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

摘要-项目2：神经特征、发育先兆和儿童精神障碍的结局 ASD和ADHD 尽管自闭症谱系障碍(ASD)和注意力缺陷被认为是不同的诊断条件 多动症(ADHD)高度并存。临床表现、危险因素和共同疾病的重叠 ASD和ADHD的遗传性导致一些作者提出，这些疾病具有共同的生物学基础 在ASD综合征中，ADHD是一种较轻、不太严重的亚型。此外， 伴发ADHD的存在具有重要的临床意义，其中合并ASD和ADHD的个体 ADHD的结果要差得多。到目前为止，很少有研究关注ASD的重叠。 和儿童早期的多动症。因此，我们对ASD和ADHD的程度知之甚少 代表共同出现的ADHD症状对早期行为模式的不同情况或影响 ASD的脑机制。在项目2中，我们将研究神经信号、生物标记物、发育 与ASD和ADHD共病相关的轨迹和临床结果，首要目标是 产生的知识将允许更早地检测到这些重叠的情况并更个人化 考虑到这两种情况的相加和相互作用的治疗方法。初级阶段 项目2的目标是(1)阐明与ASD和ASD相关的共享和独特的神经特征和生物标记物。 ADHD，(2)研究共患ADHD症状的幼儿的功能和临床影响。 ASD，以及(3)确定后来被诊断为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岁的儿童 有以下临床特征的月龄：仅有ASD，ASD+ADHD，仅ADHD，以及典型的发展中 (Td)儿童。实现整体研究目标的具体目标是：(1)找出差异和 基于神经生理学和眼睛注视跟踪的神经信号和生物标记物的共性 这四组；(2)检查这些生物标记物如何与特定的症状特征相关联 ASD和ADHD共有和不同的表型特征；(3)确定ADHD在 患有自闭症的幼儿；以及(4)探索发育先兆与诊断的联系程度。 结果可以在婴幼儿时期检测到。后一个目标将通过分析来实现 后来被诊断为自闭症的儿童在出生第一年和第二年时拍摄的家庭视频记录， 仅限ADHD，ASD+ADHD，与TD，基于通过自动计算机视觉分析进行的观察 运动和情感，以及人类对发声/言语、联合注意力、凝视和 确定行为、情感和重复行为的方向。项目2将提供详细、全面的 了解自闭症儿童共患多动症的独特发展轨迹和影响。

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.