Impact of restless legs syndrome and iron deficiency on attention-deficit/hyperactivity disorder in children
Hôpital Universitaire Robert Debré, Lutetia Parisorum, Île-de-France, France Sleep Medicine
(Impact Factor: 3.15).
12/2007; 8(7-8):711-5. DOI: 10.1016/j.sleep.2007.04.022
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.
Available from: Kemal Utku Yazici
- "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"
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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.
Available from: Samuele Cortese
- "Preliminary evidence also shows that individuals with ADHD and RLS/PLMS have more severe ADHD features . "
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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.
Available from: Jamie Cassoff
- "The reviewed studies are at times inconsistent with regards to their definition of sleep restriction, disorders, and disturbance and, thus, utilize varying diagnostic criteria when examining sleep problems associated with ADHD. For example, objective (eg, apnea hypopnea index23) and subjective (eg, Pediatric Sleep Questionnaire20) are being used to define sleep disordered breathing. In addition, sleep recording methods, as well as the types and number of sleep para meters measured using these methods, vary between studies. "
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ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) is often associated with comorbid sleep disturbances. Sleep disturbances may be a risk factor for development of the disorder, a symptom of the disorder, or a comorbid condition affected by a similar psychopathology. Various studies have examined the impact of sleep deprivation on the presence/exacerbation of ADHD symptomology, as well as longitudinal and concurrent associations between different sleep disturbances and ADHD, yet the notion of sleep disturbances as a predecessor to ADHD remains unclear. As such, this review examines the evidence for sleep disturbances as a risk factor for the development of ADHD, as well as the mechanisms underlying the association between sleep patterns and ADHD. Additionally, clinical implications regarding the comorbid nature of sleep disturbances and ADHD will be considered.
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