Tatizo la Kutotulia : Tofauti kati ya masahihisho
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Awali, ilifikiriwa kuwa idadi iliyoongezeka ya [[visafirishaji vya dopamini]] kwa watu wenye TKUU ilikuwa sehemu ya pathofisiolojia lakini inaonekana idadi hii ya juu ni kutokana na adaptesheni kwa mfiduo wa vichocheo.<ref name="pmid22294258">{{cite journal |author=Fusar-Poli P, Rubia K, Rossi G, Sartori G, Balottin U |title=Striatal dopamine transporter alterations in ADHD: pathophysiology or adaptation to psychostimulants? A meta-analysis |journal=Am J Psychiatry |volume=169 |issue=3 |pages=264–72 |year=2012 |month=March |pmid=22294258 |doi=10.1176/appi.ajp.2011.11060940 |url=}}</ref> Watu wenye TKUU wanaweza kuwa na kizingiti cha [[nadharia ya kiwango cha chini cha mwamsho|kiwango cha chini cha mwamsho]]. Watu hawa huifidia hali hii kwa ongezeko la [[Kichocheo (fiziolojia)|vichocheo]], inayosababisha kukatizwa kwa umakinifu na ongezeko la tabia ya kupepesuka. Sababu kuu ya tukio hili ni kasoro ya mwitikio wa [[mfumo wa dopamini]] kwenye kichocheo.<ref>{{Cite journal|author=Sikström S, Söderlund G |title=Stimulus-dependent dopamine release in attention-deficit/hyperactivity disorder |journal=Psychol Rev |volume=114 |issue=4 |pages=1047–75 |year=2007 |month=October |pmid=17907872 |doi=10.1037/0033-295X.114.4.1047 |url=http://content.apa.org/journals/rev/114/4/1047}}</ref> Pia, kunaweza kuwa na kasoro katika njia zinazotoa [[adrenalini ]], [[serotonini]] na [[kikolini]] au nikotini.<ref name="Kooij-2010"/><ref name="Cortese-2012">{{Cite journal | last1 = Cortese | first1 = S. | title = The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know | journal = Eur J Paediatr Neurol | volume = 16 | issue = 5 | pages = 422–33 | month = Sep | year = 2012 | doi = 10.1016/j.ejpn.2012.01.009 | pmid = 22306277 }}</ref>
===Shughuli tendaji===
Nadharia moja inadai kuwa dalili hizi hutokana na ugumu katika [[shughuli za utendaji]].<ref name="Brown-2008">{{Cite journal | last1 = Brown | first1 = TE. | title = ADD/ADHD and Impaired Executive Function in Clinical Practice | journal = Curr Psychiatry Rep | volume = 10 | issue = 5 | pages = 407–11 | month = Oct | year = 2008 | doi = 10.1007/s11920-008-0065-7| pmid = 18803914 }}</ref> Shughuli za utendaji huhusu baadhi ya [[ufahamu|michakato ya kiakili]] inayohitajika kurekebisha na kudhibiti shughuli za kila siku za maisha.<ref name="Brown-2008"/> Baadhi ya kasoro hizi hujumuisha: matatizo ya stadi za kupanga, kutumia wakati vyema, [[kuahirisha]] kwingi, ugumu wa kumakinika, kasi ya kufikiria, kudhibiti hisia, kutumia kumbukumbu ya sasa na kuwa na kumbukumbu fupi.<ref name="Brown-2008"/> Kwa kawaida watu huwa na kumbukumbu ya muda mrefu.<ref name="Brown-2008"/> Vigezo vya ukosefu wa shughuli za utendaji hufikiwa katika asilimia 30- 50 ya watoto na vijana wenye TKUU.<ref>{{cite journal | pmid=20406332 | title=Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ? | author=Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH |journal=Journal of Child Psychology and Psychiatry | year=2010 | volume=51 | issue=8 | pages=895–904 | doi=10.1111/j.1469-7610.2010.02248.x}}</ref> Utafiti mmoja uligundua kuwa asilimia 80 ya watu wenye TKUU walikuwa na kasoro katika angalau mojawapo ya shughuli ya utendaji ikilinganishwa na asilimia 50 ya watu wasio na TKUU.<ref name="Nigg-2005">{{Cite journal | last1 = Nigg | first1 = JT. | last2 = Willcutt | first2 = EG. | last3 = Doyle | first3 = AE. | last4 = Sonuga-Barke | first4 = EJ. | title = Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? | format = PDF |url =http://pingpong.ki.se/public/pp/public_courses/course07292/published/0/resourceId/0/content/Nigg_etal_2005%20%28Thorell%29.pdf| journal = Biol Psychiatry | volume = 57 | issue = 11 | pages = 1224–30 | month = Jun | year = 2005 | doi = 10.1016/j.biopsych.2004.08.025 | pmid = 15949992 |archiveurl=http://web.archive.org/web/20131014040108/http://pingpong.ki.se/public/pp/public_courses/course07292/published/0/resourceId/0/content/Nigg_etal_2005%20(Thorell).pdf|archivedate=2013-10-14}}</ref> Kutokana na kiwango cha ubongo kukua na matakwa ya juu ya kudhibiti utendaji mtu anapozidi kukua, kasoro za TKUU zinaweza kutojionyesha kikamilifu hadi kufikia ujana au hata utu uzima wa mapema.<ref name="Brown-2008"/>
==Utambuzi==
TKUU hutambuliwa kwa kadirio la ukuaji wa tabia za utotoni na za kiakili kwa mtu binafsi; ikijumuisha kutozingatia athari za dawa, matibabu na matatizo mengine ya kimatibabu au kisaikaitria kama maelezo ya dalili.<ref name = NICE2008/>{{Rp|p.19–27|date=March 2013}} Mara nyingi utambuzi huzingatia maoni kutoka kwa wazazi na walimu<ref name=Lake2011/> huku utambuzi mwingi ukianzishwa baada ya mwalimu kutoa madai haya.<ref name=Erk2009>{{cite book |author=Erkulwater, Jennifer L.; Dr Rick Mayes; Dr Catherine Bagwell; Dr Jennifer Erkulwater; Mayes, Rick; Bagwell, Catherine |title=Medicating children: ADHD and pediatric mental health |publisher=Harvard University Press |location=Cambridge |year=2009 |pages=4–24 |isbn=0-674-03163-6}}</ref> Hii inaweza kuonekana kama kipeo cha mojawapo ya/au [[tabia za binadamu]] endelevu zinazopatikana katika watu wote.<ref name=NICE2008>{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG72FullGuideline.pdf|format=PDF|title=CG72 Attention deficit hyperactivity disorder (ADHD): full guideline |publisher=NHS|author=National Institute for Health and Clinical Excellence|authorlink=National Institute for Health and Clinical Excellence |date=24 September 2008 }}</ref>{{Rp|p.130|date=November 2012}} Utambuzi hauthibitishwi au kutupiliwa mbali ikiwa mtu atanufaika na matibabu au la.<ref name=Lake2011/> Kwa vile tafiti za picha za ubongo hazina matokeo imara miongoni mwa watu, picha hizi hutumika kufanya utafiti pekee wala si utambuzi.<ref>{{cite web|url=http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp |title=MerckMedicus Modules: ADHD –Pathophysiology|archiveurl=http://web.archive.org/web/20100501074844/http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp|archivedate=1 May 2010|date=August 2002}}</ref>
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