This candidate for an ADAMHA SDAC proposes an organized five year program of didactic study and supervised research that will provide her with the specific research methods she needs to become an independent investigator in pediatric neuropsychiatry. The career development plan under the preceptorship of Martha Denckla, Professor of Neurology at Johns Hopkins University, includes the supervised development of psychiatric scales for a head injured population and the attainment of facility in the use of a computerized lesion location technique. The plan includes a didactic component with laboratory courses in neuroscience, biostatistics and epidemiology. The supervised research project examines the psychopathology of severe head injury in children and adolescents. Psychiatric sequelae are among the most serious and enduring disabilities of head injured patients. The frontal lobes and their connections are convergence areas for the control of emotional and intellectual functions. This study will focus on documenting the contribution of lesion location to a spectrum of psychiatric outcomes. Specifically, the following psychiatric hypotheses will be tested: that patients with MRI frontal lobe pathology limited to the orbital frontal lobe will develop psychiatric symptoms of disinhibited behaviors; that patients with MRI frontal lobe pathology limited to the mesial frontal lobe will demonstrate symptoms of underactivated behaviors; and that either orbital or mesial frontal lobe lesions will intensify pretraumatic psychiatric symptoms. Dorsolateral frontal lesions, while neither causing nor intensifying psychiatric symptoms, will cause specific cognitive impairment.
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