A Multi-Method Investigation to Distinguish Sluggish Cognitive Tempo from ADHD

区分认知节奏缓慢与多动症的多方法研究

• 批准号: 9145784
• 负责人: Stephen P Becker
• 金额: $ 13.5万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-18 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9145784
• 关键词: Academic achievement; Address; Age; Anxiety; Attention; Attention deficit hyperactivity disorder; Award; Behavior; Behavioral; Behavioral Medicine; California; Child; Childhood; Clinical; Clinical Psychology; Cognitive; Colorado; Communities; Comorbidity; Coupled; Data; Daydreams; Development; Development Plans; Diagnosis; Diagnostic; Disease; Educational workshop; Electroencephalography; Emotions; Environment; Etiology; Fogs; Foundations; Functional disorder; Goals; Grant; Health; Hyperactive behavior; Image; Impairment; Intelligence; Intervention; Interview; Investigation; Knowledge; Life; Los Angeles; Magnetic Resonance Imaging; Magnetoencephalography; Measures; Medical center; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Modeling; Motor; Neuropsychological Tests; Neuropsychology; Neurosciences; Participant; Pattern; Pediatric Hospitals; Performance; Pharmaceutical Preparations; Phenotype; Population; Positioning Attribute; Psychopathology; Recruitment Activity; Research; Research Personnel; Research Project Grants; Sampling; Series; Site; Symptoms; Testing; Time; Training; Universities; Visual Motor Coordinations; Work; Writing; Youth; achievement test; age group; associated symptom; base; brain behavior; career; career development; clinically significant; design; disease classification; disorder control; evidence base; experience; faculty research; functional disability; imaging modality; improved; inattention; interest; medical specialties; meetings; member; neuroimaging; neurophysiology; neuropsychological; patient oriented research; programs; psychostimulant; research data dissemination; response; skills; social; statistics; sustained attention; symposium; symptom cluster; temporal measurement; theories

 DESCRIPTION (provided by applicant): My long-term career goal is to establish a research program to understand the etiology and developmental consequences of attention-deficit/hyperactivity disorder (ADHD) comorbidities, with a particularly emphasis in sluggish cognitive tempo (SCT). As an initial step in developing this research program, I have led a series of studies examining whether ADHD and SCT are not only distinct statistically but also differentially or uniquely associated with youths' functioning. My pilot work shows that while SCT is associated with higher rates of ADHD inattention, depression, anxiety, and daytime sleepiness, SCT is nonetheless statistically distinct from these domains. I have also found that SCT symptoms are associated with both academic and social impairments, even after controlling for ADHD. Since SCT symptoms are statistically distinct from ADHD and are uniquely associated with a range of impairments, it has been argued that SCT may be disorder separate from ADHD. Moreover, the clinical significance of the SCT construct is underscored by preliminary data showing the presence of elevated SCT to predict a poorer response to psychostimulant medication in children with ADHD. This suggests that frequently-used, evidence-based ADHD treatments are inadequate for children with ADHD who also display SCT. These findings point to the importance of SCT and the need for systematic research investigating the etiology, external correlates, and developmental progression of SCT. I am currently a research faculty member within the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children's Hospital Medical Center (CCHMC), and the K23 mechanism will enable me to focus my time and effort to develop a career as an independent clinical researcher. As my research interests have evolved, I recognize the need to obtain additional training in neuropsychology and neurophysiology to allow for a more comprehensive, multi-modal examination of ADHD and SCT. My training objectives are intended to address critical gaps in my knowledge to prepare me for an independent research career. Specifically, I plan to (1) obtain expertise in brain-behavior relationships with a specific emphasis in neuropsychology, (2) gain knowledge in neuroscience and neuroimaging methods with a specific emphasis in magnetoencephalography (MEG) and electroencephalography (EEG), (3) obtain training in statistics and programming relevant to neuropsychological and neurophysiological research with pediatric populations, and (4) improve grant-writing skills and extend research dissemination. I will accomplish these training objectives through coursework, guidance from my mentors and consultants with expertise in particular components of my training plan, completion of my research project, and attendance at relevant seminars, workshops, and conferences. Completion of the training and career development plan will enable me to achieve my long-term goal to establish an independent career in patient-oriented research that significantly advances our understanding of SCT and ADHD comorbidity. In order to separate out the unique correlates of SCT, I propose a research project that will be the first study to directly compare children with elevated SCT (with and without ADHD) to typically developing children and children with ADHD-only using a multi-method neuroimaging and behavioral approach. My study will use recently-validated SCT measures to recruit 184 children (ages 8-12 years) into four groups (n = 46 per group): SCT-only, ADHD-only, SCT+ADHD, and typically developing controls. All children will complete a comprehensive assessment that includes a diagnostic interview assessing SCT, ADHD, and psychiatric comorbidities, intelligence and academic achievement testing, and a battery of neuropsychological tests. A subset of participants will perform a task assessing distinct attentional networks while undergoing MEG (co- registered with structural MRI), an optimal imaging methodology given its excellent spatial and temporal resolution. This project will allow me to identify the underlying dysfunctions and impairments that distinguish SCT from ADHD, in turn having clear relevance for theory, nosology, and intervention. Cincinnati Children's Hospital provides an excellent environment to facilitate my development as an independent investigator studying brain-behavior relationships in ADHD and SCT. An exceptional mentoring team has been assembled to support my training and career development. Under the direction of Dr. Jeffery Epstein (primary sponsor), the Center for ADHD is a world-class ADHD specialty center. Also at CCHMC, Dr. Jing Xiang (Director, MEG Center; co-mentor) and Dr. Dean Beebe (Director, Neuropsychology Program; co- mentor) will provide mentorship in MEG and neuropsychology, respectively. Drs. Leanne Tamm and James Peugh will provide on-site expertise in ADHD neuroimaging and statistics, respectively. Finally, Dr. Erik Willcutt (University of Colorado Boulder) and Dr. Sandra Loo (University of California, Los Angeles) will provide external expertise in how neuropsychological and neurophysiological methods can inform models of ADHD comorbidity specifically. The cumulative experiences laid out in my training plan will provide the foundation for an independent research program with the goal of receiving an R01 prior to the end of the K23 award.

 描述（由适用提供）：我的长期职业目标是建立一个研究计划，以了解注意力缺陷/多动症障碍（ADHD）合并症的病因和发展后果，并特别强调了缓慢的认知节奏（SCT）。作为制定该研究计划的第一步，我领导了一系列研究，研究了ADHD和SCT不仅在统计学上是不同的，而且与年轻人的功能有差异化或唯一相关。我的飞行员工作表明，尽管SCT与ADHD不注意，抑郁症，焦虑和白天嗜睡率较高，但SCT在统计学上与这些领域的统计学差异。我还发现，即使在控制了多动症之后，SCT符号也与学术和社会障碍相关联。由于SCT符号在统计学上与ADHD不同，并且与一系列障碍唯一相关，因此有人认为SCT可能与ADHD分开。此外，SCT构建体的临床意义被初步数据所忽略了，表明SCT升高的存在，以预测ADHD儿童对精神刺激药物的反应较差。这表明经常使用的，基于证据的多动症治疗对也显示SCT的患有多动症的儿童不足。这些发现表明，SCT的重要性以及对研究SCT的病因，外部相关性和发育进展的系统研究的需求。我目前是辛辛那提儿童医院医疗中心（CCHMC）行为医学和临床心理学部门的研究教师，K23机制将使我能够集中精力和精力来发展作为独立临床研究人员的职业。随着我的研究兴趣的发展，我认识到有必要获得神经心理学和神经生理学的额外培训，以便对ADHD和SCT进行更全面的多模式检查。我的培训目标旨在解决我所知的关键差距，以使我为独立的研究职业做好准备。具体而言，我计划（1）在神经心理学方面的特定强调，（2）获得神经科学和神经影像学方法的知识，并在磁脑摄影学（MEG）（MEG）和电脑术（EEG）中获得特定强调的神经科学和神经影像学方法的知识，（EEG）获得统计学和NEUROPSICAGICAIMICIAGIATIALIGICAIMICIAGICAIMICANICION和NEUROPSOIMITION与NEUROPSOIMITION与NEUROPSOIMITION，（3） （4）提高赠款技巧并扩大研究传播。我将通过课程，导师的指导和顾问的指导来实现这些培训目标，并具有专家培训计划的特定组成部分，完成研究项目的完成以及参加相关的半手赛，讲习班和会议。培训和职业发展计划的完成将使我能够实现我的长期目标，以建立以患者为导向的研究的独立职业，从而大大提高了我们对SCT和ADHD合并症的理解。为了将SCT的独特相关性分开，我提出了一个研究项目，该项目将是第一个将儿童与儿童与 使用多方法神经影像和行为方法，通常会升高SCT（有和没有多动症），通常会开发仅使用ADHD的儿童。我的研究将使用最近验证的SCT测量，将184名儿童（8-12岁）招募为四组（每组n = 46个）：仅SCT，仅ADHD，仅ADHD，SCT+ADHD，并且通常开发对照。所有儿童都将完成全面的评估，其中包括诊断性访谈评估SCT，ADHD和精神病合并症，智能和学术成就测试以及一系列神经心理学测试。一部分参与者将执行任务评估不同的注意网络，同时经过MEG（与结构MRI共同注册），这是一种最佳的成像方法，鉴于其出色的空间和临时分辨率。该项目将使我能够确定将SCT与ADHD区分开的潜在功能障碍和障碍，进而对理论，细胞学和干预明显缓解。辛辛那提儿童医院提供了一个极好的环境，以支持我作为一名独立研究者研究ADHD和SCT中脑行为关系的独立研究人员的发展。一支杰出的心理团队已经组装，以支持我的培训和职业发展。在Jeffery Epstein博士（主要赞助商）的指导下，多动症中心是世界一流的ADHD专业中心。同样在CCHMC，Jing Xiang博士（MEG Center； Co-Mentor）和Dean Beebe博士（Neuropsychology Program; Co-Incortor）将分别提供MEG和Neuropsychology的指导。 Leanne Tamm博士和James Peugh博士将分别提供ADHD神经影像学和统计数据的现场专业知识。最后，埃里克博士 威尔卡特（科罗拉多大学博尔德大学）和桑德拉·卢（Sandra Loo）博士（加利福尼亚大学，洛杉矶分校）将在神经心理学和神经生理学方法中如何为ADHD合并症的模型提供外部专业知识。我的培训计划中提出的累积经验将为独立研究计划提供基础，目的是在K23奖励结束之前获得R01。