Developmental origins and early detection of ADHD and dysregulatory psychopathology

ADHD 和失调性精神病理学的发育起源和早期发现

• 批准号: 10537406
• 负责人: JOEL T NIGG
• 金额: $ 5.95万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10537406
• 关键词: 3 year old; 5 year old; Area; Attention deficit hyperactivity disorder; Award; Behavioral; Biological; Birth; Brain; Child; Child Health; Clinical Trials; Data; Development; Early Diagnosis; Early Intervention; Early identification; Electroencephalography; Emotional; Goals; Hand; Healthcare; Infant; Inflammation; Intercept; Intervention; Justice; Learning; Life; Literature; Magnetic Resonance Imaging; Measurable; Measures; Modeling; Nursery Schools; Outcome; Parents; Pregnancy; Psychopathology; Risk; Risk Factors; Role; School-Age Population; Schools; Shapes; Signal Transduction; Symptoms; System; Testing; Time; Toddler; Work; caregiving; clinical application; clinical candidate; cohort; cost; emotion dysregulation; emotion regulation; family burden; follow-up; indexing; prevent

Project Summary (No change from Parent Award) The goal of this proposal is to identify early life predictors of symptoms of ADHD and associated behavioral and emotional problems. To do so children are followed from before birth to 4.5 years of age—on the cusp of school entry and well into the preschool period. ADHD and related problems with behavioral and emotional dysregulation are often not clinically identified until school age. By that point they are difficult to reverse. This proposal answers calls in the literature for earlier identification of risk and for discovery of early life mechanisms that can be targets for low-risk yet effective early life intervention to prevent the full onset of these problems. To do so we expand the study of an existing maternal-infant cohort by adding measures, time points, and an older outcome. We extend the cohort from the toddler years into the preschool period when psychopathology has begun to take shape and be able to be relatively reliably characterized. Key mechanisms to be examined are (a) biological signals in early life, focused on maternal inflammation and serotonergic metabolites during pregnancy and the trajectory of change in those signals in the first three years of life; (b) brain development as indexed by EEG measures from birth to age 3 years (lower cost and more readily clinically applicable than MRI at this stage); and (c) behavioral dynamics in early caregiving, about which little is known regarding ADHD risk in the first 24 months of life. The inflammation hypothesis builds on striking preliminary data uncovered by the PI's in their prior work. The EEG metrics likewise are supported by preliminary evidence. The behavioral data also have strong preliminary data and build on multiple theorists' proposals about the role of early emotional regulation in subsequent risk for dysregulatory psychopathology and ADHD. Both baseline (intercept) and change (trajectory) measures will be examined to help evaluate when in development a particular domain or level of analysis is most informative to subsequent outcome. Each of these hypotheses is examined in stand-alone fashion, and then with those findings in hand, an integrative developmental model will be tested. If successful the study will open new directions for low-risk yet potentially effective early intervention by identifying specific, measurable, and reversible risk factors or mechanisms as candidates for clinical trial follow up.

项目概要（与家长奖没有变化） 该提案的目标是确定 ADHD 症状以及相关行为和行为的早期生命预测因子。 为此，我们对孩子从出生前到 4.5 岁（即将上学）进行跟踪。 进入并进入学龄前阶段，并出现多动症以及相关的行为和情绪问题。 到了学龄期，调节失调往往无法被临床发现，这一点很难扭转。 该提案回应了文献中关于早期识别风险和发现早期生命机制的呼吁 这可以成为低风险但有效的早期生活干预的目标，以防止这些问题的全面发生。 为此，我们通过添加措施、时间点和年龄较大的人来扩展现有母婴队列的研究 我们将队列从幼儿时期延伸到精神病理学发生的学前时期。 已开始形成并能够相对可靠地表征的关键机制是（a）。 生命早期的生物信号，重点关注妊娠期间母体炎症和血清素代谢物 以及生命头三年中这些信号的变化轨迹；(b) 大脑发育的索引； EEG 测量从出生到 3 岁（此阶段比 MRI 成本更低，更容易临床应用）； (c) 早期护理中的行为动态，对于前 24 小时的 ADHD 风险知之甚少 炎症假说建立在 PI 之前发现的惊人的初步数据之上。 脑电图指标同样得到了初步证据的支持。 初步数据并建立在多个理论家关于早期情绪调节的作用的建议之上 基线（拦截）和变化（轨迹）的后续风险。 将检查措施以帮助评估在开发过程中特定领域或分析水平何时是最重要的 这些假设中的每一个都以独立的方式进行检验，然后 有了这些发现，我们将测试一个综合发展模型，如果成功的话，该研究将启动。 通过确定具体的、可衡量的和 可逆的风险因素或机制作为临床试验随访的候选者。