That electric feeling

Advances in genetics and imaging offer hope for understanding ADHD

Bill Snyder
Published: November, 2003

Before he started taking Ritalin four years ago, J.T. King just couldn’t sit still. “I feel like I have electricity running through me,” he told his parents when he was in the second grade. “I feel like if I stuck my hands out, … lightning bolts would come out of my fingers.”

J.T. is still bothered sometimes by that electric feeling. But today, thanks to the medication, his parents’ perseverance and his own determination, the gregarious seventh grader is succeeding in school, competing in chess tournaments and mastering every video game he tries. “He’s awesome,” marvels his mother, Jere King.

This 14-year-old computer whiz from Franklin, Tenn., has attention deficit hyperactivity disorder (ADHD), the most commonly diagnosed behavioral problem in children. There is recurring debate about whether ADHD is over-diagnosed, or whether some hyperactive youngsters aren’t getting the treatment they need.

What confounds any discussion about the diagnosis and treatment of ADHD is its complexity. ADHD is actually a constellation of symptoms – the hallmarks of which are a persistent pattern of hyperactivity, impulsive behavior and difficulty paying attention. No single cause for these symptoms has yet been found and, to complicate matters even further, ADHD is often diagnosed in conjunction with learning disabilities and other behavior problems.

These mysteries are rapidly being unraveled, thanks to recent advances in genetics, brain imaging and the ability to manipulate the genetic make-up of laboratory mice. “Advancements in technology have changed the whole field completely,” asserts Richard Shelton, M.D., professor of Psychiatry and Pharmacology at Vanderbilt University Medical Center, and an expert on the treatment of depression, bipolar disorder and ADHD. “I’m asking questions now that I couldn’t possibly have asked even five years ago.”

To understand ADHD, as well as other disorders of brain functioning, we must first journey deep into the nervous system – down to the cellular level. There we’ll find the molecules that make it possible for electrical signals to jump the gaps between individual nerve cells, called synapses, and transmit information at lightning speed throughout the body.