Neural signatures, developmental precursors, and outcomes in young children with ASD and ADHD

摘要-项目2：神经信号，发育前体，和幼儿的结果， ASD和ADHD 虽然被认为是不同的诊断条件，自闭症谱系障碍（ASD）和注意力缺陷 多动症（ADHD）是高度共病。临床表现、风险因素和共同因素的重叠 ASD和ADHD的遗传性使得一些作者提出这些疾病共享潜在的生物学特性， ADHD是ASD综合征中较轻、较不严重的亚型。而且 共病ADHD的存在具有重要的临床意义， ADHD的结果更差。到目前为止，很少有研究集中在ASD的重叠 和注意力缺陷多动障碍。因此，我们对ASD和ADHD在多大程度上 代表不同的条件或共同发生的ADHD症状对早期行为模式的影响， 自闭症的大脑机制在项目2中，我们将研究神经信号，生物标志物，发育 轨迹，以及与ASD和ADHD共病相关的临床结局，总体目标是 产生的知识，将允许这些重叠的条件和更个性化的早期检测 治疗方法考虑到这两种情况的叠加和相互作用。主 项目2的目标是（1）阐明与ASD和ASD相关的共享和不同的神经特征和生物标志物， ADHD，（2）检查患有ADHD的幼儿同时出现ADHD症状的功能和临床影响， ASD，以及（3）识别后来诊断为ASD的婴儿和幼儿的早期特征， ADHD症状加重为此，在项目2中，我们将招募四组36-72岁之间的儿童 月龄，具有以下临床特征：仅ASD、ASD+ADHD、仅ADHD和典型发展中 (TD)孩子实现我们总体研究目标的具体目标是（1）识别差异， 基于神经生理学和眼睛注视跟踪的神经特征和生物标志物的共性 四组;（2）检查这些生物标志物如何与特定的症状谱相关， ASD和ADHD的共同和不同的表型特征;（3）确定ADHD在儿童中的临床影响。 ASD幼儿;（4）探索与诊断相关的发展前兆的程度 结果可以在婴幼儿时期检测到。后一个目标将通过分析 仅在后来被诊断为ASD的儿童的第一年和第二年拍摄的家庭录像， 仅ADHD，ASD+ADHD与TD，基于通过自动计算机视觉分析进行的观察， 运动和影响，以及人类编码的发声/言语，联合注意，凝视和 定向行为、情感和重复行为。项目2将提供详细、全面的 了解ASD儿童的独特发展轨迹和并发ADHD的影响。

ABSTRACT – Project 2: Neural signatures, developmental precursors, and outcomes in young children with ASD and ADHD Although recognized as distinct diagnostic conditions, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are highly comorbid. The overlap in clinical presentation, risk factors, and co- heritability of ASD and ADHD has led some authors to propose that these disorders share underlying biological mechanisms and that ADHD is a milder, less severe subtype within the ASD syndrome. Moreover, the presence of co-occurring ADHD has significant clinical implications, where individuals with comorbid ASD and ADHD have substantially poorer outcomes. To date, very little research has focused on the overlap of ASD and ADHD during early childhood. Thus, we know relatively little about the extent to which ASD and ADHD represent distinct conditions or the impact of co-occurring ADHD symptoms on early behavioral patterns and brain mechanisms in ASD. In Project 2, we will study the neural signatures, biomarkers, developmental trajectories, and clinical outcomes associated with comorbid ASD and ADHD with the overarching goal of generating knowledge that will allow earlier detection of these overlapping conditions and more individualized treatment approaches that take into account the additive and interactive effects of both conditions. The primary goals of Project 2 are to (1) elucidate shared and distinct neural signatures and biomarkers related to ASD vs. ADHD, (2) examine the functional and clinical impact of co-occurring ADHD symptoms in young children with ASD, and (3) identify early characteristics of infants and toddlers later diagnosed with ASD with and without elevated ADHD symptoms. To this end, in Project 2, we will recruit four groups of children between 36-72 months of age with the following clinical features: ASD only, ASD+ADHD, ADHD only, and typically-developing (TD) children. The specific aims to achieve our overall study goals are to (1) identify differences and commonalities in neural signatures and biomarkers based on neurophysiology and eye-gaze tracking across the four groups; (2) examine how these biomarkers are correlated with specific symptom profiles based on shared and distinct phenotypic characteristics of ASD and ADHD; (3) determine the clinical impact of ADHD in young children with ASD; and (4) explore the extent to which developmental precursors linked to diagnostic outcome can be detected during the infant-toddler period. The latter aim will be accomplished by analyzing home video recordings taken in the first and second year of life of children later diagnosed with ASD only, ADHD only, ASD+ADHD, vs. TD, based on observations made via automated computer vision analysis of movement and affect, as well as human coding of vocalizations/verbalizations, joint attention, gaze and orienting behavior, affect, and repetitive behaviors. Project 2 will provide a detailed, comprehensive understanding of unique developmental trajectories and impacts of co-occurring ADHD in children with ASD.