Frontal and executive dysfunction is a central aspect of ADHD

Abstract

In the target article, Sagvolden and collaborators propose that attentional-deficit/hyperactivity disorder (ADHD) is the result of a general behavioral deficit which is mainly caused by a hypofunctioning mesolimbic dopaminergic system. Although we partly agree with this view, we think that it tends to overlook the dysfunction of prefrontal and frontostriatal executive functions by considering them to be a consequence of alterations in reward and extinction mechanisms. Rather, we believe that ADHD is the result of an overall cognitive and behavioral condition, associated to a generalized dopaminergic network dysfunction, and may not be easily attributable to a single basic behavioral function.