Imaging Stimulant Effects on Emotional Lability in Children with ADHD

描述（由申请人提供）：注意缺陷/多动障碍（ADHD）是儿童精神病学中最常见的疾病之一，影响3-8%的学龄儿童。虽然ADHD的主要特征是注意力不集中、多动和冲动，但情绪不稳定在这一人群中也是一种常见的损害症状。然而，对于ADHD儿童情绪不稳定背后的神经生物学基础知之甚少。此外，精神兴奋剂作为ADHD的一线治疗药物，已知可以减少ADHD症状，包括情绪不稳定，但精神兴奋剂对情绪不稳定产生有益作用的神经生物学机制却很少被研究。为了解决这一知识差距，我们建议进行一项纵向，多模态MRI研究，以检查精神兴奋剂对ADHD儿童大脑情感网络的影响。我们将把一项多模态MRI研究与一项精神兴奋剂利地安非他明的随机临床试验结合起来，这样研究参与者在治疗前将进行一次MRI扫描，然后在利地安非他明或安慰剂治疗12周后进行第二次MRI扫描。这项研究将提高我们对多动症儿童情绪不稳定的神经生物学基础的认识，以及精神兴奋剂减轻这种症状的机制。推进这种类型的知识是至关重要的，有几个原因，但最重要的是，更清楚地了解精神兴奋剂有效的神经生物学机制，将促进更有效和有针对性的治疗的发展，以及推进我们对多动症病理生理学的理解。

DESCRIPTION (provided by applicant): Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in pediatric psychiatry affecting 3-8% of school age children. Although ADHD is primarily characterized by inattention, hyperactivity and impulsivity, emotional lability is a common and impairing symptom in this population. Little is known, however, about the neurobiological substrates that underlie emotional lability in children with ADHD. Moreover, psychostimulants, the first-line treatment of ADHD, are known to reduce ADHD symptoms including emotional lability, yet the neurobiological mechanisms by which psychostimulants have their salutary effects upon emotional lability have scarcely been studied. To address this knowledge gap, we propose to conduct a longitudinal, multimodal MRI study to examine the effects of psychostimulants on the brain's affective network in children with ADHD. We will combine a multimodal MRI study with a randomized clinical trial of the psychostimulant lisdexamfetamine such that study participants will have an MRI scan prior to treatment and then a second MRI scan after 12 weeks of treatment with either lisdexamfetamine or placebo. The study will advance our knowledge of the neurobiology underlying emotional lability in children with ADHD, as well as the mechanism by which psychostimulants alleviate this symptom. Advancing this type of knowledge is critical for several reasons, but most importantly a clearer understanding of the neurobiological mechanisms by which psychostimulants are effective will promote the development of more effective and targeted treatments, as well as advance our understand of the pathophysiology of ADHD.