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ADHD Research Update: September 2016

ADHD Research Update: September 2016


  • Three new studies in children with ADHD reveal an association with seizures, the benefits of after-school exercise, and brain changes linked to treatment.[1-3] Scroll through the slides for the latest findings and take-home messages.

  • SOURCES
    1. Bertelsen EN, Larsen JT, Petersen L, et al. Childhood epilepsy, febrile seizures, and subsequent risk of ADHD. Pediatrics. 2016;138:e20154654.
    2. Bustamante EE, Davis CL, Frazier SL, et al. Randomized controlled trial of exercise for ADHD and disruptive behavior disorders. Med Sci Sports Exerc. 2016;48:1397-1407.
    3. Schrantee A, Tamminga HGH, Bouziane C, et al. Age-dependent effects of methylphenidate on the human dopaminergic system in young vs adult patients with attention-deficit/hyperactivity disorder. JAMA Psychiatry. 2016;73:955-962.


  • 1. Childhood Epilepsy and Febrile Seizures Have Strong Association With Development of ADHD: A Danish population-based study included 906,379 children who were followed up for 22 years. Among these patients, 13,573 (1.5%) had a diagnosis of epilepsy, 33,947 (3.8%) had a history of febrile seizures, and 21,079 developed ADHD (2.3%). The fully adjusted incidence rate ratio of ADHD was 2.72 in children with epilepsy, 1.28 in those with febrile seizures, and 3.22 in children with both epilepsy and febrile seizures.[1]


  • Clinical implications: Early identification of ADHD symptoms is essential in patients with epilepsy and febrile seizures to initiate proper assessment and treatment—and subsequently to reduce the likelihood of negative long-term consequences of ADHD.


  • 2. After-School Programs Improve ADHD Symptoms: This study involved a 10-week after-school program for children with ADHD and/or disruptive behavior disorder (DBD) who lived in a poor urban community. Nineteen children were randomized to an exercise program, and 16 were randomized to a comparable but sedentary attention control program. Cognitive and behavioral outcomes showed between-group effect sizes that favored exercise on hyperactive symptoms and verbal working memory, and that favored controls on visuospatial working memory and oppositional defiant symptoms.[2]


  • Take-home message: The integration of structured behavior management into after-school programs can maximize participation and achieve clinical benefits for children with ADHD and DBD.


  • 3. Methylphenidate May Alter Cerebral Blood Flow Response in Children With ADHD: A randomized, double-blind, placebo-controlled trial of 99 patients found an increase in the cerebral blood flow response to methylphenidate after 16 weeks of treatment within the thalamus of children aged 10 to 12 years, but not in adults or in an age-matched placebo group. This increase may lead to changes in dopamine neurotransmission.[3]


  • Clinical implications: The results suggest the need for tighter regulation of ADHD diagnoses and more careful selection of young patients for methylphenidate therapy.

References: 

1. Bertelsen EN, Larsen JT, Petersen L, et al. Childhood epilepsy, febrile seizures, and subsequent risk of ADHD. Pediatrics. 2016;138:e20154654.
2. Bustamante EE, Davis CL, Frazier SL, et al. Randomized controlled trial of exercise for ADHD and disruptive behavior disorders. Med Sci Sports Exerc. 2016;48:1397-1407.
3. Schrantee A, Tamminga HGH, Bouziane C, et al. Age-dependent effects of methylphenidate on the human dopaminergic system in young vs adult patients with attention-deficit/hyperactivity disorder. JAMA Psychiatry. 2016;73:955-962.

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