PURPOSE: The purpose of this study is to identify the prevalence of attention-deficit hyperactivity disorder (ADHD) among children treated for childhood malignant hematologic diseases, and determine the different characteristics of the patients with ADHD as opposed to the patients without ADHD, which will help to predict the development of ADHD and to help treat them. METHODS: 172 patients diagnosed as childhood malignant hematologic diseases went through the test battery including diagnostic criteria for ADHD in pediatric neurology department of Seoul St. Mary's hospital from March 2009 to May 2012. Age, sex, ADHD type, hematologic diseases type, age at onset of hematologic diseases, treatment with/without chemotherapy and relapse were investigated. These data were compared between the groups of the patients without ADHD and with ADHD. RESULTS: Out of 172 patients, Fifty one patients (29.6%) had both ADHD and childhood malignant hematologic diseases. Sex (male), age at onset of hematologic diseases (< or =5 years) and treatment(with chemotherapy) was significantly higher in the patients with ADHD than the patients without ADHD (P<0.05). Male had about 2.9 fold increased risk for ADHD compared to female (P=0.005). The patients < or =5 years of age at onset had about 3.3 fold increased risk for ADHD compared to the patients > or =11 years (P=0.007). The patients with chemotherapy had about 3.4 fold increased risk for ADHD compared to the patients without chemotherapy (P=0.023). CONCLUSION: This study showed childhood malignant hematologic disorders has significant correlation with ADHD. In addition, Male, < or =5 years of age at onset and use of chemotherapy in the patients can be necessary to predict ADHD. Therefore, early detection and establishment of the countermeasures for ADHD are necessary.
Attention Deficit Disorder with Hyperactivity* ; Child ; Drug Therapy ; Female ; Hematologic Diseases* ; Humans ; Male ; Neurology ; Prevalence ; Recurrence ; Seoul

In this study, efforts were made to collect 88 traditional Chinese medicine (TCM) prescriptions for treating ADHD from public literatures, establish a medication database and conduct data mining on the efficacy, properties, tastes, meridian entries and compatibility regularity of TCMs by using frequency analysis, association rules analysis and cluster analysis. The results showed 33 herbs with a high frequency (≥ 10%). The top 12 frequently applied ADHD herbs were respectively Acori Tatarinowii Rhizome, Polygalae Radix, Prepared Rehmanniae Radix, Os Draconis, Glycyrrhizae Radix et Rhizome, Poria, Concha Ostreae, Testudinis Carapacis et Plastri, Paeoniae Alba Radix, Schisandrae Fructus Chinensis, Fructus Corni, Dioscoreae Rhizoma. The top seven types of frequently applied ADHD herbs by effect were respectively tonic herb, sedative herbs, livei-wind calming herbs, heat clearing herbs, astringent herbs, awaking herbs and damp clearing and diuresis promoting herbs. The top three properties were warm, cold and neutral, with warm as the dominance. The top three tastes were sweetness, bitterness and acridity, with sweetness as the dominance. The top three meridian entries were liver meridian, heart meridian and kidney meridian. The association rules analysis showed commonly used herbal pairs. Polygalae Radix-Acori Tatarinowii Rhizome, Concha Ostreae-Os Draconis, Prepared Rehmanniae Radix-Fructus Corni-Os Draconis. Eight highly frequent cluster prescriptions were summarized based on the cluster analysis. This study indicates that basic TCM prescriptions for treating ADHD were principally composed of tonics (nourishing liver and kidney, invigorating heart and spleen) and tranquilization, which were supplemented with herbs for calming liver, clearing heat, promoting qi-circulation, promoting blood-circulation, reducing phlegm and calming endogenous wind. The combination of multiple data mining techniques can reflect the clinical medication regularity of herbs for treating ADHD in an overall and objective manner.
Attention Deficit Disorder with Hyperactivity ; drug therapy ; Data Mining ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Meridians

There are two types of refractory nocturnal enuresis. The first type corresponds to patients who are refractory from initial success, and the second type refers to refractory nocturnal enuresis after long-term success, in patients who cannot discontinue medications for enuresis. In the former type, it is necessary to determine whether the timing of medications is appropriate, whether the usage of antidiuretics is appropriate, whether any lifestyle changes have taken place, and whether there are secondary causes of enuresis. In the latter type, enuretic alarm treatment should be considered initially, and it is then important to investigate whether a respiratory obstruction is present in patients with nocturnal polyuria, whether the patient is constipated, and whether patients with non-monosymptomatic nocturnal enuresis have lower urinary tract symptoms or attention deficit hyperactivity disorder.
Attention Deficit Disorder with Hyperactivity ; Drug Resistance ; Drug Therapy ; Enuresis ; Humans ; Life Style ; Lower Urinary Tract Symptoms ; Nocturnal Enuresis* ; Polyuria

OBJECTIVE: This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. METHODS: To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. RESULTS: Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. CONCLUSION: The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool.
Asian Continental Ancestry Group ; Attention Deficit Disorder with Hyperactivity ; Child* ; Drug Therapy ; Humans ; Japan* ; Methylphenidate* ; Reaction Time ; Atomoxetine Hydrochloride

OBJECTIVETo estimate the prevalence of attention deficit hyperactivity disorder (ADHD) in children with epilepsy, and the factors that may contribute to the prevalence of co-morbidity between ADHD and epilepsy.

METHODSA total of 256 children aged 6-15 years old who were diagnosed with epilepsy were enrolled. The prevalence of ADHD in children with epilepsy, and the factors that may contribute to the development of co-morbidity between ADHD and epilepsy were explored.

RESULTSThe systematic evaluation in 192 patients was completed. Of the 192 children, 81 (42.2%) were diagnosed with ADHD. The earlier the epilepsy onset, the higher the frequency of the co-morbidity of ADHD occurring. The longer the period of antiepileptic medication, the higher the prevalence of the co-morbidity of ADHD. Epileptic children receiving a combination of antiepileptic drugs had a higher prevalence of ADHD. ADHD was more common in children with some specific types of epilepsy, such as Lannox-Gastaut syndrome and generalized tonic-clonic epilepsy, or epilepsy with multifocal epileptic discharges in the EEG record.

CONCLUSIONSADHD occurs frequently in children with epilepsy. The factors associated with increased risk of ADHD include the onset age of epilepsy, the types of seizures or epileptic syndromes, the epileptiform EEG discharges, and the effects of antiepileptic drugs.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; epidemiology ; etiology ; Child ; Comorbidity ; Electroencephalography ; Epilepsy ; complications ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Prevalence

OBJECTIVEMethylphenidate is recommended as a first-line modality for treating attention deficit hyperactivity disorder (ADHD). In the past, immediate release methylphenidate (IR-MPH) was used for ADHD. Now oral osmotic-methylphenidate (OROS-MPH) is used for ADHD in China. This study was designed to investigate the efficacy and safety of OROS-MPH for treatment of ADHD in children.

METHODSNinety-nine children with ADHD were randomly administered with OROS-MPH (18 mg/time, once daily) and IR-MPH (5 mg/ time, twice or three times per day). After 6 weeks of treatment, the therapeutic effects were evaluated by the SNAP-IV and the IVA-CPT.

RESULTSFifty patients completed the 6-week treatment. The effective rate (83.3% vs 75%) and the complete remission rate (44% vs 25%) in the OROS-MPH treatment group were higher than that in the IR-MPH treatment group. There were statistically significant differences in the SNAP-IV and IVA-CPT scores before and after treatment in the two groups (P<0.01). The two groups had a similar incidence of side effects during treatment.

CONCLUSIONSOROS-MPH for the treatment of ADHD is effective and safe in children, and its once-daily administration is more convenient.

Administration, Oral ; Adolescent ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; Child ; Female ; Humans ; Male ; Methylphenidate ; administration & dosage ; adverse effects

PURPOSE: Methylphenidate (MPH) is an effective medication for the treatment of attention deficit hyperactivity disorder (ADHD). However, about 30% of patients do not respond to or are unable to tolerate MPH. Based on previous findings, we hypothesized that great variability in response time (RT) among Korean children with ADHD on a computerized continuous performance attention test would be related to poor MPH treatment response. MATERIALS AND METHODS: Children (ages 6-18 years) with ADHD were recruited for a prospective 12-week, open-labeled, multicenter study to examine optimal dosage of OROS methylphenidate. Of the 144 subjects selected, 28 dropped out due to adverse events, medication noncompliance, or follow-up loss, and an additional 26 subjects with comorbid disorders were excluded from statistical analyses. We defined 'responders' as subjects who received a score of less than 18 on the attention deficit hyperactivity disorder rating scale (ARS; Korean version, K-ARS) and a score of 1 or 2 on the Clinical Global Impression-Improvement scale (CGI-I). RT variability was assessed with the ADHD diagnostic system (ADS). RESULTS: Fifty-nine (67%) subjects responded to MPH treatment. The non-responders showed greater RT variability at baseline (Mann Whitney U = 577.0, p < 0.01). Baseline RT variability was a significant predictor of MPH response (Nagelkerke R2 = 0.136, p < 0.01). It predicted 94.9% of responder, 17.2% of non-responder and 69.3% of overall group. CONCLUSION: High RT variability may predict poor response to MPH treatment in children with ADHD.
Adolescent ; Attention Deficit Disorder with Hyperactivity/*drug therapy ; Child ; Female ; Humans ; Korea ; Male ; Methylphenidate/*therapeutic use ; *Reaction Time ; Treatment Outcome

Based on collecting data at home and abroad, we combined clinical practice of scientific researches. We also summarized key points for design and evaluation of clinical studies in treating children's attention deficit hyperactivity disorder by Chinese medical new drugs from objective and design, selection of diagnostic criteria, recruitment and dropping-out of subjects, effectiveness evaluation, safety evaluation, drug combination, and quality control, and so on. We hope to provide reference for design and evaluation of clinical studies by Chinese medical new drugs.
Attention Deficit Disorder with Hyperactivity ; drug therapy ; Biomedical Research ; Child ; Clinical Studies as Topic ; Data Collection ; Drugs, Chinese Herbal ; therapeutic use ; Humans

Attention-deficit/hyperactivity disorder (ADHD) is a common developmental neuropsychiatric disorder. Although ADHD can often be treated with stimulant class medications to alleviate symptoms, such treatments may cause undesirable side effects. Recently, Traditional Chinese medicine (TCM) has been gaining interest with treatment potential for ADHD and the lack of the stimulant-associated undesirable side effects. Animal models are useful for study the efficacy and mechanisms of TCM treatment for ADHD, however, previous studies of TCM on ADHD animal models, in general, have not considered appropriate experiemental designs. There were many concerns regarding the choice and source of the model and control animals, drug administration methods, behavioral and biochemical testing criteria, humane use of animals, and statistical power, etc. In this review, we discuss these issues present in the previous literature of animal research, and propose guidelines for future studies in particular consideration with the unique characteristic of Chinese medicine itself.
Animals ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Mice ; Rats

Adolescent ; Attention ; drug effects ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; physiopathology ; Child ; Electroencephalography ; drug effects ; Female ; Follow-Up Studies ; Humans ; Male ; Psychomotor Performance ; Treatment Outcome