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Lee SY, Li SC, Yang CY, Kuo HC, Chou WJ, Wang LJ. Gut Leakage Markers and Cognitive Functions in Patients with Attention-Deficit/Hyperactivity Disorder. CHILDREN 2023; 10:children10030513. [PMID: 36980071 PMCID: PMC10047799 DOI: 10.3390/children10030513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/18/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a commonly seen mental disorder in children. Intestinal permeability may be associated with the pathogenesis of ADHD. The study herein investigated the role of gut leakage biomarkers in the susceptibility of ADHD. A total of 130 children with ADHD and 73 healthy controls (HC) individuals were recruited. Serum concentrations of zonulin, occludin, and defensin (DEFA1) were determined. Visual attention was assessed with Conners’ continuous performance test (CPT). In order to rate participants’ ADHD core symptoms at home and school, their parents and teachers completed the Swanson, Nolan, and Pelham—Version IV Scale (SNAP-IV), respectively. We found significantly lower DEFA1 levels in the ADHD group compared to that in the HC group (p = 0.008), but not serum levels of zonulin and occludin. The serum levels of DEFA1 showed an inverse correlation with the inattention scores in the SNAP-IV parent form (p = 0.042) and teacher form (p = 0.010), and the hyperactivity/impulsivity scores in the SNAP-IV teacher form (p = 0.014). The serum levels of occludin showed a positive correlation with the subtest of detectability in the CPT (p = 0.020). Our study provides new reference into the relation between gut leakage markers and cognition, which may advance research of the pathophysiology of ADHD.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Sung-Chou Li
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Chia-Yu Yang
- Department of Microbiology and Immunology/Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8753); Fax: +886-7-7326817
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Sun H, Chen Y, Huang Q, Lui S, Huang X, Shi Y, Xu X, Sweeney JA, Gong Q. Psychoradiologic Utility of MR Imaging for Diagnosis of Attention Deficit Hyperactivity Disorder: A Radiomics Analysis. Radiology 2017; 287:620-630. [PMID: 29165048 DOI: 10.1148/radiol.2017170226] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose To identify cerebral radiomic features related to diagnosis and subtyping of attention deficit hyperactivity disorder (ADHD) and to build and evaluate classification models for ADHD diagnosis and subtyping on the basis of the identified features. Materials and Methods A consecutive cohort of 83 age- and sex-matched children with newly diagnosed and never-treated ADHD (mean age 10.83 years ± 2.30; range, 7-14 years; 71 boys, 40 with ADHD-inattentive [ADHD-I] and 43 with ADHD-combined [ADHD-C, or inattentive and hyperactive]) and 87 healthy control subjects (mean age, 11.21 years ± 2.51; range, 7-15 years; 72 boys) underwent anatomic and diffusion-tensor magnetic resonance (MR) imaging. Features representing the shape properties of gray matter and diffusion properties of white matter were extracted for each participant. The initial feature set was input into an all-relevant feature selection procedure within cross-validation loops to identify features with significant discriminative power for diagnosis and subtyping. Random forest classifiers were constructed and evaluated on the basis of identified features. Results No overall difference was found between children with ADHD and control subjects in total brain volume (1069830.00 mm3 ± 90743.36 vs 1079 213.00 mm3 ± 92742.25, respectively; P = .51) or total gray and white matter volume (611978.10 mm3 ± 51622.81 vs 616960.20 mm3 ± 51872.93, respectively; P = .53; 413532.00 mm3 ± 41 114.33 vs 418173.60 mm3 ± 42395.48, respectively; P = .47). The mean classification accuracy achieved with classifiers to discriminate patients with ADHD from control subjects was 73.7%. Alteration in cortical shape in the left temporal lobe, bilateral cuneus, and regions around the left central sulcus contributed significantly to group discrimination. The mean classification accuracy with classifiers to discriminate ADHD-I from ADHD-C was 80.1%, with significant discriminating features located in the default mode network and insular cortex. Conclusion The results of this study provide preliminary evidence that cerebral morphometric alterations can allow discrimination between patients with ADHD and control subjects and also between the most common ADHD subtypes. By identifying features relevant for diagnosis and subtyping, these findings may advance the understanding of neurodevelopmental alterations related to ADHD. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Huaiqiang Sun
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Ying Chen
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Qiang Huang
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Su Lui
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Xiaoqi Huang
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Yan Shi
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Xin Xu
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - John A Sweeney
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
| | - Qiyong Gong
- From the Department of Radiology, Huaxi MR Research Center (H.S., Y.C., S.L., X.H., J.A.S., Q.G.), Research Core Facilities (H.S., Q.H.), and Department of Psychiatry (Y.C., Y.S., X.X.), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, Sichuan, China (Y.C., Y.S., X.X., Q.G.); and Department of Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan, China (Y.S.,Q.G.)
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