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CLINICAL UNIT BASED RESEARCH

Developmental Biopsychiatry Research Program

Development of Objective Tests to Aid in Diagnosis

A primary goal of the Developmental Biopsychiatry Research Program has been to develop objective tests to facilitate psychiatric evaluation of children.

Major findings

(1.) Children and adolescents with major depression have a disturbed circadian rest-activity rhythm, based on actigraphy. This parameter discriminated depressed children and controls with 85% accuracy (replicated). This procedure can also discriminate depression from ADHD and post-traumatic stress disorder. The commercial and clinical viability of our actigraph method is being assessed with FDA premarket approval. (Ambulatory Monitoring, Inc.)

(2.) We measured the precise pattern of movements of children taking a computerized attention test with a sophisticated infrared motion analysis system. A simple composite discriminated children with ADHD from normal controls with 93% accuracy. A new company has been created and capitalized to seek FDA medical device approval, and to commercialize this test. (OPTAx Systems, Inc.)

Dr. Teicher's recent work has uncovered some of the biological roots of Attention Deficit Hyperactivity Disorder (ADHD), a chronic mental disorder. Although there is no cure for ADHD, early diagnosis and appropriate treatment are critical. Dr. Teicher recently developed OPTAx, a test that provides physicians with objective measures of the key symptoms of ADHD: inattention, impulsivity, and hyperactivity.

(3). Steady-state estimates of cerebral perfusion using fMRI T2 relaxometry closely correlates with objective measures of activity in ADHD. Hyperactivity is associated with diminished perfusion of left prefrontal cortex and putamen. Only ADHD children who were objectively hyperactive showed a beneficial effect of methylphenidate on activity and attention, and only those who were objectively hyperactive showed enhanced cerebral blood flow on methylphenidate.

(4.) ADHD is diagnosed much more often in boys than girls. Objective measures in 694 first and second graders revealed that as many girls as boys had problems with attention. Twice as many boys as girls were objectively hyperactive. Comparison with teacher ratings suggests that ADHD is over diagnosed in boys and under-diagnosed in girls.