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Hypothalamic-pituitary-adrenal axis function in children with attention-deficit hyperactivity disorder
M Kaneko1, Y Hoshino, S Hashimoto
1Department of Neuropsychiatry, Fukushima Medical College, Japan.
Insights
Attention-deficit hyperactivity disorder (ADHD) in children is linked to hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Some ADHD children show abnormal cortisol rhythms and reduced response to the dexamethasone suppression test (DST).
Area of Science:
- Neuroendocrinology
- Child Psychiatry
- Developmental Psychology
Background:
- The hypothalamic-pituitary-adrenal (HPA) axis regulates stress response.
- Dysregulation of the HPA axis is implicated in various neurodevelopmental disorders.
- Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
Purpose of the Study:
- To investigate HPA axis function in children diagnosed with ADHD.
- To assess diurnal cortisol variation and dexamethasone suppression test (DST) response in this cohort.
- To explore potential correlations between HPA axis abnormalities and ADHD symptom severity.
Main Methods:
- Salivary cortisol levels were measured to assess diurnal rhythm.
- The dexamethasone suppression test (DST) was administered to evaluate HPA axis suppression.
- Participants were 30 children diagnosed with ADHD.
- Children were categorized based on hyperactivity severity.
Main Results:
- Only 43.3% of children with ADHD exhibited a normal diurnal salivary cortisol rhythm.
- The DST demonstrated suppression in 46.7% of the ADHD children.
- Abnormal diurnal rhythms and DST non-suppression were more prevalent in severely hyperactive children compared to mildly hyperactive ones.
Conclusions:
- These findings suggest that a subset of children with ADHD exhibit HPA axis functional abnormalities.
- HPA axis dysregulation appears more pronounced in children with severe hyperactivity.
- Further research is warranted to understand the role of HPA axis dysfunction in ADHD pathophysiology.
Abstract:
Examined hypothalamic-pituitary-adrenal axis (HPA axis) function in 30 children with attention-deficit hyperactivity disorder (ADHD) by measuring the diurnal variation and response to the dexamethasone suppression test (DST) of saliva cortisol. Normal diurnal saliva cortisol rhythm was found in only 43.3% of the ADHD children. DST showed suppression in 46.7% of the ADHD children. An abnormal diurnal rhythm and nonsuppression to the DST were more frequent in the severely hyperactive group than in the mildly were more frequent in the severely hyperactive group than in the mildly hyperactive group of children with ADHD. These results suggest abnormalities in HPA axis function in some children with ADHD, especially those exhibiting severe hyperactivity.