Prefrontal cortex

The prefrontal cortex is the front region of the brain, located just behind the forehead, responsible for the highest-level cognitive functions: planning, decision-making, impulse control, emotional regulation, working memory, and social awareness. It's often described as the brain's 'CEO.'

In ADHD, the prefrontal cortex shows structural and functional differences: it tends to be slightly smaller in volume (a gap that narrows with age) and shows lower activation during tasks that require executive control. This underactivation directly explains ADHD symptoms — difficulty inhibiting impulses, planning, sustaining attention, and regulating emotions.

The prefrontal cortex finishes maturing around age 25–30 (later in people with ADHD), which explains why adolescence with ADHD is particularly challenging and why some symptoms improve in adulthood.