Attention-deficit/hyperactivity disorder in neurofibromatosis type 1
Yang Hou1, Jiaxiu Song1, Dan Liu1
1Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA.
Developmental Medicine and Child Neurology
|July 30, 2026
Summary
Children with neurofibromatosis type 1 (NF1) exhibit higher attention-deficit/hyperactivity disorder (ADHD) symptoms, peaking in middle childhood. Understanding these age-specific ADHD patterns and profiles is crucial for early intervention in NF1.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Genetics
Background:
- Neurofibromatosis type 1 (NF1) is a genetic disorder associated with various neurodevelopmental challenges.
- Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity in children with NF1, impacting cognitive and behavioral functions.
- Limited research exists on age-specific ADHD symptom trajectories and distinct symptom profiles in this population.
Purpose of the Study:
- To characterize age-specific patterns of ADHD symptoms in children with NF1.
- To identify distinct ADHD symptom profiles within this cohort.
- To explore associations between ADHD symptom presentation and demographic/disease-specific factors.
Main Methods:
- A cross-sectional design was employed, analyzing observational data from 656 children with NF1 (ages 3-18).
- Time-varying effect modeling was used to examine age-varying ADHD symptom patterns.
- Latent profile analysis classified children into distinct ADHD symptom profiles.
Main Results:
- Children with NF1 consistently showed elevated inattention and hyperactivity/impulsivity symptoms compared to normative data.
- ADHD symptom patterns followed an inverted U-shaped trajectory, peaking around age 10 years.
- Four ADHD profiles were identified: typical range, severe combined, mild combined, and predominantly inattentive. Female sex and lower parental education correlated with greater symptom severity.
Conclusions:
- ADHD symptoms are prevalent and elevated across childhood in individuals with NF1, with a peak in middle childhood.
- Significant heterogeneity exists in ADHD symptom presentation among children with NF1.
- Early identification, continuous monitoring, and tailored interventions are essential to address the long-term academic, social, and functional consequences of ADHD in NF1.
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