Biosignatures of Executive Function and Emotion Regulation in young children with ADHD

项目摘要 儿童的早期外化行为问题，包括注意力的症状- 缺陷/多动障碍（ADHD），如注意力不集中、多动和冲动， 是幼儿心理健康转诊的最常见原因，发生在10- 25%的学龄前儿童尽管循证治疗的成功发展 对于ADHD，早期干预对儿童的长期影响很小， 长期学业和社会障碍。理解长期的主要障碍 治疗对ADHD儿童的影响是，目前对这种疾病的定义依赖于 只在DSM-V症状描述上。过于简单的分类系统限制了我们的 了解ADHD中存在的异质性，特别是在学龄前， 小学早期这种疾病的异质性表明多动症 可能以具有不同神经心理学特征的多个亚组为特征， 假设这些分布反映了不同的潜在神经生物学基质。 然而，缺乏对ADHD神经生物学的既定理解， 特别是在执行功能（EF）和情绪调节（ER）领域。在 根据NIMH战略计划（战略1.4），我们寻求克服这些问题， 通过识别来自整合的不同“生物特征”的限制， 神经生物学（功能和结构磁共振成像（MRI）;功能 MRI和弥散加权MRI）和EF和ER的病理生理学标志物。这将 帮助早期识别和定制治疗行为和神经心理 ADHD的症状此外，我们建议研究 已识别的“生物特征”可预测儿童的早期干预反应。理解 更好地捕捉EF和ER的异质性可能会导致更有针对性的治疗 改善多动症儿童的社交和学习功能。

Project Summary Children’s early externalizing behavior problems, including symptoms of Attention- Deficit/Hyperactivity Disorder (ADHD) such as inattention, hyperactivity, and impulsivity, are the most common reason for early childhood mental health referrals and occur in 10- 25% of preschoolers. Despite the successful development of evidence-based treatments for ADHD, early interventions have been shown to have little impact on children’s long- term academic and social impairment. A major barrier to understanding the long-term treatment impact on children with ADHD is that current definitions of the disorder rely solely on DSM-V symptom profiles. A simplistic classification system limits our understanding of the heterogeneity present in ADHD, particularly during the preschool and early elementary school years. The heterogeneity of the disorder suggests that the ADHD may be characterized by multiple subgroups with varying neuropsychological profiles, with the assumption is that these profiles reflect different underlying neurobiological substrates. However, an established understanding of the neurobiology of ADHD is lacking, in particular, in the executive function (EF) and emotion regulation (ER) domains. In accordance with the NIMH strategic plan (Strategy 1.4) we seek to overcome these limitations by identifying distinct “biosignatures” derived from an integration of neurobiological (functional and structural magnetic resonance imaging (MRI); functional MRI and diffusion-weighted MRI) and pathophysiological markers of EF and ER. This will aid in the early identification and tailored treatment of behavioral and neuropsychological phenotypes of ADHD. Additionally, we propose to examine the extent to which the identified “biosignatures” predict children’s early intervention response. Understanding and better capturing the heterogeneity of EF and ER may lead to more targeted treatments to improve children with ADHD’s social and academic functioning.