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Wagamaga OP t1_itkvdop wrote

A recent study published in NeuroImage: Clinical used state-of-the-art neuroimaging techniques to determine what brain changes may cause childhood ADHD to go into remission. Christienne Damatac and colleagues looked at brain changes in those diagnosed with ADHD over 16 years. Their findings suggest that improved hyperactivity and inattentiveness symptoms result from increased white matter density in the brain region known as the left corticospinal tract. Additionally, reduced ADHD symptoms were associated with more neural connections in the same region.

ADHD is a common childhood diagnosis. However, some are fortunate enough to grow out of the challenging symptoms by adulthood, and others never do. Understanding why this is so may lead to important innovations in treating the disorder. One hypothesis is that the malfunctioning parts of the brain that result in ADHD symptoms are never able to repair themselves. Instead, for some, as the brain develops, other regions take over the responsibilities of the damaged areas. Dramatic and colleagues were curious if this was so and if these changes would persist over time.

https://www.sciencedirect.com/science/article/pii/S221315822200122X

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sweglord42O t1_itmpjhi wrote

I don't understand why scientists expect the brain to "repair" itself. An ADHD brain develops the way it does not because of some aberrant process, but because thats how it was supposed to develop. The fact that its a developmentally different brain does not mean that the brain is "damaged".

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princessfoxglove t1_itnbr1x wrote

As much as I love the idea of saying that the brain is not "damaged", it is unfortunately untrue that the ADHD brain is developed the way it is "supposed to".

ADHD is in fact a neurodevelopmental disorder, which means that during key stages of development both before and after birth brain growth and connectivity was impaired and that leads to lifelong developmental and practical issues with the brain and central nervous system.

Even though we can't point to a single cause for the major known neurodevelopmental disorders, we can compare neurodevelopmentally disordered brains to brains that developed without major (or minor) disruptions to development.

For example, with ADHD, brains show less matter overall, especially in the prefrontal cortex (controlling executive function), amygdala, (emotional regulation), hippocampus, (memory and emotional regulation), basal ganglia (emotion, movement, intention and action) as well as poorer connectivity through multiple different structures of the brain. This isn't an exhaustive list of the regions that are affected, since there are multiple factors that affect development, some genetic, some epigenetic, some environmental, and on and on.

In addition, the chemical differences with dopamine and norepinephrine are less efficient, which adds to the executive function challenges and adds to the learning time needed.

Our brains weren't supposed to develop this way - many of us can trace very well what the likely factors were when we look at our family history. For example, my mother and grandmother both were heavy smokers while pregnant, and both experienced some fairly severe trauma when they were younger.

The result, for me personally, was that my mother's smoking resulted in me being born premature and underweight with trauma at birth, and poorly developed brain and lungs. I have ADHD with many of the resulting comorbidities from poor brain development that I can actually pinpoint. I have poor gross motor control, emotional regulation challenges, a learning disability, and the regular basket of ADHD symptoms.

My brain is developmentally abnormal. You can compare it to a brain that developed without the interference of smoking and trauma and genetic causes in the same way that you can compare my hands, which are developmentally normal, to hands that developed abnormally, say, with webbing or an extra finger. You can make the same comparison between a heart that developed normally to a heart that developed abnormally with a hole in it.

When it comes to "repairing" what we're talking about is building new connections in the brain to compensate for the deficits of abnormal development, which is where educators and therapists (emotional, speech, occupational, etc.) come in.

For example, the parts of my brain that control gross motor function, vision, numbers, spatial awareness - they suck. This translates, for me, into having a hard time judging speed, distance, counting, maths skills, and movement. However, through targeted, informed learning understanding my brain differences, I have been able to learn maths, play sports, learn to drive, and play piano. However, for me to learn these things, I needed a higher number of repetitions than the average learner, needed multisensory approaches, needed to engage different parts of my brain, and had to build different connections to "repair" the faulty connectivity that I came with.

In maths, for example, I really struggle with number concepts. For me to understand division conceptually I had to learn it with visual and verbal processing rather than just numbers alone; I didn't understand that 30/2=15. I had to first see it with a group of 30 split into two physical groups using manipulatives, then understand that when we say "thirty divided 'by' two", the "by" actually means "into two equal groups" and/or "if thirty is divided into groups with two each in them, you will have 15 of those groups". I had to literally write out those sentences to understand that 30/2=15.

And I have to do that for every maths concept, from division to fractions to algebra to factors - if not, the information will not stay in my long-term memory. I have uneven cognitive development, whereby my verbal processing and intelligence is much higher, so I built pathways to conceptual understanding through those areas of my brain to compensate for the damaged developmentmal areas that could not function normally. So in a sense, I have "repaired" my brain's number sense to that of a neurodevelopmentally normal brain at this point. Now I just know 30/2=15.

People with major neurodevelopmental disorders need to do this is many areas for many different skills and functions, and do all the time.

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sweglord42O t1_itnq79a wrote

I understand what you mean but I also disagree with you on some points. My main issue is with the language used not the content of the article or your comment.

I don't believe there is any high quality data on this topic but from my understanding, most people with ADHD do not have an inciting event that "causes" them to develop ADHD. This is not to deny your experience, but I do not believe that it is the norm for people with ADHD.

My ADHD brain developed as it should have, there were not any environmental or biological factors that interrupted my brain development. That's not to say it didn't develop differently compared to the "average" person. I think that conceptualizing an ADHD brain as "damaged" gives it the idea that you can "fix" it to become a typical brain.

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princessfoxglove t1_itnrzi5 wrote

>I don't believe there is any high quality data on this topic but from my understanding, most people with ADHD do not have an inciting event that "causes" them to develop ADHD.

There is a plethora of peer-reviewed research on this. The tough thing for most laypeople to understand is that development of ADHD, autism, and the other major neurodevelopmental disorders is multifactorial and therefore hard to trace and almost never determined by a single cause.

In your case, you are not aware of the causes for your neurodevelopmental differences, but that doesn't mean they don't exist, and they exist regardless of your opinion.

You are conflating the science of neurodevelopmental disorders with the social science of how we frame normal development and how neurotypicality is preferred. The heart of what you are saying is that neurodevelopmental disorders should be accepted and the people with them should not have stigma or be pressured to do the extra individual work to be socially accepted or function according to neurotypical norms and values. To some extent, this is true. We do need to be more inclusive. It's better for everyone!

However, the science of is remains that neurodevelopmental disorders cause deficits that are a significant challenge outside of norms, and the science shows that those deficits can in many cases be overcome thanks to neuroplasticity and advanced understanding of how to educate and medicate.

People with ADHD are more likely to be in a fatal car crash because of our poor brain development. We have poorer reaction time, are more impulsive, and have issues with our parietal lobes, and so on. However, with extra practice, medication, and activities that encourage growth in the affected areas of the brain, we can become good, safe drivers. We can "fix" those deficits to be able to enjoy driving.

If we were to just stop and say "nah ADHD folks can't fix their deficits," we'd end up with a blanket ban on ADHD drivers, which wouldn't be very inclusive at all.

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sweglord42O t1_ito2huu wrote

>In your case, you are not aware of the causes for your neurodevelopmental differences, but that doesn't mean they don't exist, and they exist regardless of your opinion.

That is as empty a statement as "every effect has a cause". Yes of course there are genetic, social and environmental causes for my developmental differences. I don't deny that at all. However, everything about the way we develop is multifactorial whether you turn out normal or not. It's wrong to say there are causes for my ADHD as if they were different from the same causes that make people develop normally. If that's what you mean, I 100% agree with you.

However, I want to be clear. I believe that it is inaccurate to say that there is a "cause" for ADHD in the sense that a virus is a "cause" for respiratory illness. This is what people hear when we say there are things that cause ADHD.

ADHD is not a monolith. There can be ADHD with a probable cause (your case), ADHD that is caused by a delay in brain development (kid who eventually grows out of ADHD), ADHD secondary to physical trauma as a child, ADHD that is "caused" by a brain that is just meant to be structurally different in its mature state. I would say that the first and third scenarios I describe to have "causes" for ADHD. The other two I wouldn't say there are causes. This is what I was referring to when I say there is not well defined data to describe what is more common.

I am in no way denying that people with ADHD have difficulties and that there are compensatory strategies to mitigate those difficulties.

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yungsphincter t1_itm6xmz wrote

The corticospinal tract is motor though

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beebeeff t1_itnm2ew wrote

I was wondering the same thing. I can’t find anything that suggests the relationship between left corticospinal tract and executive function and attention.

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