Concussion and Attention-Deficit/Hyperactivity Disorder: Investigating the relationship between cognitive outcome, prescription stimulants, and functional MRI biomarkers in the ABCD study.

脑震荡和注意力缺陷/多动障碍：在 ABCD 研究中调查认知结果、处方兴奋剂和功能性 MRI 生物标志物之间的关系。

• 批准号: 10448885
• 负责人: Benjamin Paul Kay
• 金额: $ 18.95万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448885
• 关键词: Address; Adolescence; Adolescent; Affect; Attention; Attention deficit hyperactivity disorder; Attentional deficit; Back; Biometry; Brain; Brain Concussion; Brain Injuries; Brain region; Child; Childhood; Childhood Injury; Clinical; Cognition; Cognition Disorders; Cognitive; Cognitive deficits; Controlled Study; Craniocerebral Trauma; Data; Diagnosis; Diagnostic; Functional Magnetic Resonance Imaging; Funding; Future; Gender; Goals; Hospitals; Image; Linear Models; Linear Regressions; Link; MRI Scans; Magnetic Resonance Imaging; Measures; Medicine; Memory; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Modeling; National Institute of Neurological Disorders and Stroke; Neurologic; Neurologic Deficit; Observational Study; Outcome; Participant; Pattern; Performance; Pharmaceutical Preparations; Phenotype; Physicians; Population; Recording of previous events; Reporting; Research; Rest; Scanning; Schools; Scientific Advances and Accomplishments; Scientist; Severities; Short-Term Memory; Signal Transduction; Socioeconomic Status; Stimulant; Symptoms; Techniques; Testing; Time; Training; Traumatic Brain Injury; United States National Institutes of Health; base; career; cognitive development; cognitive neuroscience; cognitive testing; cohort; comorbidity; design; experimental study; imaging study; inattention; innovation; magnetic resonance imaging biomarker; mild traumatic brain injury; nervous system disorder; neuroimaging; neuromechanism; neuronal patterning; power analysis; prescription stimulants; programs; recruit; relating to nervous system; statistics; stimulant use; sustained attention; treatment response

Project Summary/Abstract Traumatic brain injury (TBI) is the most common cause of acquired neurological deficits in children. Mild TBI, or concussion, is highly prevalent in adolescence, and is linked with short- and long-term cognitive deficits, chiefly inattention. Attention-deficit hyperactivity disorder (ADHD) is similarly prevalent in children and represents a primary form of inattention that occurs even without a history of head injury. The phenotypic similarity between primary ADHD vs long-term symptoms of inattention subsequent to concussion is both a diagnostic dilemma and clinical window of opportunity into the mechanisms by which brain injury affects cognition. In line with this framework, the goal of this K23 award is to provide the applicant with training necessary to identify distinct signatures of brain activity in children with primary ADHD vs ADHD with a history of concussion, which will motivate mechanism-specific treatments for these inattention symptoms. The proposed research leverages the Adolescent Brain Cognitive Development study, which is the largest ever cohort of children with concussion paired with detailed cognitive and functional MRI data, to achieve this goal. It capitalizes on the the superb cognitive neuroscience and imaging expertise of the applicant's mentors and collaborators to achieve the applicant’s short-term goals of training in cognitive assessment (Dr. Barch), TBI research (Dr. Brody), ADHD research (Dr. Fair), task-based (stop signal, n-back) fMRI (Dr. Barch), resting state fMRI (Dr. Dosenbach), and multivariate imaging statistics (Dr. Thompson). The proposed training will facilitate the applicant’s long-term goal of becoming an independent physician-scientist in the field of cognitive neuroimaging. These training goals will be advanced through the proposed research. First, the applicant will use multivariate fMRI methods to detect distinct patterns of task-related brain activation (Aim 1a) and resting-state connectivity (1b) in children with ADHD and a history of concussion, compared to controls and either condition alone. Then the applicant will investigate the fMRI correlates of time since last concussion (Aim 2) using task-related and resting-state fMRI. Finally, the applicant will perform exploratory analysis on the effects of prescription stimulant medications on brain activity in these groups (Aim 3). Notably, the proposed methods and techniques can be extended to answer many other outstanding questions about the intersection between neurological and cognitive disorders in the ABCD and future imaging studies. With a research program that employs multiple converging techiques to interrogate neural signatures related to concussion and its cognitive sequelae, the applicant will continue to address research questions relevant to the NINDS throughout his independent career.

项目概要/摘要 创伤性脑损伤 (TBI) 是儿童获得性神经功能缺损的最常见原因。 脑震荡在青春期非常普遍，主要与短期和长期认知缺陷有关 注意力缺陷多动障碍（ADHD）在儿童中普遍存在，是一种常见的疾病。 即使没有头部受伤史也会发生注意力不集中的主要形式 之间的表型相似性。 原发性多动症与脑震荡后注意力不集中的长期症状都是一个诊断困境 和临床机会窗口研究脑损伤影响认知的机制。 框架，该 K23 奖项的目标是为申请人提供必要的培训，以识别独特的 原发性多动症儿童与有脑震荡病史的多动症儿童的大脑活动特征，这将 拟议的研究利用了针对这些注意力不集中症状的激励机制。 青少年大脑认知发展研究，这是有史以来规模最大的脑震荡儿童队列研究 结合详细的认知和功能 MRI 数据，它利用了精湛的技术来实现这一目标。 申请人的导师和合作者的认知神经科学和成像专业知识，以实现 申请人的短期培训目标：认知评估（Barch 博士）、TBI 研究（Brody 博士）、ADHD 研究（Fair 博士）、基于任务（停止信号、n-back）fMRI（Barch 博士）、静息态 fMRI（Dosenbach 博士）以及 多元成像统计（汤普森博士）。拟议的培训将有利于申请人的长期培训。 成为认知神经影像领域的独立医师科学家的目标。 首先，申请人将使用多元功能磁共振成像方法来推进目标。 检测儿童任务相关大脑激活（目标 1a）和静息状态连接（1b）的不同模式 与对照组和单独任何一种情况相比，患有注意力缺陷多动症和脑震荡病史的申请人。 将使用任务相关和静息状态来研究自上次脑震荡以来时间的 fMRI 相关性（目标 2） 最后，申请人将对处方兴奋剂药物的效果进行探索性分析。 值得注意的是，所提出的方法和技术可以扩展到这些群体的大脑活动。 回答有关神经系统疾病和认知障碍之间的交叉点的许多其他悬而未决的问题 在 ABCD 和未来的成像研究中，我们采用了多种融合技术的研究计划。 为了询问与脑震荡及其认知后遗症相关的神经特征，申请人将继续 在他的独立职业生涯中解决与 NINDS 相关的研究问题。