Ictal and interictal EEG abnormalities in ADHD children recorded over night by video-polysomnography
Rosalia Silvestri1, Antonella Gagliano, Tiziana Calarese
1Sleep Medicine Centre, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy. rosalia.silvestri@unime.it
Insights
Attention-deficit/hyperactivity disorder (ADHD) in children is frequently linked to abnormal EEG findings and sleep disturbances. These neurological and sleep issues impact cognitive abilities and behavior.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neurodevelopmental Disorders
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
- Children with ADHD often exhibit sleep problems and may have underlying neurological abnormalities.
- The co-occurrence of epilepsy-related discharges and sleep disorders in ADHD requires further investigation.
Purpose of the Study:
- To determine the prevalence of ictal and interictal epileptiform discharges (IEDs) and sleep disorders in children with ADHD.
- To explore the associations between EEG abnormalities, sleep issues, and cognitive/behavioral variables in ADHD patients.
Main Methods:
- Forty-two ADHD outpatients underwent overnight video-polysomnography (video-PSG).
- Behavioral and neuropsychological assessments were conducted.
- Spearman correlation coefficients were used to analyze relationships between EEG, sleep, cognitive, and behavioral data.
Main Results:
- 86% of ADHD children had sleep disorders, with 26% diagnosed with Restless Leg Syndrome (RLS).
- 53.1% of children showed IEDs, including centro-temporal, frontal, and temporal-occipital spikes.
- Nocturnal seizures were observed in three patients.
- Significant correlations were found between seizures, cognitive scores, and IEDs.
- Inattention, hyperactivity, and oppositional behaviors were linked to RLS.
Conclusions:
- ADHD is commonly associated with epileptiform abnormalities on EEG.
- Seizures and IEDs appear to influence cognitive functions in ADHD.
- Sleep disorders have a more pronounced effect on behavioral than cognitive indicators in ADHD.
Abstract:
In this paper we explore the prevalence of ictal and interictal epileptiform discharges (IEDs) and sleep disorders in ADHD children referred to a sleep clinic for all night video-PSG. Forty-two ADHD outpatients (35 males and 7 females) underwent video-PSG and a behavioural/neuropsychological assessment. Spearman correlation coefficients (p<0.05 criterion level) were used to assess the association between cognitive, behavioural, clinical (co-morbidity), sleep (sleep efficiency) and EEG (seizures, IEDs, localization of IEDs foci) variables. Sleep disorders were found in 86% of ADHD children; among these, 26% had RLS. 53.1% of ADHD children had IEDs (28.2% centro-temporal spikes, 12.5% frontal spikes, 9.3% temporal-occipital spikes and 2.3% generalized S-W). Nocturnal seizures were recorded in three patients: two with atypical interictal rolandic spikes and one with left frontal slow abnormalities. A significant relationship (p<0.05) emerges between nocturnal seizures and WISC-R IQ score and visual-spatial memory test and between some cognitive variables and interictal rolandic spikes. High levels of inattention, impulsivity/hyperactivity and oppositional behaviours were related (p<0.01 or 0.05) with Restless Leg Syndrome diagnosis. In conclusion, ADHD is a condition often associated with EEG epileptiform abnormalities. Seizures/IEDs presence seems to play a role on cognitive abilities, conversely sleep disorders have a stronger impact on behavioural rather than cognitive indicators.
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