Common pesticide may increase risk of ADHD

Mice exposed to a commonly used pesticide in utero and through lactation exhibited several features of ADHD, including dysfunctional dopamine signaling in the brain, hyperactivity, working memory, attention deficits and impulsive-like behaviour.

A commonly used pesticide may alter the development of the brain's dopamine system, responsible for emotional expression and cognitive function, and increase the risk of attention deficit hyperactivity disorder in children, according to a new Rutgers study.

The research published Wednesday in the Journal of the Federation of American Societies for Experimental Biology (FASEB J.), by Rutgers scientists and colleagues from Emory University, the University of Rochester Medical Center, and Wake Forest University discovered that mice exposed to the pyrethroid pesticide deltamethrin in utero and through lactation exhibited several features of ADHD, including dysfunctional dopamine signaling in the brain, hyperactivity, working memory, attention deficits and impulsive-like behaviour.

Attention deficit hyperactivity disorder most often affects children, with an estimated 11 percent of children between the ages of 4-17, about 6.4 million, diagnosed as of 2011.

Boys are three to four times more likely to be diagnosed than girls. While early symptoms, including an inability to sit still, pay attention and follow directions, begin between the ages of 3 to 6, diagnosis is usually made after the child starts attending school full time.

Importantly, in this study, the male mice were affected more than the female mice, similar to what is observed in children with ADHD.

The ADHD-like behaviours persisted in the mice through adulthood, even though the pesticide, considered to be less toxic and used on golf courses, in the home, and on gardens, lawns and vegetable crops, was no longer detected in their system.

Although there is strong scientific evidence that genetics plays a role in susceptibility to the disorder, no specific gene has been found that causes ADHD and scientists believe that environmental factors may also contribute to the development of the behavioural condition.

Using data from the Centers for Disease Control, National Health and Nutrition Examination Survey (NHANES) the study analyzed health care questionnaires and urine samples of 2,123 children and adolescents.

Researchers asked parents whether a physician had ever diagnosed their child with ADHD and cross-referenced each child's prescription drug history to determine if any of the most common ADHD medications had been prescribed.

Children with higher pyrethroid pesticide metabolite levels in their urine were more than twice as likely to be diagnosed with ADHD.

These findings provide strong evidence, using data from animal models and humans, that exposure to pyrethroid pesticides, including deltamethrin, may be a risk factor for ADHD, says lead author Jason Richardson, associate professor in the Department and Environmental and Occupational Medicine at Rutgers Robert Wood Johnson Medical School and a member of the Environmental and Occupational Health Sciences Institute (EOHSI).

"Although we can't change genetic susceptibility to ADHD, there may be modifiable environmental factors, including exposures to pesticides that we should be examining in more detail," says Richardson.

Young children and pregnant women may be more susceptible to pesticide exposure because their bodies do not metabolize the chemicals as quickly.

This is why, Richardson says, human studies need to be conducted to determine how exposure affects the developing fetus and young children.

"We need to make sure these pesticides are being used correctly and not unduly expose those who may be at a higher risk," Richardson says.

More information: "Developmental pesticide exposure reproduces features of attention deficit hyperactivity disorder." FASEB J fj.14-260901; published ahead of print January 28, 2015, doi: 10.1096/fj.14-260901

Genetic discovery could increase understanding of ADHD

Scientists at Trinity College Dublin have discovered that a mutation in a single gene involved in the functioning of the brain's nervous system can lead to hyperactivity symptoms that are characteristic of Attention-Deficit Hyperactivity Disorder (ADHD).

Getting the nervous system wired up properly is a big job. The brain contains billions of different types of nerve cells, which all have to be connected in a very precise fashion.

This circuitry self-assembles as an embryo grows, based on a developmental programme involving the actions of thousands of different genes.

The scientists discovered that a mutation in a single mouse gene, 'Elfn1', can have a big effect.

Their new findings give impetus to discover whether mutations in Elfn1 in humans can give rise to similar symptoms and whether they might play a part in some patients with epilepsy and ADHD.

These two conditions occur together far more often than expected by chance.

In an article just published in the international journal, PLOS ONE, Associate Professor in Genetics at Trinity, Kevin Mitchell, and Research Technical Officer, Dr Jackie Dolan, investigated the importance of the function played by Elfn1 and the protein it produces when expressed.

They did this by experimentally removing it from some mice and comparing the effects against those seen in mice with the normal gene.

Although overall brain anatomy and patterns of connectivity remained normal, there was clear evidence of disturbance in brain function in individuals without Elfn1.

Seizures occurred in some, and these became more common over time and were easily triggered by human interaction.

Secondly, hyperactivity was observed, and this showed an unusual response to the stimulant, amphetamine.

Amphetamine normally causes hyperactivity in animals that have Elfn1 present, as it does in most humans. Here, it reduced the hyperactivity of the mice without the gene.

This is similar to the situation in patients with ADHD, where amphetamine and related drugs have a paradoxical, calming effect.

"These findings clearly show that removal of the Elfn1 gene affects brain circuits with multiple consequences for behaviour," said Dr Dolan.

The seizures likely relate to the function of Elfn1 in dampening the response of the nervous system to strong stimuli in key brain structures called the cortex and hippocampus.

However, the development of ADHD-like hyperactivity focused on a different brain structure, known as the habenula.

This structure is part of a system that integrates information from multiple regions of the brain and regulates the activity of nerve cells that produce mood-regulating chemicals such as dopamine and serotonin.

Professor Mitchell said: "We are at the beginning of this process of figuring out how this gene works and understanding the consequences when it is mutated but, these animals provide a unique model to investigate how subtle changes in brain development can ultimately result in aberrant brain function".

Elfn1 was first discovered by Dr Dolan, Professor Mitchell and colleagues in 2007. The protein it produces when expressed allows communication from one nerve cell to another. In a study published in Science last year, Emily Sylwestrak and Anirvan Ghosh, of the University of California, San Diego, showed that the Elfn1 protein determined what kind of connection was made onto those nerve cells.

More information: dx.plos.org/10.1371/journal.pone.008049

Antipsychotic drug use in children for mood, behaviour disorders increases type 2 diabetes risk

Prescribing of "atypical" antipsychotic medications to children and young adults with behavioral problems or mood disorders may put them at unnecessary risk for type 2 diabetes, a Vanderbilt University Medical Center study shows.

Young people using medications like risperidone, quetiapine, aripiprazol and olanzapine led to a threefold increased risk of developing type 2 diabetes within the first year of taking the drug, according to the study published Aug. 21 in the journal JAMA Psychiatry.

Wayne A. Ray

While other studies have shown an increased risk for type 2 diabetes associated with the use atypical antipsychotic medications, this is the first large, well-designed study to look at the risk in children, said Wayne A. Ray, Ph.D., professor of Preventive Medicine, and senior author of the study.

The authors note the use of these drugs for non-psychosis-related mood, attention or behavioral disorders in youth/children now accounts for the majority of prescriptions.

"Because we wanted to address this question of risk for indications for which there were therapeutic alternatives, we deliberately excluded those taking antipsychotics for schizophrenia and other psychoses; thus, our entire sample consisted of patients for whom there were alternatives to antipsychotics," Ray said.

State-provided, de-identified medical records were examined for TennCare youths ages 6-24 from 1996 through 2007.

During that time children and youth who were prescribed treatment with atypical antipsychotics for attention, behavioral or mood disorders, were compared with similar youth prescribed approved medications for those disorders.

Even with the further elimination of certain disorders that are commonly associated with diabetes, like polycystic ovarian syndrome, those taking antipsychotics had triple the risk of developing type 2 diabetes in the following year, with the risk increasing further as cumulative dosages increased.

The increased risk persisted for at least a year after the medications were stopped.

Ray and his colleagues point out developing type 2 diabetes is still rare in this age group. Of the nearly 29,000 children and youth in the antipsychotic medication group and 14,400 children in the control group, 106 were ultimately diagnosed and treated for type 2 diabetes.

"That's why this study had to be so large, in order to detect clinically meaningful differences in the risk of type 2 diabetes, a relatively uncommon, but serious condition for children and youth," Ray said.

The take-away message for providers, said Ray, is to carefully examine alternatives to antipsychotic use.

"This is particularly important for high-risk children, for example, those with elevated weight. Children should be monitored carefully for metabolic effects predisposing them to diabetes, and use of the drug should be at the lowest possible dose for the shortest possible time," he said.

More Information:  Antipsychotics and the Risk of Type 2 Diabetes Mellitus in Children and Youth -

Mindfulness: Increasing Wellbeing and Reducing Stress in UK school children

Mindfulness – a mental training that develops sustained attention that can change the ways people think, act and feel – could reduce symptoms of stress and depression and promote wellbeing among school children, according to a new study published online by the British Journal of Psychiatry.

With the summer exam season in full swing, school children are currently experiencing higher levels of stress than at any other time of year.

The research showed that interventions to reduce stress in children have the biggest impact at this time of year.

There is growing evidence that mindfulness-based approaches for adults are effective at enhancing mental health and wellbeing.

However, very few controlled trials have evaluated their effectiveness among young people.

A team of researchers led by Professor Willem Kuyken from the University of Exeter, in association with the University of Oxford, the University of Cambridge and the Mindfulness in Schools Project, recruited 522 pupils, aged between 12 and 16 years, from 12 secondary schools to take part in the study.

256 pupils at six of the schools were taught the Mindfulness in Schools Project's curriculum, a nine week introduction to mindfulness designed for the classroom.

Richard Burnett who co-created the curriculum said: "Our mindfulness curriculum aims to engage even the most cynical of adolescent audience with the basics of mindfulness. We use striking visuals, film clips and activities to bring it to life without losing the expertise and integrity of classic mindfulness teaching".

The other 266 pupils at the other six schools did not receive the mindfulness lessons, and acted as a control group.

All the pupils were followed up after a three month period. The follow-up was timed to coincide with the summer exam period – which is a potential time of high stress for young people.

The researchers found that those children who participated in the mindfulness programme reported fewer depressive symptoms, lower stress and greater wellbeing than the young people in the control group.

Encouragingly, around 80% of the young people said they continued using practices taught in MiSP's mindfulness curriculum after completing the nine week programme.

Teachers and schools also rated the curriculum as worthwhile and very enjoyable to learn and teach.

Allergies among US children increase between 1997 and 2011

For U.S. children aged younger than 18 years, the prevalence of allergies increased from 1997 to 2011, with age, race/ethnicity, and income all affecting the prevalence, according to a May data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

Kristen D. Jackson, M.P.H., and colleagues from the NCHS in Hyattsville, Md., reviewed data from the National Health Interview Surveys from 1997 to 1999 and from 2009 to 2011 to examine the prevalence of food and skin allergies in U.S. children younger than age 18 years.

According to the report, from 1997 to 2011 there was an increase in the prevalence of food and skin allergies among U.S. children.

The prevalence of skin allergies decreased, while respiratory allergies increased with increasing age.

The prevalence of food, skin, and respiratory allergies was lower among Hispanic children than among other races or ethnicities.

Compared with non-Hispanic white children, non-Hispanic black children were less likely to have respiratory allergies and more likely to have skin allergies.

The prevalence of food and respiratory allergies increased with income level, with children with family income equivalent to 200 percent or more of the poverty level experiencing the highest prevalence of allergy.

"Among children under age 18 years in the United States, the prevalence of food and skin allergies increased from 1997-1999 to 2009-2011," the authors write.

More information: More Information

Autism: Is there really an increase diagnosis

According to a recent study by The Centre for Disease Control and Prevention(CDC) the rate of autism in the US has jumped 40% from 1 in 154 to 1 in 110 between 2002 and 2006.

The study also found that ASD was 4 to 5 times higher in boys than in girls. The CDC estimates 1 in 70 boys and 1 in 315 girls have an ASD.

What accounts for this staggering increase?
The CDC admits that they can isolate no one factor at this time, without further research and conclusive evidence.

Recent developments in earlier detection might account for the rise in autism diagnoses and the CDC confirms that improved community awareness, the widening of diagnostic criteria to include more mild cases and out right earlier identification have added to this increase.

So the CDC are keen to acknowledge that is not yet conclusive that the condition is on such a steep rise, but the recognition of symptoms and labeling has drastically increased.

The AAP
The American Academy of Pediatrics recommends systematically screening children for autism at 18 months and 24 months even when a concern or risk is not conclusively recognised. Their philosophy is to screen children early and often.

However, parents are either the first to identify symptoms or the most likely and they need to be vigilant in helping track a child’s development. Close scrutiny will help determine how well they are progressing and ensuring they are not regressing in their skill development.

ASD
A child with ASD will develop symptoms before the age of 3. These symptoms can be detected as early as a few months of age, or not show up until 24 months or later. Some children develop normally until around 18 months and then stop gaining new skills, or they lose the skills they once had. Common symptoms are:

• Avoid eye contact and want to be alone
• Not respond to their name by 12 months of age
• Experience delayed speech and language skills
• Repeat words or phrases over and over (echolalia)
• Be extremely agitated by minor changes
• Have obsessive interests
• Flap their hands, rock their body or spin in circles
• Have unusual reactions to the way things sound, smell, taste, look or feel

There are three different types of ASD:

• Autistic Disorder: Significant language delays, social and communication challenges and unusual behaviors and interests. Some may have intellectual disability.
• Asperger Syndrome: Milder symptoms of autistic disorder. Typically do not have problems with language or intellectual disability.
• Pervasive Developmental Disorder (atypical autism): Usually have fewer and milder symptoms than those with typical autistic disorder. Symptoms might pose only social and communication challenges.

If you have concerns about possible delays in your child's developmental, contact your doctor in the first instance. If you are not satisfied with your doctor's response or if he confirms your suspicions, ask for a referral to a qualidied specialist. Someone that will be able to perform a more in-depth evaluation of your child.