Integrated Brain, Body and Social Intervention for ADHD

多动症的大脑、身体和社会综合干预

• 批准号: 8721466
• 负责人: JAMES F LECKMAN
• 金额: $ 88.96万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-26 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8721466
• 关键词: 8 year old; Address; Adult; Adverse effects; Affect; Animals; Area; Attention; Attention deficit hyperactivity disorder; Basic Science; Behavior; Brain; Brain region; Child; Childhood; Clinical; Cognition; Cognitive; Cognitive remediation; Complex; Computers; Development; Disease; Early Intervention; Effectiveness; Environment; Evidence based intervention; Exercise; Family; Financial compensation; Functional Magnetic Resonance Imaging; Genetic; Human; Impaired cognition; Individual; Intervention; Knowledge; Laboratories; Lead; Legal patent; Manuals; Methods; Modification; Monitor; Neurocognitive; Neurodevelopmental Disorder; Neurologic; Neuronal Plasticity; Neurosciences; Neurosciences Research; Outcome; Parents; Pathology; Performance; Pharmacotherapy; Physical Education; Physical activity; Physiological; Process; Program Reviews; Randomized Controlled Trials; Records; Reporting; Research; Resources; Schizophrenia; Site; Social Psychology; Suggestion; Symptoms; System; Testing; Time; Translating; Video Recording; base; brain behavior; clinical application; clinical care; clinically relevant; cognitive neuroscience; computer generated; computer program; computerized; design; effective therapy; evidence base; improved; innovation; neurodevelopment; neuropathology; novel; preclinical study; programs; prototype; psychologic; psychosocial development; relating to nervous system; remediation; satisfaction; social; stroke recovery; teacher; treatment as usual; treatment program

DESCRIPTION (provided by applicant): This project will evaluate and refine an innovative multi-component, neuroscience based, non- pharmacologic intervention for Attention Deficit Hyperactivity Disorder (ADHD). ADHD affects >5% of children, disrupts psychosocial development, and has broad negative outcomes. Pharmacotherapy is often of limited benefit, subject to misuse and associated with unwanted side effects. The proposed treatment program is innovative in: use of a computer based "treatment delivery system" to apply new knowledge of neuroplasticity in clinical care; transformation of existing approaches to physical education based on cognitive neuroscience; and use of an evidence based intervention from social psychology to enhance delivery and effectiveness of neuroscience based interventions. Synergistic integration of brain, body and social interventions provides a paradigm appropriate to address the complexities of neurodevelopmental disorders. The innovative computer programs have multiple newly patented capabilities not present in any previous computerized cognitive treatment exercises. Innovative physical exercises activate the same neurocognitive systems targeted by the computer exercises but in the context of whole body and inter-personal activity, particularly important for ADHD. The social level intervention facilitates participation in the computer and physical activities and it itself also activates target self-regulatory systems. Neuroplastic potential upon which our intervention is based has been dramatically demonstrated in animal and human studies. It has been successfully harnessed for treatment of adult neuropathology but application to childhood disorders has been remarkably absent despite greater plasticity during childhood. As with other clinically relevant advances in basic science, advances are also necessary in methods for treatment delivery if the new discoveries are to be applied effectively. Based on preliminary studies and discussions with the children using prototype programs, we have created innovative game-like computer programs that engage and activate targeted neurocognitive systems with the intensity and consistency that preclinical studies indicate is necessary. Moreover, new research also demonstrates the complexity of neurodevelopment disorders and their treatment due to the interplay of genetic, environmental, physiological, psychological, social, primary and compensatory processes. For example, core features of ADHD alter interactions with the environment in ways that aggravate the symptoms themselves, create additional problems and block effective delivery of treatment. New paradigms that synergistically integrate brain, behavior and social perspectives and methods are therefore needed to treat these disorders. Our program is designed for six to eight year old children in order to intervene precisely when the clinically relevant neurofunctional systems are actively developing and when clinical symptoms first appear.

描述（由申请人提供）：该项目将评估和完善一种创新的多组分，神经科学为基础的，非药物干预注意缺陷多动障碍（ADHD）。ADHD影响超过5%的儿童，扰乱心理社会发展，并具有广泛的负面后果。药物治疗通常益处有限，容易被滥用，并伴有不必要的副作用。拟议的治疗方案是创新的：使用基于计算机的“治疗传递系统”，以应用新的知识，神经可塑性在临床护理;改造现有的方法，以体育教育的基础上认知神经科学;和使用基于证据的干预，从社会心理学，以提高交付和有效性的神经科学为基础的干预措施。 大脑，身体和社会干预的协同整合提供了一个适当的范例，以解决神经发育障碍的复杂性。创新的计算机程序具有多个新的专利功能，在以前的任何计算机认知治疗练习中都没有。创新的体育锻炼激活了与计算机练习相同的神经认知系统，但在全身和人际活动的背景下，这对ADHD特别重要。社会层面的干预有助于参与计算机和体育活动，它本身也激活了目标的自我调节系统。 我们的干预措施所依据的神经可塑性潜力已在动物和人类研究中得到了显着证明。它已成功地用于治疗成人神经病理学，但应用于儿童疾病一直显着缺席，尽管更大的可塑性在儿童时期。与基础科学的其他临床相关进展一样，如果要有效地应用新发现，治疗方法也必须取得进展。基于使用原型程序与儿童进行的初步研究和讨论，我们已经创建了创新的游戏式计算机程序，这些程序以临床前研究所表明的必要强度和一致性参与并激活目标神经认知系统。此外，新的研究还表明，由于遗传、环境、生理、心理、社会、初级和补偿过程的相互作用，神经发育障碍及其治疗非常复杂。例如，ADHD的核心特征改变了与环境的相互作用，从而加剧了症状本身，产生了额外的问题并阻碍了有效的治疗。因此，需要协同整合大脑，行为和社会观点和方法的新范式来治疗这些疾病。我们的计划是专为6至8岁的儿童，以便在临床相关的神经功能系统正在积极发展和临床症状首次出现时进行精确干预。

项目成果

Effects of Integrated Brain, Body, and Social (IBBS) intervention on ERP measures of attentional control in children with ADHD.

脑、身体和社会综合 (IBBS) 干预对 ADHD 儿童注意力控制 ERP 测量的影响。

• DOI: 10.1016/j.psychres.2019.06.021
• 发表时间: 2019
• 期刊: Psychiatry research
• 影响因子: 11.3
• 作者: Smith,StephanieD;Crowley,MichaelJ;Ferrey,Anne;Ramsey,Kathleen;Wexler,BruceE;Leckman,JamesF;Sukhodolsky,DenisG
• 通讯作者: Sukhodolsky,DenisG

A Randomized Controlled Trial of an Integrated Brain, Body, and Social Intervention for Children With ADHD.

针对患有多动症儿童的综合大脑，身体和社会干预的随机对照试验。

• DOI: 10.1177/1087054716647490
• 发表时间: 2020-03
• 期刊: Journal of attention disorders
• 影响因子: 3
• 作者: Smith SD;Vitulano LA;Katsovich L;Li S;Moore C;Li F;Grantz H;Zheng X;Eicher V;Aktan Guloksuz S;Zheng Y;Dong J;Sukhodolsky DG;Leckman JF
• 通讯作者: Leckman JF

Using micro-cognition biomarkers of neurosystem dysfunction to redefine ADHD subtypes: A scalable digital path to diagnosis based on brain function.

使用神经系统功能障碍的微观认知生物标志物重新定义 ADHD 亚型：基于大脑功能的可扩展数字诊断路径。

• DOI: 10.1016/j.psychres.2023.115348
• 发表时间: 2023
• 期刊: Psychiatry research
• 影响因子: 11.3
• 作者: Wexler,BruceE;Kish,Ryan
• 通讯作者: Kish,Ryan

An integrated program of computer-presented and physical cognitive training exercises for children with attention-deficit/hyperactivity disorder.

针对注意力缺陷/多动症儿童的计算机呈现和身体认知训练的综合计划。

• DOI: 10.1017/s0033291720000288
• 发表时间: 2021
• 期刊: Psychological medicine
• 影响因子: 6.9
• 作者: Wexler,BruceE;Vitulano,LawrenceA;Moore,Christina;Katsovich,Liliya;Smith,StephanieD;Rush,Cindy;Grantz,Heidi;Dong,Jinxia;Leckman,JamesF
• 通讯作者: Leckman,JamesF