Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.

中文翻译：

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ADHD中的精准医学护理：神经兴奋和抑制的案例

注意缺陷/多动障碍（ADHD）是一种神经发育障碍，已在世界范围内越来越普遍。它的核心症状，包括难以调节注意力，活动水平和冲动，出现在儿童早期，并且可以持续一生。针对儿茶酚胺神经传递的当前药理学选择有效地缓解了部分但并非全部受影响个体的症状，使临床医生不得不采用试错法进行治疗。在这篇综述中，我们讨论了来自临床前和人体研究的最新实验证据，这些证据表明在早期发育过程中额纹状体回路的兴奋/抑制（E / I）失衡可能导致回路的持久神经解剖学异常，从而导致多动症的持续存在成年后的症状。