Neural Markers of the Transition from ADHD risk before age 7 to stable diagnosis

描述（由申请人提供）：目前估计美国注意力缺陷/多动障碍（ADHD）的患病率为3- 5%。第一次诊断的年龄通常在6-7岁之间，当学生第一次入学时;然而，许多父母会争辩说，他们观察到ADHD的迹象/症状要早得多。有趣的是，在所有被诊断患有ADHD的3-4岁儿童中（使用传统的家长/教师访谈方法），只有大约50%的儿童在7岁时继续符合诊断标准。以前试图在7岁之前实现更好的诊断稳定性，扩大了测量的行为数量和种类。虽然这些尝试略微提高了可预测性，但尚未实现该年龄段的新黄金标准。这个K 01研究计划的主要目标是检查神经系统的发展，这些神经系统标志着从ADHD的体征和症状到稳定的ADHD诊断的过渡。通过使用神经成像来更好地推断潜在的生物学，可以更好地预测哪些在3岁时表现出高度注意力不集中和多动的儿童将在7岁及以后继续表现出这些行为。7岁以后继续符合ADHD诊断标准的儿童很可能在整个童年时期继续符合诊断标准，并且在40-70%的情况下进入成年。即使他们在成年后不符合障碍的标准，根据他们的童年诊断，他们也会增加学业失败，社会问题，物质使用障碍，车祸和监禁的风险。神经影像学研究表明，从8岁到成年，患有和不患有ADHD的儿童和青少年的认知控制缺陷与前额叶皮层的差异激活有关。然而，关于3-7岁幼儿认知控制发展的神经基础以及这如何有助于ADHD的发展，我们知之甚少。这是一个重大的知识差距，考虑到这段时间对ADHD神经病学的持续表达可能是多么重要。研究人员发现，研究执行功能的神经发育根源具有挑战性，因为我们对这么小的孩子的大脑成像能力有限。然而，允许EEG数据收集在3-4奥尔兹和fMRI数据收集在5-7奥尔兹的技术最近已经完善，并在这里提出。

DESCRIPTION (provided by applicant): Current estimates place the prevalence of attention-deficit/hyperactivity disorder (ADHD) in the US at 3-5%. The usual age of first diagnosis is between 6-7 years of age when students are first entering school; however, many parents will argue that they observed signs/symptoms of ADHD much earlier. Intriguingly, of all 3-4 year old children diagnosed with ADHD (using traditional parent/teacher interview methods), only about 50% continue to meet diagnostic criteria at age 7. Previous attempts at achieving better diagnostic stability before the age of seven have expanded the number and kinds of behavior that are measured. Although these attempts have slightly improved predictability, no new gold standard for this age range has been achieved. The primary goal of this K01 research plan is to examine the development of the neural systems that mark the transition from signs and symptoms of ADHD to stable ADHD diagnosis. By using neuroimaging to better infer the underlying biology, better prediction of which children who exhibit elevated inattention and hyperactivity at age 3 will continue to exhibit these behaviors at age 7 and beyond may be achieved. Children who continue to meet diagnostic criteria for ADHD after the age of 7 are very likely to continue to meet diagnostic criteria across childhood, and in 40-70% of cases into adulthood. Even if they do not meet criteria for the disorder in adulthood they will, based on their childhood diagnosis, have increased risk for academic failure, social problems, substance use disorder, car accidents, and incarceration. Neuroimaging studies have associated deficits of cognitive control with differential activation of the prefrontal cortex in children and adolescents with and without ADHD ages 8 through adulthood. Less is known, however, about the neural basis of the development of cognitive control in younger children ages 3-7 and how this contributes to the development of ADHD. This is a major gap in knowledge, considering how crucial this time period may be to the continued expression of ADHD symptomology. Researchers have found it challenging to investigate the neuro-developmental roots of executive function because of limitations in our ability to image the brain in children this young. However, techniques allowing EEG data collection in 3-4 year olds and fMRI data collection in 5-7 year olds have recently been perfected and are proposed here.