Estrogen Effects on ADHD and Cognition

雌激素对多动症和认知的影响

• 批准号: 10011836
• 负责人: MICHELLE M MARTEL
• 金额: $ 69.86万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011836
• 关键词: Adolescence; Adult; Affect; Age; Animals; Attention; Attention deficit hyperactivity disorder; Back; Basic Science; Biological; Biological Assay; Childhood; Clinic; Clinical; Cognition; Cognitive; Communities; Data; Deltastab; Diagnosis; Disease; Dopamine; Estradiol; Estrogens; Evaluation; Exclusion Criteria; Exhibits; Experimental Designs; Feasibility Studies; Female; Goals; Gonadal Steroid Hormones; Health; Hormonal; Hormone use; Hormones; Human; Impairment; Impulsivity; Laboratories; Link; Longitudinal Studies; Measurement; Measures; Menstrual cycle; Menstruation; Neurocognitive; Ovarian hormone; Ovulation; Participant; Persons; Pharmaceutical Preparations; Phase; Prevalence; Progesterone; Psychology; Puberty; Publishing; Rattus; Research Design; Risk; Risk Factors; Role; Saliva; Sampling; Short-Term Memory; Symptoms; Test Result; Testing; Thinking; Translating; Universities; Visit; Withdrawal; Woman; Work; animal data; base; clinical practice; clinical predictors; clinically significant; cognitive function; cognitive performance; cognitive testing; comorbidity; design; falls; hypothalamic pituitary gonadal axis; improved; inattention; innovation; male; multilevel analysis; perimenstrual; personalized approach; proliferative phase Menstrual cycle; recruit; response; sex; social media; treatment response; virtual; young adult; young woman

Females with Attention-Deficit/Hyperactivity Disorder (ADHD) remain dramatically understudied, even though they exhibit increased impairment beginning around puberty. Estrogen rises rapidly at puberty and exerts important effects on dopamine and cognition in both humans and animals. Both animal and human work suggest that cognition and ADHD symptoms may be sensitive to hormonal effects, particularly in highly impulsive females. Yet, the effect of estrogen on ADHD symptoms in young adult women remains virtually unstudied. Our pilot data in 33 naturally-cycling young women suggest that among women with greater ADHD symptoms, within-person declines in estrogen, particularly in the context of rising levels of progesterone, just post-ovulation, are associated with clinically significant increases in ADHD symptoms. Yet, no published empirical work has directly examined the role of circulating estrogen in relation to ADHD symptoms and cognitive mechanisms in women with ADHD. The current study would pioneer a new stage of work by being the first to utilize a rigorous quasi-experimental design that involves intensive longitudinal measurement across the menstrual cycle in order to examine within-person estrogen effects on ADHD and cognitive mechanisms in young women with ADHD. A sample of 120 young women ages 18 to 25 with inattention, overactivity, or impulsivity problems will be recruited from the university health center and local ADHD clinic, psychology department, and through social media. Participants will be comprehensively assessed for ADHD and exclusion criteria (e.g., use of hormone-based medication or hormonal conditions). Female participants will complete well-established assessment measures of ADHD and other psychopathological symptoms and diagnoses and cognition and provide saliva samples of hormones in the laboratory during a baseline laboratory visit within the first few days of the start of their menstrual cycle (i.e., during the mid-follicular phase, characterized by stable low estrogen). Then, they will provide daily saliva samples for hormone assay each morning and complete short daily assessments of ADHD and cognition every evening for up to 2 full menstrual cycles. They will also complete laboratory cognitive testing of inhibition and working memory targeted to key cycle phases characterized by declining estrogen (post-ovulatory, perimenstrual) and a cycle phase characterized by stable high estrogen levels (midluteal), based on menses onset and ovulation test results. Multi-level modeling will evaluate the clinical significance of within-person estrogen associations with ADHD and cognition with consideration of progesterone as an interactive factor. Effects of comorbid disorders and affect will also be explored. Study results have the potential to shift our understanding of ADHD in women by consideration of dynamic hormone influences. In addition, results will change clinical practice by indicating the need to account for cycle phase in ADHD evaluations in women, as well as suggest personalized approaches to treatment targeted to cycle phase or hormone levels.

女性注意力缺陷多动障碍（ADHD）仍然严重不足，即使 他们在青春期开始表现出越来越多的损伤。雌激素在青春期迅速上升， 对人类和动物的多巴胺和认知都有重要影响。动物和人类的工作 这表明认知和ADHD症状可能对激素的影响敏感，特别是在高度 冲动的女性然而，雌激素对年轻成年女性ADHD症状的影响几乎仍然存在。 未经研究。我们在33名自然骑自行车的年轻女性中的试验数据表明，在患有多动症的女性中， 症状，体内雌激素下降，特别是在孕激素水平上升的情况下， 排卵后，与ADHD症状的临床显著增加有关。然而，没有出版 实证工作直接研究了循环雌激素与ADHD症状的关系， ADHD女性的认知机制目前的研究将开创一个新的工作阶段， 第一个利用严格的准实验设计，包括密集的纵向测量， 月经周期，以检查体内雌激素对ADHD的影响以及 患有多动症的年轻女性一个120名18到25岁的年轻女性的样本，她们注意力不集中，过度活跃， 冲动问题将从大学健康中心和当地ADHD诊所，心理学， 部门，并通过社交媒体。参与者将接受全面的ADHD和排除评估 标准（例如，使用基于激素的药物或激素状况）。女性参与者将完成 ADHD和其他精神病理学症状和诊断的成熟评估措施， 认知，并在基线实验室访视期间在实验室中提供激素的唾液样本。 她们月经周期开始的最初几天（即，在卵泡中期，其特征在于稳定的 低雌激素）。然后，他们将每天早上提供唾液样本进行激素检测并完成 每天晚上对ADHD和认知进行简短的日常评估，最多持续2个完整的月经周期。他们还将 完成针对关键周期阶段的抑制和工作记忆的实验室认知测试 特征为雌激素下降（排卵后，围月经期）和周期阶段，特征为稳定 高雌激素水平（黄体中期），基于月经开始和排卵试验结果。多层次建模将 评估人内雌激素与ADHD和认知功能相关性的临床意义， 考虑孕酮作为一个相互作用的因素。共病疾病和情感的影响也将被 探讨了研究结果有可能改变我们对女性ADHD的理解， 动态激素的影响。此外，结果将改变临床实践，表明需要考虑 对于女性ADHD评估的周期阶段，以及建议个性化的治疗方法， 针对周期阶段或激素水平。