Psychiatric neuroeconomics offers an alternative approach to understanding mental
disorders by studying the way disorder-related neurobiological alterations constrain
economic agency, as revealed through decisions about choices between future goods.
In this article, we apply this perspective to understand suboptimal decision making
in attention-deficit/hyperactivity disorder (ADHD) by integrating recent advances
in the neuroscience of decision making and studies of the pathophysiology of ADHD.
We identify three brain networks as candidates for further study and develop specific
hypotheses about how these could be implicated in ADHD. First, we postulate that altered
patterns of connectivity within a network linking medial prefrontal cortex and posterior
cingulate cortex (i.e., the default mode network) disrupts ordering of utilities,
prospection about desired future states, setting of future goals, and implementation
of aims. Second, we hypothesize that deficits in dorsal frontostriatal networks, including
the dorsolateral prefrontal cortex and dorsal striatum, produce executive dysfunction-mediated
impairments in the ability to compare outcome options and make choices. Third, we
propose that dopaminergic dysregulation in a ventral frontostriatal network encompassing
the orbitofrontal cortex, ventral striatum, and amygdala disrupts processing of cues
of future utility, evaluation of experienced outcomes (feedback), and learning of
associations between cues and outcomes. Finally, we extend this perspective to consider
three contemporary themes in ADHD research.
Key Words
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Article info
Publication history
Published online: May 07, 2012
Accepted:
April 5,
2012
Received in revised form:
March 19,
2012
Received:
December 1,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
