Sleep Dysfunction and Neurocognitive Outcomes in Adolescent ADHD

摘要 本次K23指导患者导向研究职业发展奖的目标是拓宽 候选人在注意力集中青少年的睡眠障碍和神经认知方面的专业知识- 缺陷/多动障碍(ADHD)。青春期的ADHD经常预示着有害的学业 和社会结果。在某种程度上，功能低下可能是由于ADHD患者观察到的神经认知缺陷； 然而，这些缺陷的程度是可变的，导致更大损害的机制 有些人，而不是其他人，很难被理解。睡眠障碍是一个潜在的因素 在患有ADHD的一组年轻人中观察到的神经认知异常。具体地说，睡眠障碍是 在ADHD中很常见，在ADHD的核心特征和神经认知之间有相当大的重叠 睡眠障碍的相关因素。然而，睡眠生理学与可变的临床和 ADHD青少年的神经认知结果还有待调查。拟议K23的培训目标 将包括获得基于实验室的高级管理、评分和分析方面的专业知识 多导睡眠图数据，ADHD患者睡眠障碍的神经认知和临床相关性的评估， 并增强了对典型发育期和ADHD患者睡眠功能发育轨迹的理解 青少年。这些目标将通过指导、研究和课程作业来实现，这将导致 一项独立资助的研究项目，旨在阐明睡眠问题的生物学机制 和神经认知障碍，并开发针对CORE的基于睡眠的创新干预措施 这一人群中的症状。Scott Kollins博士，此应用程序的主要导师，有很好的记录 评估ADHD临床和神经认知结果的临床研究。他是当权者的主管 申请者将接受培训的研究培训地点。这项研究计划包括使用多导睡眠图来 评估患有ADHD的青少年和健康对照组(HC)的睡眠障碍和神经认知结果。 最初的假设预测，患有ADHD的青少年将表现出持续时间缩短，潜伏期延长， 与HC相比，夜间唤醒增加，增量能量减少，睡眠纺锤波中断。 预测了组内的可变性，我们将探索是否存在有和没有的不同子组 ADHD组中的睡眠问题。此外，睡眠障碍被预测与较差的睡眠有关 ADHD青少年的神经认知和临床表现。如果这些假设得到支持，那就睡觉吧 干扰可能是ADHD表型亚型的生物标志物。此外，检查这一构造 可能会为制定可能影响睡眠的预防和干预策略提供信息 青少年ADHD的精神障碍和核心症状。

ABSTRACT The goal of this K23 Mentored Patient-Oriented Research Career Development Award is to broaden the candidate’s expertise in sleep disturbance and neurocognition in adolescents with Attention- Deficit/Hyperactivity Disorder (ADHD). ADHD in adolescence is frequently predictive of detrimental academic and social outcomes. In part, poor functioning may be due to neurocognitive deficits observed in ADHD; however, the extent of these deficits is variable and the mechanisms contributing to greater impairment in some individuals and not others are poorly understood. Sleep disturbance represents one potential contributor to the neurocognitive abnormalities observed in a subset of youth with ADHD. Specifically, disturbed sleep is prevalent in ADHD and there is considerable overlap between core ADHD features and the neurocognitive correlates of sleep impairment. However, associations between sleep physiology and variable clinical and neurocognitive outcomes in ADHD youth have yet to be investigated. Training objectives for the proposed K23 will include gaining expertise in advanced laboratory-based administration, scoring, and analysis of polysomnographic data, assessment of neurocognitive and clinical correlates of sleep impairment in ADHD, and enhanced understanding of developmental trajectories of sleep function in typically developing and ADHD adolescents. These objectives will be met through mentoring, research, and coursework, which will result in an independently funded program of research to elucidate the biological mechanisms underlying sleep problems and neurocognitive impairment in ADHD and develop innovative sleep-based interventions targeting core symptoms in this population. Dr. Scott Kollins, the primary mentor for this application, has a strong record of clinical research assessing clinical and neurocognitive outcomes in ADHD. He is the director of the established research training site where the applicant will be trained. The research plan involves using polysomnography to assess sleep disturbance and neurocognitive outcomes in adolescents with ADHD and healthy controls (HC). The primary hypothesis predicts that adolescents with ADHD will display reduced duration, increased latency, increased nocturnal awakenings, reduced delta power, and disrupted sleep spindles compared to HC. Variability within groups is predicted, and we will explore whether there are distinct subgroups with and without sleep problems within the ADHD group. In addition, sleep disturbance is predicted to be associated with poorer neurocognitive and clinical presentations in ADHD adolescents. If these hypotheses are supported, sleep disturbance may represent a biomarker for phenotypic subtypes of ADHD. In addition, examining this construct may inform development of prevention and intervention strategies with the potential to impact sleep disturbance as well as core symptoms of ADHD in adolescents.