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1.
Medicina (B Aires) ; 80 Suppl 2: 58-62, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150715

RESUMO

Epilepsy and attention deficit and hyperactivity disorder (ADHD) are frequent conditions in pediatrics. Their association is frequent and complex, often sharing psychiatric comorbidity. Patients who present epilepsy and ADHD, show equal frequency in both genders, with the inattentive type, as predominant presentation. Cognitive deficit increases the risk of associating ADHD in patients with epilepsy. There is not enough evidence for other risk factors, however there is enough information that allows to ant icipate its presence in some types of epilepsy, with neuropsychological models that evidence the underlying network dysfunction. The relationship with frequency and seizure control, electroencephalographic alterations and antiepileptic drugs (AEDs) is also reviewed. Recommendations to reduce adverse effects of AEDs are described. The diagnosis must therefore be based on suspicion, through clinical instruments and assessments of cognitive functioning. Multimodal treatment is also recommended in patients with ADHD with and without epilepsy. Psych stimulants can be used safely. The quality of life of the patients and their families is affected, so it is advisable for them to be supported by a specialized team that could provide education, early assessment and therapy. If they are omitted, the consequences can be negative at school, social environment and emotional development, which could be relevant and become persistent.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Epilepsia/complicações , Epilepsia/fisiopatologia , Anticonvulsivantes/uso terapêutico , Criança , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Comorbidade , Epilepsia/tratamento farmacológico , Humanos , Fatores de Risco
2.
Lancet ; 395(10222): 450-462, 2020 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-31982036

RESUMO

Attention-deficit hyperactivity disorder (ADHD), like other psychiatric disorders, represents an evolving construct that has been refined and developed over the past several decades in response to research into its clinical nature and structure. The clinical presentation and course of the disorder have been extensively characterised. Efficacious medication-based treatments are available and widely used, often alongside complementary psychosocial approaches. However, their effectiveness has been questioned because they might not address the broader clinical needs of many individuals with ADHD, especially over the longer term. Non-pharmacological approaches to treatment have proven less effective than previously thought, whereas scientific and clinical studies are starting to fundamentally challenge current conceptions of the causes of ADHD in ways that might have the potential to alter clinical approaches in the future. In view of this, we first provide an account of the diagnosis, epidemiology, and treatment of ADHD from the perspective of both the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the eleventh edition of the International Classification of Diseases. Second, we review the progress in our understanding of the causes and pathophysiology of ADHD on the basis of science over the past decade or so. Finally, using these discoveries, we explore some of the key challenges to both the current models and the treatment of ADHD, and the ways in which these findings can promote new perspectives.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/efeitos adversos , Humanos , Guias de Prática Clínica como Assunto
3.
Proc Natl Acad Sci U S A ; 117(1): 641-649, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31907309

RESUMO

Early childhood deprivation is associated with higher rates of neurodevelopmental and mental disorders in adulthood. The impact of childhood deprivation on the adult brain and the extent to which structural changes underpin these effects are currently unknown. To investigate these questions, we utilized MRI data collected from young adults who were exposed to severe deprivation in early childhood in the Romanian orphanages of the Ceaușescu era and then, subsequently adopted by UK families; 67 Romanian adoptees (with between 3 and 41 mo of deprivation) were compared with 21 nondeprived UK adoptees. Romanian adoptees had substantially smaller total brain volumes (TBVs) than nondeprived adoptees (8.6% reduction), and TBV was strongly negatively associated with deprivation duration. This effect persisted after covarying for potential environmental and genetic confounds. In whole-brain analyses, deprived adoptees showed lower right inferior frontal surface area and volume but greater right inferior temporal lobe thickness, surface area, and volume than the nondeprived adoptees. Right medial prefrontal volume and surface area were positively associated with deprivation duration. No deprivation-related effects were observed in limbic regions. Global reductions in TBV statistically mediated the observed relationship between institutionalization and both lower intelligence quotient (IQ) and higher levels of attention deficit/hyperactivity disorder symptoms. The deprivation-related increase in right inferior temporal volume seemed to be compensatory, as it was associated with lower levels of attention deficit/hyperactivity disorder symptoms. We provide compelling evidence that time-limited severe deprivation in the first years of life is related to alterations in adult brain structure, despite extended enrichment in adoptive homes in the intervening years.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/patologia , Encéfalo/patologia , Desenvolvimento Infantil/fisiologia , Criança Institucionalizada/psicologia , Carência Psicossocial , Adoção , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Estudos Transversais , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Inteligência , Testes de Inteligência , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Tamanho do Órgão , Orfanatos , Estudos Prospectivos , Romênia , Fatores de Tempo , Reino Unido , Adulto Jovem
4.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31964760

RESUMO

Pediatricians regularly care for children who have experienced child maltreatment. Child maltreatment is a risk factor for a broad range of mental health problems. Issues specific to child maltreatment make addressing emotional and behavioral challenges among maltreated children difficult. This clinical report focuses on 2 key issues necessary for the care of maltreated children and adolescents in pediatric settings: trauma-informed assessments and the role of pharmacotherapy in maltreated children and adolescents. Specific to assessment, current or past involvement of the child in the child welfare system can hinder obtaining necessary information or access to appropriate treatments. Furthermore, trauma-informed assessments can help identify the need for specific interventions. Finally, it is important to take both child welfare system and trauma-informed assessment approaches into account when considering the use of psychotropic agents because there are critical diagnostic and systemic issues that affect the prescribing and discontinuing of psychiatric medications among children with a history of child maltreatment.


Assuntos
Maus-Tratos Infantis/psicologia , Serviços de Proteção Infantil , Transtornos Mentais/tratamento farmacológico , Psicotrópicos/uso terapêutico , Adolescente , Ansiedade/etiologia , Ansiedade/terapia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/legislação & jurisprudência , Serviços de Proteção Infantil/legislação & jurisprudência , Bases de Dados Factuais , Depressão/etiologia , Depressão/terapia , Exposição à Violência/psicologia , Inquéritos Epidemiológicos , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/etiologia , Pediatras , Resiliência Psicológica , Transtornos do Sono-Vigília/etiologia , Determinantes Sociais da Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Suspensão de Tratamento
5.
J Med Microbiol ; 69(1): 14-24, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31821133

RESUMO

Neuropsychiatric disorders (NPDs) such as depression, anxiety, bipolar disorder, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) all relate to behavioural, cognitive and emotional disturbances that are ultimately rooted in disordered brain function. More specifically, these disorders are linked to various neuromodulators (i.e. serotonin and dopamine), as well as dysfunction in both cognitive and socio-affective brain networks. Increasing evidence suggests that the gut environment, and particularly the microbiome, plays a significant role in individual mental health. Although the presence of a gut-brain communication axis has long been established, recent studies argue that the development and regulation of this axis is dictated by the gut microbiome. Many studies involving both animals and humans have connected the gut microbiome with depression, anxiety and ASD. Microbiome-centred treatments for individuals with these same NPDs have yielded promising results. Despite its recent rise and underlying similarities to other NPDs, both biochemically and symptomatically, connections between the gut microbiome and ADHD currently lag behind those for other NPDs. We demonstrate that all evidence points to the importance of, and dire need for, a comprehensive and in-depth analysis of the role of the gut microbiome in ADHD, to deepen our understanding of a condition that affects millions of individuals worldwide.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Disbiose/complicações , Microbioma Gastrointestinal , Humanos
6.
Psychiatr Hung ; 35(1): 30-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31854320

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder. According to literature data, perinatal adversities might be associated with the occurrence of ADHD, but the results are inconclusive at the moment. The aim of the present study is to describe perinatal adversities in children with ADHD. METHODS: The data of children in County Fejér Pedagogical Service in three consecutive school years (2012-2015) was analyzed. In the present sample, 219 children with special education needs were diagnosed with ADHD (age: 9.0 years, SD: 3.1 years; 36 girls). The diagnosis was based on ICD-10 criteria. The present analysis is restricted to the presence of preterm birth, complicated/prolonged labor, intrauterine hypoxia and birth asphyxia in children with ADHD from different areas (central, urban or rural) of the county. Logistic regression analysis was performed to assess the effects of gender, age was used as a covariate. RESULTS: Within this sample, the presence of complicated/prolonged labor was significantly lower (OR: 0.378, p<0.039) in girls compared to boys. The other studied variables did not show significant differences regarding gender. Intrauterine hypoxia was registered in 28 cases, while birth asphyxia was registered in 15 cases. The presence of preterm birth was 8.7%, and showed distinctive differences according to living area (central: 3.6% vs rural: 11.3%). CONCLUSIONS: Our results indicate the importance of registering perinatal complications and long term follow up of these children in the direction of neurodevelopmental disorders, however a limitation of the present study is the lack of a control group.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Complicações na Gravidez , Efeitos Tardios da Exposição Pré-Natal , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Perinatologia , Gravidez
7.
Dev Sci ; 23(1): e12844, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31056844

RESUMO

Low socioeconomic status (SES) is associated with greater risk for symptoms of attention-deficit/hyperactivity disorder (ADHD). One mechanism through which SES may confer risk for ADHD is by influencing brain structure. Alterations to cortical thickness, surface area and subcortical volume have been associated with low SES and with the presence of ADHD across multiple studies. The current study examined whether cortical thickness, surface area or subcortical volume mediate the associations between SES and ADHD in youth 3-21 years old (N = 874) from the Pediatric Imaging, Neurocognition and Genetics Study. Freesurfer was used to estimate cortical thickness, surface area and subcortical volume from structural magnetic resonance imaging. Parents reported on demographics, family SES, ADHD diagnoses and the presence of child attention problems. Statistical mediation was assessed using a bootstrap resampling procedure. Controlling for parental ADHD, child age, gender, birth weight and scanner, children in low SES families were more likely to be in the ADHD group. Consistent with previous reports in this sample, low SES was associated with reduced surface area across the frontal lobe and reduced subcortical volume in the amygdala, cerebellum, hippocampus and basal ganglia. Of these regions, a significant indirect effect of SES on ADHD status through subcortical volume was observed for the left cerebellum (95% confidence interval: 0.004, 0.022), the right cerebellum (95% confidence interval: 0.006, 0.025), and the right caudate (95% confidence interval: 0.002, 0.022). Environmentally mediated changes in the cerebellum and the caudate may be neurodevelopmental mechanisms explaining elevated risk of ADHD in children in low SES families.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Encéfalo/ultraestrutura , Classe Social , Adolescente , Tonsila do Cerebelo/patologia , Encéfalo/anatomia & histologia , Encéfalo/patologia , Mapeamento Encefálico/métodos , Criança , Pré-Escolar , Feminino , Lobo Frontal/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Adulto Jovem
8.
Environ Health Prev Med ; 24(1): 74, 2019 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-31812162

RESUMO

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fumar Tabaco/efeitos adversos , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Pré-Escolar , Cotinina/sangue , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Mães , Gravidez , Terceiro Trimestre da Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Risco , Fatores Sexuais , Fumar Tabaco/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-31861799

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is the most common cognitive and behavioural disorder affecting children, with a worldwide-pooled prevalence of around 5%. Exposure to particulate matter (PM) air pollution is suspected to be associated with autism spectrum disorders and recent studies have investigated the relationship between PM exposure and ADHD. In the absence of any synthesis of the relevant literature on this topic, this systematic review of epidemiological studies aimed to investigate the relationship between the exposure of children to PM and ADHD and identify gaps in our current knowledge. In December 2018, we searched the PubMed and EMBASE databases. We only included epidemiological studies carried out on children without any age limit, measuring PM exposure and health outcomes related to ADHD. We assessed the quality of the articles and the risk of bias for each included article using the Newcastle-Ottawa Scale and the Office of Health Assessment and Translation (OHAT) approach, respectively. The keyword search yielded 774 results. Twelve studies with a total number of 181,144 children met our inclusion criteria, of which 10 were prospective cohort studies and 2 were cross-sectional studies. We subsequently classified the selected articles as high or good quality studies. A total of 9 out of the 12 studies reported a positive association between PM exposure to outdoor air pollution and behavioral problems related to attention. Despite these results, we found a significant degree of heterogeneity among the study designs. Furthermore, 11 studies were judged to be at a probably high risk of bias in the exposure assessment. In conclusion, we opine that further high quality studies are still needed in order to clarify the association between PM exposure and ADHD diagnosis.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Material Particulado/efeitos adversos , Poluição do Ar/efeitos adversos , Atenção , Criança , Estudos Transversais , Humanos , Estudos Prospectivos
10.
Biomed Res ; 40(5): 179-188, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31597903

RESUMO

Single prenatal exposure to valproic acid (VPA) in rodents is a widely used preclinical model of autism spectrum disorder (ASD). Continuous prenatal VPA exposure has been recently proposed as a new ASD model that closely captures the neuropathological features of ASD, including increases in cerebral cortex volume and the number of cortical upper layer neurons. We investigated the influence of prenatal VPA exposure on the behavior of adult offspring of pregnant dams that received intraperitoneal injections of VPA twice on one day during the genesis of cortical upper layer neurons. Mice exposed to VPA at E14 (E14-VPA) showed typical behavior abnormalities including reduced social interaction, hyperactivity, and poor maze learning due to attention deficit/impulsivity relative to healthy controls. Histological analysis revealed that E14-VPA mice had significantly increased neuronal density and impaired neural activity in the prefrontal cortex, but not the somatosensory area, which is likely linked to the observed abnormalities in social behavior. These results suggest that this VPA exposure method is a good model for gaining new insights into the underlying neuropathology of ASD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Comportamento Animal/efeitos dos fármacos , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/embriologia , Exposição Materna/efeitos adversos , Organogênese/efeitos dos fármacos , Comportamento Social , Ácido Valproico/efeitos adversos , Animais , Feminino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/embriologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal
11.
Muscle Nerve ; 60(6): 732-738, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31520483

RESUMO

INTRODUCTION: Myotonic dystrophy type 1 (DM1) is caused by a CTG (cytosine-thymine-guanine) trinucleotide repeat expansion. Congenital DM (CDM) presents in the first month of life, whereas individuals with infantile and juvenile DM1 have later onset of symptoms. METHODS: We performed a retrospective chart review of patients with childhood-onset DM1 seen at one of three locations in Dallas, Texas between 1990 and 2018. Symptoms, disease course, cognitive features, and family history were reviewed. RESULTS: Seventy-four patients were included; CDM was diagnosed in 52 patients. There was maternal inheritance in 74% of patients. CTG repeat number ranged from 143 to 2300. Neuropsychiatric and cognitive deficits were common. Over half of the patients had GI disturbances, and orthopedic complications were common. DISCUSSION: Myotonic dystrophy type 1 in children requires a multidisciplinary approach to management. Presenting symptoms vary, and repeat expansion size does not necessarily directly relate to severity of symptoms. A consensus for outcome measures is required.


Assuntos
Distrofia Miotônica/fisiopatologia , Asma/etiologia , Asma/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Doença do Sistema de Condução Cardíaco/etiologia , Doença do Sistema de Condução Cardíaco/fisiopatologia , Criança , Pré-Escolar , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/fisiopatologia , Feminino , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Herança Materna , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Transtornos do Humor/etiologia , Transtornos do Humor/fisiopatologia , Distrofia Miotônica/complicações , Distrofia Miotônica/genética , Miotonina Proteína Quinase/genética , Estudos Retrospectivos , Expansão das Repetições de Trinucleotídeos
12.
Pediatr Blood Cancer ; 66(11): e27947, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31418996

RESUMO

BACKGROUND: Survivors of childhood brain tumors are prone to sleep and neurocognitive problems. Effective interventions to improve neurocognitive functioning are largely lacking. In general, sleep problems are negatively related to neurocognitive functioning, but this relationship is unclear in survivors of childhood brain tumors. Therefore, the occurrence of sleep problems, potential risk factors, and the relation between sleep and executive functioning were evaluated. PROCEDURE: Baseline data of a randomized controlled trial on the effectiveness of neurofeedback were used. Childhood brain tumor survivors 8-18 years of age with parent-reported neurocognitive complaints ≥2 years after treatment were eligible. Parents completed the Sleep Disturbance Scale for Children. Executive functioning was assessed by parents and teachers (Behavior Rating Inventory of Executive Functioning). Multiple linear regression analyses were used to examine sociodemographic and medical characteristics and emotional difficulties and hyperactivity/inattention (Strength and Difficulties Questionnaire) as potential risk factors for sleep problems, and to assess the association between sleep and executive functioning. RESULTS: Forty-eight percent of survivors (n = 82, 7.0 ± 3.6 years post diagnosis, age 13.8 ± 3.2 years) had sleep problems and scored significantly worse than the norm on the subscales Initiating and Maintaining Sleep, Excessive Somnolence, and the total scale (effect sizes 0.58-0.92). Emotional problems and/or hyperactivity/inattention were independent potential risk factors. Sleep problems were associated with worse parent-reported executive functioning. CONCLUSIONS: Sleep problems occur among half of childhood brain tumor survivors with neurocognitive problems, and are associated with worse executive functioning. Future studies should focus on the development of sleep interventions for this population, to improve sleep as well as executive functioning.


Assuntos
Dano Encefálico Crônico/etiologia , Neoplasias Encefálicas/psicologia , Sobreviventes de Câncer/psicologia , Transtornos do Comportamento Infantil/etiologia , Transtornos Cognitivos/etiologia , Transtornos do Sono-Vigília/etiologia , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Dano Encefálico Crônico/psicologia , Neoplasias Encefálicas/terapia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos Cognitivos/epidemiologia , Irradiação Craniana/efeitos adversos , Craniotomia/efeitos adversos , Emoções , Função Executiva , Humanos , Testes Neuropsicológicos , Prevalência , Psicologia , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/epidemiologia
13.
Int J Equity Health ; 18(1): 132, 2019 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438974

RESUMO

BACKGROUND: Racism is a pervasive experience in the life of Aboriginal Australians that begins in childhood. As a psychosocial stressor, racism compromises wellbeing and impacts developmental trajectories. The purpose of the present study was to estimate the effect of racism on indicators of Australian Aboriginal child socio-emotional wellbeing (SEWB) at one to two years after exposure. Age-related differences in the onset of symptoms were explored. METHODS: Data from the B- and K-cohorts of the Longitudinal Study of Indigenous Children were used (aged 6 to 12 years). Racism, confounding variables, and the Strengths and Difficulties Questionnaire (a measure of SEWB) were collected by questionnaires and guided interviews with each child's main caregiver. Adjusted Poisson regression was used to estimate the relative risk (RRa) effects of racism on SEWB for both cohorts separately. RRa were pooled in a random effects meta-analysis. RESULTS: Exposure to racism was associated with an adjusted point estimate indicating a 41% increased risk for total emotional and behavioural difficulties, although the confidence intervals were wide (pooled RRa 1.41, 95% CI 0.75, 2.07). Analyses by cohort showed younger children had higher RRa for total difficulties (RRa 1.72, 95% CI 1.16, 2.54), whilst older children had higher RRa for hyperactive behaviour (RRa 1.66, 95% CI 1.01, 2.73). CONCLUSIONS: The effects observed contributes to our understanding of the impact of racism on Aboriginal Australian children. Support for emotional and behavioural difficulties, and hyperactive behaviour, for Aboriginal children might help counteract the effects of racism. Future longitudinal research and policies aimed at reducing racism in Australian society are necessary.


Assuntos
Transtornos do Comportamento Infantil/etiologia , Comportamento Infantil/psicologia , Bem-Estar da Criança/psicologia , Emoções , Saúde Mental , Grupo com Ancestrais Oceânicos/psicologia , Racismo/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Austrália , Cuidadores , Criança , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Inquéritos e Questionários
14.
Nutrients ; 11(9)2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31443337

RESUMO

This synopsis paper aims to identify if a common pattern of learning and social difficulties can be conceptualized across recent longitudinal studies investigating the influence of mild-to-moderate gestational iodine deficiency (GID) on offspring's optimal cognitive and psycho-social development. The main studies investigated are: The Southampton Women's Study (SWS)-United Kingdom; the Avon Longitudinal Study of Parents and Children (ALSPAC)-United Kingdom; the Gestational Iodine Cohort Longitudinal Study-Tasmania, Australia, and the Danish National Birth Cohort Case-Control Study-Denmark. In contrast to severe GID where there is a global negative impact on neurodevelopment, mild-to-moderate intrauterine iodine deficiency has subtler, but nonetheless important, permanent cognitive and psycho-social consequences on the offspring. This paper links the results from each study and maintains that mild-to-moderate GID is associated with a disorder that is characterized by speed of neural transmitting difficulties that are typically associated with working memory capacity difficulties and attention and response inhibition. The authors maintain that this disorder is better identified as Gestational Iodine Deficiency Processing Disorder (GIDPD), rather than, what to date has often been identified as 'suboptimal development'. The Autistic Spectrum Disorder (ASD), Attention Deficit, Hyperactivity Disorder (ADHD), language and literacy disorders (learning disabilities and dyslexia) are the main manifestations associated with GIDPD. GIDPD is identified on IQ measures, but selectively and mainly on verbal reasoning IQ subtests, with individuals with GIDPD still operating within the 'normal' full-scale IQ range. Greater consideration needs to be given by public health professionals, policy makers and educators about the important and preventable consequences of GID. Specifically, more emphasis should be placed on adequate iodine intake in women prior to pregnancy, as well as during pregnancy and when lactating. Secondly, researchers and others need to further extend, refine and clarify whether GIDPD, as a nosological (medical classification) entity, is a valid disorder and concept for consideration.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Espectro Autista/etiologia , Deficiências Nutricionais/sangue , Iodo/deficiência , Transtornos da Linguagem/etiologia , Aprendizagem , Complicações na Gravidez/sangue , Comportamento Social , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Biomarcadores/sangue , Criança , Comportamento Infantil , Desenvolvimento Infantil , Deficiências Nutricionais/complicações , Deficiências Nutricionais/diagnóstico , Escolaridade , Feminino , Humanos , Iodo/sangue , Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/psicologia , /psicologia , Gravidez , Complicações na Gravidez/diagnóstico , Efeitos Tardios da Exposição Pré-Natal , Prognóstico , Fatores de Risco
15.
Encephale ; 45(4): 357-362, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31255245

RESUMO

ADHD is the most common psychiatric disorder of childhood. It is considered to be a neurodevelopmental disorder that may persist from chilhood into adulthood. In childood it is associated with several outcomes such as inattention, hyperactivity and impulsivity. Symptoms may change as a person gets older with an increased risk of developing psychiatric comorbidities such as depression, anxiety and substance addiction. However, recent studies diverge from the traditional perspective. These authors hypothesized that ADHD may appear in adulthood, not as a continuation of child ADHD, but some limitations have to be considered. Firstly, ADHD often goes unrecognized throughout childhood. Secondly, families may help the children to develop compensation strategies and adaptative behaviors. The purpose of this report is to better investigate these different and innovative clinical results and understand if adult ADHD could really be considered as a distinct, different pathology, as a late-onset disorder. We conducted a brief review of literature and included the most recent scientific longitudinal follow-up cohort studies. We conclude that, while adult ADHD is still considered a continuation from childhood, many questions of late-onset ADHD remain and further research is necessary to better understand and explain the etiology, the development, the clinical impact, and the psychotherapeutic and pharmacologic treatment of this late-onset disorder.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Adulto , Fatores Etários , Idade de Início , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Humanos , Fatores de Risco
16.
Eur J Pediatr ; 178(8): 1129-1137, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31227889

RESUMO

Heterogeneous cognitive deficits have been described in the spectrum of benign epilepsy with centro-temporal spikes, which strongly correlate with the intensity of interictal epileptiform discharges and its spreading, in particular during sleep, mostly within the perisylvian cognitive network. The aim of this review is to discuss current findings regarding the connection between sleep alterations and cognitive function in the spectrum of benign epilepsy with centro-temporal spikes. A longer sleep onset latency is the only evident sleep macrostructure alteration reported in the spectrum of benign epilepsy with centro-temporal spikes. On a microstructural level, a higher spike count of descending compared to ascending slopes of sleep cycles, an impairment of slow wave downscaling, and amplitude and slope of slow waves were found in the spectrum of benign epilepsy with centro-temporal spikes. Moreover, children with benign epilepsy with centro-temporal spikes had a reduced non-rapid eye movement sleep instability, in terms of cyclic alternating pattern, similar to that found in children with attention-deficit hyperactivity disorders and in children with obstructive sleep apnea and centro-temporal spike during sleep. Children with benign epilepsy with centro-temporal spikes have a known comorbidity with attention-deficit hyperactivity disorders and obstructive sleep apnea.Conclusion: Considering the common sleep microstructure alterations, the presence of attention deficit and hyperactivity and/or sleep apnea may be a considered warning sign in the case of benign epilepsy with centro-temporal spikes. What is Known: • Sleep related-cognitive deficits have been described in the spectrum of benign epilepsy with centro-temporal spikes. The degree of sleep alterations may predict the neurocognitive outcome, and help clinicians to choose the right treatment. What is New: • Considering the common sleep microstructure alterations, attention deficit and sleep apnea, may be a considered warning signs.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Epilepsia/fisiopatologia , Apneia Obstrutiva do Sono/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Epilepsia/diagnóstico , Humanos , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia
17.
Neurol Sci ; 40(9): 1909-1915, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31104170

RESUMO

Chronic traumatic encephalopathy (CTE) is very frequent and studied among contact sport players, above all American Football. Now, the defined diagnosis is only post-mortem and, consequently, more detailed diagnostic in-vivo instruments are needed to facilitate diagnosis and to allow a follow up. This clinical questionnaire (Trauma Questionnaire-TraQ) has been designed to investigate in parallel the traumatic load and clinical and cognitive subjective symptoms. It evaluates 4 anamnestic fields (specific sport activity, all previous pathological events, clinical manifestations compatible with TBI (traumatic brain injury) or CTE and subjective perception of personal memory efficacy with PRMQ questionnaire). The aim of TraQ questionnaire is to allow a standardized follow-up of active players and to identify subclinical disturbances that may become warnings. A pilot comparative study with TraQ on 105 subjects (75 AF players and 30 comparable people without a history of contact-sports activity) revealed that AF players have an increased amount of severe head trauma, an amplified level of subjective aggressiveness, more olfactory deficits but also more speech subjective problems, previously never related with CTE. In view of the obtained results, the TraQ seems to be useful (1) to obtain a better quantification of the traumatic load; (2) to differentiate the risk of long-term neurological consequences, allowing better management of different athletes right from the pre-symptomatic phases; (3) to manage prevention strategies if regularly applied to periodic visits to sports fitness; and (4) to identify the predisposing factors for the development of CTE and other neurological consequences of TBI with follow-up studies.


Assuntos
Traumatismos em Atletas/diagnóstico , Lesões Encefálicas Traumáticas/diagnóstico , Futebol Americano/lesões , Psicometria/instrumentação , Índice de Gravidade de Doença , Adolescente , Adulto , Agressão/fisiologia , Traumatismos em Atletas/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Lesões Encefálicas Traumáticas/complicações , Encefalopatia Traumática Crônica/complicações , Encefalopatia Traumática Crônica/diagnóstico , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/etiologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/etiologia , Parestesia/diagnóstico , Parestesia/etiologia , Projetos Piloto , Inquéritos e Questionários , Adulto Jovem
18.
Dev Neuropsychol ; 44(4): 368-384, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31068020

RESUMO

The current longitudinal study examined academic outcomes of children diagnosed with secondary attention deficit-hyperactivity disorder (S-ADHD) following stroke in comparison to children with stroke-only and children with developmental ADHD (D-ADHD), and explored potential predictors of progress in these groups. We followed 55 children (n = 17 S-ADHD, n = 18 stroke-only, and n = 20 D-ADHD) over approximately four years. Children with S-ADHD and D-ADHD were more likely to have a comorbid learning disability, but children with S-ADHD were more likely to have declines in their reading scores over time. No individual or neurological factors accounted for declines. Math scores were equally likely to decline across all youth.


Assuntos
Sucesso Acadêmico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Cognição/fisiologia , Leitura , Acidente Vascular Cerebral/complicações , Adolescente , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/patologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Pré-Escolar , Comorbidade , Dislexia , Função Executiva , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Matemática , Estudos Retrospectivos , Acidente Vascular Cerebral/patologia
19.
Pharmacol Biochem Behav ; 182: 22-34, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31103523

RESUMO

Attention Deficit Hyperactivity Disorder (ADHD) is a persistent, and impairing pediatric-onset neurodevelopmental condition. Its high prevalence, and recurrent controversy over its widespread identification and treatment, drive strong interest in its etiology and mechanisms. Emerging evidence for a role for neuroinflammation in ADHD pathophysiology is of great interest. This evidence includes 1) the above-chance comorbidity of ADHD with inflammatory and autoimmune disorders, 2) initial studies indicating an association with ADHD and increased serum cytokines, 3) preliminary evidence from genetic studies demonstrating associations between polymorphisms in genes associated with inflammatory pathways and ADHD, 4) emerging evidence that early life exposure to environmental factors may increase risk for ADHD via an inflammatory mechanism, and 5) mechanistic evidence from animal models of maternal immune activation documenting behavioral and neural outcomes consistent with ADHD. Prenatal exposure to inflammation is associated with changes in offspring brain development including reductions in cortical gray matter volume and the volume of certain cortical areas -parallel to observations associated with ADHD. Alterations in neurotransmitter systems, including the dopaminergic, serotonergic and glutamatergic systems, are observed in ADHD populations. Animal models provide strong evidence that development and function of these neurotransmitters systems are sensitive to exposure to in utero inflammation. In summary, accumulating evidence from human studies and animal models, while still incomplete, support a potential role for neuroinflammation in the pathophysiology of ADHD. Confirmation of this association and the underlying mechanisms have become valuable targets for research. If confirmed, such a picture may be important in opening new intervention routes.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Inflamação/complicações , Adolescente , Animais , Transtorno do Deficit de Atenção com Hiperatividade/imunologia , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Sistema Nervoso Central/embriologia , Sistema Nervoso Central/crescimento & desenvolvimento , Sistema Nervoso Central/fisiopatologia , Criança , Citocinas/metabolismo , Dopamina/metabolismo , Feminino , Ácido Glutâmico/metabolismo , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Masculino , Camundongos , Modelos Animais , Norepinefrina/metabolismo , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores de Risco , Serotonina/metabolismo , Adulto Jovem , Ácido gama-Aminobutírico/metabolismo
20.
PLoS One ; 14(4): e0214864, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30973908

RESUMO

Preterm birth is associated with heightened risk for attention-deficit/hyperactivity disorder (ADHD)-like symptoms and neurocognitive impairments, including impairments in performance monitoring. Here, we investigate the cognitive and neurophysiological processes from a performance-monitoring task in preterm-born adolescents and examine whether these processes in preterm-born adolescents reflect identical neurophysiological impairments to those observed in term-born adolescents with ADHD. We compared 186 preterm-born individuals to 69 term-born individuals with ADHD and 135 term-born controls on cognitive-performance measures and event-related potentials (ERPs) of conflict monitoring (N2) and error processing (ERN, Pe) from a flanker task. Preterm-born adolescents demonstrated reduced N2, ERN and Pe amplitudes, compared to controls, and similar ERN and Pe impairments to term-born adolescents with ADHD. While ADHD symptoms correlated with ERN amplitude at FCz among the preterm-born, ERN amplitude at Fz, N2 and Pe amplitude were not associated with ADHD symptoms. Preterm-born individuals show impairments on neurophysiological indices of conflict monitoring (N2) and error processing (ERN and Pe). Early neurophysiological error processing may be a marker underlying the processes linked to the increased risk for ADHD among preterm-born individuals. Error detection processes are malleable and potential targets for non-pharmacological interventions. Preterm-born individuals are likely to benefit from early interventions.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Nascimento Prematuro/psicologia , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estudos de Casos e Controles , Criança , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Eletroencefalografia , Potenciais Evocados , Feminino , Humanos , Recém-Nascido , Masculino , Testes Neuropsicológicos , Nascimento Prematuro/fisiopatologia , Desempenho Psicomotor , Fatores de Risco , Adulto Jovem
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