PRENATAL EXPOSURE TO MANGANESE AND ADHD-LIKE BEHAVIORS IN CHILDHOOD

描述（由研究者提供）：注意缺陷多动障碍（ADHD）的病因尚不清楚，确定可改变的环境危险因素对降低其发病率很重要。锰（Mn）既是一种必需的营养物质，而且在高水平时，是一种潜在的神经毒物，一般人群通常接触到这种物质。本研究的主要目的是通过新生儿行为评估量表（NBAS）和学龄儿童（中位数=8岁）的三种评估来调查产前Mn与婴儿ADHD相关行为的关系：(1)临床诊断的ADHD；(3)采用正式的心理测试，包括神经行为评估系统2连续表现测试和韦氏儿童智力量表（第三版）的组成部分，对ADHD相关行为进行测量。我们还将研究锰和铅（Pb）对ADHD风险的潜在协同作用。这项研究将在1993年至1998年间出生的788名婴儿中进行，这些婴儿的母亲居住在马萨诸塞州新贝德福德一个金属和多氯联苯污染的港口和超级基金附近。锰在存档的脐带血样本中测量。将用多变量回归来估计关联，控制大范围的协变量。这项拟议的研究是迄今为止美国规模最大的研究，旨在评估产前锰对儿童随后神经行为的影响，并将受益于使用具有良好特征的人群，这些人群自出生以来就进行了纵向发育评估，并且可以获得丰富的儿童不良发育风险因素信息。结果将为锰作为常见行为障碍（如多动症）的潜在可补救风险因素的作用提供重要见解。公共卫生相关性：锰（Mn）是一种天然存在的金属，既是必需的营养素，也是潜在的神经毒物。本研究将探讨产前锰与儿童神经行为发育，特别是adhd相关行为之间的关系。我们的研究结果将为锰作为这种日益常见和昂贵的儿童行为障碍的潜在可补救风险因素的作用提供重要的见解。

DESCRIPTION (provided by investigator): The etiology of Attention Deficit Hyperactivity Disorder (ADHD) is poorly understood and identification of modifiable environmental risk factors is important for reducing its incidence. Manganese (Mn) is both an essential nutrient and, at high levels, a potential neurotoxicant to which the general population is commonly exposed. The primary aim of the proposed research is to investigate the association of prenatal Mn with behaviors associated with ADHD among infants using the Neonatal Behavioral Assessment Scale (NBAS), and among school-aged children (median=8 years) using three assessments: (1) clinically diagnosed ADHD; (2) behaviors associated with ADHD assessed with the Conners' Rating Scale for Teachers: and (3) behaviors associated with ADHD measured with formal psychometric tests, including the Neurobehavioral Evaluation System 2 Continuous Performance Test, and components of the Wechsler Intelligence Scale for Children-Third Edition. We will also investigate potential synergism between Mn and lead (Pb) on risk for ADHD. The study will be conducted among a birth cohort of 788 infants born between 1993 and 1998 to mothers residing adjacent to a metal- and PCB-contaminated harbor and Superfund site in New Bedford, Massachusetts. Mn is measured in archived cord blood samples. Associations will be estimated with multivariable regression, controlling for a wide range of covariates. The proposed study is the largest U.S. study to date to assess the effect of prenatal Mn on subsequent neurobehavior in children and will benefit from the use of a well characterized population whose development has been assessed longitudinally since birth and for whom a wealth of information on risk factors for adverse child development is available. Results will provide important insight into the role of Mn as a potentially remediable risk factor for common behavioral disorders such as ADHD. PUBLIC HEALTH RELEVANCE: Manganese (Mn) is a naturally occurring metal which is both an essential nutrient, and potential neurotoxicant. This study will investigate the association between prenatal Mn and childhood neurobehavioral development, particularly ADHD-related behavior. Our findings will provide important insight into the role of Mn as potentially remediable risk factor for this increasingly common and costly behavioral disorder of childhood.