Diagnostic Performance of Erythropoietin and Erythropoietin Receptors Levels in Children with Attention Deficit Hyperactivity Disorder

Evaluation of Erythropoietin and Erythropoietin Receptor Levels in Children with Autistic Spectrum Disorder: Cross-sectional Study

Objective

Autistic spectrum disorders (ASD) are a heterogeneous collection of neurodevelopmental disorders with an unknown etiology. Erythropoietin is a versatile growth factor that plays a crucial role in the nervous system, exhibiting high expression in various regions of the brain, including neurons, glial cells and endothelial cells. Recent animal studies have demonstrated that Epo exerts neuroprotective and neurotrophic effects. The objective of this study was to examine the levels of erythropoietin-(Epo) and its receptor-(EpoR) in children with ASD and to elucidate the potential effects of Epo in the disorder.

Methods

The study involved 50 children diagnosed with ASD based on the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders criteria, with ASD severity assessed using the Childhood Autism Rating Scale. Additionally, a control group of 50 healthy children was included. Serum samples were collected from both groups, and levels of Epo and its EpoR.

Results

There were no statistically significant differences between the age and sex distributions of the ASD and control groups (p > 0.05). However, analysis of the serum samples revealed a statistically significant reduction in Epo levels in the ASD cohort compared to the control.

Conclusion

The results of our study indicate that Epo may have potential as an adjunctive therapy for children with ASD. The observed decrease in Epo levels and increase in EpoR levels in children with ASD suggest a dysregulation in the Epo-EpoR axis that may contribute to the pathophysiology of ASD. Further research is required to investigate the therapeutic effects of modulating Epo levels in ASD and to elucidate the mechanisms underlying these changes.

Serum Erythropoietin and Ischemic-Modified Albumin Levels in Adolescents with Obsessive-Compulsive Disorder

Erythropoietin (EPO) has neuroprotective effects by increasing oxidative stress resistance and stabilizing redox balance. Ischemic-modified albumin (IMA) is a product of protein oxidation, and recent evidence suggests that IMA can be used as an indicator of oxidative damage. This study aimed to investigate serum EPO and IMA levels in obsessive-compulsive disorder (OCD) patients and to investigate the relationship between EPO and IMA levels and clinical variables such as disease duration and disease severity. A total of 68 adolescents (11-18 years old), including 35 OCD patients (18 males/17 females) and 33 healthy controls (14 males/19 females) without comorbid disorders matched for age, gender, and BMI, were included in the study. The enzyme-amplified chemiluminescence technique determined serum EPO levels, and serum IMA levels were determined by the spectrophotometric method. Serum EPO levels were lower in OCD patients compared to healthy controls (p = 0.002; Z =  - 3.123), and serum IMA levels (ABSU) were significantly higher in the OCD group (p = 0.005). A significant positive correlation was found between IMA levels and the duration of OCD symptoms (p = 0.015, r = 0.409). The study's findings contribute to the growing body of evidence implicating inflammatory and oxidative processes in the pathogenesis of OCD. The potential of EPO and IMA levels as diagnostic biomarkers for OCD aligns with the ongoing efforts to identify reliable biological markers for the disorder. The positive correlation of IMA levels with the duration of OCD shows the importance of early detection of oxidative damage.

Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review

CONTEXT

Correct diagnosis is essential for the appropriate clinical management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.

OBJECTIVE

This systematic review provides an overview of the available diagnostic tools.

DATA SOURCES

We identified diagnostic accuracy studies in 12 databases published from 1980 through June 2023.

STUDY SELECTION

Any ADHD tool evaluation for the diagnosis of ADHD, requiring a reference standard of a clinical diagnosis by a mental health specialist.

DATA EXTRACTION

Data were abstracted and critically appraised by 1 reviewer and checked by a methodologist. Strength of evidence and applicability assessments followed Evidence-based Practice Center standards.

RESULTS

In total, 231 studies met eligibility criteria. Studies evaluated parental ratings, teacher ratings, youth self-reports, clinician tools, neuropsychological tests, biospecimen, EEG, and neuroimaging. Multiple tools showed promising diagnostic performance, but estimates varied considerably across studies, with a generally low strength of evidence. Performance depended on whether ADHD youth were being differentiated from neurotypically developing children or from clinically referred children.

LIMITATIONS

Studies used different components of available tools and did not report sufficient data for meta-analytic models.

CONCLUSIONS

A valid and reliable diagnosis of ADHD requires the judgment of a clinician who is experienced in the evaluation of youth with and without ADHD, along with the aid of standardized rating scales and input from multiple informants across multiple settings, including parents, teachers, and youth themselves.

Analysis of Serum VEGF, IGF-1, and HIF-1α Levels in ADHD

OBJECTIVE

In recent years, it has been emphasized that various growth factors that affect neurogenesis may lead to ADHD. In this study, we aimed to investigate the role of VEGF, IGF-1, and HIF-1α growth factors in the etiopathogenesis of ADHD.

METHOD

Levels of VEGF, IGF-1, and HIF-1α were compared between 40 ADHD children and 40 healthy children, aged 7 to 13 years.

RESULT

VEGF, IGF-1, and HIF-1α levels did not significantly differ between the groups. There was a negative correlation between serum VEGF levels and the parent-rated T-DSM-IV-S (AD) subscale. There was a positive correlation between serum IGF-1 levels and the parent-rated T-DSM-IV-S (AD) subscale, and SDQ (ES) subscale.

CONCLUSION

Given our limitations and the fact that some of our findings differ from those of other studies, it is evident that this area requires additional research with larger samples.