NEUROBEHAVIORAL EVALUATION CORE

在2001年对我们的抗灾减灾中心申请的评论中，研究部分指出(第5页)：该中心将需要增加行为方面的专门知识，以便在赠款开发的早期阶段为这一领域提供更好的投入。作为对这一建议的回应，我们建议开发神经行为评估核心(NEC)，为研究人员提供这种专业知识。NEC的主要目标是为MRDDRC项目提供复杂的神经行为和神经心理学研究支持，并为此目的开发或验证新方法。我们可靠而准确地定义发育和行为表型的能力，极大地促进了我们对发育复杂神经行为障碍的理解的科学进步。 行为和认知变量的测量在疾病和发育研究中至关重要，这些研究构成了我们的MRDDRC。在过去的3-5年里，以行为和/或心理社会为重点的解除武装、复员和重返社会方案项目数量大幅增加。这些研究的目的一直是关于患有影响认知和行为的各种神经遗传、神经发育或后天障碍的儿童的发展、认知和行为结果。除了对潜在的医学状况(例如尿素循环障碍或癫痫)进行严格的研究外，这些调查的目的是描述对儿童认知和行为发育的影响。20到30年前，这类研究可能集中在发展的广泛方面，例如这些儿童的智力水平。更新的方法允许更深入地关注诸如注意力、执行功能和记忆子过程等关键发展因素。发展性神经心理学知识库的爆炸性增长将潜在的神经发育和障碍与行为和认知发展联系起来，进一步推动了儿科研究包括神经行为和神经心理功能的复杂模型的必要性。 从历史上看，许多本可以从神经心理学和神经行为变量检查中受益的研究没有包括这种评估，因为：1)对可用措施的了解有限；2)研究项目预算内的专家人员和/或测试材料的成本限制；以及3)缺乏执行这些评估的熟练人员。NEC的主要目标是改善获得适当措施的机会，并提高在整个MRDDRC进行的神经行为研究的整体质量。 在NEC内部，我们建议：1)提供广泛的神经心理测试服务；2)开发和管理神经成像协议的神经行为任务，包括通过神经成像核心的功能磁共振项目；3)就研究研究中神经行为和神经心理测量的适当设计和使用向MRDDRC研究人员提供咨询；以及4)培训研究人员及其工作人员使用这些测量。随着这一技术的日益成熟，研究人员将能够评估多个级别的神经行为结果，例如，特定的神经心理过程，如记忆或执行功能，以及生活质量功能状态。这将能够与在遗传水平(利用分子遗传学、蛋白质组学和生化分析核心)和神经病理生理学水平(利用神经成像核心)探索病因的研究结合起来。

In the critique of our MRDDRC application in 2001 the study section stated (p.5): behavioral expertise will need to be added to the Center to provide better input into this area at an early stage of grant development. In response to this suggestion we propose to develop the Neurobehavioral Evaluation Core (NEC) that will provide investigators with this expertise. The primary objective of the NEC is to provide sophisticated neurobehavioral and neuropsychological research support to MRDDRC projects, and to develop or validate new methods for this purpose. Scientific advancement of our understanding of complex neurobehavioral disorders of development is facilitated greatly by our ability to reliably and precisely define the developmental and behavioral phenotype. Measurement of behavioral and cognitive variables is crucial in studies of disease and development that comprise our MRDDRC. Over the past 3-5 years, there has been a substantial increase in the number of MRDDRC projects with a behavioral and/or psychosocial focus. The aims of these studies have been on the developmental, cognitive, and behavioral outcomes in children who have a variety of neurogenetic, neurodevelopmental, or acquired disorders that affect cognition and behaivor. In addition to a rigorous study of the underlying medical condition (e.g. urea cycle disorders or epilepsy), these investigations aim to describe the impact on the child's cognitive and behavioral development. Twenty to thirty years ago, this type of research might have focused on the broad aspects of development, such as the level of intelligence of these children. Newer methods allow a far more in depth focus into such critical developmental factors as attention, executive function, and memory subprocesses. The explosion of developmental neuropsychological knowledge base linking underlying neurological development and disorder with behavioral and cognitive development has further fueled the need for pediatric research to include sophisticated models of neurobehavioral and neuropsychological function. Historically, many studies that could have potentially benefited from examination of neuropsychological and neurobehavioral variables have not included such assessments because of: 1) limited knowledge regarding available measures; 2) cost-constraints within research project budgets for expert personnel and/or purchase of testing materials; and 3) lack of access to personnel skilled in the performance of these assessments. The primary goal of the NEC is to improve access to appropriate measures and to enhance the overall quality of neurobehavioral research being conducted throughout the MRDDRC. Within the NEC, we propose to: 1) provide access to an extensive battery of neuropsychological testing services; 2) develop and administer neurobehavioral tasks for neuroimaging protocols, including fMRI projects through the Neuroimaging Core; 3) provide consultation to MRDDRC investigators on the proper design and use of neurobehavioral and neuropsychological measures in research studies; and 4) train investigators and their staff in the use of these measures. With this increased sophistication investigators will be able to assess several levels of neurobehavioral outcome, e.g., specific neuropsychological processes, such as memory or executive function, together with quality of life functional status. This will be able to be coupled with studies exploring etiologic factors at the genetic level (utilizing the Molecular Genetics, Proteomics and Biochemical Analysis Core) and neuropathophysiologic level (using the Neuroimaging Core).