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ADHD in girls: neuroimaging and executive behavior

Principal Investigator:
E. Mark

This study is closed to participant accural and we are currently writing papers.
This is a proposal to determine whether ADHD is associated with different brain anomalies/abnormalities in girls and boys. Since girls have not been studied as intensively/extensively as have boys, our focus is on the distinctive features hypothesized to be characteristic of girls with ADHD; the features we are best positioned to investigate are those probed by neuroimaging and neurobehavioral techniques. The neural basis of these deficits will be investigated by examining correlations of performance on motor/executive neurobehavioral tasks (inhibition, response preparation, working memory) and anatomic MRI (aMRI)-based quantitative measures of brain regions (frontal, basal ganglia, cerebellum).
We will recruit 200 children (100 children with ADHD and 100 age-, gender-, and IQ-matched controls), aged 9-11.5 years, with the goal of having 50 children in each group complete behavioral testing, and anatomic MRI. Children will be included in the ADHD group if they are ages 9 through 11.5 and meet criteria for ADHD. The diagnosis of ADHD will be based on DSM-IV criteria (ADHD/Inattentive Type, Hyperactive/Impulsive Type and Combined Type, at the time of assessment) and will be made by a neurologist (Dr. Mostofsky) using a structured parent interview – the Diagnostic Interview for Children and Adolescents-IV (DICA-IV; Reich, Welner, & Herjanic, 1997).
Children will be excluded if they have any of the following, established via review of medical/developmental history: 1) diagnosis of Mental Retardation, Developmental Language Disorder, Reading Disability, or a Pervasive Developmental Disorder. Children living in foster care will also be excluded. There are no major medical risks involved in the participation of this research.
Stimulant medications are short-acting, with most having a half-life ranging from 3-12 hours, and are generally used in ADHD to achieve short-term control of hyperactive and impulsive behavior during school-related activities. The medications are rarely prescribed in a manner that results in coverage throughout the day, and are in fact often only used on school days (with no medication administered on weekends and holidays). Therefore, steady state is not generally achieved, and we do not anticipate any adverse consequences of having the medication held (something that is commonly done on weekends and holidays as part of common prescribing practice). There are no known risks associated with the paper/pencil (motor and eye-movement tasks) and computerized attention tests. Children may experience some frustration if they lose points in one of the computerized tests. They also may also become bored with some of the procedures. There are no known risks associated with this kind of MRI scanning. There will be no direct benefit to the individual subject, aside from that which will benefit society.
Because this is a minimal risk study the PI will review the data monthly. However, if an unanticipated event occurs the event will be brought to the investigator’s attention immediately. Adverse events will be reported to the KKI office of research compliance, the KKI administration, the JHMIRB, and the research sponsors.

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