NORMAL DEVELOPMENT OF STARTLE RESPONSES

本课题是对电击调制的成熟研究。 儿童期与规范数据在儿童精神分裂症综合征中的应用 注意力缺陷多动障碍(ADHD)。这样做的主要目的是 建议继续我们对ADHD惊厥调制的研究 由当前文献和我们自己的数据提出的台词，即 ADHD的病理生理学可能位于吻侧至 脑干区域。为了探索这一假设，将使用Startle作为 评价注意缺陷多动障碍儿童持续注意的探讨 性能任务(CPT)。注意缺陷多动症儿童表现出注意力缺陷 在CPT上，电击衰减程度可以反映出 注意投入量与脑干下游皮质控制 感觉处理机制。此外，这项提议延续了我们的 规范的成熟研究，将其扩展到CPT衰减 通过研究学龄前儿童的这种惊吓调制 孩子们。因为30%的ADHD受试者有主要的夜间活动 遗尿症，是那些患有遗尿症的ADHD男孩表现出来的 显著降低惊厥的抑制性预刺激调制 (PMS)，这项建议的一个新目标是在确定的群体中研究PMS 患有和不伴有遗尿症的多动症男孩和纯净的男孩 夜间遗尿症。这些组织将足够大，以便他们的 维度特征(ADHD的严重程度和频率 夜间遗尿症)和预期的共病(对立性挑衅 注意缺陷多动障碍，夜间尿液和尿失禁， 并且可以评估两组中特定的发育障碍。 因为初级夜间活动有很强的家庭成分 遗尿症，每个纯遗尿症男孩的父母都将接受经前综合症检测。 因此，这项提议将探索一种家庭成员 遗尿症的神经生理标志物。这项提议的一个特点是 评价诊断和功能神经解剖学的特异性。这 将通过比较遗尿症和ADHD人群不仅实现 正常对照，但在经前综合征和CPT上也是如此 惊吓实验的衰减。据预计， 遗尿剂将显示缺乏抑制性PMS和正常的CPT衰减 惊吓，提示有原发性脑干功能障碍，而ADHD男孩 将显示相反的情况，提示皮质功能障碍，下游 对惊吓调制的影响。

This project is a maturational study of startle modulation during childhood and an application of the normative data to the syndrome of attention-deficit hyperactivity disorder (ADHD). The major aim of this proposal is to continue our studies of startle modulation in ADHD along lines suggested by current literature and our own data, namely that pathophysiology in ADHD is likely to be located in structures rostral to brainstem regions. To explore this hypothesis, startle will be used as a probe to evaluate the sustained attention of ADHD during a continuous performance task (CPT). ADHD children have shown attentional deficits on the CPT, and startle attenuation can reflect the degree of attentional engagement and downstream cortical control of brainstem sensory processing mechanism. Additionally this proposal continues our normative maturational studies, extending them to CPT attenuation of startle, by studying this type of startle modulation in preschool children. Since 30 percent of our ADHD subjects had primary nocturnal enuresis, and it was those ADHD boys with enuresis who showed significantly reduced inhibitory prestimulation modulation of startle (PMS), a new aim of this proposal is to study PMS in definitive groups of boys with ADHD with and without nocturnal enuresis and boys with pure nocturnal enuresis. These groups will be large enough so that their dimensional characteristics (severity of ADHD, and frequency of nocturnal enuresis) and expected comorbidity (oppositional defiant disorder in ADHD, daytime wetting and encopresis in nocturnal enuretics, and specific development disorders in both groups can be evaluated. Because there is a strong familial component to primary nocturnal enuresis, both parents of each pure enuretic boy will be tested for PMS. Hence, this proposal will explore the possibility of a familial neurophysiologic marker in enuresis. A feature of this proposal is the evaluation of diagnostic and functional neuroanatomic specificity. This will be achieved by comparing the enuretic and ADHD populations not only with normal controls but also with each other on both the PMS and CPT attenuation of startle experiments. It is anticipated that the enuretics will show deficient inhibitory PMS and normal CPT attenuation of startle, suggesting a primary brainstem dysfunction, while ADHD boys will show the opposite, suggesting cortical dysfunction, with downstream effects on startle modulation.