Neurophysiological Attention Test (NAT) for Objective Assessment of ADHD

 描述（由申请人提供）：该项目旨在验证一种用于注意力缺陷/多动障碍（ADHD）的新型神经生理学评估工具。成人ADHD是普遍和持久的，并且用于评估该障碍的客观方法是有限的，特别是基于功能性神经生理学指标，这些指标也可以容易且廉价地进入广泛的市场。ADHD的一个重要方面似乎是难以在10秒的时间内维持注意力控制，表现为在持续注意力任务上的个体内表现与正常表现和其他表现不佳的时期不一致。我们已经创建了一个创新的评估工具，神经生理学注意力测试（NAT），它基于脑电图（EEG）跟踪持续的注意力。NAT提供了控制波动的关键新措施。与任何其他基于行为或EEG的评估工具不同，NAT能够在持续注意力任务期间同时跟踪关注目标和忽略干扰物（注意力控制的两个核心组成部分）的神经生理学指标中的慢下波动（ISF）（专利申请中）。第一阶段的结果表明，NAT识别的行为和EEG指标，成功地区分个人与健康的比较个体的ADHD，并与评分量表上的分数广泛用于表征注意力不集中和冲动的特点ADHD。拟议的第二阶段项目将扩展我们在第一阶段的工作，以进一步改善刺激参数，优化区分成人ADHD与对照组的EEG措施，并在更大的临床试验中测试这些改进（每组120名受试者）在三个研究中心进行，以扩大样本量并验证不同记录条件下的效用，并将确定进一步开发该设备所需的EEG传感器的最小数量。最终，预计NAT将是一种廉价，易于使用，易于分发，基于EEG的客观评估工具，为ADHD提供行为测量和功能性神经生理学生物标志物。NAT的未来用途包括告知诊断，监测治疗，评估新的治疗方法，以及对ADHD大脑机制的临床研究，这可能会导致更好的基于大脑的模型和治疗方案。

 DESCRIPTION (provided by applicant): This project aims to validate a novel neurophysiological assessment tool for Attention-Deficit/Hyperactivity Disorder (ADHD). Adult ADHD is prevalent and enduring and the objective methods for assessment of the disorder are limited, particularly based on functional neurophysiological indices that can also be made readily and inexpensively accessible to a wide market. An important aspect of ADHD would appear to be difficulty in the maintenance of attentional control over periods of 10s of seconds, manifesting as inconsistent within-individual performance on sustained attention tasks with periods of normal performance and other periods of poor performance. We have created an innovative assessment tool, the Neurophysiological Attention Test (NAT), that tracks sustained attention based on electroencephalography (EEG). The NAT provides critical new measures of the fluctuations in control. Unlike any other behavioral or EEG-based assessment tools, the NAT enables continuous tracking of infra-slow fluctuations (ISFs) in neurophysiological indices of BOTH attending targets and ignoring distractors simultaneously, two core components of attention control, during sustained attention tasks (patent pending). Phase-I results show that the NAT identifies both behavioral and EEG indicators that successfully discriminate individuals with ADHD from healthy comparison individuals, and that correlate with scores on rating scales widely used to characterize the inattentive and impulsive features of ADHD. The proposed Phase II project will extend our work from Phase I to further improve the stimulus parameters, optimize the EEG measures for differentiating adults with ADHD from controls, test these improvements in a larger clinical trial (120 subjects per group) conducted across three sites to expand the sample size and verify utility under different recording conditions, and will determine the minimal number of EEG sensors needed for further development of the device. Ultimately, it is expected that the NAT will be an inexpensive, easy to use, easy to distribute, EEG-based objective assessment instrument that provides behavioral measures and functional neurophysiological biomarkers for ADHD. Future uses of the NAT include informing diagnosis, monitoring treatment, evaluating new treatments, and clinical research on the brain mechanisms of ADHD that may lead to better brain-based models and treatment options.