Güleç Ahmet, Türkoğlu Serhat, Kocabaş Ramazan
Department of Child and Adolescent Psychiatry, 209th Sk. No:26, 10100 Altıeylül/Balıkesir -Balıkesir Ataturk City Hospital, Gaziosmanpasa, Turkey.
Department of Child and Adolescent Psychiatry, Selcuk University Faculty of Medicine, Selçuk University Rectorate, Alaeddin Keykubat Campus, Academia District, New Istanbul Street No: 369, Selçuklu-Konya, Postal Code: 42130, Turkey.
J Neural Transm (Vienna). 2025 Jan;132(1):157-168. doi: 10.1007/s00702-024-02831-w. Epub 2024 Sep 9.
Attention deficit hyperactivity disorder (ADHD), characterized by attention deficit, hyperactivity, and impulsivity, has recently been associated with lipid metabolism. In particular, the roles of sphingomyelin, ceramide, andgalactosylceramidase in the pathophysiology of ADHD are being investigated. This study aims to explore the relationship between sphingolipid metabolism markers and soft neurological signs (SNS) in children diagnosed with ADHD who are not undergoing medication treatment. A cross-sectional analysis was conducted on 41 children and adolescents aged 7-12 years diagnosed with ADHD and 39 neurotypically developing controls. Plasma levels of ceramide, sphingomyelin, and galactosylceramidase were measuredusing Enzyme-Linked Immunosorbent Assay (ELISA). SNS were assessed using the Physical and Neurological Examination for Soft Signs (PANESS). Statistical analyses included Student's t-tests, Mann-Whitney U tests, and Multivariate Analysis ofCovariance (MANCOVA), along with logistic regression analysis. Plasma levels of ceramide and sphingomyelin in children with ADHD showed significant differences compared to the neurotypically developing control group; however, there were no significant differences in galactosylceramidase levels between the two groups. Positive correlations were found between plasma levels of ceramide and sphingomyelin and the PANESS subscales F1 (Total Gait and Station) and F3 (Total Dysrhythmia). Additionally, logistic regression analysis indicated that high ceramide levels were positively associated with ADHD. This study underscores a significant association between alterations in sphingolipid metabolism (specifically increased levels of ceramide and sphingomyelin) and the presence of SNS in children with ADHD. These findings elucidate the potential role of sphingolipid metabolism in the pathophysiology of ADHD and provide suggestions for future therapeutic research targeting sphingolipid metabolism in the treatment of ADHD.
注意缺陷多动障碍（ADHD）以注意力不集中、多动和冲动为特征，最近被发现与脂质代谢有关。特别是，鞘磷脂、神经酰胺和半乳糖神经酰胺酶在ADHD病理生理学中的作用正在被研究。本研究旨在探讨未接受药物治疗的ADHD患儿中鞘脂代谢标志物与软性神经体征（SNS）之间的关系。对41名7至12岁被诊断为ADHD的儿童和青少年以及39名发育正常的对照儿童进行了横断面分析。使用酶联免疫吸附测定（ELISA）测量血浆中神经酰胺、鞘磷脂和半乳糖神经酰胺酶的水平。使用软性体征体格和神经检查（PANESS）评估SNS。统计分析包括学生t检验、曼-惠特尼U检验和多变量协方差分析（MANCOVA），以及逻辑回归分析。与发育正常的对照组相比，ADHD患儿血浆中神经酰胺和鞘磷脂水平存在显著差异；然而，两组之间半乳糖神经酰胺酶水平没有显著差异。发现血浆中神经酰胺和鞘磷脂水平与PANESS分量表F1（总步态和姿势）和F3（总心律失常）呈正相关。此外，逻辑回归分析表明高神经酰胺水平与ADHD呈正相关。本研究强调了鞘脂代谢改变（特别是神经酰胺和鞘磷脂水平升高）与ADHD患儿SNS存在之间的显著关联。这些发现阐明了鞘脂代谢在ADHD病理生理学中的潜在作用，并为未来针对鞘脂代谢治疗ADHD的治疗研究提供了建议。
