Esra Guney

Oxidative stress in children and adolescents with anxiety disorders

BACKGROUND Anxiety disorders are common in children and adolescents, and they can significantly impair quality of life. Genetic, neurobiological, neurochemical, and psychological factors are believed to play a role in the etiopathogenesis of anxiety disorders. Recent evidence suggests that the pathophysiology of anxiety disorders may be associated with oxidative stress. In this study, we investigated whether there are associations between children with anxiety disorders and total oxidant/antioxidant status. METHODS The experimental group consisted of 40 patients (children and adolescents) with anxiety disorders. An age- and gender-matched control group composed of 35 healthy subjects was also assessed. Venous blood samples were collected and total antioxidative status (TAS), total oxidative status (TOS), and the oxidative stress index (OSI) were determined. RESULTS Both the TOS and the OSI of the experimental group were significantly higher than those of the control group. There were no significant differences in TAS between the experimental and control groups. LIMITATIONS The main limitation of our study was the small sample size. CONCLUSIONS This study suggests that oxidative balance is impaired in children with anxiety disorders. Oxidative stress may play a role in the etiopathogenesis of anxiety disorders, and TOS may be a useful diagnostic tool in this context.

Increased Serum Levels of Epidermal Growth Factor in Children with Autism

The etiology of autism is unclear, however autism is considered as a multifactorial disorder that is influenced by neurological, environmental, immunological and genetic factors. Growth factors, including epidermal growth factor (EGF), play an important role in the celluler proliferation and the differentiation of the central and peripheral nervous system. In this study we hypothesized that EGF may play a role in the pathophysiology of autism and examined serum EGF levels in children with autism. We measured serum levels of EGF in the 27 autistic children and 28 age- matched normal controls. The serum levels of EGF in the subjects with autism were significantly higher than those of normal control subjects. However, there were no correlations between serum EGF levels and clinical variables in the subjects with autism. This is the first report demonstrating the increased serum levels of EGF in children with autism. This study suggests that increased levels of EGF might have an importance in the pathophysiology of autism.

Attention Deficit Hyperactivity Disorder and oxidative stress: A short term follow up study.

In this study, we aimed to investigate total antioxidative status (TAS) and total oxidative status (TOS) of plasma and antioxidant enzymes such as paraoxonase (PON), stimulated paraoxonase (SPON), arylesterase (ARES) and thiols in plasma of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). In the second step. this study aimed to reveal the possible effects of ADHD treatment on these parameters. Fifty-six patients with ADHD and 52 healthy controls were involved in this study. Venous blood samples were collected and oxidative and antioxidative parameters were studied. In the second phase of the study, blood samples were taken from patients using medication. Pre-treatment oxidative stress index (OSI) values and the plasma TOS levels of the patients with ADHD were statistically higher than those of the control group. The plasma thiol levels of the patients with ADHD were significantly lower than the control group. The post-treatment plasma antioxidative parameters levels were significantly higher than the pre-treatment levels. The post-treatment oxidative stress index value was significantly lower than the pre-treatment value. Therefore, oxidative metabolism was found to be impaired in children and adolescents with ADHD. It was also determined that methylphenidate repairs the oxidative balance by increasing antioxidant defence mechanisms.

Serum nerve growth factor (NGF) levels in children with attention deficit/hyperactivity disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder of childhood. The etiopathogeny of ADHD has not been totally defined. Recent reports have suggested a pathophysiological role of neurotrophins in ADHD. In this study, we evaluated serum levels of nerve growth factor (NGF) in patients with ADHD. The sample population consisted of 44 child or adolescent patients diagnosed with ADHD according to DSM-IV criteria; 36 healthy subjects were included in the study as controls. Venous blood samples were collected, and NGF levels were measured. The mean serum NGF levels of the ADHD patients were significantly higher than those of the controls. Age and gender of the patients were not correlated with serum NGF levels. There were no significant differences in NGF levels among the combined and predominantly inattentive subtypes of ADHD. Our study suggests that there are higher levels of serum NGF in drug naive ADHD patients, and that increased levels of NGF might have an important role in the pathophysiology of ADHD.

Lipid peroxidation markers in children with anxiety disorders and their diagnostic implications

Abstract Objective Numerous factors, including genetic, neurobiological, neurochemical, and psychological factors, are thought to be involved in the development of anxiety disorders. The latest findings show that the pathophysiology of anxiety disorders might be associated with oxidative stress and lipid peroxidation; however, no studies have so far investigated lipid peroxidation markers in children with anxiety disorders. Serum levels of lipid hydroperoxide (LOOH) are a reliable marker of lipid peroxidation. Paraoxonase and arylesterase are two enzymes that protect against such peroxidation, and might also be diagnostic markers. In this study, we investigated whether there are associations between anxiety disorders and lipid peroxidation markers in children, and assessed the diagnostic performance of these markers. Methods The study group consisted of 37 patients (children and adolescents) with anxiety disorders. A control group, matched for age and gender, was composed of 36 healthy subjects. Venous blood samples were collected, and LOOH levels and paraoxonase and arylesterase activity were measured. Results LOOH levels were significantly higher in the anxiety disorders group than in the control group. There were no significant differences in paraoxonase or arylesterase activities between the patient and the control groups. Discussion Lipid peroxidation or oxidative damage might play a role in the aetiopathogenesis of anxiety disorders. LOOH may be a potential biological marker for anxiety disorders in children.

The Corr elation of Attention Deficit Hyperactivity Disorder with DRD4 Gene Polymorphism in Turkey

Abstract Attention Deficit Hyperactivity Disorder (ADHD) is a disorder with a strong genetic background, and genetic factors are thought to play a crucial role in its aetiology and developmental course. In this study the researchers investigated the correlation of ADHD with the dopamine receptor D4 (DRD4) gene. Fifty patients (6–10 years of age) diagnosed between 1994 and 2001 and followed up 7–14 years until their adolescence and young adulthood (16–25 years of age) were included in the study. Fifty healthy individuals of the same age were included as the control group. DRD4 gene analysis of patients was performed after detailed clinical evaluation. The researchers found that 88% of patients continued to meet the criteria of ADHD in adolescence and young adulthood. The most frequent DRD4 gene alleles among the ADHD and control groups were 4-, 8- and 2-repeat alleles. While the frequency of the 8-repeat allele was higher than reported global estimations, none of the three alleles were found to be significant for ADHD. However, in the presence of the 2-repeat allele for the combined subtype of ADHD diagnosed in childhood, the persistence ratio was found to be statistically significant in adolescence and young adulthood. The DRD4 gene may play a role in the developmental course of ADHD in the Turkish population.

Increased levels of serum neopterin in attention deficit/hyperactivity disorder (ADHD).

Attention deficit/hyperactivity disorder (ADHD) is the most frequently occurring neuropsychiatric disorder in childhood with an etiology that is not fully understood. A number of reviews that have addressed the neurobiology of ADHD have focused on imaging and genetics. Relatively little attention has been given to factors/mechanisms involved in the brain dysfunction. We suggest that changes in cellular immunity may be involved. Neopterin is a good indicator of cellular immunity, and we evaluated serum levels of neopterin in patients with ADHD. The study group consisted of 49 patients with ADHD. An age- and gender-matched control group was composed of 31 healthy subjects. Venous blood samples were collected, and the levels of neopterin were measured. The levels of neopterin were significantly higher in ADHD than in the comparison subjects. Cellular immunity may have a role in the etiopathogenesis of ADHD.

Genetic and Environmental Factors in Autism

Autism is a neurodevelopmental disorder characterized by impaired social interaction, and verbal and nonverbal communication as well as limited and repetitive behaviours. Although symptomatology of autism may be noticed around early months, diagnosis generally occurs around 24-36 months, however in some cases diagnosis may be delayed to adulthood [1]. Since behavioural symptoms and the degree of functional impairment are variable, the au‐ tistic disorder is described as a heterogenous symptom cluster of varying etiological and pathological basis [2]. Described as a multifactorial disorder created by interaction of neuro‐ logic, immunologic, environmental, and genetic factors, autistic disorder has no definite cause [3, 4]. In many cases in whom the etiology remains unclear are diagnosed as idiopath‐ ic autism or non-syndromic autism [5, 6]. Seventy percent of cases with idiopathic autism have basic symptoms without physical abnormalities whereas 30% have complex autism in which dysmorphic features are detected such as microcephaly and/or structural brain mal‐ formations [7]. Autism is associated with other syndromes such as Fragile X syndrome, Down Syndrome, and tuberosclerosis in 5-25% of the cases ([8, 9]. Although phenotypic het‐ erogeneity is the biggest challenge for research efforts directed to identify autism etiology [10], currently it is widely accepted that environmental and genetic factors play essential role in genesis of autistic disorder thanks to a recent advance in research techniques related to biological factors and widespread studies in this field [11, 12].

Attention deficit hyperactivity disorder and anti-Purkinje autoantibodies: no link?

ABSTRACT OBJECTIVES: Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder that begins in early childhood, and many factors play role in its etiology. Many studies have been conducted to identify the causes of ADHD, but the exact factors are still unknown. Although cerebellar dysfunction in the etiology of ADHD was shown in different studies, the possible causes of dysfunction and the role of neuroinflammation among these causes has not been clarified yet. Anti-Yo is an antibody against the antigens in the cytoplasm of purkinje cells and indicates cerebellar degeneration, and Anti-Hu and Anti-Ri are antibodies against cellular nuclear antigens of purkinje cells. This study aimed to evaluate the role of neuroinflammation that is a potential cause of cerebellar dysfunction, which is thought to be an important factor in the development of ADHD. METHODS: This is a cross-sectional and descriptive study that aimed to evaluate the potential association between ADHD and cerebellar neuroinflammation by comparing the serum anti-purkinje cell antibody measurements between case and control groups. The cases were recruited at the Gazi University Child Psychiatry Department, and laboratory analyses were performed at the Ankara Numune Research and Training Hospital Medical Microbiology Department. Sixty children and adolescents with ADHD, and 60 healthy controls were planned to be included in the study. Cases that admitted with ADHD symptoms were given Conners teacher forms according to routine procedure; then the cases with scores over the cut-off of Conners teacher form were evaluated clinically for a diagnosis of ADHD, and after clinical evaluations they were asked to participate the study if they met the eligibility criteria. If they accept to participate the study, informed consents were given to cases and parents, and meanwhile, Turkish version of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) was also applied to cases. A 5-ml serum was spared from the blood samples that obtained for routine test during diagnosis. Control group was planned to be formed from the blood samples of 60 healthy children that admitted to child psychiatry clinic for counselling. At the time of analyses, diluted according to the directions of manufacturers, incubated with fluorescent staining including antibodies (Anti-Hu, Anti-Yo, and Anti-Ri), and evaluated under immunofluorescent microscope by three specialists. RESULTS: Sixty healthy volunteers and 60 cases with ADHD were included in the study. Some of the samples were excluded from the study due to the damage to laboratory tubes during transport. Assessments were conducted with 52 ADHD and 52 healthy control samples. The male/female ratio was 41/11(78.8%/21.2%) in the patient group and 35/17 (67.3%/32.7%) in the control group (p = 0.185). Average age was 9.81 ± 2.41 in the patient group and 9.46 ± 2.14 in the control group (p = 0.442). No positive results were obtained for anti-Purkinje antibody in ADHD or control groups. CONCLUSIONS: No evidence regarding the potential role of cerebellar neuroinflammation in the etiology of ADHD was determined in this study. But these results need replication in larger samples and different methods.

Assessment of perceived parental acceptance-rejection and psychological adjustment levels of children diagnosed with attention-deficit hyperactivity disorder

Assessment of perceived parental acceptance-rejection and psychological adjustment levels of children diagnosed with attention-deficit hyperactivity disorder Objective: This study aimed to assess the perceived parental acceptance-rejection and psychological adjustment levels of children diagnosed with attention-deficit hyperactivity disorder (ADHD). Method: This study included 64 children aged 9 to 12 who were diagnosed with ADHD and 52 healthy children and their parents. Children were evaluated with ‘Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version’. The Parental Acceptance-Rejection QuestionnaireChild Form, Personality Assessment Questionnaire and a Personal Information Questionnaire formed by the researchers have been used as data collection tools. Results: In this study in which ADHD and control groups were compared, it was found that children diagnosed with ADHD perceived parental rejection more and had worse psychological adjustment than those without the diagnosis. Children with ADHD reported more rejection from the mother whereas children in the control group reported less care from the father. Conclusion: This study is exceptionally important in terms of demonstrating perceived parental acceptance-rejection and psychological adjustment of children with ADHD. Besides, it has been seen that depending on the presence of ADHD, the child’s perceived parental acceptance-rejection is differently affected from the mother and the father. The findings on acceptance-rejection, in addition to giving helpful clues for ADHD family education, they will be also helpful in studies to improve the psychological assessment of these children.