ADHD: Neural Correlates of Adult Outcomes

描述（由申请人提供）：本申请基于以下假设：注意力缺陷/多动障碍-复合型（ADHD-C）的病因和恢复至少部分涉及不同的神经和认知机制。我们认为，ADHD-C是由于主要缺陷的神经系统出现的网状结构内的后脑/中脑区域，存在于个体发育早期，并保持相对静态的整个生命。此外，我们认为，症状的减少经常看到整个发展的额纹状体系统能够通过使用努力或“自上而下”的执行控制来弥补这些早期缺陷的程度有关。为了验证这一假设，我们建议在三组年轻人中使用功能性磁共振成像（fMRI）沿着神经认知测量。两组患者均来自纵向样本，均符合儿童时期ADHD-C的标准。其中，许多人可以清楚地识别为ADHD持续者（ADHD-P）或ADHD缓解者（ADHD-R）。此外，我们还有匹配良好的对照组，他们从未符合ADHD任何亚型的标准。因此，我们将评估ADHD-C中不同发育途径的神经相关性。如果我们的假设是正确的，行为和功能磁共振成像指标的系统出现的网状结构应该不同于对照组的儿童ADHD-C，无论成人的临床状态。相比之下，额纹状体功能的测量应该随着成年状态的变化而变化，例如成年后更严重的ADHD症状与这些测量的效率较差相关，而那些不再具有显著ADHD症状的人应该表现得更类似于从未ADHD的对照。

DESCRIPTION (provided by applicant): This application is based on the hypothesis that at least partially distinct neural and cognitive mechanisms are involved in the etiology of and recovery from Attention-deficit/Hyperactivity Disorder - combined type (ADHD-C). We posit that ADHD-C is due to a primary deficit in a neural system emerging from the reticular formation within the hindbrain/midbrain region that is present early in ontogeny and remains relatively static throughout the lifetime. Further, we posit that the diminution of symptoms frequently seen throughout development is related to the degree to which frontostriatal systems are able to compensate for these early deficits through the use of effort or "top-down" executive control. To test this hypothesis, we propose to use functional magnetic resonance imaging (fMRI) along with neurocognitive measures in three groups of young adults. Two groups consist of patients from a longitudinal sample, all of whom met criteria for ADHD-C during childhood. Among these, many can be clearly identified either as ADHD persisters (ADHD-P) or ADHD remitters (ADHD-R). In addition, we have well-matched controls who never met criteria for any subtype of ADHD. Thus, we will evaluate the neural correlates of diverse developmental pathways in ADHD-C. If our hypotheses are correct, behavioral and fMRI indices of the system emerging the reticular formation should differ from controls in those who had childhood ADHD-C irrespective of adult clinical status. In contrast, measures of frontostriatal function should vary as a function of adult status such that more severe ADHD symptoms in adulthood are associated with poorer efficiency on these measures while those no longer having significant ADHD symptoms should perform more similarly to never-ADHD controls.