QUANTITATIVE CLINICAL STUDIES OF MINOR ANOMALIES IN ADHD

这个项目探索了轻微的物理异常之间的关系 (MPAS)和注意力缺陷多动障碍(ADHD)。这些辅修课程 畸形特征可能具有重要的诊断意义，表明 形态发生改变或特殊畸形的一般类别 综合症。 我们的主要目标一直是应用定量和临床的MPA 对ADHD男童人群的诊断方法。我们已经检查了 选择反映胚胎学因素的单个MPA的组合。 由于脑和颅面形态起源于共同的原基和 都是由共同的力量塑造的，假设一个病态的 这一过程导致了精神病理和畸形。因此， 特定类型的畸形可能描绘出脑部发育不良 多动症。 在这个项目的第一阶段，我们发现了具体的 ADHD中由胚胎学决定的MPA类别，反映了特定的 发展机制： (A)畸形发生的时间来源， (B)蚀变类型(畸形与变形)，以及 (C)特定的胚胎原基(“原基”)，可产生多细胞分裂原。 在我们的下一阶段研究中，我们建议将这些发现扩展到 回答以下问题： (1)ADHD患者的畸形表型是否随以下因素而不同 对兴奋剂药物的反应？初步研究表明，这两项 好的和不好的应答者是畸形的，但在 不同的，生物学上可以解释的方式。 (2)在男孩中发现的ADHD畸形的模式和程度 也出现在女孩身上吗？初步数据显示，他们也是如此 变形症。 (3)ADHD患者的头面部MPAS和脑畸形是否相关， 就像他们的胚胎关系所预测的那样？我们会 确定ADHD患者的脑形态是否异常(A) 一般而言，或(B)作为药物反应的函数，以及(C) 脑部和颅面畸形的形态是否一致 在(A)和(B)项的科目内。

This project explores the relationship between minor physical anomalies (MPAs) and Attention-deficit Hyperactivity Disorder (ADHD). These minor dysmorphic features may be of major diagnostic significance, indicating general classes of altered morphogenesis or specific malformation syndromes. Our primary goal has been to apply quantitative and clinical MPA diagnostic methods to a population of ADHD boys. We have examined combinations of individual MPAs chosen to reflect embryological factors. Since brain and craniofacial morphology arise from common primordia and are molded by shared forces, it is hypothesized that a pathological process results in both psychopathology and dysmorphology. Thus, specific classes of dysmorphology may delineate brain maldevelopment in ADHD. In the first stage of this project, we have found specific embryologically-determined classes of MPAs in ADHD, reflecting specific developmental mechanisms: (a) the chronological origin of dysmorphogenesis, (b) type of alteration (malformation versus deformation), and (c) specific embryonic primordia ("Anlagen") giving rise to MPAs. In our next stage of research, we propose to extend these findings to address the following questions: (1) Do dysmorphic phenotypes differ for ADHD patients as a function of response to stimulant medication? Pilot studies suggest that both favorable and non-favorable responders are dysmorphic, but in different, biologically interpretable ways. (2) Are the patterns and extent of ADHD dysmorphology found in boys also present in girls? Preliminary data suggest that they too are dysmorphic. (3) Are craniofacial MPAs and brain dysmorphology correlated in ADHD, as predicted by their embryological relationship? We will determine whether brain morphology is abnormal in ADHD patients (a) in general, or (b) as a function of medication response, and (c) whether patterns of brain and craniofacial dysmorphology cohere within subjects in (a) and (b).