Inhibitory Control and Emotional Processing in Pediatric ADHD

描述（由申请人提供）：注意缺陷/多动障碍（ADHD）的特征是注意力不集中、多动和冲动。抑制控制和相关额纹状体（FS）回路的缺陷一直被认为与多动症有关，但最近的研究表明，额边（FL）回路中的异常情绪处理也可能是多动症儿童多动症的重要组成部分。因此，这两方面的缺陷都可能与多动症有关，并决定了特定儿童表现出的临床表型。使用功能性磁共振成像（fMRI），本研究旨在同时研究同一组儿童中FS和FL回路的功能，因为这是确定这两个回路在ADHD儿童中是否具有可分离功能和神经心理相关性的最佳手段。本研究将检测60名患有（N=30）和非（N=30） ADHD的儿童（8 - 12岁）在执行抑制控制功能磁共振成像任务时的前脑回路功能，以及在执行情绪处理功能磁共振成像任务时前脑回路的功能。假设这些回路的功能不仅在患有和没有多动症的儿童中有所不同，而且在FS和FL回路的行为相关中也会发现双重分离。本申请的指导患者导向研究职业发展奖（K23）也要求资助Jonathan Posner医学博士进行必要的培训，以成为一名独立研究者。这笔资金将支持一个全面的项目，包括正式的教学和研讨会，由儿童神经影像学、认知和情感神经科学以及儿童精神病理学领域的专家参加。这些培训活动将提高Posner博士对以下方面的知识：a)功能磁共振成像技术；b) ADHD的病理生理学、现象学和治疗；c)情感和认知神经科学；D)纵向神经影像学研究设计；e)科学研究的伦理行为。

DESCRIPTION (provided by applicant): Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by symptoms of inattention, hyperactivity, and impulsivity. Deficits in inhibitory control and associated frontostriatal (FS) circuits have long been implicated in association with the disorder, but recent studies suggest that abnormal emotional processing within frontolimbic (FL) circuits may also be an important component of the hyperactivity evidenced in children with ADHD. Deficits in either domain may therefore be associated with ADHD and determine the clinical phenotype that a particular child exhibits. Using functional magnetic resonance imaging (fMRI), the current study aims to investigate simultaneously the functioning of FS and FL circuits in the same group of children as this is the best means to determine whether these two circuits have dissociable functions and neuropsychological correlates in children with ADHD. The study will examine in 60 children (ages 8 - 12) with (N=30) and without (N=30) ADHD the functioning of FS circuits during the performance of an inhibitory control fMRI task and the functioning of FL circuits during the performance of an emotion processing fMRI task. The hypotheses are that the functioning of these circuits will not only differ in children with and without ADHD but also that a double dissociation will be found in the behavioral correlates of FS and FL circuits. This application for a Mentored Patient-Oriented Research Career Development Award (K23) also requests funding for Jonathan Posner, MD to pursue training essential to becoming an independent investigator. This funding would support a comprehensive program including formal didactics and seminars from experts in the fields of pediatric neuroimaging, cognitive and affective neuroscience, and pediatric psychopathology. These training activities would enhance Dr. Posner's knowledge of a) fMRI techniques; b) the pathophysiology, phenomenology, and treatment of ADHD, c) affective and cognitive neuroscience; d) longitudinal neuroimaging study design; and e) the ethical conduct of scientific research. PUBLIC HEALTH RELEVANCE: ADHD is associated with a wide range of negative long-term outcomes, and causes significant hardship for children and families. Developing a better understanding of the neurobiology of ADHD may help advance research into the etiology, genetics, and treatment of the disorder.