug‐naive adult patients with ADHD, DAT availability was reduced in the nucleus accumbens, an important part of the reward system. This finding indicates the importance of the DAT in the reward system in the pathogenesis of ADHD. Inattentiveness was associated with DAT availability in the caudate nucleus, suggesting involvement of the cortico‐striato‐thalamo‐cortical circuit.

          Abstract

          Compared with 20 aged‐ and sex‐matched healthy controls, drug‐naive adults with ADHD showed significantly decreased DAT availability in the bilateral nucleus accumbens.

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          Most cited references31

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          The worldwide prevalence of ADHD: a systematic review and metaregression analysis.

          The worldwide prevalence estimates of attention deficit hyperactivity disorder (ADHD)/hyperkinetic disorder (HD) are highly heterogeneous. Presently, the reasons for this discrepancy remain poorly understood. The purpose of this study was to determine the possible causes of the varied worldwide estimates of the disorder and to compute its worldwide-pooled prevalence. The authors searched MEDLINE and PsycINFO databases from January 1978 to December 2005 and reviewed textbooks and reference lists of the studies selected. Authors of relevant articles from North America, South America, Europe, Africa, Asia, Oceania, and the Middle East and ADHD/HD experts were contacted. Surveys were included if they reported point prevalence of ADHD/HD for subjects 18 years of age or younger from the general population or schools according to DSM or ICD criteria. The literature search generated 9,105 records, and 303 full-text articles were reviewed. One hundred and two studies comprising 171,756 subjects from all world regions were included. The ADHD/HD worldwide-pooled prevalence was 5.29%. This estimate was associated with significant variability. In the multivariate metaregression model, diagnostic criteria, source of information, requirement of impairment for diagnosis, and geographic origin of the studies were significantly associated with ADHD/HD prevalence rates. Geographic location was associated with significant variability only between estimates from North America and both Africa and the Middle East. No significant differences were found between Europe and North America. Our findings suggest that geographic location plays a limited role in the reasons for the large variability of ADHD/HD prevalence estimates worldwide. Instead, this variability seems to be explained primarily by the methodological characteristics of studies.
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            The reward circuit: linking primate anatomy and human imaging.

            Although cells in many brain regions respond to reward, the cortical-basal ganglia circuit is at the heart of the reward system. The key structures in this network are the anterior cingulate cortex, the orbital prefrontal cortex, the ventral striatum, the ventral pallidum, and the midbrain dopamine neurons. In addition, other structures, including the dorsal prefrontal cortex, amygdala, hippocampus, thalamus, and lateral habenular nucleus, and specific brainstem structures such as the pedunculopontine nucleus, and the raphe nucleus, are key components in regulating the reward circuit. Connectivity between these areas forms a complex neural network that mediates different aspects of reward processing. Advances in neuroimaging techniques allow better spatial and temporal resolution. These studies now demonstrate that human functional and structural imaging results map increasingly close to primate anatomy.
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              The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population

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                Author and article information

                Contributors
                itasyun@sj8.so-net.ne.jp
                Journal
                PCN Rep
                PCN Rep
                10.1002/(ISSN)2769-2558
                PCN5
                PCN Reports: Psychiatry and Clinical Neurosciences
                John Wiley and Sons Inc. (Hoboken )
                2769-2558
                18 February 2024
                March 2024
                : 3
                : 1 ( doiID: 10.1002/pcn5.v3.1 )
                : e177
                Affiliations
                [ 1 ] Department of Neuropsychiatry Fukushima Medical University Fukushima Japan
                [ 2 ] Medical Affairs Division Janssen Pharmaceutical K.K Tokyo Japan
                [ 3 ] Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry Tokyo Japan
                [ 4 ] Department of Radiology and Nuclear Medicine Fukushima Medical University Fukushima Japan
                [ 5 ] Department of Mind & Brain Medicine Fukushima Medical University Fukushima Japan
                Author notes
                [*] [* ] Correspondence Shuntaro Itagaki, MD, PhD, Department of Neuropsychiatry, Fukushima Medical University, Hikarigaoka 1, Fukushima 960‐1295, Japan.

                Email: itasyun@ 123456sj8.so-net.ne.jp

                Author information
                http://orcid.org/0000-0001-5837-2825
                http://orcid.org/0000-0003-4228-3208
                http://orcid.org/0000-0003-2668-129X
                Article
                PCN5177
                10.1002/pcn5.177
                11114433
                38868484
                c59bbf31-6829-45f5-b6b7-0eaca22bf970
                © 2024 The Authors. Psychiatry and Clinical Neurosciences Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 January 2024
                : 24 October 2023
                : 05 February 2024
                Page count
                Figures: 6, Tables: 1, Pages: 9, Words: 5300
                Funding
                Funded by: Funding from Janssen Pharmaceutical K.K. of Johnson and Johnson in Japan
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                March 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.3 mode:remove_FC converted:15.05.2024

                adult attention deficit hyperactivity disorder,developmental disorder,dopamine transporters,single photon emission computed tomography

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