Ali Alsaqr, Saleh Alhumaid, Muteb Alanazi, Ali Abusharha
Prescribing patterns for hyperopia: an insight of the optometrist perspective and practice
BMC ophthalmology
current concepts attentiondeficithyperactivity disorder adhd emphasize role higherorder cognitive functions reinforcement processes attributed structural biochemical anomalies cortical limbic neural networks innervated monoamines dopamine noradrenaline serotonin however explanations account ubiquitous findings adhd intraindividual performance variability particularly tasks require continual responses rapid externallypaced stimuli consider attention temporal process dependent upon continuous energy supply efficient consistent function consideration feature intraindividual response variability unique adhd also found disorders leads new perspective causes potential remedies specific aspects adhd propose adhd astrocyte function insufficient particularly terms formation supply lactate insufficiency implications performance development h1 rapidly firing neurons deficient atp production slow restoration ionic gradients across neuronal membranes delayed neuronal firing h2 oligodendrocytes insufficient lactate supply impairs fatty acid synthesis myelination axons development effects occur vastly different time scales due deficient atp h1 occur milliseconds whereas due deficient myelination h2 occur months years collectively neural outcomes impaired astrocytic release lactate manifest behaviourally inefficient inconsistent performance variable response times across lifespan especially activities require sustained speeded responses complex information processing multilevel multimethod approaches required include 1 use dynamic strategies evaluate cognitive performance conditions vary duration complexity speed reinforcement 2 use sensitive neuroimaging techniques diffusion tensor imaging magnetic resonance spectroscopy electroencephalography magnetoencephalopathy quantify developmental changes myelination adhd potential basis delayed maturation brain function coordination 3 investigation prevalence genetic markers factors regulate energy metabolism lactate glutamate glucose transporters glycogen synthase glycogen phosphorylase glycolytic enzymes release glutamate synaptic terminals glutamatestimulated lactate production snap25 glutamate receptors adenosine receptors neurexins intracellular ca2 well astrocyte function 1 2 adrenoceptors dopamine d1 receptors myelin synthesis lactate transporter lingo1 quaking homolog leukemia inhibitory factor transferrin hypothesis extends existing theories adhd proposing physiological basis specific aspects adhd phenotype namely frequent transient impairing fluctuations functioning particularly performance speeded effortful tasks immediate effects deficient atp production slow restoration ionic gradients across membranes rapidly firing neurons implications daily functioning individuals adhd performance efficacy would enhanced repetitive lengthy effortful tasks segmented reduce concurrent demands speed accuracy response introduction breaks lengthyeffortful activities examinations motorway driving assemblyline production also variations task modality use self rather systempaced schedules would helpful would enable energetic demands distributed alternate neural resources energy reserves reestablished longerterm effects may manifest reduction regional brain volumes since brain areas highest energy demand affected restricted energy supply may reduced size novel forms therapeutic agent delivery system could based factors regulate energy production myelin synthesis since phenomena proposed basis unique adhd also manifests disorders implications hypotheses may relevant understanding remediating conditions well