Dysglycemia Diet: Types Of Food Affecting ADHD

ADHD triggering food not only takes it toll on kids, but on their parents, as well.

Even though sugar generally is not yet a proven cause of increased Attention Deficit Hyperactivity Disorder (ADHD) cases, too much sugar or too little of it can affect mood and energy levels. For youngsters with ADHD, moderation of sugar-rich food is a must.

Food intake is pivotal towards living a full life amid bouts with ADHD. Some favorites like those spiked with artificial coloring, flavoring, preservatives, saturated fat and caffeine decrease concentration and greatly affect a person’s sleeping habits.

According to Medical Daily, these dietary changes are must-follows. First, parents should focus on changing the content of their kids with ADHD to support the health of your their and reduce the disorder’s symptoms. Also, balance the caloric intake with a child’s needs through portion control and regular exercise.

Foods high in Vitamin B, protein, calcium and trace minerals can actually reduce symptoms on a regular basis, Active Beat notes. Such nourishment kids have to eat to curb ADHD are grouped into 5 categories.

Complex Carbohydrates: Apples, kiwis, grapefruit, pears and oranges help children with ADHD fall asleep faster, as they have trouble getting a good night’s rest quickly. Blend these fruits into a smoothie or toss them in to make a fruit salad. Young ones get bored easily, even with food. Make sure to find different means of getting all these sustenance in.

Protein-Rich Food: Eggs, cheese, beans and especially chicken aid in increasing the concentration of a young one with ADHD and the time their medications would work. While this food group is essential to help alleviate symptoms, parents need to check first for allergies or intolerance, which can aggravate symptoms.

Omega 3 Fatty Acids: Known to be nutritious in general, tuna, salmon, and nuts such as almonds, walnuts and Brazil nuts, reduce symptoms too. Fish can be paired with leafy greens to make it a healthier meal. Almonds and the like can be served during snack time.

Vegetables: These are not forced into children for nothing. Spinach, though often despised by little ones, aid in reducing ADHD triggers. If children are especially resistant to this, try mincing them and garnishing such on dishes or blend in smoothie mixes.

Whole Grain Cereals: Kids love their alphabet cereals, Froot Loops and other food with color. Though aesthetically eye-catching, this kind of cereals contain additives, which can be hazardous to children with ADHD.

Diet is not only for adults but also for the young. When moms and dads sense their child’s focus is wavering or when sleeping time turns into a struggle, rethink their intake. ADHD triggering food not only takes it toll on kids but on their parents as well.

Know more @ parentherald

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ADHD rates level off after 2011 guidelines

Since a standardized approach to ADHD diagnoses was introduced five years ago, diagnosis rates among preschoolers have leveled off, a new study finds.

The American Academy of Pediatrics study comes after the organization advocated for behavior therapy over medication therapy as the first line of defense against the disorder in 2011.

Recommendations like that may have helped lead to stabilized rates of prescribed stimulants to treat the disorder. Coupled with the stabilized rates of diagnosis, the study’s findings indicate the new guidelines haven’t led to an overdiagnosis of ADHD among young children.

All together, it’s an encouraging study for those who’ve advocated for behavioral therapy as the preferred opening treatment for ADHD.

“The story might suggest we’re becoming more reasonable in our diagnosis and capturing kids who actually have ADHD versus kids who don’t fit the diagnosis as well,” said Jonathan Stadler, associate professor of psychology at Bethany Lutheran College.

He said his departmental teachings align closely with the AAP’s recommendations on behavior therapy as a first option. But he noted it shouldn’t be seen as the be-all and end-all treatment option.

To account for the individual needs of the child, Stadler said psychologists should have a toolbox full of approaches. So while behavioral therapy should be the first tool used, for some children it’d be as effective as a hammer being used to screw in a nail.

“For some kids, they need drug therapy and for some kids that is the best way to deal with their impulse control, but I think that should be the last step not the first step,” Stadler said.

A combination of behavior and medication therapy proves effective for many, said Chip Panahon, associate professor and director of the school of psychology doctoral program at Minnesota State University.

“If you use the medication to start off and get that connection, then you can try to supplement it with the parents and school intervention,” he said, adding the schools, parents and medical professionals need to be on the same page.

Apart from behavior therapy not being effective for everyone, it can also be cost and time prohibitive for some. It involves the child regularly working with a trained psychologist on things like behavior cues.

“Many times those (behavior) techniques require more training and follow through,” Panahon said. “There’s a bigger time commitment with making sure it’s done correctly.”

Despite any barriers associated with behavior therapy, Stadler and Panahon said it’s the preferred option for a reason. Stadler noted there isn’t much known about the long-term effects of the medication on a developing brain. A measured, behavioral therapy approach also reduces the risk of a false diagnosis — and therefore a prescription that might not be needed.

“ADHD is a real condition that affects kids,” he said. “I just think we’re a little impatient diagnosing kids with ADHD.”

Holding off on medication until it’s truly deemed necessary allows more time to see if the behavior continues across different environments and contexts, he said.

Taken from mankatofreepress

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Talking to Parents About Behavioral Treatment for ADHD

The American Academy of Pediatrics recommends behavioral intervention to be the first-line approach when working with preschool-aged or very young children who have ADHD.

A combined approach is suggested when considering older kids and adolescents, which may include behavioral parent training, behavioral interventions at school, and medication. Pediatricians are often involved in the prescription of medication treatments for kids at adolescence who have ADHD.

Recent research suggests that beginning with behavioral interventions can actually be more effective for children and adolescents who have ADHD. More children tend to respond well if we start with behavioral intervention and add medication later if necessary. Treatment engagement improves among children and families who start with behavioral interventions.

The reality is, though, that even when we consider all of these variables, families struggle to follow through on treatment recommendations.

A convincing note about behavioral interventions for ADHD

A medication does a really great job at symptom reduction, but medication does not teach the child the skills that he or she would need to cope with the symptoms of ADHD.

Behavioral intervention can teach the child how to engage in appropriate behavior at home, at school, and with peers. Explaining that medication is useful for symptom reduction, and behavioral intervention teaches skills that a child might need, usually helps families really understand our treatment perspective.

Taken from medscape.

Browse here about the various types of behavior therapies which can be used effectively for the treatment of ADHD.

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Music Training May Help Treat Autism And ADHD In Kids

Taking music lessons increases brain connections in children and may be useful in treating autism and Attention Deficit Hyperactivity Disorder (ADHD), a new study has found.

The researchers studied 23 healthy children between the ages of five and six years old.
All of the children were right handed and had no history of sensory, perception or neurological disorders.

None of the children had been trained in any artistic discipline in the past.

“It’s been known that musical instruction benefits children with these disorders, but this study has given us a better understanding of exactly how the brain changes and where these new fibre connections are occurring,” said Pilar Dies-Suarez, Chief radiologist at the Hospital Infantil de Mexico Federico Gomez.

The children underwent pre-and post-musical-training evaluation with diffusion tensor imaging (DTI) of the brain.

DTI is an advanced MRI technique, which identifies microstructural changes in the brain’s white matter.

“Experiencing music at an early age can contribute to better brain development, optimizing the creation and establishment of neural networks, and stimulating the existing brain tracts,” Dr Dies-Suarez said.

The brain’s white matter is composed of millions of nerve fibers called axons that act like communication cables connecting various regions of the brain.

Diffusion tensor imaging produces a measurement, called fractional anisotropy (FA), of the movement of extracellular water molecules along axons.

In healthy white matter, the direction of extracellular water molecules is fairly uniform and measures high in fractional anisotropy. When water movement is more random, FA values decrease, suggesting abnormalities.

Over the course of life, the maturation of brain tracts and connections between motor, auditory and other areas allow the development of numerous cognitive abilities, including musical skills.

Previous studies have linked autism spectrum and ADHD with decreases in volume, fiber connections and FA in the minor and lower forceps, tracts located in the frontal cortex of the brain.

This suggests that low connectivity in the frontal cortex, an area of the brain involved in complex cognitive processes, is a bio-marker of these disorders.

After the children completed nine months of musical instruction, DTI results showed an increase in FA and axon fibre length in different areas of the brain, most notably in the minor forceps.

“When a child receives musical instruction, their brains are asked to complete certain tasks,” Dr Dies-Suarez said.

“These tasks involve hearing, motor, cognition, emotion and social skills, which seem to activate these different brain areas,” he said.

“These results may have occurred because of the need to create more connections between the two hemispheres of the brain,” he added.

Taken from http://www.ndtv.com/world-news/music-training-may-help-treat-autism-and-adhd-in-kids-study-1628940.

Know about other expressive therapies preferred for ADHD @ Expressive Art Therapies for ADHD.

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An Intervention to Promote Sleep and Reduce ADHD Symptoms

A recent study concluded that children with ADHD benefit from standardized sleep assessments.

Those with sleep disorders show both a significant improvement in sleep quality and a significant reduction in ADHD symptoms when provided with a patient-specific sleep hygiene routine and follow-up. The outcomes of study align with the current literature and further validate the recommendation for behavior modification as the first-line treatment for sleep difficulties in children with ADHD.

Study participants receiving sleep hygiene interventions had a significant reduction in ADHD symptoms and a significant improvement in sleep quality. The results substantiate the benefits of assessing sleep and instructing parents on clinical guideline-based behavior interventions incorporated into a sleep hygiene routine. The intervention was cost effective, conducive to a busy clinical setting, and easily tailored for use in pediatric primary care. The project showed the ease of assessing and treating sleep difficulties among children with ADHD and established documentation of interventions in the electronic medical record, to facilitate sharing with treatment team members and caregivers. The associated cost of assessing and treating sleep difficulties equated to provider and staff time; provider time totaled an additional 10 minutes/visit, and staff time totaled an additional 5 minutes/visit. Standardized sleep assessment and the provision of the prescriptive sleep hygiene routine occurred during routine office visits.

Strengths of the study included careful exclusion criteria for patients with medication changes, pharmaceutical and alternative sleep aids, and symptoms of obstructive sleep apnea. Additional strengths were modeling implementation of the clinical practice guideline, embedding the sleep hygiene routine in the electronic medical record, instructing a patient-specific sleep hygiene routine, and use of a brief standardized video. Each of the features shows the ease of replication of this project in other pediatric clinics. Although the overall sample size was acceptable (N = 53), convenience sampling was used to obtain the participants, and the innovation group had only 23 participants, limiting the generalizability.

The surprising factor about the study is that significant number of caregivers declined to participate in this intervention. Most parents/caregivers who declined cited lack of time or their inability to implement the sleep hygiene routine in their home. As providers, we need to acknowledge how time requested for study participation, whether real or perceived by families, affects their willingness to participate in a collaboratively developed, individualized treatment plan. As the sleep hygiene innovation evolves in our clinical settings, we will consider providing sleep assessment surveys via electronic mail or before the follow-up visit, to decrease in-office time requirements and improve participation. We will also offer the sleep intervention to all children with ADHD who score 42 or greater on the CHSQ in an effort to improve sleep hygiene and reduce the effects of disordered sleep.

Taken from medscape

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Can Mental Illness Be Prevented In The Womb?

Every day in the United States, millions of expectant mothers take a prenatal vitamin on the advice of their doctor.

The counsel typically comes with physical health in mind: folic acid to help avoid fetal spinal cord problems; iodine to spur healthy brain development; calcium to be bound like molecular Legos into diminutive baby bones.

But what about a child’s future mental health? Questions about whether ADHD might arise a few years down the road or whether schizophrenia could crop up in young adulthood tend to be overshadowed by more immediate parental anxieties. As a friend with a newborn daughter recently fretted over lunch, “I’m just trying not to drop her!”

Yet much as pediatricians administer childhood vaccines to guard against future infections, some psychiatrists now are thinking about how to shift their treatment-centric discipline toward one that also deals in early prevention.

In 2013, University of Colorado psychiatrist Robert Freedman and colleagues recruited 100 healthy, pregnant women from greater Denver to study whether giving the B vitamin choline during pregnancy would enhance brain growth in the developing fetus.

The moms-to-be were randomly given either a placebo or a form of choline called phosphatidylcholine. Choline itself is broken down by bacteria in the gut; by giving it in this related form the supplement can more effectively be absorbed into the bloodstream.

Those in the treatment group received 3,600 milligrams of phosphatidylcholine in the morning and 2,700 milligrams at night. Since phosphatidylcholine is roughly 13-15 percent choline, the amount the women received was about 900 milligrams of choline a day, twice that recommended by the Health and Medicine Division of the National Academies (and about the same amount contained in three large eggs).

After birth, infants were given either 100 milligrams of liquid phosphatidylcholine or placebo once a day for approximately three months. Given that both groups were also getting choline from regular feeding, the dose ensured that those supplemented received well over the Institute of Medicine’s guideline that infants receive at least 125 milligrams a day.

At 5 weeks old, the children were exposed to a series of clicking sounds in the lab while their brain activity was monitored by electroencephalogram, or EEG, a method for recording electrical brain activity via electrodes placed on the scalp. Normally, when exposed to the same sound successively, both infant and adult brains will exhibit “inhibition,” or a far weaker pulse of activity in response to the second sound. We realize that the now familiar tone is insignificant; our brains are unmoved.

However, in some kids this inhibition doesn’t occur — a finding linked with an increased risk for attention problems, social withdrawal and, later in life, schizophrenia.

The results published in 2013 in the American Journal of Psychiatry by Freedman’s group show that 76 percent of newborns whose mothers received choline supplements had normal inhibition to the sound stimuli. The proportion fell to 43 percent in those born to mothers who didn’t get them. It appeared that choline might steer the infant brain away from a developmental course that predicted mental health problems.

A follow-up study at 40 months found that the children who had received choline supplements in utero and after birth had fewer attention problems and less social withdrawal.

Excessive choline consumption — or that over 7,500 milligrams a day — has been associated with drops in blood pressure, sweating, gastrointestinal side effects and a “fishy” body odor. Most American diets contain a significant amount of choline, and supplementation to optimal levels poses no known side effects or risk to fetal development, Freedman says.

A genetic theory

One of the first genes to be linked to schizophrenia goes by the catchy name “CHRNA7.” Normally it encodes for a receptor on neurons in the brain that respond to the neurotransmitter acetylcholine as well as nicotine, a transmission essential to normal brain function and cognition. Genetic mutations in the CHRNA7 gene cause decreased levels of the neuronal receptor to be produced in people with schizophrenia.

A light bulb glowed for Freedman.

And the idea, he admits, is rather simple when you think about it: Choline is known to be essential to brain development and function and is also frequently deficient in pregnant women.

Couple these facts with animal and human research by Freedman and his colleagues showing that choline in the amniotic fluid also activates the CHRNA7 receptor in the developing fetal brain.

“It occurred to us that just as folic acid can help overcome defects in brain and spinal cord development, perhaps supplementing mothers with choline could help prevent mental illness,” Freedman recalls. “And now that the children in our study are over 4 years old, we can see that those given the supplement appear to be on a different developmental track, one with fewer mental problems.”

Moreover, though experimental psychosis treatments targeting the CHRNA7 gene and the receptor it codes for are being explored by other researchers, Freedman explains that levels of the receptor peak in the fetal brain and diminish after birth. “We realized the optimal time to try this intervention is during pregnancy,” he says.

Though choline is available in a number of foods — eggs, seafood and liver are particularly rich in the nutrient — Freedman’s work suggests that for many women, dietary sources may be inadequate during pregnancy. Also, prenatal supplements tend not to include it.
Two past observational studies — conducted with diet questionnaires rather than the more rigorous placebo-controlled supplementation Freedman’s group tried — also found beneficial effects associated with higher maternal choline intake during pregnancy. At 7 years of age, children of moms consuming over 400 milligrams of choline a day performed better on memory and intelligence tests. At 18 months, infants whose mothers had higher blood levels of choline had significantly higher cognitive test scores.

Dr. Steve Zeisel of the University of North Carolina was one of the first doctors to strongly advocate for choline supplementation in pregnancy. In 2012, Zeisel published the only other placebo-controlled trial of the vitamin in pregnant moms. While he did not assess for future mental health risks, the findings suggested that choline supplementation did not enhance infant cognitive function at 1 year of age. However, Freedman point outs that all of the women included in the trial were highly educated and were found to have blood metabolites reflecting diets high in healthful, choline-containing foods.

The prospects of choline supplementation in pregnancy have piqued medical interest, but also notes of caution. “I think the choline research is really intriguing, and we’re starting to investigate maternal choline levels as well,” says Catherine Monk, an associate professor in psychiatry and obstetrics and gynecology at Columbia University Medical Center. “Some prenatal vitamins do contain it and foods rich in choline are readily available. But we have a lot more research to do before we start recommending it widely.”

In general, evidence-based interventions during pregnancy and early childhood to prevent mental illness are scant. Yet there are some modifiable risk factors that might make a difference, many of which focus on improving maternal wellbeing.

Monk’s own research explores on the impact of an expecting mother’s emotional state on the developing fetus. She and others have shown that stress, depression and anxiety during pregnancy increase a child’s risk for ADHD, conduct disorders and depression later in life. At Columbia, Monk and her colleagues employ a program Practical Resources for Effective Postpartum Parenting, or PREPP, in which pregnant women who are distressed and at high-risk for postpartum depression are counseled and taught coping skills to make pregnancy and parenting more manageable emotionally.

Optimal nutrition, including choline and adequate amounts of zinc and omega-3 fatty acids, may also have developmental and mental health benefits as might avoiding smoking.

Taken from npr


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Inhibitory motor control problems may be unique identifier in adults with ADHD

Young adults diagnosed with ADHD may display subtle physiological signs that could lead to a more precise diagnosis, according to Penn State researchers.

In a recent study, young adults with ADHD, when performing a continuous motor task, had more difficulty inhibiting a motor response compared to young adults who did not have ADHD. The participants with ADHD also produced more force during the task compared to participants without ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that can continue to affect up to 65 percent of these children as they become adults, according to the researchers.

“A large group of individuals have the label ‘ADHD,’ but present with different symptoms,” said Kristina A. Neely, assistant professor, kinesiology. “One of the goals of our ADHD research is to discover unique physiological signals that may characterize different subgroups of the disorder.”

Previous studies have shown that some individuals with ADHD may have poor control of their motor systems, but until recently, the way that it was measured was not very sensitive.

“In previous tasks, motor and cognitive function was evaluated with a key-press response: You hit the button or you didn’t,” said Neely. “We measure precisely how much force an individual is producing during a continuous motor task. This type of task provides us with more information than the dichotomous ‘yes/no’ response.”

In a recent study using a continuous motor task, participants produced force with their index finger and thumb in response to cues on a visual display. Participants were instructed to produce force when the visual cue was any color except blue. In the “blue” trials, participants were told to withhold force production.

Neely and colleagues found that participants with ADHD symptoms produced more force on trials when they were told to withhold a response, compared to those without ADHD. Further, the amount of force that was produced during these trials was correlated with specific ADHD-related symptoms. The researchers presented their findings at the annual Society for Neuroscience meeting Nov. 15.

“The use of a precise and continuous motor task provides a more nuanced understanding of inhibitory control, compared to a button-press task,” said Neely. “We found that young adults with ADHD produced more force on the ‘blue’ trials compared to young adults without ADHD. And the amount of force produced was related to self-report of ADHD-related symptoms of inattention, hyperactivity and impulsivity. Moving forward, we will manipulate the parameters of our force-production task to determine which aspects of motor control are related to specific symptoms.”

Understanding the impact of particular types of ADHD and their effect on motor function could lead to more targeted diagnoses — which could aid in determining optimal treatment options for patients based on their specific symptom profile.

Taken from sciencedaily

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Decoding human thoughts may help people with ADHD

If you think your mind stops wandering when you’re doing nothing, think again. Canadian researchers have developed a new framework for understanding how human thoughts flow, even at rest and thus help people with various mental illness like attention deficit hyperactivity disorder (ADHD).

Mind-wandering is typically characterised as thoughts that stray from what you’re doing.

“Mind-wandering is not an odd quirk of the mind. Rather, it’s something that the mind does when it enters into a spontaneous mode. Without this spontaneous mode, we couldn’t do things like dream or think creatively,” said lead author Kalina Christoff, Professor at University of British Columbia, Canada.

The study published in the journal Nature Reviews Neuroscience proposed that the flow of thoughts is grounded in the interaction between different brain networks and flows freely when the mind is in its default state — mind-wandering. Yet two types of constraints — one automatic and the other deliberate — can curtail this spontaneous movement of thoughts.

However, spontaneous thought processes — including mind wandering, but also creative thinking and dreaming — arise when thoughts are relatively free from these deliberate and automatic constraints, the researchers said.

“Understanding what makes thought free and what makes it constrained is crucial because it can help us understand how thoughts move in the minds of those diagnosed with mental illness,” Christoff said.

“Everyone’s mind has a natural ebb and flow of thought, but our framework reconceptualises disorders like ADHD, depression and anxiety as extensions of that normal variation in thinking,” added Zachary Irving, postdoctoral scholar at the University of California, Berkeley.

According to Irving, “we all have someone with anxiety and ADHD in our minds. The anxious mind helps us focus on what’s personally important, whereas the ADHD mind allows us to think freely and creatively.”

Taken from hindustantimes.

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Research by campus scientists suggests environmental toxins can accumulate in fetuses

A study published Friday featuring UC Berkeley researchers found that a variety of environmental chemicals were more concentrated in fetuses than in the pregnant mothers who were exposed to them — a discovery that complicates previous research.

The study examined levels of mercury, organochlorine pesticides and other potentially harmful chemicals in a group of 77 pregnant mothers. These chemicals may be associated with the later development of conditions such as ADHD, obesity, cancer and autism, according to Tracey Woodruff, senior author of the study and UC San Francisco professor.

“The assumption that the placenta can protect the fetus from exposure to environmental chemicals is not true,” said Rachel Morello-Frosch, the study’s lead author and a UC Berkeley professor. “In certain cases it appears that some chemicals can bioaccumulate in higher levels in the fetus than in the mother.”

Fetuses are particularly vulnerable to chemical exposure, Woodruff said.

“If we are just assuming the risks are based on what the pregnant women are exposed to, we could be underestimating the impact of the chemicals on the fetus,” Woodruff said.

Researchers found that concentrations of lead, which has been banned from paint and gasoline products, where it was formerly common, have declined. However, Woodruff said the use of other chemicals — and rates of childhood ADHD and autism — are on the rise.

“(Chemical exposure) is actually much more common than people are aware of,” said John Balmes, a UC Berkeley environmental health sciences professor unaffiliated with the study. “That’s why (this) work is important, to hopefully get the word out.”

Exposure to potentially harmful chemicals can be found in a variety of sources, including fish, pesticides used on crops and flame retardants, Woodruff said. People can also be exposed through pesticides used for home pests, food packaging, and plastic utensils, according to Balmes.

Some toxic environmental chemicals continue to resurface in studies of fetuses despite being banned for years, Woodruff said.

“We’re making fewer (toxic) chemicals now, thank goodness, but we went through an era when we didn’t pay attention to how toxic chemicals were,” said Ken Cook, president of the Environmental Working Group, an environmental health research and advocacy group. “Those were some of the chemicals Tracey found in those babies.”

Researchers also hoped the study, which examined low-income Latina women, could shed new light on how toxins affect socioeconomic groups traditionally underrepresented in scientific research. Woodruff cited the case of one woman in the study whose unusually high levels of mercury could be explained by the makeup she used — a gift from relatives in Mexico.

“Some of these exposures are uniquely visited upon communities of color,” Cook said. “They might live in places that are near pollution sites, they might have occupations that bring them into contact with these substances.”

Taken from dailycal.

Know about the whole list of chemicals found in household products causing ADHD, Autism @ http://www.fettlegenie.com/adhd/house-hold-products-adhd.shtml and about the whole list of heavy metals causing ADHD, Autism @ http://www.fettlegenie.com/adhd/heavy-metal-overload-adhd.shtml.

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Teens With ADHD Report More Concussion Symptoms

Teenage athletes with attention-deficit/hyperactivity disorder (ADHD) are more likely than their peers to report concussion-like symptoms during preseason baseline tests, a new study suggests.

“This may lead us to refine the ways we use baseline concussion tests. Right now it’s a one-size-fits-all test,” said study investigator Donna Huang, MD, a resident at the Spaulding Rehabilitation Network in Boston, Massachusetts.

Previous evidence has established that the risk for concussion is elevated in the 11% of US children and adolescents with ADHD. This risk might be fueled by ADHD-related symptoms, such as inattention, impulsivity, or risk-taking behavior, explained Dr Huang.

“Research has shown that medications have an effect on cognitive scales” in patients with ADHD, she told Medscape Medical News, “but not on concussion-symptom reporting.”

Dr Huang presented the findings of the study here at the American Academy of Physical Medicine and Rehabilitation 2016 Annual Assembly.

She and her colleagues set out to determine whether the use of ADHD medications affects the reporting of concussion symptoms in a cross-sectional study of 37,510 high school athletes from Maine.

None of the participants had reported a concussion in the previous 6 months, and all completed a baseline preseason health survey and symptom questionnaire.

ADHD was self-reported by 2409 athletes (6.4%), and ADHD medication use was self-reported by 786 of these (32.6%). The remaining athletes served as the control group.

All the athletes underwent Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) to rate their experience with 22 concussion symptoms. They rated each symptom on a scale of 0 to 6, and these severity ratings were then used to calculate total score.

Girls with ADHD reported higher levels of concussion-like symptoms than boys, but the reasons for this are unclear, Dr Huang pointed out.

Overall, however, both girls and boys with ADHD reported significantly more concussion symptoms than their peers without ADHD, irrespective of medication use.

It is not yet clear how these findings will translate into clinical practice, Dr Huang acknowledged. When student athletes do experience concussion, this information might reflect “how they report lingering symptoms,” she said. But it will be “tricky” for physicians to decide how to act on such symptom reporting.

“We don’t want to send someone with persistent symptoms back into play, but whether they’re safe to return to play still isn’t entirely clear,” she pointed out.

“These findings are fascinating,” said Monica Rho, MD, chief of musculoskeletal medicine at the Sports and Spine Rehabilitation Center at Rehabilitation Institute of Chicago in Illinois.

“Because ImPACT testing isn’t perfect,” she said, “it’s important to get this type of information and have it be established,” she told Medscape Medical News.

Because of the effect ADHD symptoms might have on detail-oriented, intensive testing, it is not clear whether people with ADHD will consistently produce the same baseline scores, Dr Rho explained.

In addition, the scoring system used — in which all 22 concussion symptoms were given equal weight — is not a sound approach, said Dinesh Kumbhare, MD, from the Division of Physical Medicine and Rehabilitation at the University of Toronto, Ontario, Canada.

“They all become equal in importance, and therefore equally diluted,” Dr Kumbhare told Medscape Medical News.

The study was funded by the Mooney-Reed Charitable Foundation. Dr Huang, Dr Rho, and Dr Kumbhare have disclosed no relevant financial relationships.

Taken from medscape

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