ADHD: Neural Correlates of Adult Outcomes

描述(申请人提供)：这项申请是基于这样一个假设，即至少部分不同的神经和认知机制参与了注意力缺陷/多动障碍混合型(ADHD-C)的病因和康复。我们假设ADHD-C是由于后脑/中脑区域内的网状结构出现的神经系统的初级缺陷，该结构在个体发育早期存在，并在整个生命周期中保持相对静止。此外，我们假设，在整个发育过程中经常出现的症状的减少与额纹状体系统能够通过使用努力或“自上而下”的执行控制来补偿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磁共振成像(FMRI)和神经认知测量。两组由纵向样本中的患者组成，所有患者在童年时期都符合ADHD-C标准。在这些人中，许多人要么是ADHD持久者(ADHD-P)，要么是ADHD汇款者(ADHD-R)。此外，我们还有匹配良好的对照组，他们从未达到任何ADHD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，无论成年人的临床状态如何，网状结构的行为和功能磁共振指数都应该与儿童ADHD-C患者的对照组有所不同。相反，额纹状体功能的测量应该随着成人状态的不同而不同，这样成年后更严重的ADHD症状与这些测量的效果更差有关，而那些不再有明显ADHD症状的人应该表现得更类似于从未患有ADHD的对照组。

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.