Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study.
Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study.
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DOI：
10.1371/journal.pone.0057926
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Kao CH
中科院分区：
文献类型：
--
作者：
Chou IC;Chang YT;Chin ZN;Muo CH;Sung FC;Kuo HT;Tsai CH;Kao CH
本研究采用来自同一人群数据库的2个队列，对注意缺陷多动障碍（ADHD）和癫痫之间的双向相关性进行了评价。我们使用台湾全民健康保险研究数据库的数据，建立了2个独立的队列研究，参与者<19岁。我们将队列1分为两组：（1）1999-2008年期间最初诊断为癫痫的2468例患者，以及（2）9810例随机选择的性别和年龄匹配的非癫痫对照组。我们将队列2分为2组：（1）3664例新诊断的ADHD患者和（2）14522例性别和年龄匹配的非ADHD患者。我们在2008年底的两个队列中评估了随后ADHD与癫痫的关系，反之亦然。中位随访7-7.5年后，队列1中癫痫患者的ADHD发生率为7.76，无癫痫患者为3.22（每1000人-年）。与非癫痫组相比，癫痫组ADHD的校正风险比（HR）为2.54（95% CI 2.02-3.18）。在队列2中，中位随访3-3.5年后，ADHD患者和非ADHD患者的癫痫发生率分别为3.24和0.78（每1000人-年），HR为3.94（95% CI 2.58-6.03）。这项研究显示，在2项队列研究中，ADHD和癫痫之间存在双向关联。这两种疾病之间的致病因素可能是共同的，导致大脑中的转录变化级联，从而改变癫痫发作前的行为或认知。
This study presents an evaluation of the bidirectional correlation between attention deficit hyperactivity disorder (ADHD) and epilepsy using 2 cohorts from the same population database. We used data from the Taiwan National Health Insurance Research Database to establish 2 separate cohort studies with participants <19 years old. We subdivided Cohort 1 in 2 groups: (1) 2468 patients initially diagnosed with epilepsy during the period 1999–2008, and (2) 9810 randomly selected sex- and age-matched non-epileptic controls. We subdivided Cohort 2 into 2 groups: (1) 3664 patients with newly diagnosed ADHD and (2) 14 522 sex- and age-matched non-ADHD patients. We evaluated the risk of subsequent ADHD in relationship to epilepsy and vice versa in the 2 cohorts at the end of 2008. The ADHD incidence in Cohort 1 was 7.76 in patients with epilepsy and 3.22 in those without epilepsy (per 1000 person-years) after a median follow-up of 7–7.5 years. The adjusted hazard ratio (HR) for ADHD was 2.54 (95% CI 2.02–3.18) in the epilepsy group compared to the non-epilepsy group. In Cohort 2, the incidence of epilepsy was 3.24 in patients with ADHD and 0.78 in those without ADHD (per 1000 person-years) after a median follow-up of 3–3.5 years and an HR of 3.94 (95% CI 2.58–6.03). This study shows a bidirectional association between ADHD and epilepsy in the 2 cohort studies. Causative factors may be common between these 2 disorders, leading to a cascade of transcriptional changes in the brain that alter behavior or cognition prior to seizures.
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