Abstract
BackgroundTo explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood.MethodChildhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer’s specifications. Absolute titers were also collected as continuous variables.ResultsFourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.Conclusionspatients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood. Moreover, they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and the ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.
Highlights
To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, anti-basal ganglia antibodies (ABGA), and recurrent infections during early childhood
According to the outpatient service routine, all patients had been screened for adult ADHD using the Adult ADHD Self Reporting Scale (ASRS-1.1) screener, and the DSM-IV ADHD diagnosis was confirmed through the Diagnostic Interview for Adult ADHD (DIVA 2.0)
According to the present preliminary study, patients with ADHD might be prone to infections during childhood, subclinical streptococcal infections in adulthood, and they seem to have a high risk for basal ganglia autoimmunity as adults
Summary
To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood. ADHD is one of the most prevalent neurodevelopmental disorders and it is characterized by a persistent pattern of inattention and/or hyperactivity and/or impulsivity, leading to functional impairment [1] and several lifetime consequences [2]. Oliva et al BMC Psychiatry (2020) 20:542 interaction in the caudate and putamen have supported the pivotal role of subcortical basal ganglia anomalies in the pathophysiology of ADHD [8, 9]. A variable and complex interaction between predisposing genetic and environmental factors during the early months or years of life could affect the normal path of neurodevelopment. Considering the above-mentioned structural and functional evidences, environmental factors influencing basal ganglia development should be worthy of investigation. A more recent study has documented the negative impact of exposure to polycyclic aromatic hydrocarbons on the caudate nucleus, even below the legislated annual target levels established in the European Union [14]
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