Periodic Reporting for period 4 - CoCA (Comorbid Conditions of Attention deficit / hyperactivity disorder)
Periodo di rendicontazione: 2020-07-01 al 2021-06-30
To further elucidate the mechanisms of comorbidity, we a) measured the human circadian system by actimetry (i.e. the objective measurement of movements over the day) and parallel hormone measurements, and b) performed neuroimaging (fMRI) using a pharmacological dopamine challenge to modulate the reward system. We found significant differences in saliva circadian hormone levels (hunger hormone ghrelin, stress hormone cortisol) in ADHD comorbidity groups. Modulation of the dopamine system changed the communication between several brain reward centers, which had a role in treatment response in a clinical study.
Importantly, we aimed to test whether lifestyle interventions (Bright Light Therapy and Exercise) that target our proposed mechanisms can decrease the burden of comorbid symptoms. Measurement was done using a novel smartphone based system which was validated and further investigated, showing that e.g. ADHD patients benefit more from physical activity in improving their mood than healthy controls. The clinical trial on the interventions, the so-called PROUD trial, is currently being analysed. The findings from this pilot study will be used to judge whether future research is warranted to assess efficacy of these lifestyle interventions in a larger trial.
In parallel, we made substantial effort to disseminate our main concepts, ideas and data to the public along with respective recommendations for patients, professionals and policymakers. This resulted in both professional contributions to conferences and scientific journals, but also in a number of outlets for the general public such as newspapers and social media. Our social media strategy was further expanded and outreach to patients was ensured by organising patient events.
As ADHD and comorbid conditions cause substantial burden of disease and are major cost drivers in society, our results impact highly on mental healthcare and associated cost. As ca. 3% of the adult population suffer from ADHD, with >50% of those patients having a comorbid condition, a large part of the population is a potential target for prevention and early interventions. We also strived to raise awareness for this patient group by engaging in societal outreach to educate lay audiences and professional healthcare providers.