Although current medication therapies ameliorate ADHD behavioral symptoms, problems with inadequate? response or tolerability are common. Most perplexing, in consideration of ADHD-related cognitive deficits? and in spite of several hundred studies demonstrating acute behavioral response to stimulants, is the failure? of many decades of research to demonstrate long-term, stimulated-related enhancements in learning. This? manifest inadequacy of current therapies highlights the potential importance of developing treatments that? specifically remediate executive function deficits as an important path to improve outcome.? Neurochemical influences on cognitive functions in ADHD are complex. The over-arching premise of this? project is that optimal behavioral and cognitive responses are possible with treatments that robustly enhance? both dopamine (DA) and norepinephrine (NE). Our goal is to test the short-term efficacy of a combination? pharmacotherapy, derived from translational research and clinical observations, against standard stimulant? monotherapy on both symptom and cognitive endpoints. In addition, a novel aspect of the study will be to? test prospectively whether a dual benefit on both behavior and cognition predicts clinically significant? improvements in learning over longer-term treatment. Lastly, based upon our preliminary data and? hypothesized mechanisms of treatment response, the proposed study will examine the potential of? electroencephalography (EEC) in predicting optimal long-term benefit. The clinical trial will enroll 180? children and adolescents with ADHD-Combined Type in an active-controlled randomized parallel group study? testing the comparative efficacy of guanfacine (GUAN), methylphenidate (MPH), and combination? GUAN/MPH on ADHD symptoms and clinical response rates. Improvements in cognition during the acute? treatment phase will predict greater academic achievement over the 12 month maintenance period.? The project will represent an initial scientific investment in a new phase of translational treatment research? on cognition in developmental psychopathologies. The designs and methodology tested in the proposed trial? will serve as a platform for testing other interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Specialized Center (P50)
Project #
5P50MH077248-02
Application #
7480927
Study Section
Special Emphasis Panel (ZMH1)
Project Start
2007-08-01
Project End
2011-07-31
Budget Start
2007-08-01
Budget End
2008-07-31
Support Year
2
Fiscal Year
2007
Total Cost
$451,196
Indirect Cost
Name
University of California Los Angeles
Department
Type
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Sturm, Alexandra; Rozenman, Michelle; Piacentini, John C et al. (2018) The Effect of Neurocognitive Function on Math Computation in Pediatric ADHD: Moderating Influences of Anxious Perfectionism and Gender. Child Psychiatry Hum Dev 49:822-832
Sturm, Alexandra; Rozenman, Michelle; Chang, Susanna et al. (2018) Are the components of social reciprocity transdiagnostic across pediatric neurodevelopmental disorders? Evidence for common and disorder-specific social impairments. Psychiatry Res 264:119-123
McGuire, Joseph F; Piacentini, John; Storch, Eric A et al. (2018) A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale. Neurology 90:e1711-e1719
Sabb, Fred W; Hellemann, Gerhard; Allen, Nicholas B et al. (2018) Enhanced switching and familial susceptibility for psychosis. Brain Behav 8:e00988
Loo, Sandra K; McGough, James J; McCracken, James T et al. (2018) Parsing heterogeneity in attention-deficit hyperactivity disorder using EEG-based subgroups. J Child Psychol Psychiatry 59:223-231
Greene, D J; Williams Iii, A C; Koller, J M et al. (2017) Brain structure in pediatric Tourette syndrome. Mol Psychiatry 22:972-980
Loo, Sandra K; Bilder, Robert M; Cho, Alexander L et al. (2016) Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 55:674-682.e1
Bilder, Robert M; Loo, Sandra K; McGough, James J et al. (2016) Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 55:667-73
McCracken, James T; McGough, James J; Loo, Sandra K et al. (2016) Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study. J Am Acad Child Adolesc Psychiatry 55:657-666.e1
Lenartowicz, Agatha; Delorme, Arnaud; Walshaw, Patricia D et al. (2014) Electroencephalography correlates of spatial working memory deficits in attention-deficit/hyperactivity disorder: vigilance, encoding, and maintenance. J Neurosci 34:1171-82

Showing the most recent 10 out of 29 publications