Is high prevalence of vitamin D deficiency a correlate for attention deficit hyperactivity disorder?

The aim of the study was to determine the association between vitamin D and attention deficit hyperactivity disorder (ADHD), and difference in the level of vitamin D in ADHD children and control. This a case–control study carried out in school health and primary health care clinics. A total of 1,331 children and adolescents who were diagnosed with ADHD based on clinical criteria and standardized questionnaires were enrolled in this study and were matched with 1,331 controls, aged 5–18 years old. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The study found significant association between ADHD and vitamin D deficiency after adjusting for BMI and sex (adj. OR 1.54; 95 % CI 1.32–1.81; P < 0.001). Majority of the ADHD children were in the age group 5–10 years (40.7 %), followed by 11–13 years (38.4 %). The proportion of BMI <85th percentile was significantly over represented in ADHD group as compared to healthy control (87.8 vs. 83 %; P < 0.001, respectively), while on the other hand, BMI >95th percentile was over represented in the control than ADHD group (7.6 vs. 4.6 %; P < 0.001, respectively). Mean values of vitamin D (ng/mL) were significantly lower in ADHD children (16.6 ± 7.8) than in healthy children (23.5 ± 9.0) (P < 0.001). There was significant correlation between vitamin D deficiency and age (r = ?0.191, P = 0.001); calcium (r = 0.272, P = 0.001); phosphorous (r = 0.284, P = 0.001); magnesium (r = 0.292, P = 0.001); and BMI (r = 0.498, P = 0.001) in ADHD children. The vitamin D deficiency was higher in ADHD children compared to healthy children.     

Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children’s ADHD? Study protocol of a randomized controlled multicentre trail

Heritability of deficit and hyperactivity disorder (ADHD) is high. Thus, frequently both children and parents are affected. Parental ADHD often has a negative impact on parent-child interactions and may constitute a significant barrier to a successful treatment of the child's ADHD. The objective of our randomized controlled multicentre trial is to evaluate whether the treatment of maternal ADHD improves the efficacy of a behavioural parent training for children's ADHD. One hundred and forty-four mother-child pairs, both affected by ADHD according to DSM-IV, will be treated at five sites in Germany. Mothers are randomized to manualized cognitive-behavioural group psychotherapy plus open methylphenidate treatment or to control treatment (supportive counselling). After 13 weeks of treatment, manualized behavioural parent training will be administered to all mother-child pairs. Therapists are graduated psychologists or physicians. Treatment integrity will be established by independent supervision. Primary endpoint (child's externalizing symptoms) is rated by interviewers blind to the mother's treatment allocation. Intention-to-treat analysis will be performed within a linear regression model (Current Controlled Trials ISRCTN73911400).     

The effect of polyphenolic extract from pine bark,Pycnogenol® on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD)

Abstract

Attention deficit hyperactivity disorder (ADHD) belongs to the neurodevelopmental disorders characterized by impulsivity, distractibility and hyperactivity. In the pathogenesis of ADHD genetic and non-genetic factors play an important role. It is assumed that one of non-genetic factors should be oxidative stress. Pycnogenol^®, an extract from the pine bark, consists of bioflavonoids, catechins, procyanidins and phenolic acids. Pycnogenol^® acts as powerful antioxidant, chelating agent; it stimulates the activities of some enzymes, like SOD, eNOS, and exhibits other biological activities.

Aim: The aim of this randomized, double-blind, placebo-controlled trial was to investigate the influence of administered Pycnogenol^® or placebo on the level of reduced (GSH) and oxidized (GSSG) glutathione in children suffering from ADHD and on total antioxidant status (TAS). This is the first investigation of the redox glutathione state in relation to ADHD.

Results: One month of Pycnogenol^® administration (1 mg/kg body weight/day) caused a significant decrease in GSSG and a highly significant increase in GSH levels as well as improvement of GSH/GSSG ratio in comparison to a group of patients taking a placebo. TAS in children with ADHD was decreased in comparison with reference values. Pycnogenol^® administration normalizes TAS of ADHD children.     

To what extent are task-switching deficits in children with attention-deficit/hyperactivity disorder independent of impaired inhibition?

Executive functions, higher-order cognitive functions needed for goal-directed behavior, have been studied extensively in the search for endophenotypes for ADHD, yet results have been inconclusive. We examine the performance of children with ADHD in task switching as an as yet understudied potential endophenotype. A group of 20 children with ADHD and a group of 23 children without ADHD (ages 7?C12) performed a task-switching paradigm and a Go/No-Go Task. Children with ADHD displayed significantly greater specific switch costs, that is, compared to control children they were especially impaired directly after task switches. There were no group differences with respect to the general switch costs, which are estimated by comparing performance on single task blocks to the block where both tasks are intermixed. Specific switch costs and Go/No-Go error rate were significantly correlated; yet, group differences in the task-switching paradigm remained significant even when inhibition was controlled for. This pattern of results suggests that children with ADHD are neither generally impaired in executive function nor only impaired with respect to inhibition. Instead, they display a highly specific deficit with regard to the flexible suppression and amplification of different task rules according to the context. Our conclusion that task switching has the potential to be added to the list of ADHD endophenotypes is strengthened by the independence of task-switching deficits and inhibition.     

Self-perception of self-regulatory skills in children with attention-deficit/hyperactivity disorder aged 8–10 years

Several studies have reported a characteristic "positive illusory bias" in the self-evaluation of children with ADHD. However, results are controversial. The aim of the present study was to investigate whether children with ADHD aged 8 to 10 years can rate their self-regulatory skills accurately when assessed with an age appropriate instrument. Twenty-seven children with ADHD and 27 matched normal control children completed the Self-rating Scale of Self-regulatory Function (SelfReg), a new rating scale that has been specifically designed for this age group. As expected, children with ADHD rated themselves significantly more dysfunctional than control children. In most domains, self-ratings of children with ADHD did not diverge from parent and teacher ratings to a greater extent than self-ratings of control children, although overall results indicated a moderate tendency toward a positive bias. When a cluster analysis based on discrepancies between children's and adults' evaluations was carried out, three groups with different self-rating patterns emerged: A "positive bias" group containing exclusively children with ADHD, a "negative bias" group containing both children with ADHD and control children, and the largest group of accurate self-raters which also included children from both diagnostic groups. It is concluded that overly positive self-judgments are not a ubiquitous finding in ADHD, but may be confined to a specific subgroup of children whose specific characteristics remain to be determined.     

Is urine intercellular adhesion molecule-1 a marker of renal disorder in children with ureteropelvic junction obstruction?

Aim: We aimed to investigate whether urine intercellular adhesion molecule-1 (ICAM-1) might serve as a marker of renal disorder in children with ureteropelvic junction obstruction.

Material and methods: Twenty-nine children with severe hydronephrosis (HN) were compared with 23 participants with mild HN and with 19 healthy peers.

Results: Urine ICAM-1/uCre levels were significantly higher in HN children than healthy controls (P?<0.01), and in severe HN when compared with mild HN (p?<0.05).

Conclusions: It seemed to us that uICAM-1 is a biomarker of renal disorder, and might have the potential to predict which patients will require surgery.     

Is insufficient sleep duration associated with suicidal behavior in Korean adolescents?

Sleep and Biological Rhythms - The second leading cause of death among Korean adolescents was suicide in 2014. We assessed the relationship between sleep duration and suicidal behavior (ideation,...     

Is the interaction of CNP with tubulin and microtubules required for process extension in oligodendrocytes?

The STOP protein (stable tubule-only polypeptide) is a calmodulin-regulated protein which associates with microtubules and induces cold stabilization. There are different isoforms of this protein that arise from alternative splicing of STOP mRNA. Neurons express two major variants N-STOP (125 kDa) and E-STOP (84 kDa). NIH 3T3 fibroblasts contain a major F-STOP isoform (42 kDa) and two minor STOP variants (48 and 89 kDa). Previously, we demonstrated the presence of N-STOP in the cytoskeleton associated with myelin isolated from animals injected with apotransferrin. Since this protein was only described as a neuronal protein we decided to further investigate the expression of this protein in oligodendrocyte cultures. The analysis of the STOP protein expression in oligodendrocyte shows that STOP protein is expressed in the soma and processes of oligodendrocyte precursors, as well as in immature and mature oligodendroglial cells. In addition, we found that MBP shows a high degree of colocalization with STOP protein. By Western blot analysis, it was found that these cells express a major STOP variant (89 kDa). When the cultures were exposed to cold temperature we found that STOP protein associates with microtubules and induces microtubule cold stabilization. Under these experimental conditions, we found that MBP associates with microtubules too, and maintains its colocalization with STOP protein. At present, we are doing new assays directed to further characterize STOP (89 kDa) protein and to elucidate how this protein participates in the formation of myelin by oligodendrocytes.     

Are basal metabolic rate prediction equations appropriate for female children and adolescents?

Wong, William W., Nancy F. Butte, Albert C. Hergenroeder,Rebecca B. Hill, Janice E. Stuff, and E. O'Brian Smith. Are basalmetabolic rate prediction equations appropriate for female children andadolescents? J. Appl. Physiol. 81(6):2407-2414, 1996.The basal metabolic rate (BMR), which accountsfor 50-70% of total energy expenditure, is essential forestimation of patient and population energy needs. Numerous equationshave been formulated for prediction of human BMR. Most equations incurrent use are based on measurements of Caucasians performed more thanfour decades ago. We evaluated 10 prediction equations commonly usedfor estimation of BMR in 76 Caucasian and 42 African-American girlsbetween 8 and 17 yr of age against BMR measured by whole-bodycalorimetry. The majority of the prediction equations (9 of10) overestimated BMR by 60 ± 46 kcal/day (range,15-176 kcal/day). This overestimation was found to besignificantly greater (P < 0.05) forAfrican-Americans (77 ± 17 kcal/day) than for Caucasians (25 ± 17 kcal/day) in six equations, controlling for age, weight, and sexualmaturity. We conclude that ethnicity is an important factor inestimation of the BMR and that the current prediction equations are notappropriate for accurate estimation of the BMR of individual femalechildren and adolescents.

     

Is the renin-angiotensin system involved in urinary concentration mechanisms?

Renin release elicited by i.v. injection of loop-diuretics was used to study the effects of angiotensin II (AII) on intrarenal hemodynamics. The vasoconstrictive action of intrarenally synthesized AII predominates in the efferent glomerular arteriole. Such a vasoconstrictive effect could affect blood flow in the vasa recta which stem from efferent arterioles of juxtamedullary glomeruli. Renin secretion and renal inner medullary blood flow (tissue clearance of 133Xe) were simultaneously measured before and after frusemide-induced renin release. The relationship between renin secretion and renal inner medullary blood flow was inverse. Changes in renal medullary blood flow may be physiological determinants of medullary osmolality and renal concentration ability. The intrarenal role of AII in urinary concentration recovery after frusemide was examined. Inhibition of renin release by propranolol or AII-blockade (by saralasin or Hoe 409) delayed recovery of urinary osmolality. In the conscious rat, propranolol slowed down recovery of the cortico-papillary gradient for sodium. Its vasoconstrictive action on the efferent glomerular arteriole might enable the renin-angiotensin system to participate in the control of renal excretion of salt and water.     

Is emotion recognition the only problem in ADHD? effects of pharmacotherapy on face and emotion recognition in children with ADHD

The objectives of this study were to evaluate both face and emotion recognition, to detect differences among attention deficit and hyperactivity disorder (ADHD) subgroups, to identify effects of the gender and to assess the effects of methylphenidate and atomoxetine treatment on both face and emotion recognition in patients with ADHD. The study sample consisted of 41 male, 29 female patients, 8–15 years of age, who were diagnosed as having combined type ADHD (N = 26), hyperactive/impulsive type ADHD (N = 21) or inattentive type ADHD (N = 23) but had not previously used any medication for ADHD and 35 male, 25 female healthy individuals. Long-acting methylphenidate (OROS-MPH) was prescribed to 38 patients, whereas atomoxetine was prescribed to 32 patients. The reading the mind in the eyes test (RMET) and Benton face recognition test (BFRT) were applied to all participants before and after treatment. The patients with ADHD had a significantly lower number of correct answers in child and adolescent RMET and in BFRT than the healthy controls. Among the ADHD subtypes, the hyperactive/impulsive subtype had a lower number of correct answers in the RMET than the inattentive subtypes, and the hyperactive/impulsive subtype had a lower number of correct answers in short and long form of BFRT than the combined and inattentive subtypes. Male and female patients with ADHD did not differ significantly with respect to the number of correct answers on the RMET and BFRT. The patients showed significant improvement in RMET and BFRT after treatment with OROS-MPH or atomoxetine. Patients with ADHD have difficulties in face recognition as well as emotion recognition. Both OROS-MPH and atomoxetine affect emotion recognition. However, further studies on the face and emotion recognition are needed in ADHD.     

Is there a place in the United Kingdom for intensive antacid treatment for chronic peptic ulceration?

Sixty nine patients with chronic duodenal or juxtapyloric ulceration were studied in a prospective double blind randomised trial to compare the efficacy of antacid and placebo at high (30 ml seven times daily) and low (10 ml as required) doses. After four weeks ulcers had healed in 12 out of 18 patients (67%) receiving "low dose" antacid compared with in six out of 17 patients (35%) receiving low dose placebo; ulcers had also healed in six out of 19 patients (32%) receiving "high dose" antacid compared with in two out of 15 patients (13%) receiving high dose placebo. Overall, the effect of antacid was superior to that of placebo in healing ulcers (p less than 0.05) and the effect of low dose treatment was superior to that of high dose treatment (p less than 0.01). There were no significant differences between antacid and placebo at eight weeks. Antacid was better than placebo in relieving pain, but the difference was not significant. Poor compliance and high incidence of diarrhoea made high dose antacid an impractical treatment. Low dose antacid was associated with a significantly better rate of healing than high dose antacid and was far better tolerated. This low dosage of antacid should be considered to be an active treatment in trials of ulcer healing.     

Aggression in young children with concurrent callous–unemotional traits: can the neurosciences inform progress and innovation in treatment approaches?

Parenting is the 'clean water' of healthy psychological development and parenting interventions remain the number one treatment at the individual and community levels for early-onset aggression and antisocial behaviour in children. However, recent progress in child psychopathology research is specifying a number of biological mechanisms that interact with environmental risk to influence pathways into aggression and antisocial behaviour. After a brief review of the parent training literature, we focus on child factors, especially callous-unemotional traits, that parse 'aggressive' children into more homogeneous groupings, and then review selected ideas about the origins of aggression coming from the neurosciences (such as neurobehavioural responsivity to emotional stimuli; hypothalamic-pituitary axis abnormalities influencing low cortisol and low serotonin production). We review human and, where relevant, animal models of neurobiological system changes with particular attention to developmental timing and interactions with environmental factors, especially parenting. Based on this innovative research, we then discuss a number of ideas that hold potential for interventions. We conclude that the future will see the development of interventions that aim for synergy between specific biological processes and psychological experiences as they unfold developmentally. The use of D-cycloserine in fear extinction and oxytocin in affiliative bonds is used as an example of these futuristic approaches.     

Selenium and its relationship with selenoprotein P and glutathione peroxidase in children and adolescents with Hashimoto’s thyroiditis and hypothyroidism

The essential trace element selenium (Se) is required for thyroid hormone synthesis and metabolism. Selenoproteins contain selenocysteine and are responsible for biological functions of selenium. Glutathione peroxidase (GPx) is one of the major selenoproteins which protects the thyroid cells from oxidative damage. Selenoprotein P (SePP) is considered as the plasma selenium transporter to tissues. The aim of this study was to evaluate serum Se and SePP levels, and GPx activity in erythrocytes of children and adolescents with treated Hashimoto’s thyroiditis, hypothyroidism, and normal subjects.Blood samples were collected from 32 patients with Hashimoto’s thyroiditis, 20 with hypothyroidism, and 25 matched normal subjects. All the patients were under treatment with levothyroxine and at the time of analysis all of the thyroid function tests were normal. GPx enzyme activity was measured by spectrophotometry at 340 nm. Serum selenium levels were measured by high-resolution continuum source graphite furnace atomic absorption. SePP, TPOAb (anti-thyroid peroxidase antibody), and TgAb (anti-thyroglobulin antibody) were determined by ELISA kits. T₄, T₃, T₃ uptake and TSH were also measured.Neither GPx activity nor SePP levels were significantly different in patients with Hashimoto’s thyroiditis or hypothyroidism compared to normal subjects. Although GPx and SePP were both lower in patients with hypothyroidism compared to those with Hashimoto’s thyroiditis and normal subjects but the difference was not significant. Serum Se levels also did not differ significantly in patients and normal subjects. We did not find any correlation between GPx or SePP with TPOAb or TgAb but SePP was significantly correlated with Se.Results show that in patients with Hashimoto’s thyroiditis or hypothyroidism who have been under treatment with levothyroxine and have normal thyroid function tests, the GPx, SePP and Se levels are not significantly different.     

Dopamine and its metabolites in human peripheral nerves: Is there a widely distributed system of peripheral dopaminergic nerves?

Norepinephrine (NE), dopamine (DA) and its metabolites homovanillic acid (HVA) and 3, 4-dihydroxyphenylacetic acid (DOPAC) were analyzed in human ventral spinal nerve roots and peripheral nerves by gas chromatography-mass spectrometry. High concentrations of DA and HVA were found in almost all tissues analyzed. The concentration of DA and HVA was usually higher than in blood. In vagus nerve and in some spinal nerve roots, the concentration of DA was higher than that of NE, while in other nerves (splanchnic nerve and genitofemoral nerve) DA represented 20 or more percent of NE. The concentration of HVA was usually higher than the concentration of DA indicating that a large portion of DA in peripheral nerves is catabolized and not converted to NE. High concentrations of DA and HVA in human peripheral nerves indicate that a wide distribution of peripheral DA-containing nerves might exist. The distribution of DA in different nerves suggests an association of potential DA-containing nerves with the autonomic nervous system.     

Out with the Old and in with the New—Is Backward Inhibition a Domain-Specific Process?

Effective task switching is supported by the inhibition of the just executed task, so that potential interference from previously executed tasks is adaptively counteracted. This inhibitory mechanism, named Backward Inhibition (BI), has been inferred from the finding that switching back to a recently executed task (A-B-A task sequence) is harder than switching back to a less recently executed task (C-B-A task sequence). Despite the fact that BI effects do impact performance on everyday life activities, up to now it is still not clear whether the BI represents an amodal and material-independent process or whether it interacts with the task material. To address this issue, a group of individuals with Williams syndrome (WS) characterized by specific difficulties in maintaining and processing visuo-spatial, but not verbal, information, and a mental age- and gender-matched group of typically developing (TD) children were subjected to three task-switching experiments requiring verbal or visuo-spatial material to be processed. Results showed that individuals with WS exhibited a normal BI effect during verbal task-switching, but a clear deficit during visuo-spatial task-switching. Overall, our findings demonstrating that the BI is a material-specific process have important implications for theoretical models of cognitive control and its architecture.