Inhibitory Control and Emotional Processing in Pediatric ADHD

描述(由申请人提供)：注意力缺陷/多动障碍(ADHD)的特征是注意力不集中、多动和冲动的症状。长期以来，抑制控制和相关的额纹状体(FS)回路的缺陷一直被认为与ADHD有关，但最近的研究表明，额边缘(FL)回路中的异常情绪处理也可能是ADHD儿童多动的重要组成部分。因此，任何一个领域的缺陷都可能与ADHD有关，并决定特定儿童表现出的临床表型。利用功能磁共振成像(FMRI)，本研究旨在同时研究同一组儿童的FS和FL回路的功能，因为这是确定这两个回路在ADHD儿童中是否具有分离功能和神经心理相关性的最佳手段。这项研究将考察60名(8-12岁)ADHD儿童(N=30)和非ADHD儿童(N=30)在执行抑制性控制功能磁共振任务时FS回路的功能，以及在情绪处理fMRI任务执行期间FL回路的功能。假设这些回路的功能不仅在患有ADHD和不患有ADHD的儿童中有所不同，而且在FS和FL回路的行为关联中也会发现双分离。这份以患者为导向的研究职业发展奖(K23)的申请书还要求为乔纳森·波斯纳医学博士提供资金，以继续进行成为一名独立调查员所必需的培训。这笔资金将支持一个全面的项目，包括正式的教学和来自儿童神经成像、认知和情感神经科学以及儿童精神病理学领域专家的研讨会。这些培训活动将增强波斯纳博士对a)功能磁共振成像技术；b)ADHD的病理生理学、现象学和治疗；c)情感和认知神经科学；d)纵向神经成像研究设计；以及e)科学研究的伦理行为的知识。 公共卫生相关性：ADHD与一系列负面的长期后果有关，并给儿童和家庭带来严重困难。更好地了解ADHD的神经生物学可能有助于推进对该疾病的病因学、遗传学和治疗的研究。

DESCRIPTION (provided by applicant): Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by symptoms of inattention, hyperactivity, and impulsivity. Deficits in inhibitory control and associated frontostriatal (FS) circuits have long been implicated in association with the disorder, but recent studies suggest that abnormal emotional processing within frontolimbic (FL) circuits may also be an important component of the hyperactivity evidenced in children with ADHD. Deficits in either domain may therefore be associated with ADHD and determine the clinical phenotype that a particular child exhibits. Using functional magnetic resonance imaging (fMRI), the current study aims to investigate simultaneously the functioning of FS and FL circuits in the same group of children as this is the best means to determine whether these two circuits have dissociable functions and neuropsychological correlates in children with ADHD. The study will examine in 60 children (ages 8 - 12) with (N=30) and without (N=30) ADHD the functioning of FS circuits during the performance of an inhibitory control fMRI task and the functioning of FL circuits during the performance of an emotion processing fMRI task. The hypotheses are that the functioning of these circuits will not only differ in children with and without ADHD but also that a double dissociation will be found in the behavioral correlates of FS and FL circuits. This application for a Mentored Patient-Oriented Research Career Development Award (K23) also requests funding for Jonathan Posner, MD to pursue training essential to becoming an independent investigator. This funding would support a comprehensive program including formal didactics and seminars from experts in the fields of pediatric neuroimaging, cognitive and affective neuroscience, and pediatric psychopathology. These training activities would enhance Dr. Posner's knowledge of a) fMRI techniques; b) the pathophysiology, phenomenology, and treatment of ADHD, c) affective and cognitive neuroscience; d) longitudinal neuroimaging study design; and e) the ethical conduct of scientific research. PUBLIC HEALTH RELEVANCE: ADHD is associated with a wide range of negative long-term outcomes, and causes significant hardship for children and families. Developing a better understanding of the neurobiology of ADHD may help advance research into the etiology, genetics, and treatment of the disorder.