Susannah

Picturing the secrets of the extraordinary ADHD Brain

Updated: Mar 1, 2023

Cutting-edge fMRI can now show us ADHD brain connectivity in real time. What’s been revealed and how can this insight improve our lives?

It’s all about networking!

I’m thrilled that we are discovering more about ADHD all the time. Scientists have new ways of revealing how our brains work, and most recently functional Magnetic Resonance Imaging (fMRI) has literally allowed us to see inside the brain as it works.

Excitingly, they have been able to recognise a major difference in the connectivity within the ADHD brain, when compared with a neurotypical brain.

This work is described by world-renowned ADHD experts Ned Hallowell M.D. and John Ratey M.D. in their recent ground-breaking publication, ADHD 2.0.

In very simple terms, brain connectivity is all about networks. We are looking at just a couple.

The DMN or default mode network, (shown in blue)

Aptly named the ‘default’ network, this is the group of connections active during daydreaming and creative, expansive thinking. This ‘connectome’ links the autobiographic part of the brain with the part which enables forward-thinking and planning and imagination. With this network active, you might be relaxing in a daydream, musing creatively or thinking openly with, say, a cryptic crossword.

The TPN or task-positive network, (shown in yellow)

This is the network that gets you down to work. It also keeps you on track. Whatever you have set your mind to, whether it’s a home project, a work project, exercise or deliberately resting, you are carrying out your intention.

These two networks, the DMN and the TPN have what is known as an anticorrelation property. This means that in a neurotypical brain, when the TPN is turned on and you’re on task, the DMN is turned off, and vice-versa.

Diagram of the view of the right side of the brain showing areas involved in the DMN (blue) and TPN (yellow).

In the ADHD brain, however, the fMRI shows that when the TPN is turned on, the DMN is on as well, trying to muscle its way in and pull you into its grasp, thereby distracting you. In ADHD therefore, the DMN completes with TPN. (Hallowell and Ratey, 2021)

One simple way of looking at this brain circuitry is to imagine a railway system. TPN and DMN are the two sets of tracks and our thoughts the train, with our actions following along as carriages. Ideally, we’d all be at ease on the DMN track with the ability to move effortlessly across the points to the nearby TPN track at will, and back again

In our ADHD brains, however, the DMN and TPN tracks run perilously close to one another, with many points of contact along the way. We become easily distracted by the glittery thoughts on the DMN track.

Sights, sounds and our other senses tempt us from our tasks. Even though we try to stay on the TPN track, our attention splits and our engine can easily sail off down the DMN line. Our actions, the carriages, carry on ‘mindlessly’ down the TPN line. Think, for example of attempting to read an uninteresting piece of text. The eyes follow the words, but the mind is elsewhere.

Our focus can also jump track and veer

off towards our often-unreliable autobiographical site (in DMN), and this is how we might easily become ruminators. Hyper-focus can be explained in these terms too. If the points worked better along the TPN track, we wouldn’t run the risk of spinning off into hyper-focus so often. No wonder staying on track is so exhausting with an ADHD railway system!

Having this analogy, let’s take time to picture our own circuitry and make it work for us.

Firstly, consider self-awareness is your signalling system

1. Knowing how easy it is for our brains to ‘jump track’ from the TPN to the DMN, begin to identify when you are most likely to do this. Is it most noticeable when you are hungry? Tired? Bored? Dehydrated? By committing your response to paper or device, you’ll reinforce your findings and help reduce the amount of times it happens.

2. Try to recognise these ‘signals’ and visualise where you want to be heading instead. We are good at distracting ourselves in TPN, and with practice it’s not difficult when we’re in DMN, so long as we remain self-aware.

3. Have a mantra ready for when you become aware of needing to get back on the TPN. Something visual like: You’re on the wrong line! Back on track!

Secondly, maintain your points

1. Have a favourite quick fix to hand. Hallowell and Ratey suggest doing anything – anything- so long as it is focussed on the world outside your brain. It works quicker if it is a physical activity. Something as simple as consciously tapping out a beat, jumping, singing (especially if you know ‘the Runaway train went down the track’..!), clapping, hopping, running or making a fuss of a pet all work brilliantly and almost instantaneously. You could even act out changing those points with an energetic sweep of the arms!

2. It becomes much easier with practice. The more you switch away from the DMN, the easier it becomes. Think of it as keeping your points in tip-top condition.

Third, look after your TPN track

1. The correct medication, in the correct dosage, at the right time, will help you stay on

track. Are you happy yours are doing the job they should? Is it time for a meds review?

2. Cut time and energy-wasting frustration by being clear about your destination. Before you set off, spend twice as much time as you think you’ll need carefully visualising the end result. That way you won’t be tempted to go ‘sight-seeing’ along the DNM en route and end up off course.

3. Maintain a steady forward path. Routines, habits and planning ahead are all wonderful tools to keep us orientated and minimise that ‘where am I heading?’ feeling.

4. Hallowell says: [In today’s world] unfortunately, the TPN is akin to a muscle that atrophies when not used. So, as we mentally flit around, the TPN weakens and our attention span shortens.

The more we use our TPN, the easier it is to remain there. So, exercise your brain, learn something new, like a language or a new skill. Challenge yourself to stay on track with apps like Saplingly, stopwatches or timers. By definition it’s not a quick fix, but it really does work!