Active clinical trials for "Attention Deficit Disorder with Hyperactivity"

Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders in children and adolescents. ADHD's nosology is largely based on clinical phenomenology that includes such symptoms as inattention, hyperactivity and impulsivity. However, a reliable ADHD biomarker has still not been determined either for differential diagnosis or for monitoring treatment effects. MicroRNAs (miRNAs) are small non-coding RNA molecules that function in the process of RNA silencing and the post-transcriptional regulation of gene expression. MiRNAs are found in abundance throughout the nervous system and play a vital role in the transcriptional networks with regards to human brain development. Currently, miRNAs' involvement in the pathogenesis of ADHD continues to be unclear. Therefore, this study aims to investigate the prospective role of miRNAs in ADHD and to determine whether miRNA levels in peripheral blood can serve as a biomarker and a diagnosis panel for ADHD. In the preliminary study, blood samples were collected from five patients with ADHD and five healthy control subjects. The use of Next Generation Sequencing (NGS) techniques has identified 23 miRNAs as potential biomarkers for ADHD. During this three-year proposal, we intend to recruit 100 drug-naïve patients with ADHD and 100 age- and gender-matched control subjects (Training Set). Blood will be obtained through direct puncture of the vein from each participant to analyze the miRNAs by using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The behavior and neuropsychology of each participant will be assessed. This research will construct a miRNAs diagnosis panel using the Support Vector Machine (SVM) classification model to discriminate ADHD from non-ADHD. The validity of the miRNA diagnosis panel will then be re-examined using an independent validation sample composed of 50 patients with ADHD and 50 control subjects (Testing Set). All of the 150 patients with ADHD will receive treatment in a traditional clinical practice and then will be followed up with for 12 months. At the twelfth month, the same procedures as those performed at the baseline will be replicated to examine the influence of ADHD medications on miRNAs, as well as determine whether miRNAs can serve as a biomarker to portray the condition of ADHD under treatment. MiRNA target gene prediction and functional annotation analysis will also be performed. This study will develop a potential diagnostic panel for ADHD through the use of combinations of multiple miRNA expressions. We will provide proof of the relationships of miRNAs profiles and ADHD manifestations in clinical samples and further explain the molecular pathogenesis of ADHD. Such information may become an important reference for future research and clinical treatments for patients with ADHD.

The purpose of this study is to test whether children with attention-deficit/hyperactivity disorder (ADHD) are impaired in the ability to flexibly adapt brain network organization in response to shifting cognitive demands during the exertion of cognitive control, by assessing changes in network dynamics resulting from stimulant administration in children with ADHD, and how those changes relate to behavioral and symptom improvements. Subjects will be children with ADHD aged 8-12. Subjects will participate in multiple testing sessions that include: diagnosis and eligibility screening, neuropsychological and behavioral testing, and, if eligible, MRI scans and a medication challenge. Children with ADHD who are enrolled in the medication challenge will undergo one MRI scan on placebo and one MRI scan on stimulant medication, counterbalanced and double-blind. Functional connectivity will be measured using functional MRI and innovative graph theoretical analytic tools will be implemented. Network metrics will be related to symptomatology and behavioral testing measures. It is hypothesized that stimulant administration in children with ADHD will increase flexibility in network reconfiguration in response to changing cognitive control demands as compared to when they are on placebo. It is further hypothesized that the degree to which brain network organization is changed will be related to the degree of improvement in cognitive control performance.

Attention deficit/hyperactivity disorder (ADHD) has been recognized as a common (5-8%), early-onset, long-term impairing, heterogeneous neuropsychiatric disorder with high heritability. Due to its lifelong impairments up to adulthood, adult ADHD has drawn much more attention in Western studies in the past decade; however, there has been no such study in Asian countries. The ultimate goals of this longitudinal follow-up study are to investigate the outcomes of a cohort of children with attention-deficit/hyperactivity (ADHD) and their healthy controls at young adulthood as the primary aim; and to test whether structural and functional brain connectivity can be endophenotypes of ADHD, to localize the brain area that are corresponding to methylphenidate treatment effects, and to identify the genetic variants corresponding to the persistence of ADHD, treatment effect of methylphenidate, neurocognitive dysfunction, and structural and functional dysconnectivity in the brain as the secondary aims. With the accomplishment of these goals, this study will provide the first-hand data on adult ADHD in non-western countries, and will be one of few world-class studies on the topics of neurocognitive and imaging genomics on adult ADHD.

The purpose of this study is to examine the neural basis of response inhibition, working memory, and sustained attention in adolescents and adults with Attention-Deficit/Hyperactivity Disorder (ADHD), with particular emphasis on quantifying the effects of methylphenidate (i.e., treatment with psychostimulants) on neural function. Participants will undergo electrophysiological measurement of brain function during laboratory cognitive tasks. This research is aimed to develop a better understanding of how ADHD neural dysfunction relates to clinical presentation and medication response during the transition from adolescence to adulthood. The specific aims and hypotheses are: Specific Aim: To characterize the effect of Ritalin (methylphenidate) on neural activity underlying performance on the response inhibition task in ADHD adolescents and adults. Hypothesis 1) Methylphendiate will increase N2 and P3 amplitude in ADHD persons during medicated EEG sessions; Hypothesis 2) There will be a significant age × medication interaction such that ADHD teens will show increased amplitude of N2 while medicated, particularly at frontal sites, whereas ADHD adults will show differentially greater effect of medication on P3 amplitude and latency at central sites. Hypothesis 3) Brain activity assessed by fMRI will differ between unmedicated and medicated states.

To evaluate the sensitivity and responsiveness of a standardized, validated, computer-based, battery of neuro-psychometric tests in adults with ADHD.

The purpose of this study is to determine whether motorcycle drivers with ADHD are at a greater risk for motorcycle accidents, and whether this risk can be mitigated by treatment with methylphenidate. We will evaluate the effectiveness of Methylphenidate on driving performance, among motorcycle drivers, and investigate the correlation between improvement of ADHD symptoms (inattention and impulsivity) and driving performance.

The objectives of this study are to investigate: the evolution of ADHD symptoms, remission rate of ADHD, social and school function, and familial relationship; the adherence to CONCERTA, treatment modality, and average treatment duration during the 3-year follow-up period; and the effect of medication on the changes of neuropsychological functioning.

The study will evaluate the effectiveness of a standardized EEG method with the intended clinical users in the intended clinical settings with the intended population (patients who would typically receive a clinician's evaluation for ADHD). Multiple sites will be examined to provide a sample of patients across numerous communities with different demographics. The goal is to evaluate if the predictive accuracy of EEG will not be inferior to that of a widely-used and extensively validated ADHD scale in the prediction of ADHD in the intended use population as evaluated by Best Estimate Diagnosis.

Attention deficit/hyperactivity disorder (ADHD) has been recognized as a common (5-8%), early-onset, long-term impairing, heterogeneous neuropsychiatric disorder with high heritability. Pharmacotherapy (methylphenidate and atomoxetine) has been proved to be the most effective treatment for ADHD. Gau (PI) has done extensive research on ADHD and published 7 SCI papers in ADHD pharmacotherapy. The PI published the first paper in the effectiveness of atomoxetine in improving executive functions among 30 boys with ADHD in the world (International Journal of Neuropsychopharmacology, 2009 Oct 23:1-14. [Epub]). Due to its lifelong impairments up to adulthood, adult ADHD has drawn much more attention in Western studies in the past decade; however, there is lack of such information in Asian population except the PI's three SCI papers on adult ADHD. Because little is known about atomoxetine effect in adults with ADHD except symptoms reduction, this proposal aims to investigate the efficacy of atomoxetine beyond symptoms improvement. The significance of this project is its novelty and research and clinical relevance because there is lack of information regarding long-term effect of atomoxetine on neuropsychological and brain imaging functions on adults with ADHD, a high-prevalent mental disorder with long-term impairment in adults.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD), characterized by inattention, hyperactivity, and impulsivity, is among the most common neuropsychiatric disorders worldwide (5-10% at school age) and in Taiwan (7.5%). The DSM-IV ADHD consists of three subtypes: predominantly Inattentive (ADHD-I), predominantly Hyperactivity/Impulsivity (ADHD-H), and Combined subtypes (ADHD-C). Although the DSM-IV field trials indicate that the current subtypes differ significantly on variables such as age of onset, gender ratio, and level of social and academic impairment, little has been addressed whether the DSM-IV subtypes differ neuropsychologically. Numerous researches have proved that stimulants (methylphenidate is the only stimulant in Taiwan) are the most effective medication in treating ADHD. Although the efficacy of methylphenidate on behavioral measures has been established in Taiwan, there is no information about neuropsychological measures. Specific Aims: to validate ADHD subtype by neuropsychological measures; and to investigate the efficacy of methylphenidate on the improvement of executive functioning among children with ADHD. Subjects and Methods: Participants will consist of 20 children with ADHD-C, 20 with ADHD-I, 10 with ADHD-H and 50 controls without ADHD in the age range of 7 to 10. The measures include the psychiatric interviews (Chinese K-SADS-E), neuropsychological tests (WISC-III, Cancellation Test, Digit Span, Trail Making Test, CPT, Circle Tracing Test), self-administered rating scale (SNAP-IV), and investigator administered assessment (CGI and Behavior Observation Ratings). Anticipated Results: We anticipated that children in the ADHD and non-ADHD group will perform differently on the neuropsychological tests with more deficits in neuropsychological functions in the ADHD group. Also, we expected that methylphenidate will improve the performance on the neuropsychological tests and reduce the behavioral symptoms of ADHD children. Subtypes difference in the neuropsychological functions is also expected.