O TDAH na prática neurológica do adulto: muito além da desatenção

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental condition that, although frequently associated with childhood, may extend into adulthood, impairing cognitive, emotional, and social functioning. This thesis aims to review the scientific literature on adult ADHD, with an emphasis on integrating neurobiological, clinical, and therapeutic aspects from a neurological perspective. This is a narrative review based on recent national and international publications that aim to understand the neuroanatomical and functional foundations of the disorder, its clinical presentation in adulthood, and the primary therapeutic approaches available. Evidence indicates that ADHD results from dysfunctions in frontostriatal, frontoparietal, and cerebellar circuits, associated with dopaminergic and noradrenergic alterations that compromise inhibitory control, sustained attention, and reward mechanisms. Clinically, the disorder manifests as inattention, impulsivity, executive dysfunction, and impaired emotional regulation, impacting occupational performance and interpersonal relationships. The recognition of ADHD in adults remains limited, due to both the symptomatic overlap with other disorders and the lack of specific diagnostic protocols. Treatment should be multimodal, combining pharmacological therapies — particularly stimulants and noradrenergic agents — with psychotherapeutic interventions and cognitive rehabilitation strategies. The integration between neuroscience and clinical practice enables the understanding of ADHD as a complex neurobiological condition that requires continuous and interdisciplinary management. It is concluded that improving the diagnosis and treatment of adult ADHD depends on acknowledging its cerebral basis and adopting individualized therapeutic approaches, thereby promoting functional improvement and quality of life.