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Secondary attention-deficit/hyperactivity disorder following perinatal and childhood stroke: impact on cognitive and
Tricia S Williams1, Samantha D Roberts1, Andrea M Coppens2
1a Departments of Psychology & Psychiatry, Division of Neurology , The Hospital for Sick Children , Toronto , ON , Canada.
Insights
Pediatric stroke survivors have a higher risk of developing attention-deficit/hyperactivity disorder (ADHD). Children with secondary ADHD after stroke showed poorer cognitive and academic performance compared to other groups.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
Background:
- Pediatric stroke is a significant concern, potentially leading to long-term neurodevelopmental challenges.
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
Purpose of the Study:
- To investigate the incidence and characteristics of secondary ADHD in children with a history of stroke.
- To compare cognitive and academic outcomes in children with secondary ADHD versus stroke-only and developmental ADHD.
Main Methods:
- Retrospective clinical study of children aged 4-18 with a history of stroke.
- Neuropsychological assessments were used to identify ADHD diagnoses.
- Comparison of demographic, clinical, and neurocognitive data between groups.
Main Results:
- 13.1% of children with stroke received a secondary ADHD diagnosis.
- Children with secondary ADHD were younger at stroke onset and had higher rates of perinatal stroke and seizures.
- No differences in lesion characteristics (pattern, size, laterality) were found.
- Children with secondary ADHD exhibited the lowest cognitive and academic scores.
Conclusions:
- Pediatric stroke increases the risk for developing secondary ADHD.
- Secondary ADHD in pediatric stroke survivors is associated with significant cognitive and academic deficits.
- Early identification and intervention are crucial for children with stroke and ADHD.
Abstract:
This cross-sectional retrospective clinical research study examines a large group of children followed within a pediatric stroke program and a developmental attention-deficit/hyperactivity disorder (ADHD) clinic at the Hospital for Sick Children, between May 2004 and June 2016. All children with a history of stroke who participated in a neuropsychological assessment between the ages of 4 and 18 years were considered for inclusion. From a sample of 275 participants with a history of stroke, 36 children (13.1%) received a diagnosis of secondary ADHD. Children with secondary ADHD were younger at the time of stroke and more likely to be identified as having a presumed perinatal stroke and persistent seizures than children without secondary ADHD diagnoses. There were no differences in pattern of lesion, size, or laterality between children who developed secondary ADHD and those who did not. Children with secondary ADHD had the lowest scores across all cognitive and academic measures compared to children with stroke-only and developmental ADHD. Findings highlight the added risk of receiving a diagnosis of secondary ADHD following pediatric stroke. Implications for future research and directed intervention are discussed.
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