Neural and Clinical Biomarkers of Risk for ADHD: A Focus on Preschoolers

项目摘要 注意力缺陷多动障碍（ADHD）是一种早发性、遗传性、流行性和病态的神经生物学疾病， disorder.虽然ADHD通常在幼儿期发病，但在确定ADHD的发病年龄方面存在很长的延迟。 这种疾病经常持续多年，使儿童处于发生严重不良反应的高风险之中。 后果这就需要加强努力，早期识别有多动症风险的幼儿。等 努力可以帮助预防性干预，减轻疾病的发展及其病态 后果一个机会，以帮助确定儿童在多动症的风险是通过研究学龄前年龄 有多动症的父母的后代这是因为：1）最常见的儿童年龄得到临床 ADHD的诊断是在小学早期，因此学龄前可能是理想的目标 对于早期识别有ADHD风险的儿童，2）ADHD具有高度遗传性，父母的后代 患有多动症的人患这种疾病的风险增加。我们有初步数据表明，某些临床和 神经影像学特征可以预测哪个孩子会患上ADHD。为此，我建议的研究将 包括对100名有ADHD风险的学龄前儿童（4-6岁）的临床和神经影像学评估 和50个父母没有多动症的学龄前儿童进行对照。的 将对儿童进行为期两年的前瞻性随访，以监测他们是否患有ADHD诊断或 没有我们的中心目标是确定ADHD风险的临床指标和神经生物标志物， 学龄前的综合征前期儿童会患上这种疾病。 我是一名获得委员会认证的儿童和青少年精神病学家，我的临床和科学重点是早期 儿童精神病理学鉴定在我早期的职业生涯中，我利用现有的纵向临床数据， ADHD家族研究评估情绪和焦虑障碍的临床预测因子我还进行了神经成像 研究检查了与老年人逆境临床指标相关的神经生物标志物， 儿童和成人。为了进一步发展我的专业知识，并成为一个独立的调查员在该领域的早期 识别，统计分析培训，神经成像，幼儿期和前瞻性数据收集， 必要我相信，通过领导这项名为“ADHD风险的神经和临床生物标志物： 以学龄前儿童为重点”，采用纵向设计， 发展ADHD风险的临床和神经影像学生物标志物，沿着有针对性的训练计划， 教学和指导，解决我的培训目标，将帮助我建立独立性。

PROJECT SUMMARY Attention-Deficit/Hyperactivity Disorder (ADHD) is an early onset, heritable, prevalent and morbid neurobiological disorder. While ADHD typically onsets in early childhood, there are lengthy delays in the identification of the disorder frequently spanning many years, putting the children at elevated risks for developing serious adverse consequences. This calls for improved efforts in early identification of young children at risk for ADHD. Such efforts can help preventive interventions that mitigate the progression to the full disorder and its morbid consequences. One opportunity to help identify children at risk for ADHD is through studying the preschool aged offspring of parents with ADHD. This is so because 1) the most common age of children getting the clinical diagnosis of ADHD is in the early elementary school years, hence the preschool years could be an ideal target for the early identification of children at risk for ADHD, and 2) ADHD is highly heritable, and offspring of parents with ADHD are at increased risk to develop the disorder. We have preliminary data that certain clinical and neuroimaging characteristics could predict which child will develop ADHD. To this end, my proposed study will include clinical and neuroimaging assessments of 100 pre-syndromatic preschoolers (ages 4-6) at risk for ADHD by virtue of having a parent with ADHD, and 50 control preschoolers whose parents do not have ADHD. The children will be followed prospectively for two years to be monitored whether they develop ADHD diagnosis or not. Our central aim is to identify clinical indicators and neural biomarkers of the risk for ADHD that will foretell which preschool aged, pre-syndromatic children will develop the disorder. I am a board-certified Child and Adolescent Psychiatrist who has had a clinical and scientific focus on early identification of pediatric psychopathology. In my early career, I utilized existing longitudinal clinical data of an ADHD family study to evaluate clinical predictors of mood and anxiety disorders. I also conducted neuroimaging studies examining neural biomarkers cross-sectionally associated with clinical indicators of adversity in older children and adults. To further develop my expertise and become an independent investigator in the field of early identification, training in statistical analysis, neuroimaging, early childhood, and prospective data collection is necessary. I believe that by leading the proposed study titled, “Neural and clinical biomarkers of risk for ADHD: A Focus on Preschoolers” which incorporates a longitudinal design involving preschool aged children assessing clinical and neuroimaging biomarkers of the risk for developing ADHD, along with a pointed training plan with didactics and mentorship that address my training goals, will help me establish independence.