Traumatic Brain Injury (TBI) and ADHD

00:00 Introduction
00:48 Brief discussion of causes of ADHD
03:11 Explanation of how TBI might cause ADHD due to nature of TBI brain damage
06:27 How is TBI and its severity related to subsequent risk for ADHD
08:42 How ADHD increases risk for subsequent TBI (especially the mild forms)
10:23 Brief discussion that stimulant medications can help manage TBI neurocognitive deficits
11:20 Conclusion

Research References

Asarnow, R. et al.. (2021). Association of Attention-Deficit/Hyperactivity Disorder Diagnoses With Pediatric Traumatic Brain InjuryA Meta-analysis. JAMA Pediatrics, 175(10), 1009-1016. doi:10.1001/jamapediatrics.2021.2033

[NinjaCoderInTraining]

My mom accidentally dropped me on my head pretty badly as a toddler. Knowing how clumsy ADHD people can be, I just realized it is heritable even without the risk genes lol

[Authentistic-ism]

I have both autism and TBI from a car accident and domestic violence abuse. We don't even know all the different types of TBI my different experiences caused. But now a lot of people ask me if I have ADHD when before the brain injuries I didn't show symptoms. A lot of the brain injury and ADHD symptoms overlap. I particularly have problems with short-term memory and impulse control and emotional regulation before the brain injury I was able to mask my autism and didn't have meltdowns but now I do have them

[chickenfooker]

I Had ADHD symptoms before a moderate TBI at 11 (smashed head on pavement when playing on ice). This appeared to accelerate symptoms: I couldn't concentrate in class and was often kicked out for disrupting others.

[julietteferrars]

Thanks for addressing TBI! I love these discussions, they give my brain something to chew on and ponder.

[briangilliland]

Thank you for this post!I became epileptic after a serious brain injury and after trying so many medication cocktails I was finally stabilized with two. Now I am much older and I recently have been diagnosed with Executive Functioning Disorder. Taking medication has been a godsent for me for focus and balance.
Thank you for sharing your knowledge and dedicated research!

[ShutchyerLips]

My youngest (12) can confirm tbi is more likely to occur with adhd present. She's the most hyper and scattered of our family of 5, who all have diagnosed adhd. She gets a concussion or near concussion at least once per year from sports or rough play with friends. I'm always worried it will lead to a more severe condition, which could lead to more of these incidents, which could set her up for an even more difficult life than she's already going to have. Limiting her self-expression through sports isn't the answer, but we have joked about getting her a helmet because it's so hard to watch it happen.

[jimwilliams]

This interested me because I did have a fall on ice some years back, and I hit the back of my head in a rapid deceleration that I now understand that the prefrontal cortex really does not like, as it causes the front of the brain to pull away from the front of the skull. I did not lose consciousness, which is the question that physicians always ask when I inquire about it, and you’ve explained why, thank you. I wonder about it sometimes with regard to an unusually intense episode of trauma/flight response a few months later. I had been dealing with the death of a parent and care for the other, and a major change at work which put much more pressure on me, and I did and do ascribe the incident, and a subsequent period of extreme dysregulation, depression and SI, to those events. But I still wonder if the impact contributed to my increasing mental health issues. I’ve examined the details of the last 15 years, which have included a lot of stressors, and see everything as part of an overall upward arc; no one event shows a outsized effect, but rather a cumulative one. All of it did intensify existing ADHD and ASD symptoms, though.

In terms of my early childhood, I strongly suspect lead exposure contributed to my deficiencies, though my parents’ traits indicate the heritable aspects of my disorders. I grew up during peak leaded gas, in old houses with lead paint, and I suspect a bout of anemia was related to lead exposure. This was before testing for lead was typical, though. It all adds up...

[KateFo-wo]

this caught my attention immediately. i've got adhd and mdd and got into a ski accident when I was 12 that gave me a tbi. (broke my face lol.) i always assumed that the nosedive all my symptoms took in the years after that was from the severe depression and the trauma i got from the healing period (months of being stuck in a dark room, ) and i figured adhd as a genetic condition couldnt get worse with injury. but maybe that wasn't exactly the case, how interesting

[Indiekid-]

I found out recently, in my late 40s, that I was thrown at the wall in temper by my father when I was teething at 11 months old. I was punished my whole childhood by my mother and stepfather for what are traits of ADHD, and until recently I was unaware that this had happened or that I had ADHD. My mostly absent real father died when I was 13 and I have never been able to work out if he had ADHD and passed it to me or he caused it.
I’d be interested to know if any research has been done into whether TBI can worsen ADHD and if someone acquires ADHD through a severe TBI, can this be passed on, and if so is this possible evidence for epigenetics in humans?

[franceslothian]

My daughter who is diagnosed ADHD bumped her head on several memorable occasions between the age of 1 and 3. She has one or two scars on her head to prove it.

[raewynfern]

Just going for ADHD diagnosis now at 62 after having had my whole life, and my 2 boys... Had TBI frontal lobe 30 months ago and slow to recover, then ADHD hit stronger than ever 6 months ago. Also TBI frontal lobe at age 6... in NZ girls weren't diagnosed in 1960s or 70s, and brain injury back to school within a week. Raynauds in family inherited too. Does it matter if ADHD was just genetic or worse from TBIs? I'm expected to suck it up and get on with life!

[Indiekid-]

0:49 I think the true statistics of this could be slightly skewed. For example, I don’t think data regarding difficult births including forceps etc. are properly recorded and correlated to people later diagnosed with ADHD. I think cases of maltreatment, accidents and incidents including toxins etc aren’t going to be accurately recorded (more so than causes that don’t include possibility of blame), many parents wouldn’t want to get into trouble or would assume the baby was ok and not report what had happened.

I also think that it should be imperative to properly understand if people with ADHD acquired through post-natal damage, perinatal complications, infections, lead and other toxins, fetal alcohol exposure or prematurity/low birth weight can pass on their ADHD the same way as people with ADHD that isn’t acquired through anything but inherited genetics are able to. If there is a difference then I think ADHD is more of a descriptor of problems in the cerebellum than a condition in its own right, and an inadequate one at that. Also, if this is the case, it would be better to understand these different things that cause ADHD symptoms, in their own right. It makes them at least as different from each other as types 1 and 2 diabetes and is information that is in some ways more relevant than if someone is inattentive type vs hyperactive etc.

[userzyx]

thankyou for your informative videos -- acceleration & deceleration like domestic violence against children or shaking children too violently ; but yes, if there is a lack of tissue connectivity, then that may be induced through that ; or lacking nutrition impeding development

[melusine]

Hmmm... i know of 2 incidents as a kid - once off a trampoline at about age 6/7 (i think) - the only time ive been hospitalised (just over night no blood or stitches i think. ) And once at about 12? Falling off a horse(helmet thankfully) .

I have no idea if i changed after that.

[yoannastefanova]

Hello, is there any meaningful research on the interaction between a partial agenesis of the corpus callosum and ADD symptoms. How to identify if the symptoms are those of ADD or the result of the partial agenesis (or both)?

[Madkalibyr]

I’m 35, had an ischemic stroke and during imaging found a very large arachnoid cyst in my head

[jacobekker]

I would like a contrast of TBI and ABI, as TBI is a subset of ABI. I'm sure my brain tumor and its recision caused damage separate from the tumor dilating brain structure. Trauma is only one of many ways the brain can be damaged.

[WooblyShnufflepops]

Is there any research on TBI acquired ADHD and the risks for offspring?

[chrisarchibeque]

Dr Barkley, have you seen any of the new farside comics online?

[pardalote]

How do post viral effects on the brain fit into the picture? I would be very interested to hear of any research. I definitely had ADHD traits as a child and earlier on in my adult life, but it was only after recovering from COVID couple with menopause that I just could no longer cope. I got my ADHD diagnosis last year at 54, and medication had been a game changer.