Abstract:

Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder characterized by inattention and/or hyperactivity-impulsivity, which is closely related to the executive function deficits resulting from the dysplastic of prefrontal cortex. However the underlying psychological mechanisms behind neurological abnormalities leading to core symptoms in children with ADHD remain unclear, particularly how executive function deficits, which are related to abnormal prefrontal development as the underlying cognitive deficit and endophenotype, influence the emergence of core symptoms of ADHD. To address this scientific question about why and how executive function affect the two core symptoms of ADHD, the following aspects are analyzed and discussed. Firstly, based on the neuro - cognitive - behavioral developmental path, it can be inferred that executive function deficits may be the pathogenesis of the core symptoms of ADHD at the cognitive level and act as a cognitive bridge connecting neuro-developmental abnormalities to the core symptoms. Secondly, executive function can be divided into two distinct components: “cold” and “hot”, which may be the two cognitive pathways leading to different core symptoms of ADHD. And these deficits can result in different behavioral manifestations and have diverse effects on developmental outcome. Among that, the “cool” executive function deficits rooted in the dorsal prefrontal cortex might be the dominant factor affecting inattention symptoms, while the “hot” executive function deficits linked to the ventromedial prefrontal cortex might be emerge as the primary contributor to the symptom of hyperactivity and impulsivity. Building upon this understanding, the present study combines empirical and theoretical evidence to investigate the specific mechanisms through which deficits in the subcomponents of “cold” and “hot” executive function influence the two core symptoms of ADHD. And a graph is presented to illustrate the relationships between the abnormal behavioral manifestations and key executive function deficits observed in children with ADHD under these two core symptom categories. Specifically, on the one hand, the deficits in “cool” executive function mainly results in failures in working memory representation, lack of inhibitory control, and difficulties in cognitive flexibility, and further lead to limitations in attention maintenance, selection, and switching. On the other hand, the deficits in “hot” executive function bring problems like delay aversion, reward abnormality and motivation disorders, which make one fail to inhibit behavior and more likely to make impulsive decision, thereby displaying more symptoms of hyperactivity or impulsivity. In addition to elaborating the specific mechanisms of action of executive function deficits affecting core symptoms of ADHD from the perspective of cognitive and neural correlations, further empirical evidence is provided to support and refine the mechanisms from the perspective of causal manipulation of cognitive interventions and neuroregulatory techniques. Finally, future studies are expected to examine and improve the theoretical model of “cold” and “hot” executive function deficits affecting the core symptoms of ADHD, and provide more empirical evidence at the cognitive neural level. Meanwhile, future studies need to examine this influence the mechanism mentioned above in ecological backgrounds, and further develop intervention projects with personalization, precision and long-acting to alleviate the core symptoms of ADHD based on executive function. To sum up, examining the impact and mechanisms of “cold” and “hot” executive function deficit on the two core symptoms of ADHD children from the perspectives of neuroscience, cognition, and behavior is of great scientific value and practical significance. This exploration offers evidence at the cognitive and neuroscience levels, enabling a deep understanding of the pathogenesis of ADHD. Additionally, it provides an evidence-based foundation for individualized interventions and precise treatments for children with ADHD by examining the effectiveness of interventions through causal manipulation of cognitive interventions and neuroregulatory techniques.

Key words: Attention-deficit/hyperactivity disorder, executive function deficit, core symptom, prefrontal cortex, mechanism