Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

West, Dirk Van; Claes, Stephan; Deboutte, Dirk

doi:10.1007/s00787-009-0011-1

Cited by 66 publications

(35 citation statements)

References 68 publications

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“…However, at 25/30 min post-challenge (cort_lastP) cortisol levels were elevated, although with considerable more variability, in the TYPs and ADHDs groups to a greater extent than in either of the other non-SOR groups. This cortisol response pattern in our children with ADHDs had been identified in our earlier work, and stands in contrast to other studies which found that children with ADHD and externalizing disorders tend to show blunted cortisol levels in response to a challenge or stressor (King et al, 1998; Hong et al, 2003; van West et al, 2009). The children in this study with ADHDt did show a more attenuated cortisol response, suggesting that SOR may influence the cortisol response in children with ADHD.…”

Section: Discussionsupporting

confidence: 49%

Sensory over-responsivity and ADHD: differentiating using electrodermal responses, cortisol, and anxiety

Lane

Reynolds

Thacker

2010

Front. Integr. Neurosci.

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Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity for years, but a clear understanding of the relationship between sensory modulation disorders and attention deficit hyperactivity disorder (ADHD) has proven elusive. Our preliminary work suggested that patterns of salivary cortisol and electrodermal responsivity to sensation may be linked to different groups of children with ADHD; those with and without sensory over-responsivity (SOR). Additionally, SOR has been linked to anxiety, and anxiety has been linked to ADHD. A clearer understanding of the relationship between anxiety, SOR, and ADHD may support a better understanding of ADHD diagnostic subtypes. We examined neuroendocrine, electrodermal and behavioral characteristics and sought to predict group membership among 6- to 12-year-old children with ADHD and SOR (ADHDs), ADHD and no SOR (ADHDt), and typicals (TYP). Behavioral questionnaires were completed to document SOR and anxiety. Lab testing used a Sensory Challenge Protocol (SCP) with concurrent electrodermal measurement and the collection of cortisol prior to and following the SCP. Results substantiated links between SOR and anxiety, in both TYP and ADHD children. Results suggests that ADHD should be considered in conjunction with anxiety and sensory responsivity; both may be related to bottom-up processing differences, and deficits in prefrontal cortex/hippocampal synaptic gating.

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Section: Discussionsupporting

confidence: 49%

Sensory over-responsivity and ADHD: differentiating using electrodermal responses, cortisol, and anxiety

Lane

Reynolds

Thacker

2010

Front. Integr. Neurosci.

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“…For example, it was suggested that catecholamine levels are altered in urine samples of patients with ADHD (Salavessa et al 2009) and that they may also exhibit an altered cortisol response (van West et al 2009). …”

Section: Proteomicsmentioning

confidence: 97%

The current status of research into attention deficit hyperactivity disorder: proceedings of the 2nd international congress on ADHD: from childhood to adult disease

Thome

Reddy

2009

ADHD Atten Def Hyp Disord

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Despite being a devastating psychiatric condition with high prevalence, ADHD has traditionally been widely under-researched, specifically in adult patients. Therefore, the recent surge in scientific projects focusing on ADHD is impressive. By reviewing selected research findings presented at the 2nd International Congress on ADHD, this paper gives an overview about current state-of-the art research in such different areas as diagnosis, classification, epidemiology, differential diagnosis and comorbidity, neurobiology (including molecular genetics, proteomics, neuroimaging and electrophysiology), environmental factors, modelling of ADHD, treatment (pharmacological and non-pharmacological), as well as forensic and social aspects.

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“…Cortisol then acts on the hypothalamus, pituitary, and hippocampus to inhibit its own production in a negative feedback loop. It has been reported that children with ADHD have a blunted cortisol response to psychosocial stressors, a decreased cortisol awakening response (CAR), or lower plasma daytime cortisol (King et al 1998;Ma et al 2011;Randazzo et al 2008;Scerbo and Kolko 1994;van West et al 2009), though there is considerable inconsistency between studies (Freitag et al 2009;Hastings et al 2009;Snoek et al 2004).…”

Section: Introductionmentioning

confidence: 98%

Genetic Evidence for the Association of the Hypothalamic–Pituitary–Adrenal (HPA) Axis with ADHD and Methylphenidate Treatment Response

et al. 2012

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Exposure to stressors results in a spectrum of autonomic, endocrine, and behavioral responses. A key pathway in this response to stress is the hypothalamic-pituitary-adrenal (HPA) axis, which results in a transient increase in circulating cortisol, which exerts its effects through the two related ligand-activated transcription factors: the glucocorticoid receptor (GR) and mineralocorticoid receptor (MR). Genetic polymorphisms in these receptors have been shown to influence HPA axis reactivity, and chronic dysregulation of the HPA axis has been associated with the development of several psychiatric disorders. The objective of the study was to test the association between four functional polymorphisms in NR3C1 (encoding GR: ER22/23EK-rs6189, N363S-rs6195, BclI-rs41423247, A3669G-rs6198) and two in NR3C2 (encoding MR: 215G/C-rs2070951, I180 V-rs5522) with childhood ADHD. Family-based association tests (FBAT) were conducted with the categorical diagnosis of ADHD, behavioral and cognitive phenotypes related to ADHD, as well as with treatment response assessed in a 2-week, double-blind, placebo-controlled trial with methylphenidate. A specific haplotype (G:A:G:G; ER22/23EK- N363S- BclI- A3669G) of NR3C1 showed a significant association with behaviors related to ADHD (particularly thought and attention problems, aggressive behavior), comorbidity with oppositional defiant disorder, and executive function domains. An association was also observed with treatment response (assessed by the Conners'-Teachers and Restricted Academic Situation Scale). In contrast, MR gene polymorphisms were not associated with any of the variables tested. To the best of our knowledge, this is the first report showing an association between functional polymorphisms in NR3C1 and ADHD, providing genetic evidence for involvement of the HPA axis in the disorder and treatment response.

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Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

Cited by 66 publications

References 68 publications

Sensory over-responsivity and ADHD: differentiating using electrodermal responses, cortisol, and anxiety

Sensory over-responsivity and ADHD: differentiating using electrodermal responses, cortisol, and anxiety

The current status of research into attention deficit hyperactivity disorder: proceedings of the 2nd international congress on ADHD: from childhood to adult disease

Genetic Evidence for the Association of the Hypothalamic–Pituitary–Adrenal (HPA) Axis with ADHD and Methylphenidate Treatment Response

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