Brain trajectories in ADHD

项目摘要 长期以来，人们一直认为ADHD包括基于大脑的病理生理学，但最新的治疗方法 到目前为止，描述ADHD非典型脑组织的研究仅限于横断面研究。海流 该项目旨在解决青春期ADHD变化的神经生物学相关性这一关键问题。在……里面 在青春期，ADHD的结果开始在一些重要的方面出现分歧，而这些方面的解释很差。了解 这些临床变化的神经生物学基础将为临床理解向前迈进一大步。在… 与此同时，在青春期，大脑功能发育的动态是非线性的，与 儿童时期的这些过程，表明对那个年龄段的更深层次的关注。建立在概念性的 这一框架整合了大脑中的认知和情绪回路，本研究有以下几点 主要目标。首先，它试图发现ADHD中不同类型的大脑组织是如何 青春期ADHD病程的人群预测。其次，它寻求跟踪发展中的变化 ADHD人群中跨网络脑组织与不同临床发育的关系 在青春期。第三，它试图评估基于大脑的“神经型”的发展前景。 患有多动症。这一努力的意义在于，它具有前所未有的能力来描述ADHD 随时间推移的神经生物学，以及尚未在ADHD中检查的脑特征方法 以前以这种方式纵向进行的，并努力将大脑成像技术应用于临床预测领域 纵向设计。该项目在实施网络和拓扑功能方面具有创新性 多波设计中的脑分析，确定ADHD(神经生物学)基于脑的类型 异质性)，并将这些与临床病程联系起来。该方法需要跟踪已经开发的 376名儿童组成的队列，采用交叉滞后的纵向设计，能够描述年龄发展的特征 7-19年。脑组织将通过扩散张量成像和静息状态功能进行操作 连接性，同时标准结构指标也将可用。青年将在每年一度的 与临床症状、共病、损害、认知功能、奖励折扣和情绪的关系 监管和运作。分析方法将跨越大脑电路、网络和拓扑测量 使用新的图论分析来表征大脑系统。临床分型将进行评估 使用社区检测程序和更标准的混合模型分析大脑特征。潜伏期 班级轨迹模型将被用来探索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 面对有关ADHD非典型脑生理学的不断掌握的临床应用领域。全是生的 正在向现场提供经过处理/清理的数据以供勘探，以最大限度地利用 独一无二的一群。

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.