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Old 09-28-05, 01:28 PM
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Perseveration, Hyperactivity, Inattention, and the Dopamine Theory - Seeking Opinions

It is commonly observed by many in the field including many here that individuals with ADHD often exhibit "hyperfocus," clinically called "perseveration," commonly defined as a state of extreme focus and interest in a single topic, often demonstrated from hours to months in length, followed almost always by a sudden loss of interest. Having given this a great deal of thought over the last year, I believe I have come to what is a sound hypothesis on why this occurs, and how it relates to ADHD. I write this hoping for opinions, and more importantly, for those well versed in current ADHD research to either show me where this has been researched otherwise, or any evidence against it.

ADHD is theorized to be related to a difference in the processing and action of dopamine in the brain. Dopamine is a paradoxical neurotransmitter, acting as both an excitatory and inhibitory NT depending on context. Important to my hypothesis are the actions of dopamine in the prefrontal cortex and in muscle movement. Current understanding and research shows that dopamine, in muscle movement, acts as an inhibitor; it appears to smooth fine muscle movement and prevent overactivity in firing resulting from acetylcholine (ACh), without stopping the firing entirely as acetylcholinesterase would. In the prefrontal cortex, dopamine is also inhibitory - in this case, it is fired in inactive-synapses, in order to prevent the firing of synapses from spillover or "random firing" as the neurons hit their threshold.

In short, dopamine prevents superfluous neuronal excitation in the prefrontal cortex, and hence, prevents random firing, as may be present in ADHD, resulting in the inability to remain on a single topic: the brain is simultaneously firing neurons regarding multiple thoughts, and so confuses itself. Dopamine also prevents and smooths small motor movements, and its absense allows for fidgeting as well as the often observed lack of motor coordination.

Further demonstrating that ADHD is caused by downregulation of dopamine in the central nervous system is the responsivity of those with ADHD to stimulant medications. These medications are known to cause a release of dopamine in virtually all systems of the brain. In the average individual, this increase in dopamine is demonstrated on top of regular amounts of dopamine, causing euphoria, hyperactivity, and so further, while in individuals with ADHD, the increase in dopamine serves only to establish a normal level, and therefore serves the usual purposes of dopamine as mentioned above.

My hypothesis regarding perseveration (hyperfocus) uses the prior as its basis - if dopamine is not fired at proper times, and yet the body is still properly metabolizing it, then where does it go? I postulate that it is stored and not released properly - except in cases of extreme interest. It is well known that dopamine is released in times when the mind must be active and alert; and in this case, it is critically important to note that pleasure also causes it to be released.

Having been stored and raised to unusually high levels due to the lack of triggers, the release of dopamine as a result of an interesting stimuli may be unusually high. This, of course, leads to the attribution of the "good" feeling from the dopamine to the interesting stimuli which caused that release. The result? Not only does the release of dopamine result in a temporary absence of ADHD symptoms, it also results in pleasure - the individual with ADHD, when this phenomena occurs, becomes literally addicted to the interesting stimuli.

This also, then, explains the complete immersion, followed by the sudden drop in interest: as the individual learns that the object of perseveration causes them joy and pleasure, they immerse themselves more and more in it. However, eventually, the inherently dysfunctional dopamine regulators return to their normal state, and prevent the release of dopamine. The addiction fades as the amounts of dopamine required to maintain the necessary feelings of joy increase, and the amounts actually released decrease drastically. Much like a new game becomes boring after it is played too many times, the topic loses its ability to make the individual feel good: the addiction passes.

I believe that this hypothesis is a key to understanding how dopamine is involved in ADHD. If validated, this intricate interaction of dopamine-related phenomena demonstrates with a very high degree of validity that dopamine-regulation is the culprit in children and adults with this disorder.
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Old 09-28-05, 01:44 PM
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Keith,

If you haven't done so already, please check out Barkley's 1997 book..... ADHD and the Nature of Self-Control.

I think you'd enjoy it.
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Old 09-29-05, 05:23 AM
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Interesting ideas Keith. I'm gonna have to chew on it for a while. I had a couple of initial impressions though.

Consider the effects of "natural dulling" over time. "Dulling" can be a natural occurance even in a healthy love relationship. Experiments have shown that even taste buds will eventually react less and less to the same repeated sweet sugar stimulus.

The other thought I had was that any activity or process has intervals where it naturally slows down. If you don't remember your aim you can easily drift off and go down a completely different road. The trick is to have a few activities that are related, that can keep reminding each other.
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Old 09-29-05, 01:28 PM
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It is interesting Keith, but I can't comment much beyond that because I could only partly follow it -- bit complex for my brain ATM. I probably oversimplify it down to the old motto from my youth, "If it feels good, do it!" With my rather disinhibited brain, it's very easy to stick with/and difficult to leave something that exciting/interesting and gives me that little squirt of dopamine. Also, it is very rare for me to lose interest in something suddenly -- I can stick with a topic or interest anywhere from days to decades.

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Old 09-29-05, 01:46 PM
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What Russ Barkley has said on that is that of the 6 types of Attention, currently deinfed by neuropsychology, 5 of those are considered to be "Input" functions of the brain,while only one is an "Output" function.

The one "Output" function (persevere/persist), is the one disrupted by ADHD.

That's (in part) why he often refers to ADHD as a "Performance Disorder" and not a "Perception" one.

We know what we're supposed to do; only we can't do it.

This is taken from my 2003 Door County Institute notes.

I believe he says the same thing is ....ADHD and the Nature of Self-Control.
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Old 04-13-10, 02:48 PM
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Re: Perseveration, Hyperactivity, Inattention, and the Dopamine Theory - Seeking Opin

Bumping up this old thread because of what Barkley says in this video . . .

"hyperfocusing is actually perseveration."

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Old 05-09-11, 07:36 PM
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Re: Perseveration, Hyperactivity, Inattention, and the Dopamine Theory - Seeking Opin

Thank you for the great video. How enlightening! I started this research for info to help my son control his "hyper focus". He is juvenile bipolar type 2 with traits of aspirers. He gets so involved I. One topic (airsoft/military history) completely consumes him. How ironic that this video explains my own behavior?! Double the irony that I could not pull away from the research to do the simple household tasks that are so over due.
So...back to my original issue....does anyone know of any tools/techniqUEs to work on controlling this?
Thanks!
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