Høy forekomst av ADHD-symptomer hos umedisinerte ungdommer med narkolepsi type 1 (NT1) etter svineinfluensapandemien

Forskere fra Nasjonalt kompetansesenter for nevroutviklingsforstyrrelser og hypersomnier (NevSom), Oslo universitetssykehus og Universitetet i Oslo har i denne studien undersøkt symptomer på ADHD hos 50 ungdommer i alderen syv til tyve år med H1N1-narkolepsi type 1 (NT1), og sammenhengen mellom ADHD-symptomer og narkolepsifenotypen. Komorbid narkolepsi/ADHD-symptomer var mer utbredt hos umedisinerte ungdommer med NT1 etter svineinfluensa enn tidligere rapportert i medisinske narkolepsi-kohorter. Den høye forekomsten skyldtes ikke eksisterende ADHD, og var vanligvis ikke korrelert med søvn- og våkenhetskarakteristika ved narkolepsi, noe som indikerer at ADHD symptomene ikke var en direkte konsekvens av forstyrret søvn eller søvnighet på dagtid.

High prevalence of ADHD symptoms in unmedicated youths with post-H1N1 narcolepsy type 1

Berit Hjelde Hansen, Hilde T Juvodden, Sebjørg Hesla Nordstrand, Rannveig Viste, Per M Thorsby, David Swanson, Kristian B Nilsen, Terje Nærland, Stine Knudsen-Heier

Studien er publisert i Sleep Medicine.

Objectives: To characterize attention deficit-hyperactivity disorder (ADHD) symptoms in unmedicated post-H1N1 narcolepsy type 1 (NT1) youths, and explore associations between ADHD symptoms and the narcolepsy phenotype.
Methods: A total of 50 consecutively enrolled post-H1N1 NT1 youths (7-20 years, 62% females, 98% HLA-DQB1∗06:02-positive, 98% CSF hypocretin-1 deficient, 88% vaccinated) were assessed after two weeks off medication for ADHD (ADHD diagnosis pre/post-narcolepsy, parent-rated ADHD symptoms) and narcolepsy-phenotyped (semi-structured interview, Stanford Sleep Questionnaire, Epworth Sleepiness Scale, polysomnography (PSG), Multiple Sleep Latency Test (MSLT)).
Results: In sum, 26 (52%) and 15 (30%) of participants had ADHD symptoms above and below the clinical significant cut-off, respectively, while 9 (18%) had no ADHD symptoms. High values were found for ADHD total score (mean (SD), 17.9 (9.5)) and ADHD subscores (inattentive score, 11.0 (6.3); hyperactive/impulsivity score, 6.9 (4.7)). These were significantly higher than previously reported in a mainly medicated narcolepsy cohort (p < 0.0001). Age, gender and disease duration did not influence scores. Two participants (4%) had ADHD diagnosis prior to narcolepsy onset. ADHD symptoms were correlated with parent-rated, but not with patient rated ESS scores, objective sleepiness (mean sleep latency), sleep fragmentation (sleep stage shift index, awakening index), or CSF hypocretin-1 level.
Conclusion: Comorbid ADHD symptoms were more prevalent in unmedicated post-H1N1 NT1 youths than previously reported in mainly medicated pediatric narcolepsy cohorts. The high prevalence was not due to pre-existing ADHD and generally not correlated with core narcolepsy sleep/wake phenotype characteristics, indicating that the ADHD symptoms were not a direct consequence of disturbed sleep or daytime sleepiness.