Sevgi Özmen

Increased Serum Phthalates (MEHP, DEHP) and Bisphenol A Concentrations in Children With Autism Spectrum Disorder The Role of Endocrine Disruptors in Autism Etiopathogenesis

The aim of this study was to investigate the relationship between autism spectrum disorders development and exposure to mono-(2-ethylhexyl)-phthalate (MEHP), di-(2-ethylhexyl)-phthalate (DEHP), and bisphenol A (BPA), 1 of the endocrine disruptors, among phthalates. The study included 48 children with autism spectrum disorder (27 boys, 21 girls) and 41 healthy subjects (24 boys, 17 girls) as controls. Serum MEHP, DEHP, and BPA levels were measured by using high-performance liquid chromatography. Children with autism spectrum disorder had significantly increased serum MEHP, DEHP, and BPA concentrations (0.47 ± 0.14 µg/ml, 2.70 ± 0.90 µg/ml, 1.25 ± 0.30 ng/ml) compared to healthy control subjects (0.29 ± 0.05 µg/ml, 1.62 ± 0.56 µg/ml, 0.88 ± 0.18 ng/ml) respectively (P = .000). The fact that higher serum MEHP, DEHP, and BPA were found levels in the autism spectrum disorder group compared to healthy controls suggests that endocrine disruptors may have a role in the pathogenesis of autism spectrum disorders.

The relationship between aggression, empathy skills and serum oxytocin levels in male children and adolescents with attention deficit and hyperactivity disorder.

Although attention deficit and hyperactivity disorder (ADHD) are recognized as neurodevelopmental disorders characterized by impairment in executive functions, impairments in social functioning are often accompanied by ADHD. Oxytocin (OT) has been investigated in a number of psychiatric disorders owing to its effects on social interactions. The aim of this study was to determine the relationship between aggression, empathy and OT levels in children with ADHD. Forty male patients with ADHD, ranging in age from 7 to 18 years, and 40 healthy age-matched and sex-matched individuals were included in this study. The patients and healthy controls filled in the Buss–Perry Aggression Questionnaire and Bryant’s Empathy Index for Children and Adolescents; the Reading the Mind in the Eyes test was then completed. Blood samples were collected for OT at the beginning of the study. Lower serum OT levels were observed in patients with ADHD compared with the healthy controls. Moreover, there was a negative correlation between serum OT level and aggression scores and a positive correlation between the serum OT level and empathy scores in patients with ADHD. We conclude that OT may play a role in aggression and empathy skills, affecting the social life of those with ADHD.

Different etiologies of acquired torticollis in childhood

IntroductionTorticollis can be congenital or may be acquired in childhood. Acquired torticollis occurs because of another problem and usually presents in previously normal children. The causes of acquired torticollis include ligamentous, muscular, osseous, ocular, psychiatric, and neurologic disorders.ObjectiveWe performed this study to evaluate the underlying causes of torticollis in childhood.Material and methodsTen children presented with complaints of torticollis between April 2007 and April 2012 were enrolled in this study. The additional findings of physical examination included neck pain, twisted neck, walking disorder, imbalance, and vomiting The identified etiologies of the enrolled children was acute disseminated encephalomyelitis in a 2.5-year-old boy, posterior fossa tumor in a 10-month-old boy, spontaneous spinal epidural hematoma in a 5-year-old hemophiliac boy, cervical osteoblastoma in a 3-year-old boy, arachnoid cyst located at posterior fossa in a 16-month-old boy, aneurysm of the anterior communicating artery in a 6-year-old girl, pontine glioma in a 10-year-old girl, and a psychogenic torticollis in a 7-year-old boy were presented.ConclusionThere is a wide differential diagnosis for a patient with torticollis, not just neurological in etiology which should be considered in any patient with acquired torticollis. Moreover, early diagnosis of etiological disease will reduce mortality and morbidity. Therefore, clinicians managing children with torticollis must be vigilant about underlying neurological complications.

Relationship between Impulsivity and Serum Oxytocin in Male Children and Adolescents with Attention-Deficit and Hyperactivity Disorder: A Preliminary Study

INTRODUCTION Here we aimed to determine the relationship between oxytocin levels and impulsivity, which is an important aspect at Attention Deficit Hyperactivity Disorder (ADHD) clinics. METHODS The study population comprised 40 ADHD patients diagnosed based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version, without other psychiatric disorders and chronic diseases aged between 8 and 15 years. The control group comprised 40 healthy, age-matched, male children and adolescents who voluntarily participated in the study. Patients and controls filled the Barratt impulsivity scale-11 (BIS-11). Ten cubic centimeters of blood was collected at 8 am for determining serum oxytocin levels. ELISA kits were used to measure serum oxytocin levels in a biochemistry laboratory. The obtained data were evaluated using appropriate statistical methods. RESULTS In this study, compared with the control group, the impulsivity scores were significantly higher and serum oxytocin levels were lower in the ADHD group (52.5±18.1 and 37.62±9.0, respectively, p<0.001). Serum oxytocin levels showed a negative correlation with impulsivity and attention subscale scores of BIS-11 in the ADHD group. CONCLUSION ADHD and impulsivity, which comprise an aspect of ADHD, may be associated with oxytocin. Serum oxytocin levels may contribute to inattention subtypes of impulsivity observed in ADHD.

The Relationship Between Parental Affective Temperament Traits and Disruptive Behavior Disorders Symptoms in Children With ADHD

Objective: This study investigated the relationship between parental affective temperaments and the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with ADHD. Method: The sample consisted of 542 treatment-naive children with ADHD and their biological parents. Children were assessed via both parent- and teacher-rated behavioral disorder scales. Parental affective temperament and ADHD symptoms were measured by self-report inventories. The relationships between psychiatric variables were evaluated using structural equation modeling. Results: According to parent-rated behavioral disorder scales, paternal cyclothymic and maternal irritable temperaments were associated with ODD scores, and maternal depressive temperament was associated with CD scores. In terms of teacher-rated behavioral disorder scales, maternal anxious temperament was associated with ODD scores, and paternal cyclothymic and maternal depressive temperaments were associated with CD scores. Conclusion: These results suggest that certain parental affective temperaments are related to an increase in symptoms of disruptive behavioral disorders in children with ADHD.

Neural Correlates of Default Mode Network Connectivity in Children with Attention Deficit and Hyperactivity Disorder

The Purpose: The objective of this study is to explore neural correlates of Default Mode Network (DMN) regions in children with attention deficit and hyperactivity disorder (ADHD) using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: The study included ten children with ADHD (aged between 9 and 16) and ten age-matched controls. Four DMN regions (medial prefrontal cortex (MPFC), the posterior cingulate cortex (PCC), left and right inferior parietal lobes (IPL) and the corresponding Broadmann areas in each one were used as seeds and their functional connectivity with the whole brain was explored and compared between ADHD and control groups using t-test (p<0.05). Results: We observed that when DMN regions were selected as seeds, the connected regions were different between two groups and were mostly in the right hemisphere in ADHD patients contrary to the left hemisphere in the control group. Conclusion: In conclusion, neural correlates of DMN regions differ in ADHD patients compared to healthy controls. Our findings suggest that in ADHD patients, DMN regions show more connectivity with the right hemisphere of the brain whereas the left hemisphere is more functionally connected with DMN in health controls. Further research is required to explore this atypical DMN connectivity in ADHD using larger cohort.

Association of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder

This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive–proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive–proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive–proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive–proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.

Evaluation of two types of drug treatment with QEEG in children with ADHD

Abstract Aims The aim of this study is to evalute the effects of methylphenidate and atomoxetine treatments on electroencephalography (EEG) signals in volunteer children diagnosed with Attention Deficit and Hyperactivity Disorder(ADHD). Methods The study contained 40 children all of whom were between the ages of 7 and 17. The participants were classified into two groups as ADHD (n=20), which was in itself divided into two groups as ADHD-MPH (ADHD- Metylphenidate treatment) (n=10) and as ADHD-ATX (ADHD-Atomoxetin treatment) (n=10), and one control group (n=20). Following the first EEG recordings of the ADHD group, long-acting methylphenidate dose was applied to one ADHD group and atomoxetine dose was applied to the other ADHD group. The effect of optimal dosage is about for 4-6 weeks in general. Therefore, the response or lack of response to the treatment was evaluated three months after the beginning of the treatment. After methylphenidate and atomoxetine drug treatment, in order to obtain mean and maximum power values for delta, theta, alpha and beta band, the EEG data were analyzed. Results The EEG power spectrum densities in all the bands yielded similar findings in both methylphenidate and atomoxetine. Although statistically significant frequency values of the electrodes were amplitude and maximally varied, in general, they appeared mostly at both frontal and temporal regions for methylphenidate and atomoxetine. Conclusion Especially, after atomoxetine treatment, Quantitative Electroencephalography (QEEG) rates at frontal area electrodes were found statistically more significant than methylphenidate QEEG rates. What has been researched in this study is not only whether QEEG is likely to support the diagnosis, but whether changes on QEEG by treatment may be related to the severity of ADHD as well.

Investigation of Attention Deficit Hyperactivity Disorder (ADHD) sub-types in Children via EEG Frequency Domain analysis

ABSTRACT Aim of the study: To investigate the frequency domain effects and changes in electroencephalography (EEG) signals in children diagnosed with attention deficit hyperactivity disorder (ADHD). Patients and methods: The study contains 40 children. All children were between the ages of 7 and 12 years. Participants were classified into four groups which were ADHD (n=20), ADHD-I (ADHD-Inattentive type) (n=10), ADHD-C (ADHD-Combined type) (n=10), and control (n=20) groups. In this study, the frequency domain of EEG signals for ADHD, subtypes and control groups were analyzed and compared using Matlab software. The mean age of the ADHD childrens group was 8.7 years and the control group 9.1 years. Results: Spectral analysis of mean power (μV2) and relative-mean power (%) was carried out for four different frequency bands: delta (0--4 Hz), theta (4--8 Hz), alpha (8--13 Hz) and beta (13--32 Hz). The ADHD and subtypes of ADHD-I, and ADHD-C groups had higher average power value of delta and theta band than that of control group. However, this is not the case for alpha and beta bands. Increases in delta/beta ratio and statistical significance were found only between ADHD-I and control group, and in delta/beta, theta/delta ratio statistical significance values were found to exist between ADHD-C and control group. Conclusion: EEG analyzes can be used as an alternative method when ADHD subgroups are identified.

Prefrontal Brain Activation in Subtypes of Attention Deficit Hyperactivity Disorder: A Functional Near-Infrared Spectroscopy Study

DOI : 10.26650/electrica.2018.99730 According to clinical symptoms, attention deficit and hyperactivity disorder (ADHD) is categorized into three groups: the predominantly inattentive subtype (ADHD-I), the predominantly hyperactive-impulsive subtype (ADHD-HI), and the combined subtype (ADHD-C). Recent advances in neuroimaging have demonstrated new approaches for assessing the ADHD subtypes with underlying pathophysiology. This study aims to examine the hemodynamic response and reaction time (RT) in healthy children and the ADHD subtypes as measured by functional near-infrared spectroscopy (fNIRS) during an auditory oddball attention task. The sample was made up of 40 children divided into four groups: control group (n=14), ADHD-I group (n=9), ADHD-HI group (n=6), and ADHD-C group (n=11). The target responses were identified and were grand-averaged for each participant. Right prefrontal cortex hemodynamic responses and groups performances on RT were compared between subtypes and between controls and subtypes. Functional near-infrared spectroscopy indicated that while control subjects exhibited higher activation than all ADHD subtypes, the ADHD subtypes did not differ from one another. Relative to control subjects, a longer RT was observed in all ADHD subtypes. The ADHD-I group showed significantly longer RTs compared to the ADHD-HI and ADHD-C groups. This study can bring a new perspective to the continuing controversy about ADHD subtypes, and the findings may help in the evaluation of fNIRS, RT, and RT variability studies in ADHD.