Establishing a comprehensive ADHD research and treatment program
Using the latest brain imaging technology, Julie Schweitzer is revealing the inner workings of the brains of adults and children with ADHD — attention-deficit/hyperactivity disorder — a devastating condition that makes it difficult for children to maintain self-control and attention. Schweitzer’s groundbreaking research using fMRI (functional magnetic resonance imaging) indicates that when people with ADHD perform tasks, their brains show increased, non-localized brain activity when compared to those without the diagnosis.
“What we’ve seen is that more areas of the brain are involved,” said Schweitzer, an associate professor of psychiatry and behavioral sciences who arrived at the UC Davis M.I.N.D. Institute in January. “This less specific, inefficient activation means people with ADHD are working much harder to accomplish similar tasks.”
Schweitzer, who also has extensive clinical experience in treating patients with ADHD, will now use her expertise to establish a comprehensive ADHD program at the M.I.N.D. Institute. “This is the ideal place to build a program that can really make a difference, both in what we know about the biology behind ADHD and how we successfully treat those who have it,” said Schweitzer, who has studied ADHD and its treatments for 20 years. “You can’t find many places that have such strong clinical programs in childhood psychiatric disorders and a research infrastructure to work with those populations.”
For Schweitzer, who was previously at the University of Maryland and Emory University, building a far-reaching program means conducting research at many different Establishing a comprehensive ADHD research and treatment program levels, including basic biological studies using brain imaging, clinical trials that test drug therapies and assessments of new behavioral interventions. It also means reaching out to local physicians and partnering with schools to raise awareness about symptoms and treatments for ADHD. Schweitzer said she is especially committed to assuring that the institute’s ADHD program addresses the needs of local schools.
“Classrooms are where children with ADHD are the most challenged. If they are not diagnosed and treated properly, the disorder can impact their ability to learn and, ultimately, their futures,” she said.
ADHD is the most common childhood psychiatric disorder, affecting 3 to 5 percent of school-aged children in the United States. Children with the disorder usually have one of three types of ADHD (see sidebar). In general, they often do poorly in school and have behavioral problems and poor relationships with others.
According to one parent, who prefers to remain anonymous, life with a child who has ADHD can be a roller-coaster ride of variable behaviors, phone calls from school principals, medication management and worry, especially when impulse control is low.
“I never knew what to expect next, even when she was very young,” she said. “I picked my child up at preschool one day and was told she had 13 time outs.”
She is very enthusiastic about the new research program at the M.I.N.D. Institute, which she hopes will lead to better understanding.
“Making ADHD a research priority gives the diagnosis greater status and helps take away some of the stigma for children who are affected and currently labeled as ‘uncontrollable’ rather than suffering from a real brain disorder. More research will also greatly improve the range of treatment options.”
According to Schweitzer, ADHD is a chronic condition with symptoms that usually persist throughout life. It is only now being recognized as one of the most common adult psychiatric disorders.
“Adults with the disorder may seem less hyperactive than when they were children, but, without treatment, they are still ‘running around’ inside their heads,” she explained. “They also have more traffic accidents, job instability and alcohol and drug abuse problems.”
Although the cause remains unknown, ADHD is often effectively treated using behavioral interventions and medication. At the M.I.N.D. Institute, Schweitzer will be using her previous brain imaging studies to develop new behavioral treatments.
“Our brain imaging research suggests that children with ADHD may need a classroom curriculum that uses more visual cues,” Schweitzer said. She predicts her research will show that children may need explicit training on using more effective visual and verbal strategies for the classroom and home. Since most medications used to treat the disorder only work for several hours, often without long-term benefits, it is important to find behavioral and environmental methods to treat ADHD.
“Ultimately, better medications and behavioral treatments are both needed,” she said.
According to Schweitzer, results from her studies are likely to inform the understanding, diagnosis and treatment of other psychiatric disorders, such as schizophrenia, in which those affected exhibit some symptoms similar to those diagnosed with ADHD.
For now, Schweitzer is excited about continuing her work, while exploring new directions in her research by collaborating with colleagues within the M.I.N.D. Institute and from other UC Davis departments.
“At UC Davis, you really get the sense that there is support throughout the system for the kind of collaborations that will move the science forward and allow us to translate those findings into clinical treatments more quickly,” she said.