The Center of Excellence in ADHD and Related Disorders supports both medical and laboratory studies which represent a critical link between basic and clinical science, often referred to as "translational research.” Translational research is that which can be quickly applied to practical patient treatment. Below is a sampling of studies that we have completed or are still conducting into attention-deficit/hyperactivity disorder (ADHD).
Clinical Trials
Our team of expert clinicians is dedicated to improving clinical care for children, adolescents, and adults with ADHD. Our efforts in pharmacogenomics, functional imaging, and psychiatric care converge in multifaceted clinical trials that transcend the boundaries between basic science and clinical treatment.
Here are a few of the contributions made to science by our team, with the help of our participants:
Imaging Stimulant and Nonstimulant Treatments for ADHD: A Network Based Approach
Since 2004 we have been conducting a series of studies that allowed us to examine the neurobiological basis for treatment response to stimulant and non-stimulant medications commonly used in treating children, adolescents, and adults with ADHD. We are interested in how medication affects the brain and how brain changes affect behavior. We examine clinical factors in response to treatment, and we study the nature and developmental course of ADHD across the lifespan.
Our recent study of Methylphenidate and Atomoxetine in ADHD: fMRI Measures of Mechanisms and Response produced exciting findings, offering a window into the common and unique neurophysiological mechanisms of response to stimulant and non-stimulant treatments.
Newcorn, J., Krone, B., Hildebrandt, T., & Stein, M. (2017). 856. Methylphenidate vs. Atomoxetine in Youth with ADHD: Comparative Effectiveness and Preference following Treatment with both Medications. Biological Psychiatry, 81(10), S346–S347. https://doi.org/10.1016/j.biopsych.2017.02.581Ð'd
Schulz, K. P., Bédard, A. V., Fan, J., Hildebrandt, T. B., Stein, M. A., Ivanov, I., Halperin, J. M., & Newcorn, J. H. (2017). Striatal Activation Predicts Differential Therapeutic Responses to Methylphenidate and Atomoxetine. Journal of the American Academy of Child and Adolescent Psychiatry, 56(7), 602–609.e2. https://doi.org/10.1016/j.jaac.2017.04.005Ð'd
Bédard, A. C., Stein, M. A., Halperin, J. M., Krone, B., Rajwan, E., & Newcorn, J. H. (2015). Differential impact of methylphenidate and atomoxetine on sustained attention in youth with attention-deficit/hyperactivity disorder. Journal of child psychology and psychiatry, and allied disciplines, 56(1), 40–48. https://doi.org/10.1111/jcpp.12272
This study and our other trials have allowed us to look at the effects of commonly prescribed medications on emotional, cognitive, and social functioning
Bédard, A. C., Newcorn, J. H., Clerkin, S. M., Krone, B., Fan, J., Halperin, J. M., & Schulz, K. P. (2014). Reduced prefrontal efficiency for visuospatial working memory in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 53(9), 1020–1030.e6. https://doi.org/10.1016/j.jaac.2014.05.011
Ivanov, I., Schulz, K., Li, X., & Newcorn, J. (2019). Reward Processing in Drug-Naive Youth with Various Levels of Risk for Substance Use Disorders: A Pilot Study. Journal of child and adolescent psychopharmacology, 29(7), 516–525. https://doi.org/10.1089/cap.2018.0175
Schulz, K. P., Krone, B., Adler, L. A., Bédard, A. V., Duhoux, S., Pedraza, J., Mahagabin, S., & Newcorn, J. H. (2018). Lisdexamfetamine Targets Amygdala Mechanisms That Bias Cognitive Control in Attention-Deficit/Hyperactivity Disorder. Biological psychiatry. Cognitive neuroscience and neuroimaging, 3(8), 686–693. https://doi.org/10.1016/j.bpsc.2018.03.004
Parvaz, M. A., Kim, K., Froudist-Walsh, S., Newcorn, J. H., & Ivanov, I. (2018). Reward-Based Learning as a Function of Severity of Substance Abuse Risk in Drug-Naïve Youth with ADHD. Journal of child and adolescent psychopharmacology, 28(8), 547–553. https://doi.org/10.1089/cap.2018.0010
Schulz, K. P., Clerkin, S. M., Newcorn, J. H., Halperin, J. M., & Fan, J. (2014). Guanfacine modulates the emotional biasing of amygdala-prefrontal connectivity for cognitive control. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 24(9), 1444–1453. https://doi.org/10.1016/j.euroneuro.2014.06.016
Ivanov, I., Liu, X., Clerkin, S., Schulz, K., Fan, J., Friston, K., London, E. D., Schwartz, J., & Newcorn, J. H. (2014). Methylphenidate and brain activity in a reward/conflict paradigm: role of the insula in task performance. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 24(6), 897–906. https://doi.org/10.1016/j.euroneuro.2014.01.017
Bédard, A. C., Schulz, K. P., Krone, B., Pedraza, J., Duhoux, S., Halperin, J. M., & Newcorn, J. H. (2015). Neural mechanisms underlying the therapeutic actions of guanfacine treatment in youth with ADHD: a pilot fMRI study. Psychiatry research, 231(3), 353–356. https://doi.org/10.1016/j.pscychresns.2015.01.012
Our prior research suggests that effective non-stimulant treatments for ADHD act through key prefrontal regions that subserve inhibitory and executive functions, although different medications may achieve these effects via distinct mechanisms. We then looked at the effects of non-medication supplements using functional magnetic resonance imaging (fMRI) with a face go/no-go task to test the prefrontal mechanism of action of the medical food Vayarin in trials of Vayarin at New York University.
Neuropsychological and Clinical Correlate studies
Although Sluggish Cognitive Tempo (SCT) may represent a clinically meaningful condition with distinct underlying pathophysiology that differs from ADHD, research indicates that SCT is common among adults with ADHD. We will investigate treatment response of adults with ADHD and SCT to Vyvanse, a commonly prescribed medication that is FDA approved for treatment of ADHD. Individuals with SCT have been characterized as having the following symptoms: 1) prone to daydreaming instead of concentrating; 2) trouble staying alert/awake in boring situations; 3) being easily confused; 4) being easily bored; 5) feeling spacey/in a fog; 6) frequently feeling lethargic; 7) being underactive/having less energy than others; 8) being slow moving; and 9) not processing information quickly/accurately.
Krone, B., Bedard, A. C., Downes, L., Downes, Q., Kirschenbaum, A., Ivanov, I., Schulz, K., & Newcorn, J. H. (2020.). Double Dissociation of Neuropsychological Correlates for Cognitive Phenotypes in ADHD. Aacap.confex.com; AACAP. Retrieved October 14, 2021, from https://aacap.confex.com/aacap/2020/meetinginfo.cgi/Paper/36781
Adler, L. A., Leon, T. L., Sardoff, T. M., Krone, B., Faraone, S. V., Silverstein, M. J., & Newcorn, J. H. (2021). A Placebo-Controlled Trial of Lisdexamfetamine in the Treatment of Comorbid Sluggish Cognitive Tempo and Adult ADHD. The Journal of clinical psychiatry, 82(4), 20m13687. https://doi.org/10.4088/JCP.20m13687
Silverstein, M. J., Leon, T. L., Krone, B., Faraone, S. V., Newcorn, J. H. & Adler, L. A. (2019). The Characteristics and Unique Impairments of Comorbid Adult ADHD and Sluggish Cognitive Tempo: An Interim Analysis. Psychiatric Annals, 49(10), https://doi.org/10.3928/00485713-20190905-01
We have been at the forefront of our field in examining affective instability, defiance, anxiety, and traumatic stress among people with ADHD.
Heber, E., Halperin, J., Krone, B., Bedard, A.-C., Ivanov, I., & Newcorn, J. H. (2016). 5.15 COGNITIVE AND EMOTIONAL CONTROL IN YOUTH WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, AND THE IMPACT OF STIMULANT AND NON-STIMULANT TREATMENT. Journal of the American Academy of Child & Adolescent Psychiatry, 55(10), S188. https://doi.org/10.1016/j.jaac.2016.09.274
Krone, B., Hildebrandt, T. B., Bedard, A.-C., Pedraza, J. D., Newcorn, J. H., & Stein, M. A. (2016). 6.39 AFFECTIVE INSTABILITY AND OPPOSITIONAL DEFIANCE IN ATTENTION-DEFICIT/HYPERACTIVITY DISORDER: TREATMENT EFFECTS. Journal of the American Academy of Child & Adolescent Psychiatry, 55(10), S216–S217. https://doi.org/10.1016/j.jaac.2016.09.359
Ongoing Studies
Medications for ADHD
Our researchers are evaluating alternativesmedications and other treatments, for children, adolescents, and/or adults, as detailed below.
Studies in Functional Magnetic Resonance Imaging (fMRI)
We use non-invasive fMRI to take pictures of the brain while you perform simple tasks, which is like playing video games. This allows us to examine the differences in brain activation between individuals with and without ADHD, or before and during treatment with a medication. By examining differences in the processes used in decision-making and impulse control, we gain insight into the mechanisms of ADHD and the ways in which ADHD treatments affect the brain. The ultimate goal is to improve ADHD treatment selection by matching to individual patient characteristics.
There are no known dangers associated with fMRI. To participate, you or your child must be comfortable with small spaces, have no metal in the body that cannot be removed (i.e., metal plates, screws, or braces), and meet inclusion criteria for the study that you choose.
Genetics Studies
In partnership with the Laboratory of Developmental Neuroscience at University of Illinois at Chicago, our researchers study the pharmacogenomics effects of ADHD treatments. We examine the characteristics of DNA donated by parents and children to determine predictors of treatment response and differences in symptom presentation.
We are also partnered with our colleagues at the University of Michigan, the University of Florida, and the University of Miami to investigate the genetic factors associated with methylphenidate metabolism, as we look for biomarkers that may one day predict who may be at risk for adverse effects of certain medications.
Behavioral Studies
We use a variety of research methods to examine the effects of behavioral interventions, or to elucidate the psychosocial correlates of ADHD
For more information about our current studies, or to participate in research, contact our team
Our general inbox: adhd.research@mssm.edu
Beth Krone, PhD: Beth.Krone@mssm.edu
Isaac J. Wert, BA: isaac.wert@mssm.edu
For more information about clinical trials nation-wide, visit www.clinicaltrials.gov
