Effect of vitamin D supplementation on brain waves, behavioral performance, nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in children with attention deficit/hyperactivity disorder: study protocol for a randomized clinical trial

The effect of vitamin D supplementation on the brain mapping and behavioral performance of children with ADHD: a double-blinded randomized controlled trials

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental diseases that are accompanied with EEG pattern changes and Low levels of 25-hydroxyvitamin D [25(OH)D]. Neurofeedback provides a feedback signal to alleviate brain wave abnormalities and offers an alternative therapy for ADHD. This study aimed to investigate the concomitant effects of Vitamin D3 supplementation and Neurofeedback on children with ADHD.

METHOD

This study was implemented on children with an established diagnosis of ADHD who received multisession Neurofeedback therapy. The intervention and control groups received 50000 IU vitamin D3 capsules and placebo respectively once a week for 2 months. The background rhythm was measured using quantitative EEG both before and at the end duration of the therapy.

RESULTS

All of the vitamin D3 treated children showed a significant increase in the 25(OH)D (46 ± 18, 28 ± 10 (ng/ml), p = 0.001) and serum calcium level (9.5 ± 0.5, 9.8 ± 0.3 (mg/dl), p = 0.003) compared to the baseline. There were a statistically significant decrease in the treatment group about theta relative power, theta/beta, and theta/alpha power ratios within two eyes conditions (p = 0.004). All the changes were significant within eye open state in the treatment group (2.4 ± 1.2, 1.7 ± 0.5, p = 0.01). There is a significant relationship between Connors scores and some brain waves improvement (in relative theta (r = 0.998) and theta-to-beta power difference score (r = 0.56) (p < 0.001).

CONCLUSION

Concomitant use of vitamin D3 supplementation and neurofeedback, increases the serum level of this vitamin and reveal favorable electrophysiological results in children with ADHD.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20200922048802N1..

The Association between Glucose 6-Phosphate Dehydrogenase Deficiency and Attention Deficit/Hyperactivity Disorder

BACKGROUND

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, impacting 4.9% of the population and more prevalent in Mediterranean communities, is a common enzymopathy with potential relevance to Attention Deficit/Hyperactivity Disorder (ADHD). This study investigated this association.

METHODS

The clinical characteristics of 7473 G6PD-deficient patients and 29,892 matched case-controls (selected at a 1:4 ratio) from a cohort of 1,031,354 within the Leumit Health Services database were analyzed using Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables.

RESULTS

In total, 68.7% were male. The mean duration of follow-up was 14.3 ± 6.2 years at a mean age of 29.2 ± 22.3 years. G6PD deficiency was associated with an increased risk of being diagnosed with ADHD (Odds Ratio (OR) = 1.16 [95% CI, 1.08-1.25], p < 0.001), seeking care from adult neurologists (OR = 1.30 [95% CI, 1.22-1.38], p < 0.001), and consulting adult psychiatrists (OR = 1.12 [95% CI, 1.01-1.24], p = 0.048). The use of stimulant medications among G6PD-deficient individuals was 17% higher for the methylphenidate class of drugs (OR = 1.17 [95% CI, 1.08, 1.27], p < 0.001), and there was a 16% elevated risk for amphetamine use (OR = 1.16 [95% CI, 1.03, 1.37], p = 0.047).

CONCLUSIONS

G6PD deficiency signals an increased risk of ADHD diagnosis, more severe presentations of ADHD and a greater need for psychiatric medications to treat ADHD.

Effect of 25 hydroxyvitamin D on attention deficit and hyperactivity in school-age children with ADHD

BACKGROUND

To observe the serum levels of 25 hydroxyvitamin D [25 (OH) D] in healthy school-age children and children with attention deficit hyperactivity disorder (ADHD) and to analyze the effects of serum 25 (OH) D on the symptoms of attention deficit and hyperactivity in school-age children with ADHD.

METHODS

According to the Diagnostic and Statistical Manual of Mental Disorders DSM-IV diagnostic criteria for ADHD in children, 80 healthy children aged 6 years or less than 10 years old and children diagnosed with ADHD in the Department of Rehabilitation Medicine, Department of Pediatrics and Department of Physical Examination of our hospital were randomly selected as research subjects. The serum 25 (OH) D level, attention deficit hyperactivity (Swanson, Nolan, and Pelham, version IV [SNAP-IV] parental version) score and Conners child behavior (PSQ) index were observed and compared between the 2 groups. In addition, the children with ADHD whose serum 25 (OH) D was lower than normal were treated with supplemental VitD3, and the changes in serum 25 (OH) D, SNAP-IV parental score and PSQ index of ADHD children were observed and compared.

RESULTS

Serum 25(OH)D was insufficient or deficient in 26 healthy children, but the SNAP-IV score and PSQ index were normal. Serum 25(OH)D was lower than normal in 69 patients in the ADHD group, which was negatively correlated with SNAP-IV score (r = -0.3479, P = .0034) and negatively correlated with PSQ index (r = -0.3566, P = .0026). After vitamin D3 (VitD3) supplementation in 69 children with serum 25(OH)D levels lower than the normal ADHD group, it was found that the SNAP-IV score (r = -0.4654, P = .0037) and PSQ index (r = -0.5680, P = .0002) of 34 children with ADHD were negatively correlated with the increase in serum 25(OH)D. The SNAP-IV score and PSQ index of the other 35 children with ADHD showed no correlation with the increase in serum 25 (OH) D (P > .05).

CONCLUSION SUBSECTIONS

Serum 25(OH)D levels lower than normal are more common in school-age children, and levels lower than normal are not the key pathogenic factor of ADHD in school-age children, but serum 25(OH)D levels lower than normal may be the upregulation factor of attention deficit and hyperactivity disorder expression in some school-age children with ADHD. The lower level of serum 25(OH)D may be closely related to the severity of ADHD symptoms in some children.