Longitudinal Investigation of the Neurobiological Underpinnings of Risk Behavior in ADHD throughout the Adolescent Transition: The Key Role of Cognitive Control and Motivation Network Development

项目总结/摘要 注意力缺陷多动障碍（ADHD）是儿童最常见的发育障碍。 儿童，影响全国约9%的儿童。虽然ADHD大大增加了穷人的风险， 学术成就，药物滥用和犯罪行为，特别是在青春期，太少知道 关于神经生物学发展轨迹如何构成这些行为和临床结果的基础。这 尽管这项工作对于及早查明危险因素、更有针对性地 治疗模式，反过来，教育，青少年司法和个人，家庭和医疗保健储蓄， 社会因此，当前项目的目标是描述纵向神经、行为和临床特征。 ADHD青少年从童年晚期到青春期中期的发展轨迹。认知的大脑系统 特别是控制和动机已经被确定为对神经病因学和神经病理学都至关重要。 注意力缺陷多动障碍和冒险行为的普遍增加以及在典型的 发育中（TD）的青少年。这些模型的一个重要方面是， 过程形成连贯的网络，以及这些网络如何相互作用和相互影响， 行为在这里，我们把这两个不同的文献，以了解过渡到 青少年ADHD因此，本文的研究重点是认知控制的成熟过程 和动机系统，单独和相互作用，在青少年与非ADHD在一个多会话 纵向设计该建议的目的包括：1）表征认知控制的行为轨迹， 动机，以及它们在ADHD和TD青少年从童年到青春期的相互作用; 2）表征 在同一时期内，结构和功能性大脑网络组织的发展，重点是 认知控制和动机的大脑网络; 3）确定神经，行为和临床 青春期前ADHD的特征，预测青春期的临床结果和冒险行为。到 为了实现这些目标，基于图论和结构方程建模的创新网络分析工具 将应用于扩散加权成像期间MRI数据的结构和功能连接性估计 （结构）和休息期间，认知控制，动机和冒险任务（功能）。这些技术 独特地能够同时表征网络内结构/功能的强度和连贯性， 连接性和跨网络交互，以及识别重要的大脑网络特征， 区分不同群体。此外，行为表现对认知控制、动机和风险- 接受任务，ADHD行为学和冒险态度和行为将被评估。该方案 研究直接符合NIH战略计划，并建立在RDoC框架之上。所有这些 这些发现将为早期识别并最终预防ADHD提供基础 更有可能导致青春期不良后果的轨迹。

PROJECT SUMMARY/ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed developmental disorder of childhood, affecting ~9% of children nationwide. Although ADHD dramatically increases the risk for poor academic achievement, substance abuse, and criminal behavior, particularly in adolescence, too little is known regarding how neurobiological developmental trajectories underlie these behavioral and clinical outcomes. This remains the case in spite of the importance of such work for earlier identification of risk factors, more targeted treatment models, and, in turn, education, juvenile justice, and healthcare savings for individuals, families, and society. The goal of the current project, therefore, is to characterize longitudinal neural, behavioral, and clinical trajectories of youth with ADHD from late childhood to mid-adolescence. Brain systems underlying cognitive control and motivation in particular have been identified as centrally important both to the neural etiology of ADHD and to the general increase in risk-taking behavior and poor decision-making observed in typically developing (TD) adolescents. An important aspect of these models is how brain regions underlying these processes form coherent networks, as well as how these networks interact and influence each other to produce behavior. Here we bring together these two disparate literatures to gain understanding of the transition to adolescence in youth with ADHD. Thus, this proposal focuses on the maturational course of the cognitive control and motivation systems, individually and in interaction, in youth with and without ADHD in a multi-session longitudinal design. The aims of this proposal include: 1) Characterize behavioral trajectories of cognitive control, motivation, and their interaction in ADHD and TD youth from childhood into adolescence; 2) Characterize the development of structural and functional brain network organization during the same time period, focusing on brain networks underlying cognitive control and motivation; and 3) Identify neural, behavioral, and clinical features of pre-adolescent ADHD that predict clinical outcomes and risk-taking behavior during adolescence. To address these aims, innovative network analytic tools based on graph theory and structural equation modeling will be applied to structural and functional connectivity estimates of MRI data during diffusion-weighted imaging (structural) and during rest, cognitive control, motivation, and risk-taking tasks (functional). These techniques are uniquely able to simultaneously characterize the strength and coherence of within-network structural/functional connectivity and across-network interactions, as well as to identify important brain network features that differentiate across groups. Additionally, behavioral performance on the cognitive control, motivation and risk- taking tasks, ADHD symptomatology, and risk-taking attitudes and behavior will be assessed. This program of research is directly in line with the NIH Strategic Plan and builds on the RDoC framework. Together, these findings will provide the groundwork that can lead to early identification and, ultimately, prevention of ADHD trajectories that are more likely to lead to adverse outcomes in adolescence.