Treatment of ADHD in Pediatric Patients with Epilepsy

描述(由申请人提供)：癫痫非常普遍，并与精神障碍的风险增加有关。慢性反复发作的患者被排除在建立儿科精神病学标准治疗的大多数药理学试验之外。寻找安全有效的治疗儿童癫痫患者精神障碍的方法具有迫切的公共卫生重要性。这一以患者为导向的研究发展奖(K23)的目的是为了让候选人成为面临癫痫的儿童和青少年精神障碍的精神药理学治疗的独立临床研究员。该提案的重点是患有ADHD和癫痫的患者。该项目将在波士顿儿童医院(CHB)进行，该医院为大量癫痫患者提供服务。约瑟夫·比德曼，医学博士，在儿科精神药理学的临床试验方面具有专业知识，将担任主要导师。CHB精神病学主席、医学博士威廉·R·比尔兹利将担任赞助商。布莱斯·布尔乔亚医学博士，CHB癫痫和临床神经生理学分部主席，是癫痫的主要顾问。研究计划：1)对患有ADHD和癫痫的儿童患者进行缓释哌酸甲酯(Concerta)的随机分组对照交叉试验；2)在精神药理学临床试验中建立确保癫痫儿童安全性的方法。职业发展计划：培训将强调在患有癫痫和精神障碍的青年患者中进行随机对照临床试验所需的技能，并探索其增加精神病理风险的神经生物学机制。在干预研究设计、统计学、发展精神病理学以及精神病理学和治疗反应评估方法方面的教学工作将补充项目顾问的监督。候选人的长期目标是开发和评估患有精神障碍和癫痫的儿童的治疗方法，并调查这些疾病的风险和治疗反应的神经生物学相关性。

DESCRIPTION (provided by applicant): Epilepsy is highly prevalent and associated with increased risk for psychiatric disorders. Patients with chronic recurrent seizures are excluded from most pharmacological trials establishing standard treatments in pediatric psychiatry. Finding safe and effective treatments for psychiatric disorders in pediatric patients with epilepsy is of pressing public health importance. The purpose of this Mentored Patient-Oriented Research Development Award (K23) is for the candidate to become an independent clinical researcher in the psychopharmacologic treatment of psychiatric disorders in children and adolescents facing epilepsy. The proposal focuses on patients with comorbid ADHD and epilepsy. The project will be conducted at Children's Hospital Boston (CHB), which serves a large population of patients with epilepsy. Joseph Biederman, MD, with expertise in clinical trials in pediatric psychopharmacology will serve as the primary mentor. William R. Beardslee, MD, Chairman of Psychiatry at CHB will serve as the sponsor. Blaise Bourgeois, MD, Chairman of the Division of Epilepsy and Clinical Neurophysiology at CHB is the principal epilepsy consultant. Research plan: The aims are: 1) To perform a randomized placcbo controlled crossover trial of extended release methylphenidate (Concerta) in pediatric patients with comorbid ADHD and epilepsy; 2) To establish methods of assuring the safety of children with epilepsy in psychopharmacological clinical trials. Career development plan: The training will emphasize skills necessary for conducting randomized controlled clinical trials in youth with epilepsy comorbid with psychiatric disorders and to explore the neurobiological mechanisms underlying their increased risk for psychopathology. Didactic work in intervention research design, statistics, developmental psychopathology, and assessment methodologies for psychopathology and treatment response will complement supervision by the program consultants. The long-term goals of the candidate are to develop and evaluate treatments for children with comorbid psychiatric disorders and epilepsy as well as to investigate neurobiological correlates of the risk and response to treatment of these disorders.