Correlation between Epilepsy and Attention Deficit Hyperactivity Disorder: A Population-Based Cohort Study

Chou, I-Ching; Chang, Yu-Tzu; Chin, Zheng-Nan; Muo, Chih‐Hsin; Sung, Fung‐Chang; Kuo, Huang-Tsung; Tsai, Chang‐Hai; Kao, Chia‐Hung

doi:10.1371/journal.pone.0057926

Cited by 69 publications

(56 citation statements)

References 24 publications

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“…47 Therefore, the associations between other developmental problems and ADHD observed in this study are plausible given that disruption in any component of the circuitry involved in attention and activity could lead to diverse neurobehavioral problems. The strong comorbid association between ADHD with CNS/neurologic disorders, particularly seizures and epilepsy, 48 that are likely to result from common underlying genetic 49 and/or environmental 50,51 risk factors confirms this well-established association from clinical samples. The availability of measures of neurocognitive function and neuroimaging in a subset of this sample will facilitate our investigation of possible mechanisms for these associations.…”

Section: Mood Disorderssupporting

confidence: 57%

Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study

Merikangas¹,

Calkins²,

Burstein³

et al. 2015

Pediatrics

106

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Section: Mood Disorderssupporting

confidence: 57%

Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study

Merikangas¹,

Calkins²,

Burstein³

et al. 2015

Pediatrics

106

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“…Several mechanisms explain how epilepsy and comorbidities are associated, including shared risk factors and bidirectional relations [5]. In our previous studies, we used the NHIRD to examine similar relationships between epilepsy and a number of conditions, including schizophrenia and attention deficit hyperactivity disorder (ADHD) [6,7]. We found a strong bidirectional relationship between schizophrenia and epilepsy.…”

mentioning

confidence: 91%

“…In another study, we found that the possibility of developing ADHD among epileptic patients is higher (adjusted HR 2.54). Conversely, ADHD increases the risk of subsequent epilepsy (adjusted HR 3.94), and vice versa [7]. Such a relationship may be explained by the existence of common pathogenic mechanisms in both conditions, including changes in neuroanatomy, neural migration dysfunction, genetic susceptibility or environmental factors.…”

mentioning

confidence: 99%

The intriguing relationship between epilepsy and type 1 diabetes mellitus. Reply to Sander JW, Novy J, Keezer MR [letter]

Chou

Kao²

2016

Diabetologia

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We thank Sander et al for their letter [1] commenting on our recent article [2], in which we reported that patients with type 1 diabetes mellitus are at an increased risk of developing epilepsy. Sander et al point out the strengths and challenges of the study. First, our researchers conducted a retrospective population-based cohort study using claims data from the Taiwan National Health Insurance Research Database (NHIRD). The coverage rate of the Taiwan National Health Insurance programme (NHI) reached 99% of the 23 million residents of Taiwan in 1998. The NHIRD is renewed annually and includes registries for beneficiaries, disease diagnosis records, medical prescriptions and other medical services. It is a large, population-based sample effectively including all Taiwanese residents. The registries of NHI claims primarily serve the purpose of administrative billing and do not undergo verification for scientific purposes. Therefore, we were unable to contact the patients directly to obtain more information, because of the anonymity assured by the identification numbers.Second, metabolic abnormalities of type 1 diabetes, such as hyper-and hypoglycaemia, may have a damaging effect on the central nervous system (CNS) and be associated with significant long-term neurological sequelae. Sander et al [1] point out that our data included hypoglycaemia as a potential confounder, although hyperglycaemia is not considered in the statistical analysis. This was because we used an in-hospital diagnosis (ICD-9-CM [www.icd9data.com/2007/Volume1] 251.0-251.2 and 775.6), whereby a patient was deemed to have hypoglycaemia occurring during follow-up. As suggested by Sander et al, patients with hyperglycaemia might have been underestimated, because this may not translate into a recoded diagnosis.Third, we found that younger age was associated with an increased risk of developing epilepsy; those aged at least 6 years were 40 percent less likely to have epilepsy than those under 6 years. This is consistent with previous studies indicating that young age is an important risk factor for electroencephalographic abnormalities [3].Fourth, 59 people were reported to have 'developed' epilepsy over the course of the study, but 27% of these (16 of 59) had a prior history of epilepsy, which would generally make these prevalent rather than incident cases. Actually, epilepsy is characterised by spontaneous recurrent seizures, but can be a pervasive condition of which seizures are just one expression [4]. Several mechanisms explain how epilepsy and comorbidities are associated, including shared risk factors and bidirectional * Chia-Hung Kao

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“…The reported prevalence of ADHD varies from 23% to 40% in children with epilepsy, compared to 3-6% of the general population [3,4]. A number of studies have reported a close association between ADHD and epilepsy [5][6][7][8][9][10]. Chou et al [10] reported…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies have reported a close association between ADHD and epilepsy [5][6][7][8][9][10]. Chou et al [10] reported…”

Section: Introductionmentioning

confidence: 99%

Electroencephalographic Abnormalities in Non-epileptic Children with Attention-Deficit /Hyperactivity Disorder

Li¹,

Chen²,

Hung³

2018

Neuropsychiatry

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Objective: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood, however few studies have investigated epileptic seizures and electroencephalographic abnormalities in children with ADHD. The aim of this study was to explore the occurrence of epileptiform discharges in children with ADHD. Method:We enrolled children with ADHD who visited the neurology clinic of our hospital between January 2014 and June 2016, all of whom met the DSM-V criteria and underwent awake and sleep electroencephalography examinations. We excluded those with histories of intellectual disabilities, epilepsy, congenital anomalies and substance abuse. None of the patients had a history of seizures before the examination.Results: A total of 121 patients were included (93 males, 28 females, mean age 6.9±2.5 years), of whom 28 (23.1%) had electroencephalographic abnormalities, including three (10.7%) with generalized epileptiform discharges and 25 (89.3%) with focal epileptiform discharges. The focal epileptiform discharges were most prevalent from the rolandic area (15/25), followed by the parietal area (5/25), frontal area (4/25) and occipital area (1/25). Fourteen (50%) of the 28 patients had abnormal electroencephalographic findings only during sleep recordings. Conclusions:Electroencephalographic focal abnormalities were found in 23.1% of our patients, of which 50% appeared only during sleep recordings. We suggest that sleep and awake electroencephalography recordings should be part of the routine assessment of children with ADHD regardless of whether or not they have overt seizures or other neurological conditions. In patients who do not respond well to traditional ADHD drugs, treatment for paroxysmal electroencephalographic abnormalities may be considered.

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Correlation between Epilepsy and Attention Deficit Hyperactivity Disorder: A Population-Based Cohort Study

Cited by 69 publications

References 24 publications

Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study

Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study

The intriguing relationship between epilepsy and type 1 diabetes mellitus. Reply to Sander JW, Novy J, Keezer MR [letter]

Electroencephalographic Abnormalities in Non-epileptic Children with Attention-Deficit /Hyperactivity Disorder

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