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Aufmerksamkeitsdefizit-Hyperaktivitäts-Syndrom (ADHS)

Führen alte Untersuchungen der individuellen Taktfrequenz zu neuen Hinweisen auf die Pathogenese?

Attention deficit hyperactivity disorder (ADHS)

Do old tests to assess individual frequency provide new information on pathogenesis?

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Zusammenfassung

12 Jungen mit gesichertem, schwerem ADHS, die zum Zeitpunkt der Studie keine Medikation erhielten, wurden erfasst. Bezüglich des DSM-IV-Systems waren alle für alle Teilaspekte der Klassifikation positiv. Sie wurden mit einer eigens programmierten Software PC-gestützt untersucht: Die Knaben wurden aufgefordert, eine Taste insgesamt 128-mal in der ihnen angenehmen Taktfrequenz zu drücken. Hinsichtlich Median und Mittelwert der Tastintervalle fand sich kein statistisch signifikanter Unterschied. Streuung und Spannweite der Intervalle waren bei Patienten mit ADHS gegenüber dem Vergleichskollektiv signifikant erhöht. Bei diesen Kindern liegt somit trotz frei wählbarer Frequenz eine erhöhte Arrhythmizität vor, was durch Umwelteinflüsse oder genetische Polymorphismen erklärt werden könnte. Eine mögliche Ursache könnte im genetischen Uhrensystem liegen. Beim Menschen sind derzeit 3 zirkadiane Uhrengene, die als Kandidatengene in Frage kommen, bekannt (clock, per2, bmal1). Sowohl bei diesen als auch bei an der Signalkaskade beteiligten Proteinen sind Polymorphismen und Mutationen beschrieben, die mit einer vermehrten Arrhythmizität gekoppelt sind.

Abstract

Twelve boys with verified diagnosis of severe attention deficit hyperactivity disorder (mean age 9.2±2.9 years) and 12 control boys were investigated. According to the DSM IV system the patients were positive regarding all aspects. None of the patients received medication at or around the time of the investigation. The boys were asked to tap a button 128 times in a frequency that felt comfortable to them. The investigation was performed with specially designed software. There was no significant difference in the mean or median intervals between tapping, However, range and spread of the tapping intervals were significantly higher in patients with hyperactivity disorder. The results show that these children perform less rhythmically although they were allowed to choose the tapping frequency themselves. There are many possible reasons for these results, ranging from social to genetic. One of the reasons could be due to changes in the genetically coded molecular clock. In humans there are only three genes identified that code for molecular clocks (CLOCK, PER2, BMAL1). In these genes as well as in other proteins and enzymes involved in the signaling pathway, mutations and polymorphisms have been described that lead to a decreased rhythm in motor timing.

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Correspondence to T. Rupprecht.

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Prof. D. Harms zum 65. Geburtstag gewidmet.

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Rupprecht, T., Schellmoser, S., Wagner, M. et al. Aufmerksamkeitsdefizit-Hyperaktivitäts-Syndrom (ADHS) . Monatsschr Kinderheilkd 153, 463–468 (2005). https://doi.org/10.1007/s00112-004-0889-0

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