Attention-Deficit/Hyperactivity Disorder is Related to Decreased Weight in the Preschool Period and to Increased Rate of Overweight in School-Age Boys

Anthropometric status of preschoolers and elementary school children with ADHD: preliminary results from the EPINED study

BACKGROUND

A current area of research interest is the association between ADHD and weight status. This paper aimed to describe the anthropometric status of school children with ADHD, considering age and clinical presentation (inattentive, hyperactive-impulsive, or combined), compared with control children.

METHODS

Participants came from the "Epidemiological Research Project on Neurodevelopmental Disorders" and consisted of 198 preschoolers (41 with ADHD) and 389 elementary school children (163 with ADHD). ADHD was diagnosed using DSM-5 criteria. Anthropometric measurements were taken at various anatomical points, and height, weight, and body composition were also measured.

RESULTS

In preschoolers, an association was found between hyperactive-impulsive ADHD and greater height and lower waist-to-height ratio. In elementary school children, regardless of the medication, combined ADHD was associated with smaller head, hip, arm, and thigh circumferences and lower weight, height, and BMI. A total of 19.7% of them were underweight. In contrast, children with inattentive and hyperactive/impulsive presentations presented the highest percentage of overweight/obesity (56%).

CONCLUSION

The anthropometric status of the school children with ADHD showed differences in terms of age and presentation. Preschoolers with hyperactive-impulsive ADHD are taller, and elementary school children with combined ADHD are shorter and smaller than their age-matched control peers.

IMPACT

The anthropometric status of the school children with ADHD showed differences in terms of age and presentation. Preschoolers with hyperactive-impulsive ADHD are taller than their control peers. Elementary school children with combined ADHD, regardless of the pharmacological treatment, are shorter and smaller than their control peers. Medication may anthropometrically affect the height of children with inattentive presentation. Anthropometric and dietary monitoring should be recommended to parents of children with ADHD, with and without medication.

Eating behavior-mediated association between attention deficit hyperactivity disorder and body fat mass

Background

Adverse eating behaviors and a high rate of obesity have been identified among children diagnosed with attention deficit hyperactivity disorder (ADHD). In this study, we investigate the relationships between eating behaviors and body fat mass among children with ADHD.

Methods

All participants were recruited from the Children's Health Care Department of the Children's Hospital of Nanjing Medical University from June 2019 to June 2020. ADHD was diagnosed according to the diagnostic criteria of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by psychiatrists. Core ADHD symptoms defined by the DSM-5 were inattention and hyperactivity/impulsivity. The anthropomorphic indices defined by the World Health Organization (WHO) were utilized in this study (body mass index [BMI], underweight, normal body mass, overweight, obesity, short stature). Body fat mass, fat mass percentage (FM%), skeletal muscle mass, skeletal muscle mass percentage (SMM%) were tested via body composition meter, and eating behaviors were assessed by parents using the Chinese version of the Children's Eating Behavior Questionnaire (CEBQ). The CEBQ was comprised of subscales related to food avoidant behaviors (satiety responsiveness, slowness in eating, fussiness, and emotional undereating) and food approach behaviors (food responsiveness, enjoyment of Food, desire to drink, and emotional overeating). The associations among ADHD, obesity and adverse eating behavior were tested through correlation analysis, and a mediating effect model was established to explore the effect of eating behaviors.

Results

A total of 548 participants aged 4-12 years were recruited. Among them, 396 were diagnosed with ADHD, with the remaining 152 enrolled in a control group. Compared with the control group, the ADHD group had higher incidences of overweight (22.5% vs. 14.5%) and obesity (13.4% vs. 8.6%) (p < 0.05). The ADHD group was more likely to display "slowness in eating" (11.01 ± 3.32 vs. 9.74 ± 2.95), "fussiness" (15.61 ± 3.54 vs. 15.03 ± 2.84), "food responsiveness" (11.96 ± 4.81 vs. 9.88 ± 3.71) and "desire to drink" (8.34 ± 3.46 vs. 6.58 ± 2.72) (p < 0.05). Moreover, The FM% of children with ADHD was positively correlated with inattention (β = 0.336, 95% CI: 0.001 to 0.673) and "food responsiveness" (β = 0.509, 95% CI: 0.352 to 0.665) in the multiple linear regression model. The mediation effect model showed that "food responsiveness" accounted for a significant portion (64.2%) of the mediating effect.

Conclusion

Children with ADHD had higher prevalence of overweight and obesity. As an important risk factor, food responsiveness may connect core symptoms of ADHD with obesity.

The Occurrence of Overweight and Obesity in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder According to Three Different Diagnostic Criteria for Obesity

Objective: This study aimed to assess the prevalence of overweight and obesity in the group of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) according to three different diagnostic criteria for obesity. The effect of ADHD treatment on the risk of obesity was controlled. Materials and Methods: The study group consisted of 58 subjects aged from 8 to 17 years with ADHD. Control group consisted of 62 healthy age- and sex-matched children and adolescents. Overweight and obesity were assessed according to International Obesity Task-Force (IOTF), World Health Organization (WHO) and European Childhood Obesity Group (ECOG) criteria. Results: There was a significantly higher incidence of obesity in ADHD group according to WHO (ADHD vs. Control: 17.2% vs. 3.2%, p = 0.01) and IOTF criteria (ADHD vs. Control: 10.3% vs. 1.6%, p = 0.04), but no significant difference according to ECOG criteria. There was significantly higher occurrence of overweight (20.7% vs. 12.8%, p < 0.001), obesity (10.3% vs. 3.5%, p < 0.001), and overweight and obesity (31.0% vs. 16.3%, p < 0.001) in the ADHD group compared to the Polish population. The analysis did not show a statistically significant relationship between the amount of taken psychostimulant and the occurrence of overweight and obesity. Conclusions: The prevalence of overweight and obesity in the group of ADHD children and adolescents varies depending on the choice of diagnostic criteria. At the same time, it is significantly more frequent than in the general population. We suggest that future studies should give a clear rationale for the selection of cutoff points to minimize errors that could confound data analysis and interpretation.

Stress/Immune Biomarkers in Saliva among Children with ADHD Status

Background. This cross-sectional study aimed to evaluate stress and immune biomarkers in saliva samples of attention-deficit/hyperactivity disorder ADHD compared to healthy non-ADHD children. Material and methods. A total of 132 children under 11 years old (8.5 ± 1.1) enrolled in a cross-sectional study: with confirmed ADHD (n = 60) and healthy controls (n = 72). The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index BMI, BMI z-score) and unstimulated saliva collection and measurements of free cortisol, salivary alpha-amylase (sAA), and secreted immunoglobulins (sIgA, IgG, and IgM) with quantitative assay (ELISA) analysis. Unpaired t-test, Welch test, or Mann-Whitney U test were applied for group comparisons when appropriate, and the correlation between variables was analyzed with Spearman's rank coefficient. Results were considered significant at p < 0.05. Results. In the ADHD group, body weight (p ≤ 0.01), BMI (p ≤ 0.009), and hip circumference (p ≤ 0.001) significantly differed, while waist size and BMI z-score did not (p > 0.05). Significant elevation of the salivary sAA (p = 0.03), sIgA (p = 0.02), and IgM (p ≤ 0.001) biomarkers were detected, without differences in the morning cortisol (p > 0.05). Significant correlations between cortisol and BMI, hip size, and IgA, as well as between IgG and sAA and IgA were obtained. Conclusions. Saliva can be used to monitor ADHD status with regard to biomarkers indicating the hypothalamus-pituitary-adrenal axis, as HPA axis, and sympathetic activity. The results indicate that morning collection of saliva in contrast to unchanged salivary cortisol, may evaluate mentioned above system dysregulations by measurements of sAA and immunoglobulins among ADHD children.

Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm

Individuals born extremely preterm are at significant risk for impaired neurodevelopment. After discharge from the neonatal intensive care, associations between the child's well-being and factors in the home and social environment become increasingly apparent. Mothers' prenatal health and socioeconomic status are associated with neurodevelopmental outcomes, and emotional and behavioral problems. Research on early life risk factors and on mechanisms underlying inter-individual differences in neurodevelopment later in life can inform the design of personalized approaches to prevention. Here, we review early life predictors of inter-individual differences in later life neurodevelopment among those born extremely preterm. Among biological mechanisms that mediate relationships between early life predictors and later neurodevelopmental outcomes, we highlight evidence for disrupted placental processes and regulated at least in part via epigenetic mechanisms, as well as perinatal inflammation. In relation to these mechanisms, we focus on four prenatal antecedents of impaired neurodevelopment, namely, (1) fetal growth restriction, (2) maternal obesity, (3) placental microorganisms, and (4) socioeconomic adversity. In the future, this knowledge may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm. IMPACT: This review highlights early life risk factors and mechanisms underlying inter-individual differences in neurodevelopment later in life. The review emphasizes research on early life risk factors (fetal growth restriction, maternal obesity, placental microorganisms, and socioeconomic adversity) and on mechanisms (disrupted placental processes and perinatal inflammation) underlying inter-individual differences in neurodevelopment later in life. The findings highlighted here may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm.

Attention Deficit Hyperactivity Disorder: Association With Obesity and Eating Disorders

Attention deficit hyperactivity disorder (ADHD) is one of the most common treatable psychiatric illnesses that affect all age groups from children to adults. Most commonly it is diagnosed in childhood or during teenage years. It can affect the mental and physical health of an individual and disrupt normal academic, career, and social functioning. The quality of life of the individual is affected; thus if diagnosed and treated, the results are good. Obesity and eating disorders are one of the comorbidities associated with ADHD and can lead to various other health problems. This study was done to find out the association between ADHD, obesity, eating disorders, and the effect of medication. We collected data from various studies through multiple electronic databases such as PubMed and Google Scholar. We found 8610 relevant articles and finally narrowed it down to 30 using various criteria. An association was found between ADHD, obesity, and eating disorders, although the mechanism linking ADHD, obesity, and eating disorders still remains unclear according to most studies. Some studies say ADHD medication helps in losing gained weight; some say they do not affect the weight.

Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention-deficit hyperactivity disorder: A systematic review and meta-analysis

Individuals with autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD) may have unhealthy bodyweight. This meta-analysis was performed to understand the weight status in individuals with ASD or ADHD. PubMed, Embase, Cochrane and ISI Web of Science databases were searched from inception until June 2020 to identify relevant studies. Prevalence estimates and their 95% confidence intervals (CIs) of obesity, overweight and underweight were separately pooled using random-effects models. A total of 95 studies were included in the meta-analysis. The pooled estimates of the prevalence of obesity, overweight and underweight were 21.8%, 19.8% and 6.4% in individuals with ASD and 14.7%, 20.9% and 4.0% in individuals with ADHD. In subgroup analyses, an increasing trend in the prevalence of unhealthy weight was observed from children aged 2 to 5 years to adults with ASD (obesity: from 16.7% to 31.3%, overweight: from 16.2% to 27.2%, underweight from 5.3% to 8.6%) and from children aged 6 to 12 years to adults with ADHD (obesity: from 13.5% to 19.3%, overweight: from 18.8% to 31.2%). The worrisome epidemic of obesity and overweight in individuals with ASD, ADHD highlighted the need for weight management.

Negative Affectivity and Emotion Dysregulation as Mediators between ADHD and Disordered Eating: A Systematic Review

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2 September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.

Excessive Weight Gain and Dental Caries Experience among Children Affected by ADHD

In recent years, attention has been paid to the co-occurrence of attention deficit hyperactivity disorder (ADHD) and obesity, but results in relation to dental caries outcomes differ. The study was conducted to determine obesity/overweight and dental caries in children suffering from ADHD and to draw comparisons with non-ADHD children. A total of 119 children under 11 years old (8.2 ± 1.2) were enrolled into a cross-sectional study: those with confirmed ADHD (n = 39), and healthy controls (n = 80). The behavioral evaluation included a parent interview directed at sweetened food/drink habits. The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index (BMI), and dental examination (International Caries Detection and Assessment System—ICDAS). Results showed a higher prevalence of abnormal body weight, hip circumference, and BMI, and a higher frequency of caries (84.6%) in the ADHD group. Significant caries differences for primary (ICDAS 0, 1, 2, 5, 6 scores) and permanent teeth (ICDAS 1, 3 scores) were recorded. The questionnaire pinpointed interplays between sugar consumption and tooth decay, especially for primary dentition. It can be concluded that the consumption of sweetened foods/drinks among ADHD children may lead to an increased rate of overweight, but may also affect oral health. Limiting sugar consumption might be one of the important elements in prevention programmes against dental caries and overweight/obesity.

Attention-deficit hyperactivity disorder symptomatology, binge eating disorder symptomatology, and body mass index among college students

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.

Overweight in Boys With ADHD Is Related to Candidate Genes and Not to Deficits in Cognitive Functions

OBJECTIVE

The aim of the study was to assess the relationship of overweight, the polymorphisms of selected candidate genes, and deficits in the executive functions among children with ADHD.

METHOD

We examined 109 boys with ADHD aged between 7 and 17 years. The study indicated variants of 14 polymorphisms in eight candidate genes. We applied seven neuropsychological tests to evaluate the executive functions. Overweight was diagnosed on the basis of the guidelines of the International Obesity Task Force.

RESULTS

Analyses revealed significant association between DRD4 rs1800955, SNAP25 rs363039 and rs363043, 5HTR2A rs17288723, and overweight in boys with ADHD. There were no significant differences in the level of neuropsychological test results between patients with overweight and without overweight.

CONCLUSION

Overweight in boys with ADHD is associated with polymorphisms in three candidate genes: DRD4, SNAP25, and 5HTR2A, but not through conditioning deficits in cognitive functions.

Perinatal Risk Factors and ADHD in Children and Adolescents: A Hierarchical Structure of Disorder Predictors

OBJECTIVE

The aim of the study was to hierarchically assess the predictive power of low and high birth weight, pre-term and post-term birth, and low Apgar score as the risk factors for ADHD.

METHOD

The data of 132 boys diagnosed with ADHD and 146 boys from control group, aged 6 to 18 years, have been analyzed. The boys were categorized according to term of birth, birth weight, and Apgar score. CART method (Classification and Regression Trees) was used for assessment of the relationship between perinatal factors and the risk of ADHD.

RESULTS

Low Apgar score (21.97% vs. 13.01%) and post-term birth (12.12% vs. 0.68%) were more frequent in the sample than in the control group. CART method additionally indicated low birth weight as associated with the risk of ADHD. Among analyzed risk factors, Apgar score had the highest predictive value.

CONCLUSION

The decreased Apgar score is the most important perinatal risk factor of ADHD. Research results also indicated a high significance of post-term birth in predicting the disorder.

Attention deficit/hyperactivity-disorder and obesity: A review and model of current hypotheses explaining their comorbidity

Available meta-analyses point to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The possible mechanisms underlying this relationship are unclear. Here, we overview the studies aimed at identifying the factors contributing to the comorbidity between ADHD and obesity, including genetic factors, fetal programming, executive dysfunctions, psychosocial stress, factors directly related to energy balance, and sleep patterns alterations. The bulk of current research has focused on reduced physical activity and abnormal eating patterns as possible causes of weight gain in individuals with ADHD. Further research is needed to explore the specific role of executive dysfunctions. None of the available published studies have evaluated physiological mechanisms such as hormonal and metabolic disorders or inappropriate neurobiological regulation of appetite. Research exploring the genetic basis for the coexistence of ADHD and obesity and epigenetic mechanisms, with particular emphasis on stress, both pre- and postnatal, seems particularly promising. Here, we propose a biopsychosocial model to integrate current findings and move the field forward to gain insight into the ADHD-obesity relationship.

ADHD in school-aged youth: Management and special treatment considerations in the primary care setting

Attention-deficit/hyperactivity disorder is considered one of the most common neurodevelopmental disorders of childhood. Primary care providers are in the unique position of providing comprehensive care-routine care, well child visits, immunizations, and other healthcare needs-to a majority of children and adolescents with attention-deficit/hyperactivity disorder. As such, primary care providers are pivotal in the diagnosis, management, and treatment of this population. This article will address special treatment considerations to aid in the management of attention-deficit/hyperactivity disorder in the primary care setting, including substance use disorders and diversion, cardiac issues and stimulant medication, medication holidays and follow-up monitoring. The database of PubMed was searched using keywords that included attention-deficit/hyperactivity disorder, children, prevalence, medication holidays, safety, cardiovascular, cardiac, blood pressure, substance use, diversion, adverse drug reactions; inclusion dates were January 1, 2011 to September 30, 2015.

Early-life exposure to EDCs: role in childhood obesity and neurodevelopment

Endocrine-disrupting chemicals (EDCs) might increase the risk of childhood diseases by disrupting hormone-mediated processes that are critical for growth and development during gestation, infancy and childhood. The fetus, infant and child might have enhanced sensitivity to environmental stressors such as EDCs due to their rapid development and increased exposure to some EDCs as a consequence of development-specific behaviour, anatomy and physiology. In this Review, I discuss epidemiological studies examining the relationship between early-life exposure to bisphenol A (BPA), phthalates, triclosan and perfluoroalkyl substances (PFAS) with childhood neurobehavioural disorders and obesity. The available epidemiological evidence suggest that prenatal exposure to several of these ubiquitous EDCs is associated with adverse neurobehaviour (BPA and phthalates) and excess adiposity or increased risk of obesity and/or overweight (PFAS). Quantifying the effects of EDC mixtures, improving EDC exposure assessment, reducing bias from confounding, identifying periods of heightened vulnerability and elucidating the presence and nature of sexually dimorphic EDC effects would enable stronger inferences to be made from epidemiological studies than currently possible. Ultimately, improved estimates of the causal effects of EDC exposures on child health could help identify susceptible subpopulations and lead to public health interventions to reduce these exposures.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity: Update 2016

While psychiatric comorbidities of attention-deficit/hyperactivity disorder (ADHD) have been extensively explored, less attention has been paid to somatic conditions possibly associated with this disorder. However, mounting evidence in the last decade pointed to a possible significant association between ADHD and certain somatic conditions, including obesity. This papers provides an update of a previous systematic review on the relationship between obesity and ADHD (Cortese and Vincenzi, Curr Top Behav Neurosci 9:199-218, 2012), focusing on pertinent peer-reviewed empirical papers published since 2012. We conducted a systematic search in PubMed, Ovid, and Web of Knowledge databases (search dates: from January 1st, 2012, to July 16th, 2016). We retained a total of 41 studies, providing information on the prevalence of obesity in individuals with ADHD, focusing on the rates of ADHD in individuals with obesity, or reporting data useful to gain insight into possible mechanisms underlying the putative association between ADHD and obesity. Overall, over the past 4 years, an increasing number of studies have assessed the prevalence of obesity in individuals with ADHD or the rates of ADHD in patients with obesity. Although findings are mixed across individual studies, meta-analytic evidence shows a significant association between ADHD and obesity, regardless of possible confounding factors such as psychiatric comorbidities. An increasing number of studies have also addressed possible mechanisms underlying the link between ADHD and obesity, highlighting the role, among others, of abnormal eating patterns, sedentary lifestyle, and possible common genetic alterations. Importantly, recent longitudinal studies support a causal role of ADHD in contributing to weight gain. The next generation of studies in the field should explore if and to which extent the treatment of comorbid ADHD in individuals with obesity may lead to long-term weight loss, ultimately improving their overall well-being and quality of life.

The NK1R-/- mouse phenotype suggests that small body size, with a sex- and diet-dependent excess in body mass and fat, are physical biomarkers for a human endophenotype with vulnerability to attention deficit hyperactivity disorder

The abnormal behaviour of NK1R-/- mice (locomotor hyperactivity, inattentiveness and impulsivity in the 5-Choice Serial Reaction-Time Test) is arguably analogous to that of patients with attention deficit hyperactivity disorder (ADHD). Evidence suggests that small body size and increased body weight are risk factors for ADHD. Here, we compared the body size, body mass and body composition of male and female NK1R-/- mice and their wildtypes that had been fed either standard laboratory chow or a high-fat (45%: 'Western') diet. Male NK1R-/- mice from both cohorts were approximately 7% shorter than wildtypes. A similar trend was evident in females. Male NK1R-/- mice fed the normal diet weighed less than wildtypes but the 'body mass index' ('mBMI': weight (mg)/length (cm)(2)) of female NK1R-/- mice was higher than wildtypes. When given the high-fat diet, the mBMI of both male and female NK1R-/- mice was higher than wildtypes. There were no consistent genotype or sex differences in protein, ash or water content of mice from the two cohorts. However, the fat content of male NK1R-/- mice on the Western diet was considerably (35%) higher than wildtypes and resembled that of females from both genotypes. We conclude that a lack of functional NK1R is associated with small body size but increases vulnerability to an increase in mBMI and fat content, especially in males. This phenotype could also be evident in ADHD patients with polymorphism(s) of the TACR1 gene (the human equivalent of Nk1r).

The relationship between motor skills, ADHD symptoms, and childhood body weight

BACKGROUND

Research has suggested an important association between motor proficiency and overweight/obesity. Many children with motor difficulties experience ADHD symptoms which have also been linked with overweight/obesity. Previous research has not considered both ADHD and motor performance when investigating their relationship with overweight/obesity.

AIMS

To investigate the relationships between motor performance, ADHD symptoms, and overweight/obesity in children.

METHODS AND PROCEDURES

A cross-sectional study was conducted involving189 children aged six to 10 years. Symptoms of ADHD were identified using the SNAP-IV rating scale. Motor impairment (MI) was identified using the Movement Battery Assessment for Children-2. Body composition was estimated from the Body Mass Index (BMI) based on World Health Organization child growth standards.

OUTCOMES AND RESULTS

Balance was the only motor skill associated with BMI even after controlling for gender and ADHD. Group comparisons revealed that the proportion of overweight ADHD children was significantly less than the proportion of overweight control children and overweight MI children; the proportion of underweight ADHD children was significantly greater than the proportion of underweight MI children.

CONCLUSIONS AND IMPLICATIONS

The results highlight the importance of taking into consideration both ADHD symptoms and motor difficulties in the assessment and intervention of physical health outcomes in children with ADHD and/or movement problems.

The impact of maternal neglect on genetic hyperactivity

Early environmental conditions are increasingly appreciated as critical in shaping behavior and cognition. Evidence suggests that stressful rearing environments can have an enduring impact on behaviors in adulthood, but few studies have explored the possibility that rearing environment could exacerbate genetic hyperactivity disorders. Uncovering a strong environmental influence on the transmission of hyperactivity could provide novel avenues for translational research. Recently we developed a selectively bred High-Active line of mice to model ADHD, providing a unique resource to address the question of environmental transmission. The High-Active line demonstrates transgenerational hyperactivity, but the influence of the postnatal environment (i.e. maternal care provided by dams) on hyperactivity had not been systemically quantified. This study employed a cross-fostering method to simultaneously address 1) whether High-Active and Control pups are provided with similar levels of care in the early environment, and 2) whether any differences in rearing environment influence hyperactive behavior. High-Active dams demonstrated impairment in all measures of maternal competence relative to Controls, which reduced survival rates and significantly reduced the body mass of offspring in early life and at weaning. While the deteriorated postnatal environment provided by High-Active dams was ultimately sufficient to depress Control activity, the hyperactivity of High-Active offspring remained unaffected by fostering condition. These data not only confirm the power of genetics to influence hyperactivity across generations, but also provide evidence that early rearing environments may not have a significant impact on the extreme end of hyperactive phenotypes.