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（由申请人提供）：我的长期职业目标是建立一个研究项目，以了解注意力缺陷/多动障碍（ADHD）合并症的病因和发育后果，特别是认知节奏缓慢（SCT）。作为开发该研究项目的第一步，我领导了一系列研究，检验 ADHD 和 SCT 是否不仅在统计上不同，而且与青少年的功能存在差异或独特的相关性。我的试点工作表明，虽然 SCT 与 ADHD 注意力不集中、抑郁、焦虑和白天嗜睡的发生率较高有关，但 SCT 在统计上与这些领域不同。我还发现，即使在控制多动症之后，SCT 症状也与学业和社交障碍相关。由于 SCT 症状在统计上与 ADHD 不同，并且与一系列损伤独特相关，因此有人认为 SCT 可能是与 ADHD 不同的疾病。此外，初步数据强调了 SCT 构建的临床意义，该数据显示 SCT 升高的存在可预测 ADHD 儿童对精神兴奋药物的反应较差。这表明，常用的循证 ADHD 治疗方法对于同时患有 SCT 的 ADHD 儿童来说是不够的。这些发现指出了 SCT 的重要性以及系统研究调查 SCT 的病因、外部相关因素和发育进展的必要性。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员，K23 机制将使我能够集中时间和精力发展作为一名独立临床研究员的职业生涯。随着我的研究兴趣的发展，我认识到需要获得神经心理学和神经生理学方面的额外培训，以便对 ADHD 和 SCT 进行更全面、多模式的检查。我的培训目标旨在弥补我知识中的关键差距，为我的独立研究生涯做好准备。具体来说，我计划（1）获得大脑行为关系方面的专业知识，特别强调神经心理学，（2）获得神经科学和神经影像方法方面的知识，特别强调脑磁图（MEG）和脑电图（EEG），（3）获得与儿科人群神经心理学和神经生理学研究相关的统计和编程培训，以及 (4) 提高资助写作技巧并扩大研究传播。我将通过课程作业、具有培训计划特定组成部分专业知识的导师和顾问的指导、完成我的研究项目以及参加相关研讨会、讲习班和会议来实现这些培训目标。完成培训和职业发展计划将使我能够实现我的长期目标，即在以患者为导向的研究中建立独立的职业生涯，从而显着增进我们对 SCT 和 ADHD 合并症的理解。为了区分 SCT 的独特相关性，我提出了一个研究项目，这将是第一个直接将儿童与 SCT 进行比较的研究 使用多种神经影像学和行为方法，将 SCT（患有和不患有 ADHD）提升到正常发育的儿童和仅患有 ADHD 的儿童。我的研究将使用最近验证的 SCT 措施将 184 名儿童（8-12 岁）分为四组（每组 n = 46）：仅 SCT、仅 ADHD、SCT+ADHD 和典型发育对照。所有儿童都将完成全面评估，包括评估 SCT、ADHD 和精神合并症的诊断访谈、智力和学业成绩测试以及一系列神经心理学测试。一部分参与者将在接受 MEG（与结构 MRI 共同配准）的同时执行评估不同注意力网络的任务，MEG 是一种最佳成像方法，具有出色的空间和时间分辨率。这个项目将使我能够识别区分 SCT 和 ADHD 的潜在功能障碍和损伤，从而与理论、疾病分类学和干预具有明确的相关性。辛辛那提儿童医院提供了一个极好的环境，以促进我作为一名独立研究者的发展，研究 ADHD 和 SCT 中的大脑行为关系。我们组建了一支出色的指导团队来支持我的培训和职业发展。在 Jeffery Epstein 博士（主要发起人）的指导下，多动症中心是世界一流的多动症专业中心。同样在 CCHMC，Jing Jing 博士（MEG 中心主任；共同导师）和 Dean Beebe 博士（神经心理学项目主任；共同导师）将分别提供 MEG 和神经心理学方面的指导。博士。 Leanne Tamm 和 James Peugh 将分别提供 ADHD 神经影像和统计学方面的现场专业知识。最后，埃里克博士 Willcutt（科罗拉多大学博尔德分校）和 Sandra Loo 博士（加州大学洛杉矶分校）将提供外部专业知识，介绍神经心理学和神经生理学方法如何专门为 ADHD 合并症模型提供信息。我的培训计划中列出的累积经验将为独立研究计划奠定基础，目标是在 K23 奖项结束之前获得 R01。