CRB BioJeL, Institut Jérôme Lejeune, Paris, France.
Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
J Intellect Disabil Res. 2021 Aug;65(8):795-800. doi: 10.1111/jir.12832. Epub 2021 Apr 20.
Attention deficit hyperactivity disorder (ADHD) is a common co-morbidity that affects up to 44% of children with Down syndrome (DS). There is a need for reliable, good quality research on the use of methylphenidate within this population. The objective of this study is to report our experience regarding the management of ADHD in these children using methylphenidate.
This study is a retrospective observation of 21 children with DS, followed at Jérôme Lejeune Institute between 2000 and 2018. The diagnosis of ADHD was made using the Diagnostic and Statistical Manual of Mental Disorders criteria. Efficacy was measured as response or non-response on two main symptoms: attention/concentration and hyperactivity/impulsivity. Safety was evaluated by the presence or absence of side effects.
Sixteen out of the 21 children (76%) showed improvement with methylphenidate. The average age of treatment onset in responding children was 8 years and 10 months versus 6 years and 3 months in non-responders (P = 0.05). Average dose/weight was significantly different in responders and non-responders (0.82 vs. 0.54 mg/kg/day, respectively; P = 0.03). Twelve children out of 21 (57%) experienced side effects; only three experienced side effects severe enough to require treatment interruption. Most common side effects were loss of appetite and difficulties in falling asleep.
Methylphenidate was effective and safe in treating ADHD in 76% of cases in children with DS, with few serious side effects to report. Early diagnosis of ADHD is important to improve the quality of life, learning, inclusion and socialisation of children with DS.
注意力缺陷多动障碍（ADHD）是一种常见的合并症，影响多达 44%的唐氏综合征（DS）儿童。需要对该人群中使用哌醋甲酯进行可靠、高质量的研究。本研究的目的是报告我们使用哌醋甲酯治疗这些儿童 ADHD 的经验。
本研究是对 2000 年至 2018 年期间在杰罗姆·勒琼研究所接受随访的 21 名 DS 儿童进行的回顾性观察。ADHD 的诊断采用《精神障碍诊断与统计手册》标准。疗效通过注意力/集中和多动/冲动两个主要症状的反应或无反应来衡量。通过有无副作用来评估安全性。
21 名儿童中有 16 名（76%）使用哌醋甲酯后症状改善。有反应的儿童开始治疗的平均年龄为 8 岁 10 个月，无反应的儿童为 6 岁 3 个月（P=0.05）。有反应者和无反应者的平均剂量/体重差异有统计学意义（分别为 0.82 和 0.54mg/kg/天；P=0.03）。21 名儿童中有 12 名（57%）出现副作用；只有 3 名因副作用严重而需要中断治疗。最常见的副作用是食欲不振和入睡困难。
哌醋甲酯治疗 DS 儿童 ADHD 的有效率为 76%，安全性良好，报告的严重副作用较少。早期诊断 ADHD 对提高 DS 儿童的生活质量、学习、融入和社交能力非常重要。
