We intend to discuss the interdisciplinary field of ADHD through the integration of epigenetics, neuroimaging, neuropshycology, neuromodulation, quality of life and public health in order to shed light both on research and on clinical development of this disorder.

This perspective is aligned with the Research Domain Criteria (RDoC) framework, which focus on the understanding of the pathophysiology of neuropsychiatry disorders. In consonance with this rationale, we hope to incorporate cognitive, behavioral, neurobiological, physiological and genomics data to discuss the main underlying mechanisms of ADHD.

In order to discuss about the factors that contributes to the phenotypic manifestation of a neurobiological disorder as ADHD it is necessary to take into account underlying biological mechanisms as well as environment variables. Early life experiences involving primary affective-regulatory processes may become embedded in the circuitry of the developing brain through epigenetic modifications and lead to long-term changes in neurobiology and behavior. The ADHD methylation profile behind of clinical phenotypic variation will be presented and discussed.

Besides the methylation profile, other neurobiological variables that might present some differences in ADHD individuals compared to typically developing subjects will be addressed. Collected data indicates that cortisal flotation may present deviations in ADHD children. These analyses will be presented, considering the possible implications of these deviations on the phenotype manifestation. Furthermore, many studies have found neuroanatomic differences between ADHD and control children, but most of these data have not been analyzed regarding the different existing phenotypes. We propose a pattern analysis of attentional profile in ADHD–inattentive type subjects as a starting point to divide individuals in different cognitive profiles. Then structural neuroimaging data will be analyzed considering the cognitive profiles obtained, evaluating the possible neuroanatomical characteristics found in each of these groups.

More on the physiological domain, eye tracking data has indentified that ADHD children present different patterns of stimulus analysis when compared to controls. These results will be discussed considering the analysis of human being and animal face stimulus. Hypothesis to explain these results will be delivered.

Regarding cognitive and behavioral ADHD phenotypes we aim to look over clinical neuropsychological profile in Brazilian children with ADHD. We will pinpoint some specific topics as music and temporal processing in ADHD, as well as reward system and delay aversion paradigm in ADHD.

In what refers to environmental variables, we intend to look over ADHD individuals and their relatives’ quality of life in an underdevelopment country, where a considerable part of the population is under vulnerability conditions. Difficulties to receive appropriated treatment and psychosocial challenges faced by the ADHD individual will be discussed.

Concerning treatment subjects, we will address a discussion about some intervention approaches as neuromodulation. Procedures and results of a group cognitive behavioral therapy with ADHD children and their parents will also be presented.

The knowledge interflow from these different domains opens a new perspective for neurophysiological diagnosis and may contribute to the elucidation of the role of epigenetic mechanisms in the determination of different clinical phenotypes.

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Frontiers in Psychiatry

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