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ADHD

Episodes

Posted on September 30th 2024 (8 months)

In this clip, Dr. Andrew Huberman discusses ADHD, behavioral strategies, stimulant use, and his reasons for quitting nicotine and views on _Mucuna pruriens_.

Posted on June 10th 2024 (11 months)

Dr. Andrew Huberman discusses the role of dopamine in driving motivation and offers practical tools for enhancing mood and focus.

Posted on November 6th 2021 (over 3 years)

Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.

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News & Publications

  • Poor diet quality increases symptom severity in children with ADHD.

    Attention deficit hyperactivity disorder (ADHD) is a neuro-behavioral condition characterized by inattention, impulsive behavior, and emotional dysregulation. The condition affects as many as 10 percent of children living in the United States and is more common among males than females. Findings from a recent study suggest that poor diet quality increases symptom severity in children with ADHD.

    Although the causes of ADHD are likely multifactorial, evidence suggests that nutrition may influence both the etiology and severity of the condition. For example, some studies have shown that addressing micronutrient deficiencies, poor omega-3 fatty acid status, and food additive sensitivities may ameliorate symptoms of ADHD.

    The study involved 134 children (ages 6 to 12 years) who had been diagnosed with ADHD and were enrolled in the Micronutrients for ADHD in Youth (MADDY) Study. Parents provided demographic information about the children’s gender, ethnicity, race, parent/guardians’ occupation, parent/guardians’ level of education, and family income, and completed food frequency questionnaires about the children’s diets. They also answered questions about the children’s behavior and ranked the severity of their ADHD symptoms.

    The data revealed that the overall diet quality of this sample of children was slightly higher than that of the average child living in the United States. However, low fruit and vegetable intake was associated with having more severe ADHD symptoms, even after considering the children’s demographics. Interestingly, high intake of refined grains was associated with having less severe symptoms. The authors posited that this might have been because refined grains are fortified with micronutrients, compensating for what might be an otherwise poor diet.

    These findings suggest that dietary factors play instrumental roles in ADHD symptom severity in children and underscore the importance of appropriate nutritional intake during childhood. Getting children to eat more fruits and vegetables can be challenging, however. This tasty, micronutrient-rich smoothie might be one way to help kids get the fruits and vegetables they need.

  • A woman’s body weight before and during pregnancy can have profound health effects on both mother and child. Women with obesity are at greater risk for developing pregnancy complications that can impair infant neurodevelopment, such as gestational diabetes, preeclampsia, preterm birth, and birth trauma. Findings from a new study suggest that maternal obesity contributes to attention deficit hyperactivity disorder (ADHD) and obesity in offspring.

    ADHD is a neuro-behavioral condition characterized by inattention and/or hyperactive or impulsive behavior that interferes with functioning, learning, or development. Obesity is characterized as having excessive body fat – typically defined as having greater than 25 percent body fat for males and greater than 33 percent body fat for females.

    The study included nearly 3,000 Finnish women and their offspring (~9,400 children). The authors of the study collected information about the children’s behavior and attention span from mothers and teachers. They gathered anthropometric data to determine the mothers' and children’s body mass index (BMI), a proxy for body fatness. They used Mendelian randomization and polygenic risk scores to assess risk for ADHD and/or obesity. Mendelian randomization is a research method that provides evidence of links between modifiable risk factors and disease based on genetic variants within a population. A polygenic risk score estimates a person’s genetic propensity for developing a trait or disease.

    They found that children whose mothers had a high BMI were more likely to develop ADHD, independent of genetic makeup. The Mendelian randomization analysis identified a bidirectional link between developing ADHD and obesity-related traits, suggesting that certain genetic variations may predispose children to both ADHD and obesity concurrently. The polygenic risk score revealed evidence for genetic overlap between having ADHD and greater BMI.

    These finding suggest that both genetic and prenatal environmental factors influence the likelihood that a woman’s child will develop ADHD and obesity. They also underscore the importance of maintaining a healthy maternal body weight before and during pregnancy.

  • Executive function refers to a set of cognitive abilities that facilitate control over voluntary behaviors, including attention control, working memory, and cognitive flexibility. While executive functions are critical for complex tasks such as planning, they are also mentally taxing. Without sufficient motivation, people with poor executive function may struggle to meet goals. Researchers report their findings that dopamine signaling is responsible for the effects of Ritalin and other stimulant medications on motivation and executive function.

    Dopamine is one of the most abundant neurotransmitters in the brain and is involved in reward-motivated behavior, learning, and memory. Activities that provide a reward (e.g., food, money) increase dopamine levels, causing a sensation of pleasure that enhances learning by deeply encoding memories related to rewarding activities. Motivation to complete a task is based, in part, on whether a task is judged to provide sufficient pleasure relative to the cost of its required effort. Capacity to synthesize dopamine varies from person to person; however, lower dopamine levels in key brain areas are associated with attention deficit hyperactivity disorder (ADHD), substance use disorders, and Parkinson’s disease. Drugs such as methylphenidate (i.e., Ritalin), a medication used to treat ADHD, and sulpiride, a medication used to treat schizophrenia and depression, interact with dopamine receptors in the brain and can increase motivation.

    The authors recruited 50 healthy adults (ages, 18 to 43 years). Participants completed a test called a cognitive effort-discounting paradigm. In this test, participants are asked how much money they would want to receive in exchange for completing tasks of varying difficulty. The authors measured the estimated effort cost as the amount of money necessary to make participants willing to perform a cognitively difficult working memory task. Participants completed effort-discounting tasks under the influence of 20 milligrams of methylphenidate, 400 milligrams of sulpiride, or a placebo on three separate testing days. The researchers used a positron emission tomography (PET) scan to measure dopamine synthesis capacity in the caudate nucleus, a brain region responsible for reward-based learning. Finally, the researchers used a statistical model based on the effort-discounting task to further explore the effects of methylphenidate and sulpiride on motivation.

    While on the placebo treatment, participants’ willingness to expend cognitive effort increased as their baseline dopamine synthesis capacity increased. Notably, while performance on the working memory task decreased with difficulty, there was no relationship between task performance and dopamine levels. Both methylphenidate and sulpiride increased willingness to expend cognitive effort, but only in participants with low baseline dopamine synthesis capacity. Using their computer model, the investigators found that methylphenidate increased feelings of reward while sulpiride decreased effort cost. Further, they found that the cost-benefit analysis involved in the decision to expend effort occurs early in the decision-making process and can be measured by patterns in gaze (focusing on a reward or cost of a task) during cognitive testing. While higher baseline dopamine synthesis capacity and drug administration did not affect gaze patterns directy, higher dopamine levels strengthened the impact of gaze and attention to the benefits versus the costs of a decision.

    These findings indicate that Ritalin and other attention-enhancing drugs work by increasing willingness to attempt cognitively-difficult tasks, not the ability.

  • Exercise improves cognitive function and reduces the risk neurodegenerative diseases such as Alzheimer’s disease. Some of these benefits are mediated by brain-derived neurotrophic factor (BDNF). Findings from a 2012 study showed that regular exercise improved cognitive function and increased BDNF levels, but a genetic variant in BDNF influenced the degree of these effects.

    BDNF is a protein that acts on neurons in the central and peripheral nervous systems. A single-nucleotide polymorphism (SNP) in the gene that encodes BDNF causes a substitution of the amino acid valine (Val) by methionine (Met) in the BDNF protein. This genetic variant, known as Val66Met, alters exercise-driven release of BDNF and affects learning, memory, and emotion.

    The intervention study involved 75 sedentary, healthy, young adults between the ages of 18 and 35 years. The participants took memory tests and mental health surveys before and after engaging in their randomly assigned respective activities: no exercise; four weeks of exercise with exercise and a test on the last day; four weeks of exercise, without exercise on the final test day; or a single bout of exercise on the last test day.

    The participants who engaged in exercise showed improvements in memory and experienced lower levels of perceived stress, but only if they exercised for four weeks including the final day of testing. Participants who engaged in a single bout of exercise showed no changes in memory performance and demonstrated higher perceived stress levels. The authors of the study noted improvements in the participants' memory only if they did not carry the Val66Met variant, suggesting that the associated reduction in BDNF release attenuated some of the cognitive benefits of exercise. They also noted that the improvements in cognitive function were not correlated to improvements in mental health.

    These findings suggest that the variable effects of exercise on brain function are related to a genetic variant that influences the production of BDNF.