While about 11 percent of children (4-17 years old) nationwide have been diagnosed with attention-deficit hyperactivity disorder (注意力缺陷多动症), the long-term health effects of having 注意力缺陷多动症 and of common 注意力缺陷多动症 medications remains understudied. 研究ers at University of Utah Health found that 注意力缺陷多动症 patients had an increased risk of developing Parkinson’s and Parkinson-like diseases than individuals with no 注意力缺陷多动症 history. The results are available online on September 12 in the journal 神经精神药理学.
“Parkinson’s disease is commonly thought of as a neurodegenerative disease associated with aging,” 格伦·汉森，D.D.S., Ph.D., professor of Pharmacology and Toxicology and School of Dentistry at U of U Health and senior author on the paper. “This may be the first time where a childhood disease and its treatment may be linked to a geriatric expression of neurodegenerative disorder.”
在回顾中, 以人群为基础的研究, Hanson’s team found 注意力缺陷多动症 patients were more than twice as likely to develop early onset (21-66 years old) Parkinson’s and Parkinson-like diseases compared to non-注意力缺陷多动症 individuals of the same gender and age. The estimated risk was six to eight-times higher for 注意力缺陷多动症 patients prescribed the stimulant medications, 包括哌甲酯利他林, Concerta, Daytrana, 元甲酸盐和甲基林), mixed amphetamine salts (Adderall) and dexmethylphenidate (Focalin).
“如果大发娱乐遵循100,随着时间的推移, in one year we would expect 1 to 2 people will develop Parkinson’s disease before age 50,” 卡伦·科廷博士.D., associate professor in Internal Medicine at U of U Health and first author on the study. “如果大发娱乐遵循100,000 adults prescribed treatment for 注意力缺陷多动症 over time, we estimate that over a year 8 to 9 patients will develop Parkinson’s disease before age 50.”
The authors caution that patients with a more severe type of 注意力缺陷多动症 may inherently be at an increased risk of motor neuron diseases like Parkinson’s, and the results may or may not be a direct result of the stimulant medication. Future studies are needed to reach a more definitive conclusion.
科廷说：“目前尚无定论。. “The increased risk we observed in people could be linked to having 注意力缺陷多动症 itself or perhaps a more severe form of 注意力缺陷多动症, which may be more likely to be treated with medications.”
注意力缺陷多动症 is a brain disorder associated with changes in the release of dopamine, which contributes to several aspects of this disorder. Parkinson’s disease is a progressive nervous system disorder associated with tremors, 动作僵硬和缓慢. Typically Parkinson’s does not develop until age 60 or later.
该团队使用了 犹他州人口数据库（UPDB） which contains vital and medical records of more than 11 million individuals who have lived in the state, 检查二十年的历史记录. 符合条件的患者出生于1950-1992年之间, 到2011年底至少20岁, 是1月1日之后的犹他州居民吗, 1996 and had no prior diagnosis of Parkinson’s or Parkinson-like diseases.
使用UPDB, 汉森和他的团队编制了一个多动症人群, 由31个组成,769名患者, 其中4人,960人服用兴奋剂(2,716人收到安非他明盐, 1,941 received methylphenidate and 303 received both). The non-注意力缺陷多动症 comparison population consisted of 158,790 individuals who were matched to the 注意力缺陷多动症 group on gender and age (5 to 1).
In addition to accounting for differences in gender and age, the study controlled for the effects of psychotic disorders and tobacco use that could be associated with Parkinson’s independent of 注意力缺陷多动症. 病人 with a history of drug or alcohol abuse were excluded from the study. The team were not able to account for other factors that could contribute to the development of Parkinson’s disease, 包括头部创伤, 脑损伤和环境毒素.
According to Hanson, the study results should be considered preliminary. This study may be limited by the misclassification of non-注意力缺陷多动症 subjects, who were diagnosed with the disorder outside of Utah, missed or incorrect diagnosis of Parkinson-like disease symptoms and the lack of information on the duration of use and dosage of 注意力缺陷多动症 medication prescribed.
This project builds on past research that reported a link between amphetamine abuse and the onset of Parkinson’s disease, 其他研究小组也证实了这一点.
“我相信这种治疗仍然是有益的, especially for children who cannot control their 注意力缺陷多动症 symptoms,汉森说. “Medication really should be considered on a case-by-case basis.”
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Hanson and Curtin carried out the research with Annette Fleckenstein, 布鲁克斯Keeshin, 黛博拉Yurgelun-Todd, Perry Renshaw and Ken Smith at U of U Health and Intermountain Healthcare. 这幅作品的标题是 Increased Risk of Diseases of the Basal Ganglia and Cerebellum in 病人 with a History of Attention-Deficit/Hyperactivity Disorder, was published online on September 12, 2018, in the journal 神经精神药理学.
This project received funding from the National Institute on Drug Abuse and support for the Utah Population Database was provided by the National Cancer Institute, University of Utah’s Program in Personalized Health as well as the National Institutes of Health Clinical and Translational Science Award, the National Center for 研究 Resources and the Utah State Department of Health.