Attention Deficient Hyperactivity Disorder Research Articles

Screen time and effects on attention deficient hyperactivity disorder in children - A systematic review

In recent years, screen time exposure and attention-deficit hyperactivity disorder (ADHD) symptom interrelations in children have garnered increasing attention. Understanding the screen time’s impact on ADHD has become crucial due to its potential influence on socialization, neurobehavioral development, and the prevalence of ADHD among pediatric populations. Conforming to the guidelines of the preferred reporting items for systematic reviews and meta-analyses, a systematic examination was undertaken, centering on research investigating the correlation between screen time and ADHD symptoms in children. The search encompassed databases including MEDLINE (through PubMed), ScienceDirect, Wiley online library, PsycINFO, ERIC, JSTOR, and PsycArticles, utilizing descriptors such as “screen time” and “attention-deficit hyperactivity disorder.” The initial search yielded 2480 articles, supplemented by an additional 10 articles from reference searches, resulting in a total of 2480 records. Excluding the duplicates, 1590 articles were screened based on abstracts, of which 130 underwent full-text examination. Ultimately, 15 studies included in this review met the inclusion criteria. These studies, conducted between 2013 and 2023, comprised cross-sectional, longitudinal, and interventional designs, presenting varying associations between screen time and ADHD symptoms across different age groups. The findings from the selected studies depict a complex relationship between screen time exposure and ADHD symptoms in children. While some studies highlight significant correlations between increased screen exposure and ADHD symptoms, others present conflicting results, indicating the need for further research. Understanding these nuances is crucial in formulating targeted interventions and delineating clearer guidelines to manage screen time concerning ADHD in children.

Psychometric properties of the Persian version of Conners Early Childhood ADHD Questionnaire-Parents’ Form in Iranian children aged 3-6 years

Background. Attention deficient-hyperactivity disorder (ADHD) is the most prevalent psychiatric diagnosis in preschool children. The present study aimed to translate and determine the validity and reliability of the Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form in Iranian children aged 3-6 years. Methods. We included 1,013 pediatrics aged <6 years in 2017-18 in Tabriz, Iran. In the first step, the questionnaire was translated into Persian using the re-translation method. Then, the content validity of the questionnaire was evaluated by ten specialists. Finally, the concurrent validity of the questionnaire was simultaneously compared with the children’s Strengths and Difficulties Questionnaire (SDQ). ROC curve was used to determine the best cut-off point, and sensitivity and specificity were measured to determine the questionnaire’s diagnostic value compared to the clinical psychiatric interview. The test-retest method was used to determine reproducibility using the intra-class correlation coefficient (ICC). The internal consistency was also evaluated with Cronbach’s alpha test. Results. Of all the 1,013 participants, 569 (56.2%) were female. The overall modified kappa agreement and concurrent validity coefficients were 0.76 and 0.70, respectively. The sensitivity and specificity of the questionnaire was estimated 86.8% and 79.4%, respectively. The ICC was calculated at 0.90, and the questionnaire’s internal consistency was calculated at an overall Cronbach’s alpha coefficient of 0.88. Conclusion. The Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form exhibited proper reliability and validity for screening the Iranian pediatric population. Practical Implications. The emerged validated tool from the present study can be used in the first-line health system in the public and private sectors for physician and non-physician healthcare providers, especially family physicians in primary health care.

Ginkgo biloba Extracts Like EGb 761® for Treatment of Non Common Indications – A Selection of Clinical Studies

AbstractExtracts of Ginkgo biloba L. are one of the most commonly applied herbal medicines. The active constituents are flavonol glycosides and terpene trilactones in particular. The special extract EGb 761® is mentioned in the German S3 clinical guideline “Demenzen” as treatment option (“kann” recommendation). Some small- and large-scale clinical studies for Ginkgo biloba leaf extracts are summarized in this publication for the indications: Tardive dyskinesia, vitiligo, anxiety/anxiety disorder, visual impairment, mountain sickness, sudden hearing loss, attention deficient hyperactivity disorder (ADHD) in children and fatigue. The studies are of different quality and show variable results. More research is warranted to draw conclusions about the effectiveness of Ginkgo biloba extracts for those indications.

Mosaicism in BRPF1-Related Neurodevelopmental Disorder: Report of Two Sisters and Literature Review

Bromodomain and PHD finger containing 1 (BRPF1)-related neurodevelopmental disorder is characterized by intellectual disability, developmental delay, hypotonia, dysmorphic facial features, ptosis, and blepharophimosis. Both de novo and inherited pathogenic variants have been previously reported in association with this disorder. We report two affected female siblings with a novel variant in BRPF1 c.2420_2433del (p.Q807Lfs ∗ 27) identified through whole-exome sequencing. Their history of mild intellectual disability, speech delay, attention deficient hyperactivity disorder (ADHD), and ptosis align with the features previously reported in the literature. The absence of the BRPF1 variant in parental buccal samples provides evidence of a de novo frameshift pathogenic variant, most likely as a result of parental gonadal mosaicism, which has not been previously reported. The frameshift pathogenic variant reported here lends further support to haploinsufficiency as the underlying mechanism of disease. We review the literature, compare the clinical features seen in our patients with others reported, and explore the possibility of genotype-phenotype correlation based on the location of pathogenic variants in BRPF1. Our study helps to summarize available knowledge and report the first case of a de novo frameshift pathogenic variant in BRPF1 in two siblings with this neurodevelopmental disorder.

Maternal vitamin D status and attention deficit hyperactivity disorder (ADHD), an under diagnosed risk factor; A review

Vitamin D is important to mediate several brain processes such as proliferation, apoptosis, and neurotransmission in early stages of life. Vitamin D deficiency during critical periods of development can lead to persistent brain alterations. Vitamin D homeostasis during pregnancy is affected by two factors which includes an increase in mother’s calcitriol levels and an increase in mother’s Vitamin D Binding protein concentrations. Attention deficient hyperactivity disorder (ADHD) is an outcome of a complicated interaction between genetic, environmental, and developmental traits, and genetic factors cover about 80% of the cases. The efficiency of the immune system can be altered by a deficiency of Vitamin D in maternal body and maternal stress during gestation such as perinatal depression. Studies have proved that during gestation if there is a deficiency of vitamin D in maternal body, it can influence the brain development of the fetus and can also alter the synthesis of the brain-derived neurotropic factor. The current manuscript has been compiled to elaborate different factors which are associated with ADHD particularly focusing on the relationship of vitamin D deficiency in mothers. References material was selected from NCBI (PUBMED), Science direct, Google scholar, Publons etc. Using the terms ADHD, Vitamin D and Maternal nutritional status. Although, controversial relationship was found between the deficiency of Vitamin D level in pregnant women and development of ADHD in children but more controlled trials are required for future direction as well as to rule out other associated causes.

Teachers’ Knowledge about Attention Deficient Hyperactivity Disorder (ADHD) among Student at Primary School in Karbala City

Teachers’ Knowledge about Attention Deficient Hyperactivity Disorder (ADHD) among Student at Primary School in Karbala City

Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders

Nocturnal enuresis (NE) is a common problem among 10% school-aged children. The etiologies underlying childhood NE is complex and not fully understood nowadays. Nevertheless, increasing evidence suggests a potential link between neurobehavioral disorders and enuresis in children. In this study, we aimed to explore novel metabolomic insights into the pathophysiology of NE and also, its association with pediatric psychiatric problems. Urine collected from 41 bedwetting children and 27 healthy control children was analyzed by using 1H-nuclear magnetic resonance spectroscopy from August 2017 to December 2018. At regular follow-up, there were 14 children with refractory NE having a diagnosis of attention deficient hyperactivity disorder (ADHD) or anxiety. Eventually, we identified eight significantly differential urinary metabolites and particularly increased urinary excretion of betaine, creatine and guanidinoacetate linked to glycine, serine and threonine metabolism were associated with a comorbidity of neurobehavioral disorders in refractory bedwetting children. Notably, based on physiological functions of betaine acting as a renal osmolyte and methyl group donor, we speculated its potential role in modulation of renal and/or central circadian clock systems, becoming a useful urinary metabolic marker in diagnosis of treatment-resistant NE in children affected by these two disorders.

Evaluating a Web-Based Adult ADHD Toolkit for Primary Care Clinicians.

Approximately 5% of the US adult population has Attention Deficient Hyperactivity Disorder (ADHD) that can negatively impact quality of life. Health care professionals report a need to increase their knowledge of and confidence in treating adult ADHD. The American Academy of Family Physicians National Research Network (AAFP NRN) collaborated with a panel of experts to create a web-based AAFP Adult ADHD Toolkit composed of resources to aid in the diagnosis, management, and treatment of adults with ADHD. Assess the impact of using an AAFP Adult ADHD Toolkit in a practice setting. Ninety-seven primary and behavioral health care professionals from AAFP NRN practices (n=6) used the Toolkit for 17 weeks. Data on Toolkit use, usefulness, implementation, impact, and changes in knowledge and confidence were collected via pre-post and weekly surveys. Mixed methods, regression analyses, t-tests, and mixed ANOVA were used to assess change over time. Use of the Toolkit improved health care providers' knowledge by midpoint relative to baseline in areas related to treatment effects, side effects, and outcomes (3.6 vs 3.0; P = .004); existing ADHD resources (3.3 vs 2.9; P = .03); and management of ADHD in patients with comorbid conditions (3.2 vs 2.7; P = .01). By the end of the study, Toolkit use was associated with increased confidence in mental health and life history interview techniques (3.5 vs 3.0; P = .03); treatment options for ADHD with comorbid mental health disorders (3.2 vs 2.3; P ≤ .001); and treatment options for ADHD with coexisting substance use disorders (3.0 vs 2.3; P = .003). By the end of the study, most participants (n=47, 87%) reported the Toolkit addressed most of their needs related to diagnosis, treatment, and management of adult ADHD. Availability and adoption of the Toolkit into the routine care of adults with ADHD measurably increased health care professionals' knowledge especially in those providers who regularly see adult patients with ADHD.

Sexual Risk Behavior and Sexually Transmitted Infections Among College Students With Disabilities.

In the past 20 years, there has been an increase in the number of college students with disabilities (SWDs) in the United States. Students with disabilities may have not received relevant, or accessible, sexual health education from medical providers, parents, or school health educators. Because of the lack of this education, the college social environment, and developmental timing of traditional college aged students, SWDs are at risk of engaging in health compromising sexual behavior. We conducted a secondary data analysis of traditionally aged (18- to 24-year-olds) college students who completed the National College Health Assessment administered in Fall 2017 and Spring 2018 (N = 95,119). We use prevalence and generalized linear models to describe self-reported sexual health behavior and outcomes among college students without disabilities and SWDs, by disability category. Findings indicate that college students with disabilities-particularly students with attention-deficient hyperactivity disorder, psychiatric conditions, and multiple disabilities-are at higher risk than students without disabilities to engage in health compromising sexual health behavior and that students with multiple disabilities have higher adjusted prevalence ratios of being diagnosed and/or treated for a sexually transmitted infection. Students with disabilities are not a monolithic population and there is cross-disability variability of engaging in health compromising and health promoting behavior. These findings highlight the need for college health promotion specialists and clinicians to advocate for accessible, sex positive, disability inclusive sexual health education.

Pharmacogenomic testing for mental health (Part I): documenting early adopter perceptions of use for eight scenarios.

Aim: We sought to understand how early adopters used pharmacogenomic (PGx) testing for treating depression and attention deficient hyperactivity disorder (ADHD). Patients & methods: We conducted a phone survey with prescribers who had previously ordered an Informed PGx (Progenity, Inc., MI, USA) test. Results: We identified 1037 prescribers in our sampling period. Respondents (n=64) were predominantly female (61.5%) and in pediatrics (n=42; 64.6%). PGx testing was used for multiple scenarios (mean 3.3±1.6); the most common was after no response to medication was observed (80%; 51/64). Most respondents state that test results typically reveal an altered metabolizer status. Conclusion: PGx test results ordered by early adopters often reveal altered metabolizers which leads them to change the depression/ADHD medication regimen. Future work should evaluate the clinical utility of PGx testing for depression/ADHD treatment.

The effectiveness of Neurofeedback as computerbased programs for children with Attention Deficient Hyperactivity Disorder

تهدف الى أثبات فعالية النيروفيدباک ( البرامج المستندة إلى الکمبيوتر ) کعلاج مساعد للأطفال ذوى اضطراب فرط الحرکة ونقص الأنتباة . ويعد اضطراب فرط الحرکة ونقص الأنتباة ، حالة تطورية من عدم الأنتباة والتشتت ، مع أو بدون فرط النشاط المصاحب،وهناک ثلاث أشکال أساسية من اضطراب فرط الحرکة ونقص الأنتباة الموصوفة فى الدليل التشخيصى والأحصائى (DSM-5) للجمعية الأمريکية للطب النفسى وهى إما عدم الأنتباة ، أو فرط الحرکة / الأندفاعية ، وإما يجمع ما بين فرط الحرکة ونقص الأنتباة. إن مسببات اضطراب فرط الحرکة ونقص الأنتباة غير معروفة ولکن يمکن تفسيرها إلى حد کبير على العوامل الوراثية ، والبيئية الوراثية ،کما إن الأباء والأمهات والأشقاء من الأطفال الذين يعانون فرط الحرکة ونقص الأنتباة هم اکثر عرضة للأصابة بالأضطراب بمعدل مرتين إلى ثمان اضعاف عن غيرهم، مما يشير إلى المساهمات الوراثية ، کما توجد فرضيات اخرى ترجع هذا الأضطراب إلى تعرض الرحم للمواد السامة ، أو المواد الصناعية ، أو التعرض للحساسية، ولکن النظام الغذائى والسکر ليس سببا من اسباب النشاط الزائد وتشتت الأنتباة. الدراسة الحالية عبارة عن دراسة تجريبية أجريت على 10 أطفال بمرکز رايت واي الطبى لذوى الأحتياجات الخاصة فى محافظة الأسکندرية بجمهورية مصر العربية ، ومن خلال التقييم النفسى الموحد تم تشخيصهم على أنهم ADHD وفقا DSM – V وتم تقسيم العينة النى شملتهم الدراسة إلى مجموعتين رئيسيتين : 5 أطفال ADHD يخضعون لجلسات النيروفيدباک کمجموعة تجريبية ، و5 أطفال يخضعون لجلسات العلاج السلوکى کمجموعة ضابطة . وأکدت النتائج أنه تم أعطاء أطفال المجموعة التجريبية (5) أطفال من ذوى فرط الحرکة ونقص الأنتباة (12) جلسة من جلسات النيروفيدباک وتم تطبيق أختبار کونرز - قبل / وبعد الجلسات حيث أظهرت قيمة p = 0.98مع عدم وجود دلالة أحصائية. وتم أعطاء أطفال المجموعة الضابطة (5) أطفال من ذوى فرط الحرکة و نقص الأنتباة (12) جلسة من جلسات العلاج السلوکى حيث کانت قيمة p = 0.98 مع عدم وجود دلالة أحصائية. وتم قياس موجات ثيتا / بيتا لأطفال المجموعة التجريبية (5) أطفال قبل / بعد تطبيق جلسات النيروفيدباک بواقع (12) جلسة حيث کانت قيمة p =0.97 مع عدم وجود دلالة أحصائية.

The Role of Lead, Manganese, and Zinc in Autism Spectrum Disorders (ASDs) and Attention-Deficient Hyperactivity Disorder (ADHD): a Case-Control Study on Syrian Children Affected by the Syrian Crisis.

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are two developmental disorders that affect children worldwide, and are linked to both genetic and environmental factors. This study aims to investigate the levels of lead, manganese, and zinc in each of ASD, ADHD, and ASD with comorbid ADHD in Syrian children born or grown during the Syrian crisis. Lead and manganese were measured in the whole blood, and zinc was measured in the serum in 31 children with ASD, 29 children with ADHD, and 11 children with ASD with comorbid ADHD (ASD-C) compared with 30 healthy children, their ages ranged between 3 and 12years. Blood lead levels were higher in the groups of ASD-C (245.42%), ASD (47.57%), and ADHD (14.19%) compared with control. Lead levels were significantly higher in children with ASD in the age of 5 or less compared with control, and they were also higher in the male ASD compared with females (P = 0.001). Blood manganese levels were lower in the groups of ASD-C (10.35%), ADHD (9.95%, P = 0.026), and ASD (9.64%, P = 0.046). However, serum zinc levels were within the reference range in all groups of study. Lead and manganese were positively correlated with each other (P = 0.01). Lead increase and manganese decrease may associate with the incidence of ASD, ADHD, or the co-occurrence of both of them together. Further studies are needed to examine the relationship between metal levels and the co-occurrence of ASD and ADHD together.

Treatment Delivery Preferences Associated With Type of Mental Disorder and Perceived Treatment Barriers Among Mexican University Students

PurposeAlthough Internet-based electronic health (eHealth) interventions could potentially reduce mental health disparities, especially in college students in under-resourced countries, little is known about the relative acceptability of eHealth versus in-person treatment modalities and the treatment barriers associated with a preference for one type over the other. MethodsParticipants were from the 2018–2019 cohort of the University Project for Healthy Students (PUERTAS), a Web-based survey of incoming first-year students in Mexico and part of the World Mental Health International College Student Survey initiative. A total of 7,849 first-year students, 54.73% female, from five Mexican universities participated. We estimated correlates of preference for eHealth delivery over in-person modalities with a multivariate logistic regression. ResultsThirty-eight percent of students prefer in-person services, 36% showed no preference for in-person over eHealth, 19% prefer not to use services of any kind, and 7% preferred eHealth over in-person treatment delivery. Being embarrassed, worried about harm to one's academic career, wanting to handle problems on one's own, beliefs about treatment efficacy, having depression, and having attention-deficient hyperactivity disorder were associated with a clear preference for eHealth delivery methods with odds ratios ranging from 1.47 to 2.59. ConclusionsAlthough more students preferred in-person services over eHealth, those reporting attitudinal barriers (i.e., embarrassment, stigma, wanting to handle problems on one's own, and beliefs about treatment efficacy) and with depression or attention-deficit hyperactivity disorder had a greater preference for eHealth interventions suggesting these are students to whom eHealth interventions could be targeted to alleviate symptoms and/or as a bridge to future in-person treatment.

SorCS2 is required for social memory and trafficking of the NMDA receptor.

Social memory processing requires functional CA2 neurons, however the specific mechanisms that regulate their activity are poorly understood. Here, we document that SorCS2, a member of the family of the Vps10 family of sorting receptors, is highly expressed in pyramidal neurons of CA2, as well as ventral CA1, a circuit implicated in social memory. SorCS2 specifically localizes to the postsynaptic density and endosomes within dendritic spines of CA2 neurons. We have discovered that SorCS2 is a selective regulator of NMDA receptor surface trafficking in hippocampal neurons, without altering AMPA receptor trafficking. In addition, SorCS2 regulates dendritic spine density in CA2 neurons where SorCS2 expression is enriched, but not in dorsal CA1 neurons, which normally express very low levels of this protein. To specifically test the role of SorCS2 in behavior, we generated a novel SorCS2-deficient mouse, and identify a significant social memory deficit, with no change in sociability, olfaction, anxiety, or several hippocampal-dependent behaviors. Mutations in sorCS2 have been associated with bipolar disease, schizophrenia, and attention deficient-hyperactivity disorder, and abnormalities in social memory are core components of these neuropsychiatric conditions. Thus, our findings provide a new mechanism for social memory formation, through regulating synaptic receptor trafficking in pyramidal neurons by SorCS2.

PSYCHOLOGICAL HELP FOR PARENTS WITH CHILDREN HAVING THE ATTENTION DEFICIENT HYPERACTIVITY DISORDER

In this article, we raise the question about necessity to provide psychological help for parents with children having the Attention Deficient Hyperactivity Disorder (ADHD) and such families at whole during children’s treatment and development. The help for parents is determined by their influence on health and personal development of their children: the psychological climate as a background of children’s development and growth influences their future health and social success.  Parents need specialized psychological help because of peculiarities of ADHD children’s behavior and because parents have their own social and psychological problems, such as high stress, depression, aggressiveness, conflict etc. ADHD is a hereditary disorder that is why, when assisting the family, it is relevant to identify and correct parents disorders, related to ADHD. Attention is drawn to the fact that, thanks to the modern research, knowledge about the scientifically sound causes of ADHD is upgraded, and parents also need to know it and take into account in the education and development of their ADHD children. As usual parents do not understand that behavioural problems and attention disorders of their children are based on biological disorders of the brain areas, and therefore children need a special attitude and developmental conditions, but not punishments. Because of  the wide range of social and psychological problems faced by the family with ADHD children (low living standards, parental alcoholism, parental stress, anxiety, depression, low self-esteem, etc), the treatment of ADHD children should be based on the comprehensive multimodal approach combining medical (pharmacological) interventions, psychological correction of behavior and development of children's and teenager's cognitive functions,  as well as information for parents and pedagogues and psychological assistance to parents. The main directions of psychological assistance to parents with ADHD children are defined: information for parents education to  improve  their knowledge about the disorder;  family psychological therapy to  normalize  marital relations, optimization of hierarchical relationships in the family;  psychotherapy and  correction of  parents  emotional  states,  so that the parent would develop effective strategies of  parenting  and children’s development. Psychological help for parents with children having the Attention Deficient Hyperactivity Disorder has to be individual. &nbsp

Restless legs syndrome in childhood and adolescence

The prevalence of restless legs syndrome (RLS) is lower among children than adults. This could be due to RLS manifestation later in life or false diagnoses in children caused by symptom similarity to other diseases such as attention deficient hyperactivity disorder (ADHD). The aim of this study was to test the reliability and validity of a questionnaire designed to identify RLS-related symptoms in children and adolescents. The questionnaire was designed for two age groups (6–12 and 13–18 years). It was distributed among 11 pediatric RLS patients and 22 healthy children and adolescents (control group). The control group answered the questionnaire twice (M1, M2; 14-day separation). Reliability was analyzed descriptively and with Spearman correlation coefficients, intraclass correlation coefficients (ICC), and test–retest variability (TRV). An index was calculated by transferring the 12 answers concerning RLS symptoms into a coding system, grading each answer between −2 and 2 and adding the grades to an index value. Low index values hint at the absence of RLS-related symptoms. Student’s t‑test was used to test the difference between healthy controls and pediatric patients. In the control group, 84% of answer pairs were identical between M1 and M2. Mean TRV was 8% (range: 2–16%), Spearman correlation coefficient 0.762, and ICC 0.754 (confidence interval: 0.473–0.899). Comparison between controls and pediatric RLS patients showed that RLS patients had significantly higher (p < 0.001) index values (mean ± SD: 18.8 ± 4) compared to controls (mean ± SD: −3.8 ± 7.6). The questionnaire can distinguish between supposedly healthy and RLS-diagnosed children and adolescents in most cases. Nonetheless, the questionnaire cannot be used alone as a diagnostic instrument.

Significantly lower serum and hair magnesium levels in children with attention deficit hyperactivity disorder than controls: A systematic review and meta-analysis

The pathophysiology of attention deficient hyperactivity disorder (ADHD) is still obscure. Some studies have discussed that magnesium levels are lower in the serum and erythrocytes of children with ADHD. However, these findings are controversial. The aim of our study is to identify whether magnesium levels are in fact lower in children with ADHD. We conducted a thorough search of the literature and examined the connection between magnesium insufficiency and ADHD. A total of twelve studies were included into the current meta-analysis. The results of our meta-analysis found that peripheral blood magnesium levels, either in plasma, serum, or whole blood, of children diagnosed with ADHD were significantly lower than those in controls (k = 8, Hedges' g = −0.547, 95% CI = −0.818 to −0.276, p < .001). The subgroup meta-analysis with serum sample sources also suggested that peripheral serum magnesium levels of children diagnosed with ADHD were significantly lower than those in controls (k = 6, Hedges' g = −0.733, 95% CI = −0.911 to −0.555, p < .001). The subgroup meta-analysis focusing on subjects with ADHD diagnosed by definite diagnostic criteria also suggested significantly lower peripheral serum magnesium levels in ADHD children than those in controls (k = 4, Hedges' g = −0.780, 95% CI = −0.985 to −0.574, p < .001). We also noted that magnesium levels in the hair of children diagnosed with ADHD were significantly lower than those in controls (k = 4, Hedges' g = −0.713, 95% CI = −1.359 to −0.067, p = .031). In this meta-analysis, we found that children diagnosed with ADHD have lower serum and hair magnesium levels than children without ADHD. Further study may be needed to investigate the behavioral influence on ADHD due to lower magnesium levels, the association between brain and serum magnesium levels, and the effects brought about by larger longitudinal cohort studies.

Cerebellar radiological abnormalities in children with neurofibromatosis type 1: part 1 - clinical and neuroimaging findings

BackgroundMany children with neurofibromatosis type 1 (NF1) have focal abnormal signal intensities (FASI) on brain MRI, whose full clinical impact and natural history have not been studied systematically. Our aims are to describe the clinical and neuroradiological features in children with NF1 and cerebellar FASI, and report on the natural history of FASI that display atypical features such as enhancement and mass effect.MethodA retrospective review of the hospital charts and brain MRIs was performed on children from Manitoba diagnosed between 1999 and 2008 with NF1, who also had cerebellar FASI on MRI.ResultsFifty patients (mean age: 16.1y, minimum-maximum: 6.4 - 30y, 27 M) were identified. Mean duration of follow up was 10.1y. Developmental delay, learning disabilities, tumors, and visual signs occurred commonly. Cerebellar signs were not reported. Mean age of the patients at baseline MRI was 7.8 (SD: 4.5) years. FASI occurred in several brain locations and were rarely confined to the cerebellum. FASI displayed mass effect and enhancement infrequently but were associated with malignancy only once. The number of FASI at baseline MRI was significantly less in patients with attention deficient hyperactivity disorder and more if a first degree relative had NF1 or if they had decreased visual acuity.DiscussionPatients with NF1 and cerebellar FASI do not have motor or consistent non-motor (e.g. developmental delay or learning disabilities) cerebellar features. The number of FASI may correlate with some clinical features. FASI may display enhancement and mass effect but they rarely become malignant.

The Prevalence of Attention Deficient Hyperactivity Disorder Among Iranian Children: A Meta-Analysis

Context: Attention deficient hyperactivity disorder (ADHD), diagnosed in psychiatric outpatient clinics, is the most common psychiatric disorder among schoolchildren. The purpose of this study is to conduct a meta-analysis on subscales related to ADHD examined on schoolchildren. Moreover, it is tried to evaluate meta-analysis of ADHD and its subscales in primary school students in Iran. Evidence Acquisition: Searching through the databases of Magiran, SID, Google Scholar, etc. a total of 16 articles were collected and weighted based on the number of cases and prevalence in binomial distribution. By using a random effects model meta-analysis (I2 = 96.5%), data were analyzed by the use of R and STATA software (version 11.2). Results: In this analysis, 27 articles published between the years of 2001 and 2016 were used. The total sample size was 15124 students whose ages ranged from six to 14 years old. The prevalence of ADHD based on parents and teachers’ consensus was 12% (CI 95%: 9.0 - 15), from parents’ perspective 15.6% (CI 95%: 9.8 - 21.5), and from teachers’ perspective 17.2% (CI 95%: 12.7 - 21.8). The subgroups’ prevalence rates based on parents and teachers’ consensus were as follows: Attention deficit (AD) = 4.2%, hyperactive impulsive (HI) = 4.1%, and combined type (CT) = 3.5%. ADHD was more prevalent in boys than girls (7.9% versus 5.5%). Conclusions: The results indicated that the prevalence of ADHD among schoolchildren is moderate; therefore, considering the importance of students’ mental health, the needs for identification, prevention, and treatment of high-risk groups by responsible institutions become obvious.

Herbs for Attention-Deficit/Hyperactivity Disorder

Abstract Nootropic herbs can be very helpful in people with attention-deficient/hyperactivity disorder (ADHD). Two herbs both called brahmi in the Ayurvedic tradition, Bacopa monnieri (bacopa) and ...