Elhady Marwa, Youness Eman R, Mostafa Rehab S I, Abdel Aziz Ali, Hussein Rania
Pediatric Department, Faculty of Medicine (for girls), Al-Azhar University , Cairo , Egypt.
Medical Biochemistry, National Research Center , Cairo , Egypt.
Appl Neuropsychol Child. 2019 Oct-Dec;8(4):347-354. doi: 10.1080/21622965.2018.1492409. Epub 2018 Aug 13.
Children with epilepsy have a high incidence of attention deficit hyperactivity disorder (ADHD). Oxidation stress and disturbed neurotransmitters are suggested mechanisms; however, their role is not fully explored. This study evaluates the association between circulating malondialdehyde as an oxidation stress marker, apelin neuropeptide, and ADHD in children with epilepsy. Fifty children with epilepsy of unknown etiology, of which 25 have ADHD, as well as 35 healthy children were included. Serum levels of malondialdehyde and apelin were estimated. We investigated the association between seizure severity, response to medications, malondialdehyde, apelin levels, and ADHD in children with epilepsy. Serum malondialdehyde and apelin levels were higher in children with epilepsy, especially those with ADHD. Malondialdehyde and apelin levels have significant positive correlation with the Chalfont Seizure Severity Score. Regression analysis showed that elevated malondialdehyde is an independent risk factor for ADHD in children with epilepsy (OR: 1.401, 95%CI: 1.056-1.859, = 0.02). No significant association was found between malondialdehyde and apelin levels and the type of epilepsy or ADHD. Longer duration of epilepsy, increased seizure severity, and uncontrolled seizures are associated with increased oxidation stress, which further increased susceptibility for ADHD. In spite of elevated apelin in children with ADHD, the elevation did not increase the risk of ADHD in children with epilepsy.
癫痫患儿注意力缺陷多动障碍（ADHD）的发病率很高。氧化应激和神经递质紊乱是可能的机制；然而，它们的作用尚未得到充分研究。本研究评估了作为氧化应激标志物的循环丙二醛、apelin神经肽与癫痫患儿ADHD之间的关联。纳入了50名病因不明的癫痫患儿，其中25名患有ADHD，以及35名健康儿童。测定了丙二醛和apelin的血清水平。我们调查了癫痫患儿的癫痫发作严重程度、对药物的反应、丙二醛、apelin水平与ADHD之间的关联。癫痫患儿，尤其是患有ADHD的患儿，血清丙二醛和apelin水平较高。丙二醛和apelin水平与查尔方特癫痫发作严重程度评分呈显著正相关。回归分析表明，丙二醛升高是癫痫患儿患ADHD的独立危险因素（OR：1.401，95%CI：1.056 - 1.859，P = 0.02）。未发现丙二醛和apelin水平与癫痫类型或ADHD之间存在显著关联。癫痫病程延长、癫痫发作严重程度增加和癫痫发作未得到控制与氧化应激增加有关，这进一步增加了患ADHD的易感性。尽管患有ADHD的患儿apelin升高，但这种升高并未增加癫痫患儿患ADHD的风险。
