| 1. |
- Lindblad, Ida, et al.
(författare)
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Adolescents with type 1 diabetes mellitus and attention-deficit/hyperactivity disorder require specific support from healthcare professionals
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:12, s. 1994-1997
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Managing type 1 diabetes mellitus requires efficient cognitive and executive skills, and adolescents who have attention-deficit/hyperactivity disorder (ADHD) may face specific challenges. This study explored young people's experiences of diabetes treatment and care.METHOD: In a population-based study, comprising 175 patients aged 5-16 years with type 1 diabetes mellitus in two Swedish counties, we found that eight also met criteria for ADHD. Six of these, aged 14.5-16 years, participated 2013-2014 in interviews that targeted aspects of their diabetes treatment. Conducted by two psychologists, these used the inductive qualitative, semi-structured interview format.RESULTS: The two boys and four girls all reported difficulties in creating routines for their diabetes treatment and that problems were aggravated during stress. They had been criticised by their parents and the diabetes team when their blood levels indicated inadequate diabetes control. They requested ongoing information, involvement of their friends, group meetings and easy access to the healthcare system during difficult times.CONCLUSION: Patients with type 1 diabetes mellitus and concomitant ADHD faced problems with their diabetes management, especially during stressful situations. Diabetes care provision should pay particular attention to patients with co-existing neuropsychiatric and neurodevelopmental disorders such as ADHD.
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| 2. |
- Nylander, Charlotte, 1979-, et al.
(författare)
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Previously undiagnosed attention-deficit/hyperactivity disorder associated with poor metabolic control in adolescents with type 1 diabetes
- 2018
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 19:4, s. 816-822
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Tidskriftsartikel (refereegranskat)abstract
- Background: Managing modern diabetes treatment requires efficient executive functions. Patients with attention-deficit/hyperactivity disorder (ADHD) and type 1 diabetes have poor metabolic control and present with ketoacidosis more often than patients without ADHD. Objective: To assess whether patients with type 1 diabetes and with indications of executive problems met criteria for ADHD, and to investigate whether these patients had difficulties achieving metabolic control. Methods: In a hospital-based study, including 3 pediatric departments at hospitals in Stockholm and Uppsala, Sweden, questionnaires regarding executive problems had been filled out by 12- to 18-year-old patients with type 1 diabetes and their parents. Out of 166 patients with completed questionnaires, 49 were selected for a clinical study due to reported executive problems/ADHD symptoms. However, 7 already had a diagnosis of ADHD, 21 denied follow-up, 8 did not respond, leaving 13 adolescents for the clinical assessment. Results: Of the clinically assessed adolescents, 9 (6 girls) met criteria for ADHD. Patients who did not respond to the follow-up and patients who were diagnosed with ADHD within the study, showed to a larger extent than the other study groups high HbA1c levels (>70 mmol/mol, 8,6%). HbA1c >70 mmol/mol (8.6%) was associated with diagnosed ADHD (prior to or within the study), odds ratio 2.96 (95% confidence interval 1.02-8.60). Conclusion: Patients with type 1 diabetes and poor metabolic control should be assessed with regard to ADHD. There is a need for paying special attention to girls with poor metabolic control.
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| 3. |
- Venizelos, Nikolaos, 1946-, et al.
(författare)
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Altered tryptophan and alanine transport in cultured fibroblast from boys with attention deficit/hyperactivity disorder (ADHD)
- 2012
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Ingår i: International Journal of Neuropsychopharmacology. - New York, USA : Cambridge University Press. - 1461-1457 .- 1469-5111. ; 15:s1, s. 224-224
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Tidskriftsartikel (refereegranskat)abstract
- Background: The amino acid tyrosine is the precursor for the synthesis of the neurotransmitters dopamine and norepinephrine, while tryptophan is the precursor of serotonin. These neurotransmitters are implicated in the pathophysiology of Attention Deficit/Hyperactivity Disorder (ADHD). A disturbed transport of tyrosine, as well as other amino acids, has been found in a number of other neuropsychiatric disorders, such as schizophrenia, bipolar disorder and autism, when using the fibroblast cell model. Hence, the aim of this study was to explore whether children with ADHD may have disturbed amino acid transport. Materials and Methods: Skin biopsies from 14 boys diagnosed with ADHD and from 13 matching boys without a diagnosis of a developmental disorder were obtained, and from the biopsies were primary fibroblast cell lines derived. The transport of the amino acids tyrosine, tryptophan and alanine across the fibroblast cell membranes was measured by the cluster tray method. The kinetic parameters, maximal transport capacity (Vmax) and affinity constant (Km) were determined. Student’s unpaired t-test or the Mann Whitney U test was used to analyze any difference between the two groups.Results: The tryptophan transport (Vmax) was significantly decreased in the ADHD group in comparison to controls (p=0.039), while the alanine transport (Vmax) was significantly increased in the ADHD group (p=0.031). There was no significant difference regarding the tyrosine transport between the two groups.Conclusions: A decreased transport capacity of tryptophan implies that less tryptophan is being transported across the BBB in the ADHD group, since tryptophan uses the same transport systems in both fibroblasts and at the blood brain barrier (BBB). This could lead to deficient serotonin access in the brain that might cause disturbances in both the serotonergic and the catecholaminergic neurotransmitter systems, since these systems are highly interconnected. The physiological importance of an elevated transport capacity of alanine to the brain is not known to date.
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| 4. |
- Venizelos, Nikolaos, 1946-, et al.
(författare)
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Decreased density of muscarinic acetylcholine receptors in fibroblast from boys with attention deficit/hyperactivity disorder (ADHD) : An in vitro study
- 2012
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Ingår i: International Journal of Neuropsychopharmacology. - New York, USA : Cambridge University Press. - 1461-1457 .- 1469-5111. ; 15:s1, s. 224-224
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is believed that the neurotransmitters, dopamine and norepinephrine are involved in the pathophysiology of the neurobehavioral disorder Attention Deficit/Hyperactivity Disorder (ADHD). Moreover, it is known that cholinergic activity can modulate dopaminergic activity in the brain. The aim of this study was to measure the density and affinity of muscarinic acetylcholine receptors (mAChRs) in children with ADHD, by using the fibroblast cell model.Methods: Fibroblast cell homogenates from 11 boys with ADHD, fulfilling the DSM-IV diagnostic criteria and from 9 matching controls were used in the study. Radioligand binding assay was used to determine the maximal binding capacity (Bmax) and the equilibrium dissociation constant (KD) of mAChRs, using the mAChR antagonist 3H-QNB. Due to non-normally distribution of the calculated data, three outliers were identified by the MADE method (two in the ADHD group, both with a non-hereditary ADHD and one in the comparison group), and were therefore excluded from the statistical analyses.Results: A significantly lower Bmax for the binding of the muscarinic antagonist 3H-QNB was observed in the fibroblasts from the children with ADHD (n=9) when compared to controls (n=8) (p=0.01), but the KD did not differ between the two groups (p=0.40).Conclusions:The present results indicate a reduced density of mAChR in fibroblasts from children with a hereditary ADHD, which might be an indicator of the disorder. However, further studies are needed to confirm these observations.
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| 5. |
- Fernell, Elisabeth, et al.
(författare)
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Aberrant amino acid transport in fibroblasts from children with autism
- 2007
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Ingår i: Neuroscience Letters. - Amsterdam : Elsevier. - 0304-3940 .- 1872-7972. ; 418:1, s. 82-86
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Tidskriftsartikel (refereegranskat)abstract
- Autism is a developmental, cognitive disorder clinically characterized by impaired social interaction, communication and restricted behaviours. The present study was designed to explore whether an abnormality in transport of tyrosine and/or alanine is present in children with autism. Skin biopsies were obtained from 11 children with autism (9 boys and 2 girls) fulfilling the DSM-IV diagnostic criteria for autistic disorder and 11 healthy male control children. Transport of amino acids tyrosine and alanine across the cell membrane of cultured fibroblasts was studied by the cluster tray method. The maximal transport capacity, Vmax and the affinity constant of the amino acid binding sites, Km, were determined. Significantly increased Vmax for alanine (p = 0.014) and increased Km for tyrosine (p = 0.007) were found in children with autism. The increased transport capacity of alanine across the cell membrane and decreased affinity for transport sites of tyrosine indicates the involvement of two major amino acid transport systems (L- and A-system) in children with autism. This may influence the transport of several other amino acids across the blood–brain-barrier. The significance of the findings has to be further explored. © 2007 Elsevier Ireland Ltd. All rights reserved
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| 6. |
- Höglund Carlsson, Lotta, et al.
(författare)
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Coexisting disorders and problems in preschool children with autism spectrum disorders
- 2013
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Ingår i: TheScientificWorldJournal. - : Hindawi Limited. - 1537-744X. ; 2013, s. 213979-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To analyze cooccurring disorders and problems in a representative group of 198 preschool children with autism spectrum disorders (ASD) who had had interventions at a specialized habilitation center.Methods. Parents and children were seen by a research team. Data were based on parental interviews, pediatric assessments, and tests of the child. Information on autistic symptoms, general cognitive function, speech and language, motor function, epilepsy, vision, hearing, activity level, behavior, and sleep was collected.Results. Three ASD categories were used: (1) autistic disorder (AD), (2) autistic-like condition (ALC) or Asperger syndrome, and (3) one group with autistic symptoms/traits but not entirely all its criteria met for ASD. Children with autism had a mean of 3.2 coexisting disorders or problems, the ALC/Asperger group had a mean of 1.6, and children with autistic traits had a mean of 1.6. The most common disorder/problems in the total group pertained to language problems (78%), intellectual disability (ID) (49%), below average motor function (37%), and severe hyperactivity/ADHD (33%).Conclusions. The results accord with the concept of early symptomatic syndromes eliciting neurodevelopmental clinical examination (ESSENCE), and highlight the need of considering ASD in a broad perspective taking also other cooccurring developmental disorders into account.
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| 7. |
- Wester Oxelgren, Ulrika, 1960-, et al.
(författare)
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Prevalence of autism and attention-deficit-hyperactivity disorder in Down syndrome : a population-based study
- 2017
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Ingår i: Developmental Medicine & Child Neurology. - : WILEY. - 0012-1622 .- 1469-8749. ; 59:3, s. 276-283
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Tidskriftsartikel (refereegranskat)abstract
- AIM To investigate the prevalence of autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD) in a population-based group of children and adolescents with Down syndrome, and to relate the findings to level of intellectual disability and to medical conditions. METHOD From a population-based cohort of 60 children and adolescents with Down syndrome, 41 individuals (29 males, 12 females; mean age 11y, age range 5-17y) for whom parents gave consent for participation were clinically assessed with regard to ASD and ADHD. The main instruments used were the Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, Swanson, Nolan, and Pelham-IV Rating Scale, and the Adaptive Behavior Assessment System-II. RESULTS High rates of ASD and ADHD were found: 17 (42%) and 14 (34%) of the 41 children met DSM criteria for ASD and ADHD respectively. INTERPRETATION Children with Down syndrome and coexisting neurodevelopmental/neuropsychiatric disorders in addition to intellectual disability and medical disorders constitute a severely disabled group. Based on the results, we suggest that screening is implemented for both ASD and ADHD, at the age of 3 to 5 years and early school years respectively, to make adequate interventions possible.
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| 8. |
- Thompson, Lucy, et al.
(författare)
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Autism With and Without Regression: A Two-Year Prospective Longitudinal Study in Two Population-Derived Swedish Cohorts.
- 2019
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 1573-3432 .- 0162-3257. ; 49:6, s. 2281-2290
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Tidskriftsartikel (refereegranskat)abstract
- Two community-based cohorts of children with autism spectrum disorder, examined using similar assessment protocols, were pooled (n = 301) and subdivided according to history of regression. Those with regression (n = 62), 20.5% of the combined cohort, were contrasted with those without regression (n = 241) at first assessment (age range 19-60 months) and at 2-year follow-up on a range of measures. The regression group was significantly more functionally impaired, with regard to intellectual function (p < .001), language development (p < .001), and to severity of autism (p < .01) at both T1 and T2. Only 14 (23.3%) had a clearly identified underlying etiology [24 (18.6%) in the non-regressive group]. There were no significant differences between those who had regressed 'from normal' and those who had regressed 'from low' functioning.
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| 9. |
- Thorsson, Max, 1995, et al.
(författare)
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A novel tablet-based motor coordination test performs on par with the Beery VMI subtest and offers superior temporal metrics: findings from children with pediatric acute-onset neuropsychiatric syndrome.
- 2023
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Ingår i: Experimental brain research. - 0014-4819 .- 1432-1106. ; 241:5, s. 1421-1436
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Tidskriftsartikel (refereegranskat)abstract
- Neuropsychiatric and neurodevelopmental disorders are often associated with coordination problems. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) constitutes a specific example of acute and complex symptomatology that includes difficulties with motor control. The present proof-of-concept study aimed at testing a new, bespoke tablet-based motor coordination test named SpaceSwipe, providing fine-grained measures that could be used to follow-up on symptoms evolution in PANS. This test enables computationally precise and objective metrics of motor coordination, taking into account both directional and spatial features continuously. We used SpaceSwipe to assess motor coordination in a group of children with PANS (n = 12, assessed on in total of 40 occasions) and compared it against the motor coordination subtest from the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) 6th edition, traditionally used to follow-up symptomatology. Using a bivariate linear regression, we found that 33 s of the directional offset from tracking a moving target in SpaceSwipe could predict the Beery VMI motor coordination (VMI MC) raw scores (mean absolute error: 1.75 points). Positive correlations between the predicted scores and the VMI MC scores were found for initial testing (radj = 0.87) and for repeated testing (radj = 0.79). With its short administration time and its close prediction to Beery VMI scores, this proof-of-concept study demonstrates the potential for SpaceSwipe as a patient-friendly tool for precise, objective assessment of motor coordination in children with neurodevelopmental or neuropsychiatric disorders.
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| 10. |
- Knez, Rajna, et al.
(författare)
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Orexin/Hypocretin System Dysfunction in ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations)
- 2022
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Ingår i: Neuropsychiatric Disease and Treatment. - : Dove Medical Press Ltd. - 1176-6328 .- 1178-2021. ; 18, s. 2683-2702
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Tidskriftsartikel (refereegranskat)abstract
- Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) is an umbrella term covering a wide range of neurodevelopmental difficulties and disorders. Thus, ESSENCE includes attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental disorders (NDDs) and difficulties, with a variety of symptoms in cognitive, motor, sensory, social, arousal, regulatory, emotional, and behavioral developmental domains, frequently co-occurring and likely having partly common neurobiological substrates. The ESSENCE concept is a clinical paradigm that promotes organizing NDDs in everyday clinical practice according to their coexistence, symptom dimensions overlapping, and treatment possibilities. Despite increased knowledge regarding NDDs, the neurobiological mechanisms that underlie them and other ESSENCE-related problems, are not well understood. With its wide range of neural circuits and interactions with numerous neurotransmitters, the orexin/hypocretin system (Orx-S) is possibly associated with a variety of neurocognitive, psychobiological, neuroendocrine, and physiological functions and behaviors. Dysfunction of Orx-S has been implicated in various psychiatric and neurological disorders. This article provides an overview of Orx-S dysfunctions' possible involvement in the development, presentation, and maintenance of ESSENCE. We provide a focused review of current research evidence linking orexin neuropeptides with specific clinical NDDs symptoms, mostly in ADHD and ASD, within the Research Domain Criteria (RDoC) framework. We propose that Orx-S dysfunction might have an important role in some of these neurodevelopmental symptom domains, such as arousal, wakefulness, sleep, motor and sensory processing, mood and emotional regulation, fear processing, reward, feeding, attention, executive functions, and sociability. Our perspective is presented from a clinical point of view. Further, more thorough systematic reviews are needed as well as planning of extensive new research into the Orx-S’s role in ESSENCE, especially considering RDoC elements.
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