Longitudinal Investigation of the Neurobiological Underpinnings of Risk Behavior in ADHD throughout the Adolescent Transition: The Key Role of Cognitive Control and Motivation Network Development

项目摘要/摘要 注意力缺陷/多动障碍(ADHD)是儿童最常见的发育障碍。 儿童，影响到全国约9%的儿童。尽管ADHD极大地增加了穷人的风险 关于学业成就、滥用药物和犯罪行为，特别是在青春期，人们知之甚少。 关于神经生物学发展轨迹是如何支撑这些行为和临床结果的。这 尽管这类工作对于更早地识别风险因素、更有针对性地进行这项工作很重要，但情况依然如此 治疗模式，反过来，教育、青少年司法和个人、家庭和医疗保健储蓄 社会。家长基金的主要目标是“对儿童的神经生物学基础进行纵向研究”。 青少年过渡期间ADHD的危险行为：认知控制和动机的关键作用 网络发展“(R01MH119091)，是为了检查纵向神经、行为和临床轨迹 从儿童期后期到青春期中期的青少年多动症患者。我们专注于与以下相关的神经行为过程 认知控制，或执行功能(EF)，以及动机，因为它们已被确定为核心重要 与ADHD的病因和在典型的发展中观察到的冒险行为的普遍增加有关 (Td)青少年。值得注意的是，在青少年经历的EF困难方面，有明显的异质性 多动症。患有注意缺陷多动障碍的青少年比没有经历EF困难的青少年预后更差的风险更高 EF困难，不管ADHD症状的严重程度。此外，EF的不同组成部分存在差异 与结果有关。具体地说，有更新缺陷的ADHD青少年的情绪调节能力较差，而 患有注意力缺陷多动症的青少年学习成绩低。因此，至关重要的是要刻画出 EF不同组成部分的纵向轨迹用于识别患有ADHD的青少年，他们是未来风险更高的人 消极的结果。因此，在本补编中，我们建议更彻底地评估EF并纵向评估 描述功能性大脑网络组织的轨迹和贯穿始终的多个不同的EF组件 患有ADHD和TD的青少年过渡到青春期。我们还建议确定这些因素是如何 轨迹与青少年的结果有关。我们通过提议额外的行为测试会话来实现这一点 对于已经注册了家长研究的参与者，我们在该研究中管理一系列EF任务并评估 与学业成绩相关的结果。通过将这种新的数据收集与大脑成像、自我报告、 通过家长资助收集的家长报告数据，我们将达到以下目的：1)特征化 ADHD患者EF不同成分在青春期过渡过程中的行为轨迹 青少年功能性脑网络组织运动轨迹与EF关系的研究 患有ADHD；以及3)根据功能性脑网络组织的轨迹确定结果有何不同 和EF性能。总之，这些发现将为早期识别提供基础。 最终，防止更有可能导致青春期不良后果的ADHD轨迹。

PROJECT SUMMARY/ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed developmental disorder of childhood, affecting ~9% of children nationwide. Although ADHD dramatically increases the risk for poor academic achievement, substance abuse and criminal behavior, particularly in adolescence, too little is known regarding how neurobiological developmental trajectories underlie these behavioral and clinical outcomes. This remains the case despite the importance of such work for earlier identification of risk factors, more targeted treatment models, and, in turn, education, juvenile justice, and healthcare savings for individuals, families, and society. The main goal of the parent grant, “Longitudinal investigation of the neurobiological underpinnings of risk behavior in ADHD throughout the adolescent transition: the key role of cognitive control and motivation network development” (R01MH119091), is to examine longitudinal neural, behavioral, and clinical trajectories of youth with ADHD from late childhood to mid-adolescence. We focus on neurobehavioral processes related to cognitive control, or executive function (EF), and motivation, as they have been identified as centrally important both to the etiology of ADHD and to the general increase in risk-taking behavior observed in typically developing (TD) adolescents. Notably, there is marked heterogeneity in terms of EF difficulties experienced by youth with ADHD. Youth with ADHD who experience EF difficulties are at higher risk of poorer outcomes than those without EF difficulties, regardless of severity of ADHD symptoms. Moreover, different components of EF differentially relate to outcomes. Specifically, youth with ADHD with deficits in updating have poor emotion regulation, while youth with ADHD with deficits in shifting have low academic achievement. Therefore, it is crucial to characterize longitudinal trajectories of distinct components of EF to identify youth with ADHD who are more at risk for future negative outcomes. Thus, in this supplement we propose to more thoroughly assess EF and to longitudinally characterize trajectories of functional brain network organization and multiple distinct EF components throughout the transition to adolescence in youth with ADHD and TD youth. We additionally propose to identify how these trajectories relate to adolescent outcomes. We achieve this by proposing an additional behavioral testing session for participants already enrolled in the parent study in which we administer a battery of EF tasks and assess academic achievement-related outcomes. By combining this new data collection with brain imaging, self-report, and parent-report data collected through the parent grant, we will achieve the following aims: 1) Characterize behavioral trajectories of distinct components of EF in ADHD throughout the transition to adolescence; 2) Characterize the relationship between trajectories of functional brain network organization and EF in adolescents with ADHD; and 3) Determine how outcomes differ based on trajectories of functional brain network organization and EF performance. Together, these findings will provide the groundwork that can lead to early identification and, ultimately, prevention of ADHD trajectories that are more likely to lead to adverse outcomes in adolescence.