Ventral Tegmental Area (VTA) Self-Activation in Attention Deficit Hyperactivity Disorder (ADHD)
Condition: ADHD
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      The purpose of this study is to see if a non-medication intervention can increase motivation
      in individuals with ADHD by observing brain activity using magnetic resonance imaging (MRI).
    

Detailed description: 
      The study involves a screening visit and 4 experimental task sessions.During the screening
      visit subjects will undergo psychiatric screening to determine if they meet criteria for a
      diagnosis of ADHD. Participants who meet criteria for a diagnosis of ADHD will also have the
      following tests done at screening: breath alcohol test, urine drug screen and urine cotinine
      (by product of tobacco) screening and intelligence quotient (IQ) assessment. Eligible
      participants will complete a battery of cognitive assessments.

      Participants meeting study inclusion will then be scheduled for 4 fMRI sessions to assess and
      manipulate the ability to self-stimulate VTA activation. Each session will contain the same
      tasks and instructions. The experimental imaging task sessions will be done within a one
      month window and will consist of two types of runs: Test Runs (one pre-test and post-test
      each) and three Training Runs.

      The purpose of the Pre-Test is to establish a baseline level of self-generated VTA activation
      prior to receiving RTFF.

      The Post-Test is designed to assess whether participants are better able to self-induce VTA
      BOLD signal in the absence of feedback (after receiving RTFF).

      Participants will begin and end each scanning session with a 2-minute resting state scan.
      Participants will rest and fixate at a cross hair.

      The purpose of the first run is to acquire data in functional space to facilitate
      registration of the VTA probabilistic atlas (MNI space) to functional space.

      The Pre-Test and Post-Test runs will be identical and will have two trial types: Activate and
      Count.

      During the Activate trials participants will be instructed to try to increase activity (BOLD
      signal) within their VTA. Specifically, we will instruct participants to try to get
      themselves into a heightened state of motivation using personally relevant thoughts and
      imagery. Importantly, they will be encouraged to optimize strategies for themselves.

      During the Count trials, participants will be instructed to count backwards. The purpose of
      these trials is to: standardize the baseline period and to provide a distractor task to
      prevent engagement in activation strategies. There will be 5 repetitions of both trial types,
      separated by a jittered inter-trial-interval (ITI; total duration 4 minutes, 5 seconds).

      The purpose of the subsequent training runs (n=3/day on each of the 4 days) is to provide
      participants with RTFF to assist them in increasing their VTA BOLD signal.

      The training runs will consist of three trial types: Activate, Count, and Rest. For both
      Activate and Count Trials, participants will be given the same instructions as during the
      test runs. During the Rest trials participants will be instructed to rest and not think of
      anything in particular. The Activate and Rest trials will include a thermometer display, as
      described below. Each trial type will be repeated 5 times per run, separated by a jittered
      ITI (total duration 6 minutes, 18 seconds).

      Following the Post-Test each day, the Cognitive Battery assessments will be repeated with the
      subject out of the scanner.
    

Intervention name(s): Real-Time functional Magnetic Resonance Imaging Feedback (RTFF)
Intervention type(s): Other
Intervention description(s): During the Activate trials, the thermometer will display the weighted average of VTA BOLD activation, dynamically updated every second. This continuously updated thermometer is the primary feedback mechanism.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other