Development of ADHD in Preschool Children: Neuroimaging and Behavioral Correlates

描述（由申请人提供）：注意力缺陷/多动障碍（ADHD）已成为学龄前儿童最常见的精神病理学诊断形式。为了解决这一令人担忧的趋势，拟议调查的总体目标是“学龄前儿童多动症的发展：神经影像学和行为相关性”是描述异常的早期发展（大脑，认知和行为）的学龄前儿童确定为多动症的风险，为了更好地了解导致行为功能障碍的神经发育途径，并最终诊断多动症，以及与行为正常化相关的那些。这项研究旨在揭示ADHD中大脑和行为发育之间的关键联系，这将有助于识别该疾病的重要早期生物标志物。 有ADHD症状的学龄前儿童有很大的社交和学业障碍风险。特别值得关注的是，观察到患有ADHD的学龄前儿童与患有ADHD的学龄儿童具有相似的功能障碍模式，并且很少有青少年能够很好地适应，包括更高的急诊室就诊率，以及增加的医疗保健费用和社会成本。ADHD对个人调整、家庭生活、学校、医疗保健和社会服务造成的高昂代价强调了了解其发展过程的重要性，最终目标是早期识别和治疗。尽管是一种需要在7岁时出现症状的疾病，但很少有关于学龄前儿童ADHD症状的纵向大脑发育的研究，并且没有涉及神经影像学。因此，拟议的研究将在成像和行为变量的混合模型中使用纵向设计，以描述和对比被确定为ADHD风险的儿童的生长（从4岁到7岁）与年龄匹配的没有ADHD症状的典型发育儿童的生长。 目标一：通过定量MRI（aMRI）和神经心理学评估来确定被确定为ADHD风险的学龄前儿童的大脑区域（皮质下和皮质）和行为的异常发育。 目标二：作为确定那些学龄前儿童风险最高的第一步，我们将确定被确定为ADHD风险的学龄前儿童的大脑区域和相关神经心理功能的发展轨迹（从4岁到7岁）。

DESCRIPTION (provided by applicant): Attention-Deficit/Hyperactivity Disorder (ADHD) has become the most commonly diagnosed form of psychopathology in the preschool years. To address this alarming trend, the overall goal of the proposed investigation, "Development of ADHD in Preschool Children: Neuroimaging and Behavioral Correlates" is to characterize the anomalous early development (brain, cognition, and behavior) of preschool children identified as at risk for ADHD, in order to better understand the neurodevelopmental pathways that lead to behavioral dysfunction and ultimately the diagnosis of ADHD, as well as those associated with normalization of behavior. This study proposes to uncover a critical link between brain and behavioral development in ADHD, which will contribute to identification of important early biomarkers for the disorder. Preschool children who present with symptoms of ADHD are at significant risk for social and academic dysfunction. Of particular concern are observations that preschoolers with ADHD have similar patterns of functional impairment as school-age children with ADHD, and that few are well-adjusted by adolescence, including higher rates of emergency room visits, and increased health care costs and societal costs. The costly toll that ADHD takes on individual adjustment, family life, schools, health care, and social services underscore the importance of understanding its developmental course, with the ultimate goal of earlier identification and treatment. Despite being a disorder (presently) requiring symptom onset by age 7 years, there have been few studies of longitudinal brain development in preschoolers presenting with symptoms of ADHD, and none involving neuroimaging. Consequently, the proposed study will use a longitudinal design in a mixed model of imaging and behavioral variables, to delineate and contrast the growth (from ages 4 to 7 years) of children identified as at risk for ADHD with that of age-matched typically developing children without symptoms of ADHD. Aim #1: To determine by quantitative MRI (aMRI), and as expressed in neuropsychological assessment, the anomalous development of brain regions (subcortical and cortical) and behavior among preschool children identified as at risk for ADHD. Aim #2: As a first step in identifying those preschoolers most at risk, we will determine the trajectory of development (from ages 4 to 7 years) of brain regions and associated neuropsychological functioning among preschool children identified as at risk for ADHD.