Impact of restless legs syndrome and iron deficiency on attention-deficit/hyperactivity disorder in children
ABSTRACT Increasing evidence suggests a significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and restless legs syndrome (RLS). Iron deficiency may underlie common pathophysiological mechanisms in subjects with ADHD plus RLS (ADHD+RLS). To date, the impact of iron deficiency, RLS and familial history of RLS on ADHD severity has been scarcely examined in children. These issues are addressed in the present study.
Serum ferritin levels, familial history of RLS (diagnosed using National Institutes of Health (NIH) criteria) and previous iron supplementation in infancy were assessed in 12 ADHD+RLS children, 10 ADHD children and 10 controls. RLS was diagnosed using NIH-specific pediatric criteria, and ADHD severity was assessed using the Conners' Parent Rating scale.
ADHD symptom severity was higher, although not significantly, in children with ADHD+RLS compared to ADHD. The mean serum ferritin levels were significantly lower in children with ADHD than in the control group (p<0.0005). There was a trend for lower ferritin levels in ADHD+RLS subjects versus ADHD. Both a positive family history of RLS and previous iron supplementation in infancy were associated with more severe ADHD scores.
Children with ADHD and a positive family history of RLS appear to represent a subgroup particularly at risk for severe ADHD symptoms. Iron deficiency may contribute to the severity of symptoms. We suggest that clinicians consider assessing children with ADHD for RLS, a family history of RLS, and iron deficiency.
- SourceAvailable from: Kemal Utku Yazici
[Show abstract] [Hide abstract]
- "www.cappsy.org tin düzeyi ve DEHB belirti şiddeti arasında anlamlı bir ilişki bulunurken (Konofal ve ark. 2004, Oner ve Oner 2008, Oner ve ark. 2008, Cortese ve ark. 2009, Oner ve ark. 2010, Konofal ve ark. 2007, Calarge ve ark. 2010, Oner ve ark. 2012) yedi çalışmada böyle bir ilişki gösterilememiştir (Millichap ve ark. 2006, Juneja ve ark. 2010, Menegassi ve ark. 2010, Lahat ve ark. 2011, Karakurt ve ark. 2011, Oğrağ ve ark. 2012, Donfrancesco ve ark. 2013). Literatürdeki DEHB ve demir eksikliği ile ilgili çalışmaların sadece dokuzunda kontro"
ABSTRACT: Dikkat eksikliği ve hiperaktivite bozukluğu, tıp literatüründe en iyi araştırılmış bozukluklardan biri olmasına rağmen, etiyolojisi halen net olarak açıklığa kavuşturulamamıştır. Dikkat eksikliği ve hiperaktivite bozukluğu’nun küratif şekilde tedavi edilmesi için bozukluk ile ilişkili etmenlerin net olarak aydınlatılması oldukça önemlidir. Literatür incelendiğinde, demir eksikliğinin dikkat eksikliği ve hiperaktivite bozukluğu patofizyolojisi için bir risk faktörü olabileceği belirtilmekle birlikte, konu ile ilgili şu ana kadar yapılan çalışmalarda çelişkili sonuçlar elde edildiği gözlenmektedir. Bu yazıda, dikkat eksikliği ve hiperaktivite bozukluğu patofizyolojisinde etkili olduğu düşünülen demir ve demirle ilişkili parametrelerin kan düzeyleri ile ilgili literatürdeki, çocuk ve ergen yaş grubunda, ülkemizde ve yurt dışında yapılmış konu ile ilgili çalışmaların incelenmesi, genel özelliklerinin derlenmesi ve sonuçlarının sunulması amaçlanmıştır.Psikiyatride Guncel Yaklasimlar 12/2014; 2015(7(1)):41-55.
[Show abstract] [Hide abstract]
- "Preliminary evidence also shows that individuals with ADHD and RLS/PLMS have more severe ADHD features . "
ABSTRACT: a b s t r a c t Preliminary evidence suggests a possible association between Attention-Deficit/Hyperactivity Disorder and Restless Legs Syndrome with or without Periodic Limb Movements during Sleep. When comorbid, Restless Legs Syndrome/Periodic Limb Movements during Sleep might aggravate Attention-Deficit/ Hyperactivity Disorder symptoms. Pharmacological treatment of Attention-Deficit/Hyperactivity Disor-der may be associated, at least in some cases, with adverse cardiovascular events, including clinically sig-nificant elevation in heart rate and systemic blood pressure. However, the characteristics of patients with Attention-Deficit/Hyperactivity Disorder at risk for cardiovascular events during pharmacological treat-ment are poorly understood. Here, we hypothesize that Restless Legs Syndrome and/or Periodic Limb Movements during Sleep comorbid with Attention-Deficit/Hyperactivity Disorder increase cardiovascular risk via imbalance in activity of the autonomic nervous system. Such an imbalance of the could be related to alterations of sleep microarchitecture also detected by cyclic alternating pattern analysis. If empirical studies confirm our hypothesis, the clinician would be advised to systematically screen for and effectively treat Restless Legs Syndrome/Periodic Limb Movements during Sleep even before starting treatment with Attention-Deficit/Hyperactivity Disorder drugs. The management of Restless Legs Syndrome/Periodic Limb Movements during Sleep might reduce cardiovascular risk during pharmacological treatment of Attention-Deficit/Hyperactivity Disorder.Medical Hypotheses 11/2012; 80(1). DOI:10.1016/j.mehy.2012.10.004 · 1.07 Impact Factor
[Show abstract] [Hide abstract]
- "Most of the studies have used semistructured interviews according to formal criteria to confirm the diagnosis of ADHD. Most of the studies have included children with all the three subtypes of ADHD (i.e., combined, predominantly inattentive, and predominantly hyperactive-impulsive types) although some articles did not specify the ADHD subtype (Kiddie et al., 2010; Konofal et al., 2004, 2007; Millichap et al., 2006; P. Oner & Oner, 2008; Sever et al., 1997) or included only children with the combined subtype (O. Oner et al., 2010). "
ABSTRACT: Objective: (a) To compare serum ferritin levels in a sample of stimulant-naïve children with ADHD and matched controls and (b) to assess the association of serum ferritin to ADHD symptoms severity, ADHD subtypes, and IQ. Method: The ADHD and the control groups included 101 and 93 children, respectively. Serum ferritin levels were determined with the enzyme-linked immunosorbent assay method. Results: Serum ferritin did not significantly differ between children with ADHD and controls, as well as among ADHD subtypes. Correlations between serum ferritin levels and measures related to IQ or ADHD severity were not significant. Conclusion: This is the largest controlled study that assessed ferritin levels in stimulant-naïve ADHD children. The findings of this study do not support a significant relationship between serum ferritin levels and ADHD. However, the authors' results based on peripheral measures of iron do not rule out a possible implication of brain iron deficiency in ADHD, grounded on neurobiological hypotheses and preliminary empirical evidence. (J. of Att. Dis. 2011; XX(X) 1-XX).Journal of Attention Disorders 01/2012; 17(4). DOI:10.1177/1087054711430712 · 2.40 Impact Factor