Prenatal exposure to paracetamol associated with ADHD and autism in childhood

Prenatal exposure to paracetamol associated with ADHD and autism symptoms in childhood
Prenatal exposure to paracetamol associated with ADHD and autism symptoms in childhood

An epidemiological study of more than 70,000 children in six European cohorts has linked symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum conditions (ASC) to the mothers’ use of paracetamol (acetaminophen) during pregnancy. The study, published in the European Journal of Epidemiology, was led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the “la Caixa” Foundation.

In total, the researchers analysed 73,881 children for whom data were available on prenatal or postnatal exposure to paracetamol, at least one symptom of ASC or ADHD, and main covariates. Depending on the cohort, 14% to 56% of the mothers reported taking paracetamol while pregnant.

The study found that children exposed to paracetamol before birth were 19% more likely to develop ASC symptoms and 21% more likely to develop ADHD symptoms than children who were not exposed.

“Our findings are consistent with previous research,” explained ISGlobal researcher Sílvia Alemany, lead author of the study. “We also found that prenatal exposure to paracetamol affects boys and girls in a similar way, as we observed practically no differences.”

“Our results address some of the weaknesses of previous meta-analyses,” commented Jordi Sunyer, researcher at ISGlobal and last author of the study. “Considering all the evidence on the use of paracetamol and neurological development, we agree with previous recommendations indicating that while paracetamol should not be suppressed in pregnant women or children, it should be used only when necessary.”

At some point during pregnancy, an estimated 46%-56% of pregnant women in developed countries use paracetamol, which is considered the safest analgesic/antipyretic for pregnant women and children. However, mounting evidence has linked prenatal paracetamol exposure to poorer cognitive performance, more behavioural problems, and ASC and ADHD symptoms.

Those previous studies have been criticised for their heterogeneity. In the new study, therefore, “an effort was made to harmonise the assessment of ADHD and ASC symptoms and the definition of paracetamol exposure,” explained Alemany. “The sample is large,” she added, “and it includes cohorts from multiple European countries: the United Kingdom, Denmark, the Netherlands, Italy, Greece and Spain. We also used the same criteria for all of the cohorts, thereby reducing the heterogeneity of criteria that has hampered previous studies.”

The study also analysed postnatal exposure to paracetamol and found no association between paracetamol use during childhood and ASC symptoms. Nevertheless, the research team concluded that further studies are needed, given the heterogeneity of postnatal paracetamol exposure among the various cohorts, which ranged from 6% to 92.8%.

The six cohorts included the study were as follows:

Yoga and breathing exercises aid children with ADHD to focus

Sergey Kiselev is a head at Laboratory of Brain and Neurocognitive Development UrFU CREDIT UrFU / Karina Golovanova.

Yoga and breathing exercises have a positive effect on children with attention deficit hyperactivity disorder (ADHD). After special classes, children improve their attention, decrease hyperactivity, they do not get tired longer, they can engage in complex activities longer. This is the conclusion reached by psychologists at Ural Federal University who studied the effect of exercise on functions associated with voluntary regulation and control in 16 children with ADHD aged six to seven years. The results of the study are published in the journal Biological Psychiatry.

“For children with ADHD, as a rule, the part of the brain that is responsible for the regulation of brain activity – the reticular formation – is deficient,” said Sergey Kiselev, head of the Laboratory of Brain and Neurocognitive Development at UrFU, head of the study. “This leads to the fact that they often experience states of inadequate hyperactivity, increased distraction and exhaustion, and their functions of regulation and control suffer a second time. We used a special breathing exercise based on the development of diaphragmatic rhythmic deep breathing – belly breathing. Such breathing helps to better supply the brain with oxygen and helps the reticular formation to better cope with its role. When the reticular formation receives enough oxygen, it begins to better regulate the child’s state of activity”.

In addition to breathing exercises, psychologists used body-oriented techniques, in particular, exercises with polar states “tension-relaxation”. The trainings took place three times a week for two to three months (depending on the program).

“Exercise has an immediate effect that appears immediately, but there is also a delayed effect. We found that exercise has a positive effect on regulation and control functions in children with ADHD and one year after the end of the exercise. This happens because the child’s correct breathing is automated, it becomes a kind of assistant that allows better supply of oxygen to the brain, which, in turn, has a beneficial effect on the behavior and psyche of a child with ADHD,” says Sergey Kiselev.

This technique was developed by the Russian neuropsychologist Anna Semenovich as part of a neuropsychological correction technique. UrFU psychologists tested how well this approach helps children with ADHD. But the study is pilot, says Kiselev. It showed that these exercises have a positive effect. However, more work needs to be done, involving more children with ADHD. This will also take into account factors such as gender, age, severi

Autism vs ADHD (The Difference between ADHD and Autism Spectrum Disorder)

Autism vs ADHD (The Difference between ADHD and Autism Spectrum Disorder) -  YouTube


Autism vs ADHD. The difference between ADHD and Autism is not always immediately obvious. Is it Autism or ADHD, or BOTH Autism AND ADHD?! Getting the right diagnosis is important! The difference between autism and ADHD can be subtle sometimes. In some areas they seem opposite but there are lots of overlapping characteristics too.

ADHD, DBD and aggressiveness: Risky genetic factors

Professor Bru Cormand, from the Faculty of Biology and the Institute of Biomedicine of the University of Barcelona (IBUB), IRSJD i and CIBERER. CREDIT UNIVERSITY OF BARCELONA

People with attention-deficit / hyperactivity disorder (ADHD) combined with disruptive behaviour disorders (DBDs) share about the 80% of genetic variants associated with aggressive and antisocial behaviours.

This is one of the conclusions of a study published in the journal Nature Communications which counts on the participation of professor Bru Cormand, from the Faculty of Biology and the Institute of Biomedicine of the University of Barcelona (IBUB), Sant Joan de Déu Research Institute (IRSJD) and the Rare Diseases Networking Biomedical Research Centre (CIBERER), and researchers Marta Ribasés and Josep Antoni Ramos Quiroga, from Vall d’Hebron Research Institute (VHIR) and the Mental Health Networking Biomedical Research Centre (CIBERSAM).

The study -the most ambitious one published to date on risk genetic factors shared between people with ADHD and DBDs- is based on the study conducted to about 4,000 affected people by these pathologies and 30,000 control individuals, within the frame of the European project Aggressotype, from the Horizon 2020 program, aimed at doing research on the neurobiological basis of the aggressive behaviour. The study is led by Ditte Demontis and Anders D. Børglum (Aarhus University, Denmark) and Stephen V. Faraone (State University of New York, United States).

ADHD: a psychiatric disorder that does not always come alone

ADHD is a common behaviour disorder -it affects about 5% of children and 2.5% adult people- and features hyperactivity, impulsiveness and attention deficit. This disorder usually comes with other psychiatric alterations, mainly disruptive behaviour disorders (DBDs), which can be associated with antisocial and aggressive behaviours.

“ADHD and DBD are caused by genetic and environmental factors. Regarding ADHD, it is estimated that genetics account for a 75%, while in DBDs, it would oscillate between 40 and 70%. These clinical pictures are more frequent in boys than girls, and when they come together, people are more likely to fall into risky behaviours, addictive substance use, and premature death”, notes Bru Cormand, professor at the Department of Genetics, Microbiology and Statistics and head of the Research Group on Neurogenetics of the UB.

“Certain people feature two or more psychiatric disorders, and this coexistence continues, in many cases, in a chronological axis, in which suffering from a psychiatric disorder such as ADHD involves opening the door to other comorbid pathologies that aggravate the life quality of those who suffer from the disorder”, notes Marta Ribasés, head of the Laboratory of Genetic Psychiatry of Vall d’Hebrón Research Institute (VHIR).

Through genome-wide association studies (GWAS), researchers analyzed the genetic contribution of changes in a single DNA nucleotide (SNP) -the most abundant ones in the human genome- to these psychiatric disorders. As part of the study, VHIR and UB experts brought samples of patients with ADHD diagnosed at Hospital Vall d’Hebron and took part in the analysis of genetic data.

More risk genetic variants in patients with ADHD and DBDs

The research team identified a genomic segment in the chromosome 11 which increases the risk of having ADHD combined with DBD. “This region has the STIM1 gen, which is involved in the regulation of calcium cell levels, neuronal plasticity and learning memory”, notes Bru Cormand, who coordinated the international working group on genetics in the Aggressotype project.

“Our study shows that genetics are more determining in people with ADHD and DBD than those who only suffer from ADHD”, highlights Bru Cormand. “If we compare the genome of patients with ADHD and DBD to that of those patients with only ADHD, we see that people affected by both disorders have a higher genetic correlation with risk genetic variants. These extra correlations of ADHD and DBD patients would probably correspond to alterations other authors had related to aggressive-related behaviours”, notes Cormand.

“If we consider ADHD to be an open door to a negative trajectory, using genetic information to identify those individuals who are more vulnerable will have a strong impact on prevention, early detection and treatment, and will shed light on new research studies to find efficient therapies that can be specific for the disorder or shared between several disorders”, notes Marta Ribasés.

The study, published in the journal Nature Communications, is a new science advance that will contribute to broaden the genetic landscape of ADHD comorbidities (that is, the series of pathologies that are correlated with this disorder). From a clinical perspective, knowing the psychiatric alterations that share genetics is a step forward, because it will enable the prediction of potential secondary complications over the life of those individuals with ADHD.

“These results allow us to better understand the origins of DBDs associated with ADHD and provide better information to the family members about this disorder”, concludes Josep Antoni Ramos Quiroga, head of the Psychiatry Service of Hospital Vall d’Hebron and the Research Group on Mental Health Psychiatry and Addictions at VHIR.