Risk of ADHD After Multiple Exposures to General Anesthesia: A Nationwide Retrospective Cohort Study

Tsai, Chia Jui; Lee, Charles Tzu Chi; Liang, Sophie Hsin Yi; Tsai, Pei Jung; Chen, Vincent Chin Hung; Gossop, Michael

doi:10.1177/1087054715587094

Cited by 35 publications

(46 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, P35 animals had significantly higher exploratory activity compared to control littermates bringing up a proposal that hyperactivity could be an obstacle in reaching control-like memory score. This might be of significance in accordance with recent studies investigating the association between early exposure to general anesthesia and developmental or behavioral disorder (DBD), with ADHD as a major component (Tsai et al 2015;Sprung et al 2012). To the best of our knowledge, this is the first experimental evidence that rodents with prolonged exposure to propofol anesthesia during neonatal period (P7) exhibited hyperactivity during early adolescence (P35).…”

Section: Neurotox Ressupporting

confidence: 88%

The Fas Ligand/Fas Death Receptor Pathways Contribute to Propofol-Induced Apoptosis and Neuroinflammation in the Brain of Neonatal Rats

Milanovic

Pešić

Lončarević-Vasiljković

et al. 2016

Neurotox Res

View full text Add to dashboard Cite

A number of experimental studies have reported that exposure to common, clinically used anesthetics induce extensive neuroapoptosis and cognitive impairment when applied to young rodents, up to 2 weeks old, in phase of rapid synaptogenesis. Propofol is the most used general anesthetic in clinical practice whose mechanisms of neurotoxicity on the developing brain remains to be examined in depth. This study investigated effects of different exposures to propofol anesthesia on Fas receptor and Fas ligand expressions, which mediate proapoptotic and proinflammation signaling in the brain. Propofol (20 mg/kg) was administered to 7-day-old rats in multiple doses sufficient to maintain 2-, 4- and 6-h duration of anesthesia. Animals were sacrificed at 0, 4, 16 and 24 h after termination of anesthesia. It was found that propofol anesthesia induced Fas/FasL and downstream caspase-8 expression more prominently in the thalamus than in the cortex. Opposite, Bcl-2 and caspase-9, markers of intrinsic pathway activation, were shown to be more influenced by propofol treatment in the cortex. Further, we have established upregulation of caspase-1 and IL-1β cytokine transcription as well as subsequent activation of microglia that is potentially associated with brain inflammation. Behavioral analyses revealed that P35 and P60 animals, neonatally exposed to propofol, had significantly higher motor activity during three consecutive days of testing in the open field, though formation of the intersession habituation was not prevented. This data, together with our previous results, contributes to elucidation of complex mechanisms of propofol toxicity in developing brain.

show abstract

Section: Neurotox Ressupporting

confidence: 88%

The Fas Ligand/Fas Death Receptor Pathways Contribute to Propofol-Induced Apoptosis and Neuroinflammation in the Brain of Neonatal Rats

Milanovic

Pešić

Lončarević-Vasiljković

et al. 2016

Neurotox Res

View full text Add to dashboard Cite

show abstract

“…Therefore, the diagnoses of hypoglycemic with/without coma based on International Classification of Diseases (ICD)‐9 codes in this study were highly reliable. In addition, some related studies with the same diagnosed method and criteria by ICD‐9 coding were already been published …”

Section: Methodsmentioning

confidence: 99%

Association of attention deficit hyperactivity disorder with recurrent hypoglycemia in type 1 diabetes mellitus

Lin

Hsu

et al. 2018

Pediatr Diabetes

View full text Add to dashboard Cite

show abstract

“…In Tsai et al's study, they have observed that children who have been exposed to GA for a long time before the age of 3 are more likely to be diagnosed with ADHD in the future [23]. It must be noted that the within-pair analysis suggested that anesthesia exposure was associated with a higher ADHD score [24] and the later ADHD are associated with prolonged or multiple exposure to anaesthetics [25].…”

Section: Discussionmentioning

confidence: 98%

A National Population Cohort Study Showed That Exposure to General Anesthesia in Early Childhood Is Associated with an Increase in the Risk of Developmental Delay

et al. 2021

View full text Add to dashboard Cite

This study investigated the relationship between exposure to general anesthesia (GA) and the risk of cognitive and mental disorders. This study has thus investigated the relationships between exposure to GA before the age of 3 and subsequent cognitive and mental disorders in a national-wide research sample. We obtained our subjects from the National Health Insurance Research Database (NHIRD) of Taiwan, which was based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Children in the hospital aged less than 3 years old were included if there was GA exposure or not during the period of year 1997 to 2008. Cox proportional hazard regression models adjusted for potential confounding factors were used to estimate the relative magnitude of the risk associated with GA exposure. The cohort contained 2261 subjects with GA and 4522 children without GA as a comparison group. GA exposure group had a higher rate of developmental delay than in the without GA group (hazard ratio 1.46, p < 0.0001). There was no significant difference in the overall incidence of ADHD, autism and intellectual disability between the GA-exposed group and the comparison cohort. In conclusion, this study reported that children exposed to GA early before the age of three had a small association with increased risk of development delay thereafter.

show abstract

Risk of ADHD After Multiple Exposures to General Anesthesia: A Nationwide Retrospective Cohort Study

Abstract: Children with multiple or ≥3 hr general anesthesia exposures before age 3 years have an increased likelihood of a later ADHD diagnosis.

Cited by 35 publications

References 35 publications

The Fas Ligand/Fas Death Receptor Pathways Contribute to Propofol-Induced Apoptosis and Neuroinflammation in the Brain of Neonatal Rats

The Fas Ligand/Fas Death Receptor Pathways Contribute to Propofol-Induced Apoptosis and Neuroinflammation in the Brain of Neonatal Rats

Association of attention deficit hyperactivity disorder with recurrent hypoglycemia in type 1 diabetes mellitus

A National Population Cohort Study Showed That Exposure to General Anesthesia in Early Childhood Is Associated with an Increase in the Risk of Developmental Delay

Contact Info

Product

Resources

About