Serum Occludin and Zonulin Levels in Children With Attention-Deficit/Hyperactivity Disorder and Healthy Controls

Objective: To evaluate zonulin and occludin levels, potentially associated with immunological pathways in the gut-brain axis, in children with attention-deficit/hyperactivity disorder (ADHD). Method: We examined the association between serum levels of zonulin and occluding, and behavioral/emotional problems in children with ADHD. 40 medicationnaïve children meeting Diagnostic and statistical (DSM-5) criteria for ADHD (11 females; mean (SD) age 9.4 (1.6) years) and 39 healthy comparisons (12 females; mean (SD) age 9.3 (1.9) years) were studied. Serum zonulin and occludin levels were measured by (ELISA). Result: We found higher mean (SD) serum zonulin levels [37.1 (28.2) vs 8.1 (4.5) ng/mL; P<0.001) and occludin levels [2.4 (1.6) vs 0.6 (0.4) ng/mL; P<0.001] in the ADHD group compared to control group. Serum zonulin levels had a positive correlation with weight (r=0.452; P=0.003) and BMI (r=0.401; P=0.01) among children with ADHD. Serum zonulin and occludin levels also had a positive correlation with Conners parent rating scale scores (r=0.58; P<0.001), and Strengths and difficulties questionnaire scores (r=0.49; P<0.001). Multiple linear regression analysis revealed that age, sex, weight, conduct problems and oppositional sub-scores were significant predictors of increased serum zonulin levels. Conclusion: These data confirm an association between ADHD, and serum zonulin and occludin levels. Pathophysiological and clinical significance of these findings needs to be elucidated.

The Efficacy of ADHD Rating Scale and Continuous Performance Tests in Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder / 대한소아신경학회지

PURPOSE:Attention deficit hyperactivity disorder(ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, impulsivity and/or hyperactivity with an onset during childhood. There are no specific diagnostic and evaluated tools. The aim of this study was to determine clinical availability of adjunctive tests for diagnosis and measure of the efficacy of treatment in ADHD patients. METHODS:The study group consisted of 41 patients under 15 years of age who visited Kangnam Sacred Heart Hospital and Kangdong Sacred Heart Hospital between January 2007 and June 2008 for evaluation of ADHD. Diagnosis was made according to the diagnostic and statistical manual for mental disorder-IV(DSM-IV) with history, physical examination, ADHD rating scale, and attention deficit hyperactivity disorder diagnostic system(ADS). After psychostimulant treatment, patients were reevaluated by previous diagnostic tools and their results were analysed by SPSS version 16.0. RESULTS:The mean age was 8.44+/-2.49 years old, male to female ratio 4.13:1(33:8). Forty one ADHD patients were subdivided into predominantly inattentive type 17(41.5%), predominantly hyperactive-impulsive type 3(7.3%) and combined type 21(51.2%). In patients, concordance rates of adjunctive tests with DSM-IV diagnostic criteria were 74.29% in Korean ADHD Rating scale(K-ARS), 59.09% in abbreviated Conners' rating scale(ACRS) and 92.68 % in ADS with DSM-IV diagnostic criteria. There were significant differences in the ADS results between before and after psychostimulant treatment. CONCLUSION:Because the concordance rates and efficacy of ADS were higher than K- ARS and ACRS in ADHD patients, it suggests that ADS is a useful method to ADHD diagnosis and treatment.

Development of the Korean Version of the IOWA Conners Rating Scale / 신경정신의학

OBJECTIVES: This study was conducted to develop the Korean version of the IOWA Conners rating scale (K-IOWA), and to examine its reliability and validity. METHODS: The subjects were 41 normal children and 40 ADHD children between the ages of 5 and 12. All of the teachers administered the K-IOWA and the abbreviated Conners' rating scale to calculate the internal consistency coefficient of the K-IOWA and to examine its validity. RESULTS: The reliability coefficient of the K-IOWA (Cronbach's alpha) was .913. The range of correlation coefficients between K-IOWA scores and the Abbreviated Conners Rating Scale scores were from .81 to .93. The mean score of the ADHD group on the K-IOWA was significantly higher than that of the normal group. The result of factor analysis showed that the K-IOWA was composed of 2 factors (Inattention/Overactive and Oppositional/Defiant). CONCLUSION: These results suggest that the K-IOWA rating scale is a very reliable and valid test and it would be useful in diagnostic evaluation and the treatment effect for ADHD children.

Development of the Korean Version of the IOWA Conners Rating Scale / 신경정신의학

OBJECTIVES: This study was conducted to develop the Korean version of the IOWA Conners rating scale (K-IOWA), and to examine its reliability and validity. METHODS: The subjects were 41 normal children and 40 ADHD children between the ages of 5 and 12. All of the teachers administered the K-IOWA and the abbreviated Conners' rating scale to calculate the internal consistency coefficient of the K-IOWA and to examine its validity. RESULTS: The reliability coefficient of the K-IOWA (Cronbach's alpha) was .913. The range of correlation coefficients between K-IOWA scores and the Abbreviated Conners Rating Scale scores were from .81 to .93. The mean score of the ADHD group on the K-IOWA was significantly higher than that of the normal group. The result of factor analysis showed that the K-IOWA was composed of 2 factors (Inattention/Overactive and Oppositional/Defiant). CONCLUSION: These results suggest that the K-IOWA rating scale is a very reliable and valid test and it would be useful in diagnostic evaluation and the treatment effect for ADHD children.

Maternal Depression and Anxiety and Ratings of Behavioral Problems of Child / 신경정신의학

OBJECTIVES: This study was aimed to investigate the relationship between maternal depression and anxiety, and their ratings of child's behavior. METHODS: 769 elementary school students participated in this study. Mothers completed the Korean Conners' Parent Rating Scale (K-CPRS), the Korean Attention-deficit/hyperactivity disorder Rating Scale (K-ARS): Home Version, the Korean Beck Depression Inventory (K-BDI) and the Korean Beck Anxiety Inventory (K-BAI). Teachers completed the Korean Conners' Teacher Rating Scale (K-CTRS) and the K-ARS: School Version. The maternal emotional status was classified into four groups (Normal, Anxious and Not Depressed, Depressed and Not Anxious, Anxious and Depressed) according to BDI and BAI scores. The subscale raw scores of K-CPRS, and K-ARS: Home version were compared among maternal emotional status by the Analysis of Covariance before and after their scores were controlled for the each subscale scores rated by teachers consistent with those rated by parents. RESULTS: All of the subscale scores of parent's form were significantly different according to maternal emotional status after controlled for the scores of teacher's form. After post hoc analysis, the scores of parents' ratings of Anxious and Not Depressed group and Anxious and Depressed group were higher than those of the Normal group. CONCLUSION: The mothers who are depressed and/or anxious tend to report more behavior problems of children than now they actually are.