多动症儿童和基线评估时的脑电图异常、癫痫发作风险以及三年后继续服用哌醋甲酯的情况。

IF 3.6 3区医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2024-06-21 DOI:10.1186/s12991-024-00510-4

Dobrinko Socanski, Geir Ogrim, Nezla Duric

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引用次数: 0

摘要

目的：本研究旨在评估被诊断为多动症（ADHD）的儿童脑电图异常（EEG-ab）的发生率，调查癫痫发作（SZ）的风险以及三年内服用哌醋甲酯（MPH）的维持情况：方法：共纳入了 517 名 6-14 岁的多动症儿童。基线评估包括确定脑电图-ab、注意力不集中多动症亚型（ADHD-I）、合并癫痫、使用抗癫痫药物（AEDs）和使用哌醋甲酯（MPH）。在为期3年的随访中，与年龄和性别匹配的无脑电异常的对照组ADHD病例相比，评估内容包括脑电异常的存在、MPH的维持、AED的使用、脑电异常病例的SZ风险等：结果：在 273 例（52.8%）病例中发现了脑电图epi-ab。在年龄、性别、ADHD-I 类型或首次使用 MPH 方面，EEG-ab 组和 EEG 无 EEG-ab 组之间没有发现明显的统计学差异。在 478 例无 EEG-epi-ab 的病例中，有 234 例（49%）出现了 EEG 非痫样异常（EEG-non-epi-ab）。值得注意的是，脑电图非epi-ab在39例有脑电图epi-ab的病例（30/39 (76.9%) vs. 9/39，(21.3%)）中出现的频率更高，这组病例被选中进行3年随访。在为期 3 年的随访中，有 EEG-epi-ab 和没有 EEG-epi-ab 的 ADHD 患者在维持服用 MPH 方面没有发现明显的统计学差异。在没有合并癫痫或合并癫痫但获得 SZ 自由的多动症病例中，没有人出现新的 SZ。只有3名患有耐药性癫痫的儿童出现了SZ，但SZ频率没有增加。EEG-epi-ab的消失率高于EEG-non-epi-ab（71.8%对33.3%）：有 EEG-epi-ab 和没有 EEG-epi-ab 的儿童在使用 MPH 方面表现出相似的模式（初次使用、阳性反应和维持使用 MPH）。尽管使用了 MPH，但合并癫痫和 EEG-ab（有或没有 EEG-epi-ab）与 SZ 风险增加无关。

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Children with ADHD and EEG abnormalities at baseline assessment, risk of epileptic seizures and maintenance on methylphenidate three years later.

Purpose: This study aimed to assess the incidence of EEG abnormalities (EEG-ab) in children diagnosed with ADHD, investigate the risk of epileptic seizures (SZ) and maintenance on methylphenidate (MPH) over a three-year period.

Methods: A total of 517 ADHD children aged 6-14 years were included. Baseline assessments included the identification of EEG-ab, ADHD inattentive subtype (ADHD-I), comorbid epilepsy, the use of antiepileptic drugs (AEDs) and the use of MPH. At the 3-year follow-up, assessments included the presence of EEG-ab, maintenance on MPH, AED usage, SZ risk in cases with EEG-epileptiform abnormalities (EEG-epi-ab), compared with control ADHD cases without EEG-epi-ab matched for age and gender.

Results: EEG-ab were identified in 273 (52.8%) cases. No statistically significant differences were observed between the EEG-ab and EEG-non-ab groups in terms of age, gender, ADHD-I type or initial use of MPH. EEG non-epileptiform abnormalities (EEG-non-epi-ab) were found in 234 out of 478 (49%) cases without EEG-epi-ab. Notably, EEG-non-epi-ab occurred more frequently in the group of 39 cases with EEG-epi-ab (30/39 (76.9%) vs. 9/39, (21.3%), a subset selected for 3-year follow-up. At 3-year-follow-up no statistically significant difference was found in maintenance on MPH in ADHD cases with and without EEG-epi-ab. Nobody of ADHD cases without comorbid epilepsy or with comorbid epilepsy with achieved SZ freedom developed new SZ. Only 3 children with drug resistant epilepsy experienced SZs, without increase in SZ frequency. The disappearance rate of EEG-epi-ab was higher than that EEG-non-epi-ab (71.8% vs. 33.3%).

Conclusions: Children with and without EEG-ab exhibited similar patterns of MPH use (initial use, positive response, and maintenance on MPH). The presence of comorbid epilepsy and EEG-ab, with or without EEG-epi-ab, was not associated with an increased risk of SZ despite the use of MPH.

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来源期刊

Annals of General Psychiatry PSYCHIATRY-

CiteScore

6.60

自引率

2.70%

发文量

审稿时长

>12 weeks

期刊介绍： Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.