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Updated: May 22, 2026

Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Attention deficit hyperactivity disorder and cognitive function in Duchenne muscular dystrophy: phenotype-genotype
Marika Pane1, Maria Elena Lombardo, Paolo Alfieri
1Department of Pediatrics, Child Neurology and Psychiatry, Catholic University, Rome, Italy.
Insights
Attention deficit hyperactivity disorder (ADHD) is common in boys with Duchenne muscular dystrophy (DMD). Specific genetic mutations linked to brain dystrophin isoforms increase ADHD risk in these patients.
Area of Science:
- Neurology
- Genetics
- Pediatrics
Background:
- Duchenne muscular dystrophy (DMD) is a severe genetic disorder primarily affecting muscles.
- Cognitive impairments and behavioral issues, including ADHD, are increasingly recognized in DMD patients.
- Understanding the prevalence and genetic correlates of ADHD in DMD is crucial for comprehensive care.
Purpose of the Study:
- To determine the frequency of attention deficit hyperactivity disorder (ADHD) in boys with Duchenne muscular dystrophy (DMD).
- To investigate the association between ADHD, cognitive abilities, and specific genetic mutations in DMD.
- To explore the relationship between genetic findings and the risk of ADHD in DMD.
Main Methods:
- 103 boys with DMD (ages 4-17) were evaluated.
- Cognitive function was assessed using Wechsler scales.
- ADHD diagnosis utilized DSM-IV-TR criteria and Conners Rating Scales.
Main Results:
- ADHD was diagnosed in 33 out of 103 DMD boys.
- Intellectual disability (ID) was present in 24.6% of patients.
- ADHD was more common with mutations affecting brain-specific dystrophin isoforms (Dp140, Dp71).
Conclusions:
- ADHD is a frequent comorbidity in Duchenne muscular dystrophy.
- Mutations impacting brain dystrophin expression are associated with a higher risk of ADHD in DMD.
- These findings highlight the importance of screening for ADHD and cognitive issues in DMD.
Objectives:
To assess attention deficit hyperactivity disorder (ADHD) in boys affected by Duchenne muscular dystrophy (DMD) and to explore the relationship with cognitive abilities and genetic findings.
Study Design:
Boys with DMD (n = 103; 4-17 years of age, mean: 12.6) were assessed using a cognitive test (Wechsler scales). Assessment of ADHD was based on the Diagnostic Statistical Manual, Fourth Edition, Text Revision criteria and on the long version of the Conners Parents and Teachers Rating Scales.
Results:
ADHD was found in 33 of the 103 boys with DMD. Attention problems together with hyperactivity (17/33) or in isolation (15/33) were more frequent than hyperactivity alone, which was found in 1 patient. Intellectual disability (ID) was found in 27/103 (24.6%). Sixty-two of the 103 boys had no ID and no ADHD, 9 had ID but no ADHD, 14 had ADHD but no ID, and 18 had both. ADHD occurred more frequently in association with mutations predicted to affect Dp140 expression (exon 45-55) and in those with mutations predicted to affect all dystrophin product, including Dp71 (ie, those that have promoter region and specific first exon between exons 62 and 63 but were also relatively frequent).
Conclusions:
Our results suggest that ADHD is a frequent feature in DMD. The risk of ADHD appears to be higher in patients carrying mutations predicted to affect dystrophin isoforms expressed in the brain and are known to be associated with higher risk of cognitive impairment.
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