Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.

Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options

Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.

Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.

Risk for emerging bipolar disorder, variants, and symptoms in children with attention deficit hyperactivity disorder, now grown up

AIM: To determine the prevalence of bipolar disorder(BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder(ADHD) through 14 years' follow-up, when participants were between 21-24 years old.METHODS: First, we examined rates of BD type Ⅰ?and Ⅱ diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD(MTA). We used the diagnostic interview schedule for children(DISC), administered to both parents(DISC-P) and youth(DISCY). We compared the MTA study subjects with ADHD(n = 579) to a local normative comparison group(LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts(TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic(PM) and non-specific manic(NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD(1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time(df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability(BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG(χ2 = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM(df 3, 2538; F = 43.2; P < 0.0001).CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2(A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.

A Controlled Study of the Effectiveness of EEG Biofeedback Training on Children with Attention Deficit Hyperactivity Disorder

In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.

MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder

Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.

Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care

Attention deficit hyperactivity disorder(ADHD)is a common and impairing behavioral health disorder,impacting over 5%of children worldwide.There are multiple evidence-based pharmacological and psychosocial treatments for ADHD,and greater service utilization is associated with improved acute and long-term outcomes.However,long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely.This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers.Families face a variety of structural and attitudinal barriers,ranging from cost and access to stigma and low self-efficacy to successfully implement change.There are multiple interventions that may enhance engagement with ADHD care including psychoeducation,integration of behavioral services in general medical settings,telehealth as well as specific adaptations to existing ADHD treatments,such as the use of motivational interviewing or shared decision making.Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers.Adding motivational interviewing,shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes.However,little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.

Whole Exome Sequencing: Novel Genetic Polymorphisms in Saudi Arabian Attention Deficit Hyperactivity Disorder (ADHD) Children

Background: Attention-deficit hyperactivity disorder (ADHD) is a widespread and debilitating disorder with relatively high prevalence in Saudi Arabia. Neuropsychological and radiological investigations have revealed that there are some differences in the components of the brain regions in children with and without ADHD. In this study we have performed whole exome sequencing (WES) in four non-familial cases of ADHD from Makkah Region to identify the genetic polymorphisms associated with the disease in our Saudi population. Methods: Exome sequencing was carried out using Ion Proton with AmpliSeq Exome library methods, and the data were analysed by Ion Reporter 5.6 software. Results: A total of 33 variants were identified from 222 genes selected from the GWAS catalogue for ADHD associated genes. However, the SNPs we identified in these genes were not reported to be associated with ADHD in previous studies. We have identified 2 novel missense variants;one in c.3451G > T;p. (Ala1151Ser) in ITGA1 gene and another is c.988G > A;p. (Ala330Thr) in SPATA13 genes. The variants rs928661, rs11150370 and rs386792899 were the only three variants that appeared on all the 4 patients studied. Six missense variants, rs16841277, rs2228209, rs2230283, rs3741883, rs1716 and rs2272606, were found in 3 different patients, respectively. However, the three documented variants are rs13166360 with bipolar disorder, rs920829 with neuropathic pain, and rs6558702 with schizophrenia. Conclusion: We have identified 2 novel variants in ADHD children. SIFT score of all variants indicates that these substitutions have damaging effects on the protein function. Further screening studies are recommended for confirmation.

Motor abilities of children and adolescents with a psychiatric condition:A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders(ASD), attention deficit hyperactivity disorder(ADHD), disruptive behavior disorders(DBD) and depression, a comprehensive systematic literature search was carried out using Pub Med, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder(ASD, ADHD, DBD, depression) in conjunction with each of the following keywords:(psycho/perceptuo) motor/movement skill(s),(psycho/perceptuo) motor/movement abilities,(psycho/perceptuo) motor/movement impairment,(psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings. CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

Cognitive Function of Children and Adolescents with Attention Deficit Hyperactivity Disorder and Learning Difficulties： A Developmental Perspective

Background： The cognitive function of children with either attention deficit hyperactivity disorder （ADHD） or learning disabilities （LDs） is known to be impaired. However, little is known about the cognitive function of children with comorbid ADHD and LD. The present study aimed to explore the cognitive function of children and adolescents with ADH D and learning difficulties in comparison with children with ADHD and healthy controls in different age groups in a large Chinese sample. Methods： Totally, 1043 participants with ADHD and learning difficulties （the ADHD ＋ learning difficulties group）, 870 with pure ADHD （the pure ADHD group）, and 496 healthy controls were recruited. To investigate the difference in cognitive impairment using a developmental approach, all participants were divided into three age groups （6-8, 9-11, and 12-14 years old）. Measurements were the Chinese-Wechsler Intelligence Scale for Children, the Stroop Color-Word Test, the Trail-Making Test, and the Behavior Rating Inventory of Executive Function-Parents （BRIEF）. Multivariate analysis of variance was used. Results： The results showed that after controlling for the effect of ADHD symptoms, the A DHD ＋ learning difficulties group was still significantly worse than the pureADHD group, which was, in turn, worse than the control group on full intelligence quotient （98.66 ± 13.87 vs. 105.17 ± 14.36 vs. 112.93 ± 13.87, P 〈 0.001 ）. The same relationship was also evident for shift function （shifting time of the Trail-Making Test, 122.50 [62.00, 194.25] s vs. 122.00 [73.00, 201.50] s vs. 66.00 [45.00, 108.00] s, P 〈 0.001） and everyday life executive function （BRIEF total score, 145.71 ± 19.35 vs. 138.96± 18.00 vs. 122.71 ± 20.45, P 〈 0.001 ） after controlling for the effect of the severity of ADHD symptoms, intelligence quotient, age, and gender. As for the age groups, the differences among groups became nonsignificant in the 12-14 years old group for inhibition （meaning interference of the Stroop Color-Word Test, 18.00 [13.00, 25.00] s vs. 17.00 [15.00, 26.00] s vs. 17.00 [10.50, 20.00] s, P =0.704） and shift function （shifting time of the Trail-Making Test, 62.00 [43.00, 97.00] s vs. 53.00 [38.00, 81.00] s vs. 101.00 [88.00, 114.00] s, P = 0.778）. Conclusions： Children and adolescents with ADHD and learning difficulties have more severe cognitive impairment than pure ADHD patients even after controlling for the effect of ADHD symptoms. However, the differences in impairment in inhibition and shift function are no longer significant when these individuals were 12-14 years old.

Vanderbilt父母评定量表在注意缺陷多动障碍中的应用价值

目的探讨Vanderbilt父母评定量表在诊治注意缺陷多动障碍疾病的应用价值。方法选取2016年10月至2018年10月在昆明市儿童医院儿童保健科确诊为注意缺陷多动障碍的儿童188例为研究对象,其父母分别填写Weiss功能缺陷评定量表(父母版)和Vanderbilt父母评定量表,分析两量表的关系。结果 Pearson相关分析发现Vanderbilt父母评定量表中注意力因子分、多动/冲动因子分,注意力及多动/冲动总分、对立违抗总分、品行障碍、焦虑抑郁总分、在校学习及人际关系总分均与Weiss功能缺陷评定量表(父母版)总分呈正相关(r值分别为0.49、0.41、0.52、0.56、0.49、0.38、0.49,均P<0.01),而控制上述因素后,多元线性回归预测模型中Vanderbilt父母评定量表的对立违抗、在校学习/人际关系仍对Weiss功能缺陷评定量表(父母版)总分有显著预测作用(t值分别为2.162、3.095,均P<0.05)。结论 Vanderbilt父母评定量表与Weiss功能缺陷量表(父母版)在注意缺陷多动障碍的诊断中具有较好的一致性,尤其在功能表现方面也是良好的预测指标。

Review of the effects of SARS-CoV2 infection and COVID-19 on common pediatric psychiatric illnesses

Severe acute respiratory syndrome coronavirus-2 is a novel coronavirus strain that causes pneumonia and acute respiratory distress syndrome along with other morbidities,collectively known as coronavirus disease 2019(COVID-19)disease.There has been widespread discussion about the psychological impact of COVID-19 particularly on children and adolescents.There have been overarching negative effects with regards to decreased physical activity,more screen time,increasingly unhealthy diets,and irregularities in sleep/wake schedules.This,coupled with disruptions in ongoing mental health treatment and associated support structures,has caused unprecedented declines in the emotional and psychosocial wellbeing of children and adolescents.This review aims to systematically review the literature to provide a general overview of the ways in which COVID-19 has affected common psychiatric illnesses in children and adolescents.The included articles in all subsections concluded that symptoms of these common childhood psychiatric disorders have generally been exacerbated by the COVID-19 pandemic.This review indicates that quarantine and the consequent isolation have had multiple significant and consistent negative implications on the mental health of children and adolescents.Our study indicates that there should be increased vigilance among providers and families to mitigate the negative psychological effects that the COVID-19 pandemic has on children with common childhood psychiatric disorders.

Vanderbilt父母评定量表在儿童抽动障碍共患病诊断中的应用

【目的】探讨儿童抽动障碍（TD）共患病的诊断方法。【方法】对136例初诊为TD于2周内复诊的患儿，先采用Vanderbilt父母评定量表（Vanderbilt ADHD Parent Rating Scale，VADPRS）进行共患病筛查，然后用DSM-IV标准确定诊断，观察其共患病漏诊情况。【结果】136例TD患儿VADPRS筛查显示：共患注意缺陷多动障碍（attention deficit hyperactivity disorders，ADHD）占52．21％（71／136）、对立违抗性障碍（oppositional defiant disorder，ODD）占31．62％（43／136）、情绪障碍（emotional disorders，ED）占21．32％（29／136），与初次诊断结果差异有显著性（χ^2=16．672，P〈O．05；χ^2=8．002，P〈0．05；χ^2=10．806，P〈O．05）。共患品行障碍（conduct disorder，CD）占17．65％（24／136），与初次诊断结果差异无显著性（χ^2=2．425，P〉0．05）。量表筛查结果与按DSM—IV标准确定诊断差异无显著性。量表表现部分结果显示：有共患病TD患儿与无共患病TD患儿功能损害总分差异有显著性（t=7．076，P〈0．05）。【结论】VADPRS筛查对于TD患儿共患病的诊断有较大帮助。

抽动及共患注意缺陷多动障碍患儿维生素D含量差异研究

目的探讨血清维生素D含量与抽动障碍(TD)发病及共患注意缺陷多动障碍(ADHD)的关系。方法选取2021年4月至2023年4月于攀枝花市中心医院儿科门诊确诊为TD的161名儿童为研究对象,根据是否共患ADHD分为单纯TD组(n=103)、TD+ADHD组(n=58),比较两组患儿维生素D含量差异情况。结果不同性别TD儿童25(OH)D含量无显著性差异(P>0.05);病程>12个月的TD儿童25(OH)D含量低于病程≤12个月的TD儿童,差异具有统计学意义(t=3.02,P<0.05);病程>12个月组TD儿童血清25(OH)D不足比例高于病程≤12个月组,差异有统计学意义(χ^(2)=6.88,P<0.05);中重度TD儿童的25(OH)D含量明显低于轻度TD儿童(t=3.64,P<0.05);中重度TD组儿童血清25(OH)D不足及缺乏比例明显高于轻度TD组,差异有统计学意义(χ^(2)=18.23,P<0.05);TD+ADHD儿童与单纯TD儿童的25(OH)D含量差异无统计学意义(P>0.05);TD+ADHD组儿童血清25(OH)D不足及缺乏比例高于单纯TD组,差异有统计学意义(χ^(2)=3.85,P<0.01)。结论维生素D缺乏程度与TD的病情、病程及合并ADHD的风险呈正相关性。

注意缺陷多动障碍儿童粗大动作技能与执行功能发展的特点及关系

目的探讨学龄期注意缺陷多动障碍(ADHD)儿童的粗大动作技能和执行功能的发展特点及其相关关系。方法2020年11月至2021年5月于北京大学第六医院和北京市海淀区万泉小学招募90例ADHD儿童,从该小学另募集年龄和性别匹配的正常发育儿童90例。采用儿童粗大动作发展测试量表第三版(TGMD-3)评估儿童的粗大动作技能,采用Stroop色词测验(SCWT)、Rey-Osterrich复杂图形测验(ROCFT)、连线测验(TMT)分别评估儿童的抑制控制、工作记忆和认知灵活性。结果ADHD儿童TGMD-3得分显著低于正常儿童(t=-6.275,P<0.001),SCWT、ROCFT、TMT测试结果均差于正常儿童(|t|≥1.986,P≤0.05)。ADHD儿童的TGMD-3得分与字义反应时(r=-0.261)、字义错误数(r=-0.404)、颜色错误数(r=-0.326)呈负相关(P<0.05),与延时结构记忆得分(r=0.228)呈正相关(P<0.05),与TMT-A反应时(r=-0.255)、TMT-A错误数(r=-0.329)、TMT-B反应时(r=-0.214)、TMT-B错误数(r=-0.474)呈负相关(P<0.05)。分层线性回归分析显示,ADHD儿童的TGMD-3得分仅对抑制控制和认知灵活性的测试结果具有预测作用(P<0.05),解释率分别为8.7%和22.5%。结论ADHD儿童的粗大动作技能和执行功能均存在发育滞后,且两者之间有一定关联,其中,粗大动作技能水平可在一定程度上影响抑制控制和认知灵活性的发展。

儿童注意缺陷多动障碍专病库构建与应用

目的/意义建立儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)专病库,解决诊疗数据分散、数据质量偏低造成的数据使用效率低的问题。方法/过程基于2020年3月—2024年4月儿童ADHD临床诊疗数据,利用自然语言处理技术实现数据后结构化,根据行业标准、诊治指南实现专病库数据标准化。结果/结论建立以75835例ADHD患儿和28万人次就诊数据为基础的儿童ADHD专病库,为ADHD人群基本特征分析、预测模型构建、优化资源配置、临床诊疗路径优化等应用方向提供数据支撑。

Attention deficit hyperactivity disorder in children with epilepsy:a multicenter cross-sectional analysis in China

Background The diagnosis and treatment of attention deficit hyperactivity disorder(ADHD)comorbid with epilepsy have been insufficiently addressed in China.We conducted a study in China to investigate the current status,diagnosis,and treatment of ADHD in children to further our understanding of ADHD comorbid with epilepsy,strengthen its management,and improve patients’quality of life.Methods We carried out a multicenter cross-sectional survey of children with epilepsy across China between March 2022 and August 2022.We screened all patients for ADHD and compared various demographic and clinical factors between children with and without ADHD,including gender,age,age at epilepsy onset,duration of epilepsy,seizure types,seizure frequency,presence of epileptiform discharges,and treatment status.Our objective was to explore any possible associations between these characteristics and the prevalence of ADHD.Results Overall,395 epilepsy patients aged 6–18 years were enrolled.The age at seizure onset and duration of epilepsy ranged from 0.1–18 to 0.5–15 years,respectively.Focal onset seizures were observed in 212(53.6%)patients,while 293(76.3%)patients had epileptiform interictal electroencephalogram(EEG)abnormalities.Among the 370 patients treated with anti-seizure medications,200(54.1%)had monotherapy.Although 189(47.8%)patients had ADHD,only 31 received treatment for it,with the inattentive subtype being the most common.ADHD was more common in children undergoing polytherapy compared to those on monotherapy.Additionally,poor seizure control and the presence of epileptiform interictal EEG abnormalities may be associated with a higher prevalence of ADHD.Conclusions While the prevalence of ADHD was higher in children with epilepsy than in normal children,the treatment rate was notably low.This highlights the need to give more importance to the diagnosis and treatment of ADHD in children with epilepsy.

益生菌辅助治疗学龄前期儿童注意缺陷多动障碍合并过敏性疾病的疗效观察

目的观察益生菌辅助治疗学龄前期儿童注意缺陷多动障碍(ADHD)合并过敏性疾病的疗效。方法选择2021年9月至2022年12月确诊ADHD且合并过敏性疾病的学龄前期患儿46例,采用随机数字法将其分为对照组(24例)和观察组(22例)。对照组予单纯行为治疗,观察组在对照组基础上予益生菌辅助治疗。比较两组患儿治疗3个月后临床疗效、血清IgE及炎性细胞因子水平。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组治疗后血清IgE、炎性细胞因子水平比较,差异有统计学意义(P<0.05)。结论益生菌辅助治疗学龄前期儿童ADHD合并过敏性疾病,可以提高临床疗效,其机制可能与调控患儿血清IgE和炎性细胞因子水平有关。

基于机器学习的注意力缺陷多动障碍风险预测研究

目的探讨基于机器学习算法对儿童注意力缺陷多动障碍(ADHD)预测的可行性。方法回顾性分析我院于2022年11月至2023年8月儿科门诊就诊患者358例,其中ADHD患儿119例,非ADHD患儿239例,以人口学基本信息、儿童个人生活情况、母亲孕期情况、家庭生活情况及遗传因素等31个变量作为危险因素,采用单因素分析筛选出具有明显差异的变量,然后分别建立决策树模型、随机森林模型、自适应提升算法及K近邻算法模型,采用受试者工作特征(ROC)曲线的面积(AUC)、特异度、准确性、F1分数及ROC曲线等进行模型预测效能评估。结果4种机器学习算法建立的ADHD的预测模型以随机森林算法最优,其AUC为0.955,特异度、准确性、F1分值分别为0.903、0.898、0.853;同时,根据随机森林模型筛选出的前五位特征变量为:教育方式、情绪稳定情况、每日看电子产品时长、学习困难情况、近期反复呼吸道感染。结论初步构建出基于机器学习算法建立儿童ADHD的预测模型,该模型对ADHD有良好的预测能力。