Brain trajectories in ADHD

项目概要 长期以来，人们一直认为多动症包括基于大脑的病理生理学，但最新的方法 迄今为止，对多动症中非典型大脑组织的描述仅限于横断面研究。目前的 该项目旨在解决青春期多动症变化的神经生物学相关性这一关键问题。在 到了青春期，多动症的结果开始在重要方面出现分歧，但目前还很难解释。了解 这些临床变化的神经生物学基础将为临床理解迈出重要一步。在 同时，在青春期，大脑功能发育的动态是非线性的，与 这些过程发生在童年时期，表明我们更深入地关注那个年龄段。建立在概念上 整合大脑认知和情感回路的框架，本研究有以下内容 主要目标。首先，它试图发现 ADHD 中不同类型的大脑组织如何 人口预测青春期 ADHD 病程。其次，它寻求跟踪发展的变化 ADHD 人群中跨网络大脑组织与不同临床发展的关系 在青春期期间。第三，它试图评估基于大脑的“神经类型”的发育前景 多动症。这项工作的意义在于其前所未有的描述多动症特征的能力 随着时间的推移，神经生物学与尚未在多动症中进行检查的大脑表征方法 以前就以这种方式进行过纵向研究，并努力将脑成像转移到临床预测领域 纵向设计。该项目在实现网络和拓扑特征方面具有创新性 多波设计中的大脑分析，识别基于大脑的 ADHD 类型（神经生物学 异质性），并将这些与临床过程联系起来。该方法需要跟踪已经开发的 采用交叉滞后纵向设计的 376 名儿童队列，能够描述年龄发展特征 7-19 岁。大脑组织将通过扩散张量成像和静息态功能进行操作 连接性，同时标准结构指标也将可用。每年都会对青年进行特征描述 与临床症状、合并症、损伤、认知功能、奖励折扣和情绪的关系 监管和运作。分析方法将涵盖脑回路、网络和拓扑测量 使用新颖的图论分析来表征大脑系统。将评估临床类型 使用社区检测程序和更标准的混合模型分析大脑特征。潜伏 班级轨迹模型将用于探索 ADHD 的不同发展类型（如果存在）。目标 直接匹配 NIMH 战略计划的关键优先事项。如果成功，该项目有望打破僵局 面对对多动症非典型脑生理学的日益掌握的临床实用性领域。全部原料 处理/清理的数据可用于现场探索，以最大限度地利用这一点 同类中的一员。

Project Summary ADHD has long been believed to include brain-based pathophysiology, but the newest approaches to describing atypical brain organization in ADHD are thus far limited to cross-sectional studies. The current project aims at the crucial question of the neurobiological correlates of change in ADHD during adolescence. In adolescence, ADHD outcomes begin to diverge in important ways that are poorly explained. Understanding the neurobiological basis of those clinical changes would provide a major step forward in clinical understanding. At the same time, in adolescence the dynamics of functional brain development are non-linear and distinct from those processes in childhood, suggesting a deeper focus on that age period. Building on a conceptual framework that integrates cognitive and emotional circuitries in the brain, the present study has the following principal objectives. First, it seeks to discover how distinct types of brain organization within the ADHD population predict in ADHD course during adolescence. Second, it seeks to track variations in the development of cross-network brain organization within the ADHD population in relation to divergent clinical development during the adolescent period. Third, it seeks to evaluate prospects for developmental brain-based “neurotypes” in ADHD. The significance of this effort lies both in its unprecedented ability to characterize ADHD neurobiology over time with methods of brain characterization that have not been examined in ADHD longitudinally in this way before, and in its effort to move brain imaging into the realm of clinical prediction using a longitudinal design. The project is innovative in regard to implementing network and topology features of brain analysis in a multi-wave design, identifying brain-based typologies of ADHD (neurobiological heterogeneity), and linking these to clinical course. The approach entails tracking of an already developed cohort of 376 children in a cross-lagged longitudinal design, enabling characterization of development from age 7-19 years. Brain organization will be operationalized with diffusion tensor imaging and resting state functional connectivity, while standard structural metrics will also be available. Youth will be characterized annually in relation to clinical symptoms, comorbidity, impairment, cognitive functioning, reward discounting, and emotion regulation and functioning. Analytic approaches will span brain circuit, network, and topological measurements using novel graph theoretical analyses to characterize brain systems. Clinical typologies will be evaluated using community detection procedures and more standard mixture model analysis of brain features. Latent class trajectory models will be used to explore distinct developmental types of ADHD if they exist. The Aims directly match key priorities of the NIMH strategic plan. If successful, the project hopes to break the impasse facing the field with regard to clinical utility of the growing grasp of atypical brain physiology in ADHD. All raw and processed/cleaned data are being made available to the field for exploration to maximize the utility of this one of a kind cohort.