Estrogen Effects on ADHD and Cognition

雌激素对多动症和认知的影响

• 批准号: 10246302
• 负责人: MICHELLE M MARTEL
• 金额: $ 66.37万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10246302
• 关键词: Adolescence; Adult; Affect; Age; Animals; Attention; Attention deficit hyperactivity disorder; Back; Basic Science; Biological; Biological Assay; Childhood; Clinic; Clinical; Cognition; Cognitive; Communities; Data; Deltastab; Diagnosis; Disease; Dopamine; Estradiol; Estrogens; Evaluation; Exclusion Criteria; Exhibits; Feasibility Studies; Female; Goals; Gonadal Steroid Hormones; Health; Hormonal; Hormone use; Hormones; Human; Impairment; Impulsivity; Laboratories; Link; Longitudinal Studies; Measurement; Measures; Menstrual cycle; Menstruation; Neurocognitive; Ovarian hormone; Ovulation; Participant; Persons; Pharmaceutical Preparations; Phase; Prevalence; Progesterone; Psychology; Puberty; Publishing; Quasi-experiment; Rattus; Research Design; Risk; Risk Factors; Role; Sampling; Short-Term Memory; Symptoms; Test Result; Testing; Thinking; Translating; Universities; Visit; Withdrawal; Woman; Work; animal data; base; clinical practice; clinical predictors; clinically significant; cognitive function; cognitive performance; cognitive testing; comorbidity; design; falls; hypothalamic pituitary gonadal axis; improved; inattention; innovation; male; multilevel analysis; perimenstrual; personalized approach; proliferative phase Menstrual cycle; recruit; response; saliva sample; sex; social media; treatment response; virtual; young adult; young woman

Females with Attention-Deficit/Hyperactivity Disorder (ADHD) remain dramatically understudied, even though they exhibit increased impairment beginning around puberty. Estrogen rises rapidly at puberty and exerts important effects on dopamine and cognition in both humans and animals. Both animal and human work suggest that cognition and ADHD symptoms may be sensitive to hormonal effects, particularly in highly impulsive females. Yet, the effect of estrogen on ADHD symptoms in young adult women remains virtually unstudied. Our pilot data in 33 naturally-cycling young women suggest that among women with greater ADHD symptoms, within-person declines in estrogen, particularly in the context of rising levels of progesterone, just post-ovulation, are associated with clinically significant increases in ADHD symptoms. Yet, no published empirical work has directly examined the role of circulating estrogen in relation to ADHD symptoms and cognitive mechanisms in women with ADHD. The current study would pioneer a new stage of work by being the first to utilize a rigorous quasi-experimental design that involves intensive longitudinal measurement across the menstrual cycle in order to examine within-person estrogen effects on ADHD and cognitive mechanisms in young women with ADHD. A sample of 120 young women ages 18 to 25 with inattention, overactivity, or impulsivity problems will be recruited from the university health center and local ADHD clinic, psychology department, and through social media. Participants will be comprehensively assessed for ADHD and exclusion criteria (e.g., use of hormone-based medication or hormonal conditions). Female participants will complete well-established assessment measures of ADHD and other psychopathological symptoms and diagnoses and cognition and provide saliva samples of hormones in the laboratory during a baseline laboratory visit within the first few days of the start of their menstrual cycle (i.e., during the mid-follicular phase, characterized by stable low estrogen). Then, they will provide daily saliva samples for hormone assay each morning and complete short daily assessments of ADHD and cognition every evening for up to 2 full menstrual cycles. They will also complete laboratory cognitive testing of inhibition and working memory targeted to key cycle phases characterized by declining estrogen (post-ovulatory, perimenstrual) and a cycle phase characterized by stable high estrogen levels (midluteal), based on menses onset and ovulation test results. Multi-level modeling will evaluate the clinical significance of within-person estrogen associations with ADHD and cognition with consideration of progesterone as an interactive factor. Effects of comorbid disorders and affect will also be explored. Study results have the potential to shift our understanding of ADHD in women by consideration of dynamic hormone influences. In addition, results will change clinical practice by indicating the need to account for cycle phase in ADHD evaluations in women, as well as suggest personalized approaches to treatment targeted to cycle phase or hormone levels.

患有注意力缺陷/多动症（ADHD）的女性仍在大大研究中，尽管 从青春期开始，它们表现出增加的损害。雌激素在青春期迅速上升 对人类和动物的多巴胺和认知的重要影响。动物和人类工作 表明认知和多动症症状可能对荷尔蒙作用敏感，特别是在高度 冲动的女性。然而，雌激素对年轻女性的ADHD症状的影响实际上仍然是 未经研究。我们在33位自然骑行的年轻妇女中的试点数据表明，在患有更大多动症的女性中 症状，雌激素的人体内部下降，特别是在孕酮水平上升的情况下，公正 卵形后，与ADHD症状的临床显着增加有关。但是，没有出版 经验工作直接研究了循环雌激素在ADHD症状和 ADHD女性的认知机制。当前的研究将通过 第一个利用严格的准实验设计，涉及整个纵向测量 月经周期以检查对ADHD和认知机制的雌激素影响 患有多动症的年轻妇女。 120名18至25岁的年轻妇女的样本，注意力不集中或 冲动性问题将从大学卫生中心和心理学的当地多动症诊所招募 部门以及通过社交媒体。参与者将对多动症和排除量进行全面评估 标准（例如，使用基于激素的药物或激素疾病）。女参与者将完成 良好的ADHD和其他心理病理症状和诊断的评估措施 认知并在实验室访问期间，在实验室中提供激素样本 月经周期开始的前几天（即，在洋灌木期间，以稳定为特征 低雌激素）。然后，他们将每天提供每天的唾液样品进行激素测定并完成 每天晚上对多动症和认知的每日简短评估，最多可容纳2个完整的月经周期。他们也会 针对关键周期阶段的抑制和工作记忆的完整实验室认知测试 其特征是雌激素下降（卵巢后，外膜）和以稳定为特征的循环阶段 基于月经的发作和排卵测试结果，高雌激素水平（脂肪中心）。多层建模将 评估人体内雌激素与多动症的临床意义，并与 考虑孕酮是一种互动因素。合并症和影响的影响也将是 探索。研究结果有可能通过考虑到女性对女性的多动症的理解 动态激素的影响。此外，结果将通过指出需要考虑的情况来改变临床实践 对于女性的多动症评估中的周期阶段，并提出了个性化治疗方法 针对周期阶段或激素水平。