Neurodevelopmental Perspectives on ADHD

ADHD 的神经发育观点

• 批准号: 8085852
• 负责人: JEFFREY M HALPERIN
• 金额: $ 68.36万
• 依托单位: QUEENS COLLEGE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8085852
• 关键词: 12 year old; 4 year old; Address; Adult; Affect; Age; Age-Years; Arousal; Attention deficit hyperactivity disorder; Base of the Brain; Behavioral; Behavioral Symptoms; Brain Stem; Brain region; Characteristics; Child; Childhood; Clinical; Cognitive; Comorbidity; Corpus striatum structure; Data Analyses; Data Set; Defect; Development; Disease; Effectiveness; Environmental Risk Factor; Etiology; Extroversion; Frequencies; Functional Magnetic Resonance Imaging; Goals; Growth; Health; Heart; Heterogeneity; High Prevalence; Home environment; Impairment; Impulsivity; Individual; Intervention; Lead; Link; Literature; Longitudinal Studies; Matched Group; Measures; Mediating; Mental disorders; Modeling; Neurocognitive; Neurocognitive Deficit; Nursery Schools; Outcome; Parents; Patients; Pattern; Performance; Personality; Positioning Attribute; Prefrontal Cortex; Preschool Child; Process; Progress Reports; Psychopathology; Recruitment Activity; Reporting; Research; Risk; Sampling; School-Age Population; Schools; Secondary to; Severities; Sex Characteristics; Short-Term Memory; Staging; Symptoms; System; Temperament; Testing; Thick; Time; Variant; Work; Youth; alertness; base; boys; cognitive control; cost; design; early childhood; emerging adult; executive function; functional disability; functional outcomes; girls; high risk; improved; inattention; insight; interest; introvert; neuropsychological; novel; prognostic indicator; prospective; relating to nervous system; teacher; theories

DESCRIPTION (provided by applicant): This competitive renewal application is based on a novel model which posits that partially distinct neural and cognitive mechanisms are involved in the etiology and developmental trajectory of attention-deficit/hyperactivity disorder (ADHD). We hypothesize that ADHD is due to a primary deficit in regulatory functions, most probably of subcortical origin, that is present early in ontogeny, remains relatively static throughout the lifetime, and is unrelated to the commonly-present, although highly variable, diminution of symptoms and impairment often seem over development. We hypothesize that the variation in diminution of symptoms and impairment frequently seen throughout development is in part related to the degree to which cortically-mediated neural systems can compensate for these early deficits through the use of "top-down" executive control. Using a large sample of "hyperactive/inattentive" and typically-developing control children who were recruited when they were 3-4 years-old and evaluated annually since then, this study will examine trajectories of ADHD symptoms over the school-age years to determine the relationship between changes in ADHD severity and the development of regulatory and executive functions over time. Children will be comprehensively reevaluated annually using clinical and neuropsychological measures between the ages of 8 and 12 years. In addition, these annual assessments will be supplemented by semi-annual parent and teacher ratings of ADHD symptom severity and impairment in the home and school settings, which will greatly facilitate our ability to conduct analyses of individualized trajectories for ADHD severity. The primary aim of the proposed project is to test the hypothesis that the diminution of ADHD symptoms typically seen over development is associated with the development of "top-down" executive processes, but that "bottom-up" regulatory functions will remain impaired irrespective of clinical improvement. If this hypothesis is confirmed, it could have a significant impact on the development of novel treatment interventions. PUBLIC HEALTH RELEVANCE: This project is designed to test a model that posits specific mechanisms that are linked to the improvement of ADHD severity over development as distinct from those that cause the disorder. If our hypothesis is confirmed, it could have a significant impact on the development of novel, long-lasting, treatment interventions for this highly impaired group of patients.

描述（由申请人提供）：这种竞争性更新应用是基于一种新型模型，该模型认为，注意力缺陷/多动症（ADHD）的病因和发展轨迹部分涉及部分不同的神经和认知机制。我们假设ADHD是由于调节功能的主要缺陷所致，最可能是皮层下起源的，这是在本体发育中的早期，在整个生命周期中仍然相对静态，并且与普遍存在的症状和障碍往往相关，尽管症状和障碍高度可变，但通常看起来却显得过多地发育。我们假设在整个发育过程中经常看到的症状和障碍的减轻变化部分与皮质介导的神经系统可以通过使用“自上而下的”执行控制来补偿这些早期缺陷的程度有关。使用大量的“多动/无激励性”和通常开发的对照儿童，这些儿童在3 - 4岁时被招募并每年进行评估，这项研究将检查学院年度ADHD症状的轨迹，以确定ADHD严重程度的变化与监管性和执行功能的变化之间的关系。每年使用8至12岁之间的临床和神经心理学指标，将全面重新评估儿童。此外，这些年度评估将以半年度的父母和教师评级为家庭和学校环境中的多动症症状严重程度和障碍，这将极大地促进我们对ADHD严重程度进行个性化轨迹的分析的能力。拟议项目的主要目的是检验以下假设：通常在发育中通常看到的ADHD症状减少与“自上而下”的执行过程的发展有关，但是“自下而上”的监管功能将仍然受损，而与临床改进无关。如果证实了这一假设，则可能会对新型治疗干预措施的发展产生重大影响。公共卫生相关性：该项目旨在测试一种模型，该模型提出了特定机制，该机制与ADHD严重程度改善发展相关的发展与引起疾病的发展不同。如果确认我们的假设，它可能会对这一高度受损的患者组的新型，持久的治疗干预措施的发展产生重大影响。