Étude de l’hypothèse d’une fatigabilité cognitive excessive comme substrat de l’impulsivité chez les adultes avec TDAH

Abstract : Attention Deficit Hyperactivity Disorder (ADHD) is a chronic, disabling neurodevelopmental and behavioral disorder. It persists in three-quarters of patients as adults. The symptom associated with the morbidity and mortality of ADHD in adults is impulsivity. The neural bases of the disorder, and in particular of impulsivity, are not known to date. In addition, a recent literature describes the feeling of discomfort that arises over time during cognitive tasks is described through the cognitive fatigue concept. It is measured by the increase in impulsiveness in intertemporal monetary choices (between an immediate reward and a delayed one). It is thus defined as the increase of the ratio "Estimation of the cost of the cognitive control during a decision / Estimation of the profit of the selected reward". It is correlated with increased impulsivity and decreased activity of the lateral prefrontal cortex (CPFL), seat of executive control. Adult ADHD is characterized by impulsivity, subjective monetary devaluation over time and a hypofunctional CPFL. This suggests a link between cognitive fatigability and a lack of cognitive control in this pathology. In this work we study the ADHD hypothesis as a paradigm of very early cognitive fatigability using neuroeconomic and decision-making theories. The overall goal is to better characterize decision-making issues in this disorder, and to improve understanding of cognitive fatigue in a pathological context.
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Master Thesis
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Jean de Lepineau. Étude de l’hypothèse d’une fatigabilité cognitive excessive comme substrat de l’impulsivité chez les adultes avec TDAH. Médecine humaine et pathologie. 2018. ⟨dumas-02180844⟩

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