Association between inflammatory cytokines and ADHD symptoms in children and adolescents with obesity: A pilot study

Cortese, Samuele; Angriman, Marco; Comencini, Erika; Vincenzi, Brenda; Maffeis, Claudio

doi:10.1016/j.psychres.2019.05.030

Cited by 47 publications

(28 citation statements)

References 28 publications

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“…was reported to increase in individuals with both ASD (36) and ADHD (37). Considering all the results of the studies reporting zonulin increase in ASD (20) and ADHD (21), reported association between serum zonulin levels and social responsiveness (21) and mentioned findings in biomarker level together, we suggest that coinciding inflammatory processes might explain our finding of the association between serum zonulin levels and social cognition deficits in ADHD.…”

Section: Discussionsupporting

confidence: 60%

Dikkat Eksikliği Hiperaktivite Bozukluğu olan Çocuklarda Serum Zonulin Düzeyleri ve Sosyal Biliş

Yurteri

Şahin

2020

Düzce Tıp Fakültesi Dergisi

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Aim: Alterations in gut-brain axis of patients with attention deficit hyperactivity disorder (ADHD) have been indicated in recent studies. The aim of this study was to determine whether serum level of zonulin, considered to be a regulator of permeability in both gut-blood and blood-brain barriers, was associated with ADHD symptoms, and to evaluate the relationship between zonulin and social cognition in children with ADHD. Material and Methods: Serum level of zonulin was analyzed by enzyme-linked immunosorbent assay (ELISA) in 40 treatment-naive children with ADHD, and age and gender matched 40 healthy children as control group. DuPaul ADHD Rating Scale was used for ADHD symptoms and reading the mind in the eyes test (RMET) was administered by the clinician to examine the social cognitive abilities. Results: We found that serum zonulin levels were significantly higher in ADHD group compared to control group (p=0.010). Also, children with ADHD have significantly lower RMET scores (p=0.007). Furthermore, we found statistically significant positive correlations between serum zonulin levels and ADHD symptoms (p<0.001) and a negative correlation between serum zonulin levels and RMET scores (p=0.001) in ADHD group. Conclusion:The present study is the first to evaluate whether there is a relationship between serum zonulin levels and social cognition in children with ADHD. The results of our study indicate that zonulin may be associated with ADHD and social cognition. Further studies with larger samples are required to determine the role of zonulin in ADHD.

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Section: Discussionsupporting

confidence: 60%

Dikkat Eksikliği Hiperaktivite Bozukluğu olan Çocuklarda Serum Zonulin Düzeyleri ve Sosyal Biliş

Yurteri

Şahin

2020

Düzce Tıp Fakültesi Dergisi

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“…While until recently there was no empirical evidence in relation to this, a recent pilot study provided initial evidence supporting a possible role of inflammatory mechanisms. In this study of 52 children seen in an obesity clinic, Cortese et al [38] found a significant correlation between cytokines involved in inflammatory processes, i.e., IL-6 and TNF-alpha, and severity of hyperactivity/impulsivity symptoms rated by both parents and teachers. This small pilot study sets the ground for larger studies ideally aiming to longitudinally follow the impact of early inflammatory alterations, linked to obesity, on later neurocognitive aspects.…”

Section: What Are the Factors Underpinning The Association Betweenmentioning

confidence: 93%

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

Cortese

2019

Brain Sciences

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This narrative review is aimed at presenting the most recent evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The review is informed by previous relevant systematic reviews and a search in Pubmed and PsycINFO up to 1 August 2019. Although the association between ADHD and obesity would seem, at first, paradoxical, in the past two decades there has been an increasing number of studies on this topic. The present review shows that there is meta-analytic evidence supporting a significant association between these two conditions, at least in adults. Growing evidence is also being published on the genetic and environmental factors underlying the association. However, the cause–effects paths, as well as the exact mechanisms explaining the association, remain unclear. Additionally, empirical evidence guiding the management/treatment of patients with the two conditions is still limited. Therefore, after almost 20 years from the first report of a link between ADHD and obesity, this association continues to be puzzling.

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“…An association study of 546 patients with ADHD and 546 controls demonstrated an association between cytokine family ciliary neurotrophic factor receptor and both adult and childhood ADHD ( 139 ). Inflammatory processes may also increase the risk of ADHD in obese individuals and peripheral inflammatory factor levels may aggravate the severity of ADHD core symptoms ( 140 , 141 ). The incidence of obesity and neuropsychiatric diseases has risen rapidly over the past three decades in the US ( 142 , 143 ).…”

Section: Inflammation/mcs and Adhdmentioning

confidence: 99%

Mast cell‑mediated neuroinflammation may have a role in attention deficit hyperactivity disorder (Review)

Song

Huang

et al. 2020

Exp Ther Med

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Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental and behavioral disorder with a serious negative impact on the quality of life from childhood until adulthood, which may cause academic failure, family disharmony and even social unrest. The pathogenesis of ADHD has remained to be fully elucidated, leading to difficulties in the treatment of this disease. Genetic and environmental factors contribute to the risk of ADHD development. Certain studies indicated that ADHD has high comorbidity with allergic and autoimmune diseases, with various patients with ADHD having a high inflammatory status. Increasing evidence indicated that mast cells (MCs) are involved in the pathogenesis of brain inflammation and neuropsychiatric disorders. MCs may cause or aggravate neuroinflammation via the selective release of inflammatory factors, interaction with glial cells and neurons, activation of the hypothalamic-pituitary adrenal axis or disruption of the blood-brain barrier integrity. In the present review, the notion that MC activation may be involved in the occurrence and development of ADHD through a number of ways is discussed based on previously published studies. The association between MCs and ADHD appears to lack sufficient evidence at present and this hypothesis is considered to be worthy of further study, providing a novel perspective for the treatment of ADHD.

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Association between inflammatory cytokines and ADHD symptoms in children and adolescents with obesity: A pilot study

Cited by 47 publications

References 28 publications

Dikkat Eksikliği Hiperaktivite Bozukluğu olan Çocuklarda Serum Zonulin Düzeyleri ve Sosyal Biliş

Dikkat Eksikliği Hiperaktivite Bozukluğu olan Çocuklarda Serum Zonulin Düzeyleri ve Sosyal Biliş

The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling

Mast cell‑mediated neuroinflammation may have a role in attention deficit hyperactivity disorder (Review)

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