Prefrontal and executive attention network lesions and the development of attention-deficit/hyperactivity symptomatology

Jeffrey E. Max, Facundo F. Manes, Brigitte A.M. Robertson, Katherine Mathews, Peter T. Fox, Jack Lancaster

Research output: Contribution to journalArticle

36 Scopus citations


Objective: To investigate the association between focal stroke lesions of Posner's executive attention network and a specific region of interest in the frontal lobes (orbital frontal and mesial frontal) and either attention-deficit/hyperactivity disorder (ADHD) or traits of the disorder (ADHD symptomatology). Method: Twenty-nine children with focal stroke lesions were studied with standardized psychiatric assessments and anatomical brain magnetic resonance imaging. The pattern of lesion overlap in subjects with ADHD symptomatology was determined. Results: Fifteen of 28 subjects with no prestroke ADHD were diagnosed with ADHD symptomatology at the time of assessment. The extent of lesions within the executive attention network was marginally related to ADHD symptomatology (p = .088; effect size = 0.66), whereas the extent of lesions in the specific frontal region of interest was significantly related to ADHD symptomatology (p = .040; effect size = 0.82). Conclusions: Lesions within Posner's executive attention network and its orbital frontal connections may be linked to important mechanisms in the expression of ADHD symptomatology after childhood stroke. These findings are consistent with functional and structural imaging findings in studies of idiopathic ADHD.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number5
StatePublished - May 2005



  • Attention-deficit/hyperactivity disorder
  • Childhood stroke
  • Executive attention
  • Frontal lobe

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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