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Effect of vitamin D treatment in children with attention-deficit hyperactivity disorder

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Abstract

Background

In this research the symptom improvement of attention-deficit hyperactivity disorder (ADHD) of children was assessed by oral vitamin D administration in Tabriz, Iran.

Methods

In this double-blind, randomized clinical trials, 96 children (2–18 years) were enrolled to placebo and vitamin D groups. Children took vitamin D pearl (50,000 IU/week) or placebo for 6 weeks. Children, who had the change in methylphenidate dosage and received any anticonvulsants and corticosteroids were excluded from the research. ADHD symptoms were diagnosed by Conners parent rating scale (CPRS) test at baseline and after intervention. ADHD Conners divided into inattention (IA), hyperactivity/impulsivity (H/I) and combination type (C) subscales. Vitamin D serum level was assessed at baseline and after 8 weeks in both groups.

Results

The differences between CPRS and its subscales were not significant at baseline (P > 0.05). The Conners IA score was decreased in vitamin D group (P < 0.05; adjusted with age and baseline values). ADHD Conners and all subscale scores reduced remarkably after intervention in patients with insufficient level of vitamin D compared to placebo (P < 0.05).

Conclusions

Oral vitamin D improved ADHD symptoms with a particular effect on inattention symptoms. In addition, symptoms related to all subscales were improved remarkably in patients with insufficient level of vitamin D. Vitamin D treatment in children with ADHD could be considered due to the expand benefit of vitamin D in body.

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References

  1. Catalá-López F, Peiró S, Ridao M, Sanfélix-Gimeno G, Gènova-Maleras R, Catalá MA. Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: a systematic review and meta-analysis of epidemiological studies. BMC Psychiatry. 2012;12:168.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hodgkins P, Setyawan J, Mitra D, Davis K, Quintero J, Fridman M, et al. Management of ADHD in children across Europe: patient demographics, physician characteristics and treatment patterns. Eur J Pediatr. 2013;172:895–906.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Landaas ET, Aarsland TIM, Ulvik A, Halmøy A, Ueland PM, Haavik J. Vitamin levels in adults with ADHD. BJPsych Open. 2016;2:377–84.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Faraone SV, Biederman J, Milberger S. An exploratory study of ADHD among second-degree relatives of ADHD children. Biol Psychiatry. 1994;35:398–402.

    Article  PubMed  CAS  Google Scholar 

  5. Chhabildas N, Pennington BF, Willcutt EG. A comparison of the neuropsychological profiles of the DSM-IV subtypes of ADHD. J Abnorm Child Psychol. 2001;29:529–40.

    Article  PubMed  CAS  Google Scholar 

  6. Goksugur SB, Tufan AE, Semiz M, Gunes C, Bekdas M, Tosun M, et al. Vitamin D status in children with attention-deficit–hyperactivity disorder. Pediatr Int. 2014;56:515–9.

    Article  PubMed  CAS  Google Scholar 

  7. Mohammadpour N, Jazayeri S, Tehrani-Doost M, Djalali M, Hosseini M, Effatpanah M, et al. Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: a randomized, double blind, placebo-controlled trial. Nutr Neurosci. 2018;21:202–9.

    Article  PubMed  CAS  Google Scholar 

  8. Sharif MR, Madani M, Tabatabaei F, Tabatabaee Z. The relationship between serum vitamin D level and attention deficit hyperactivity disorder. Iran J Child Neurol. 2015;9:48–53.

    PubMed  PubMed Central  Google Scholar 

  9. Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005;10:94–111.

    PubMed  Google Scholar 

  10. Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, et al. The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. Endocr Rev. 2012;33:456–92.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Kamal M, Bener A, Ehlayel MS. Is high prevalence of vitamin D deficiency a correlate for attention deficit hyperactivity disorder? Atten Defic Hyperact Disord. 2014;6:73–8.

    Article  PubMed  Google Scholar 

  12. Eyles D, Feron F, Cui X, Kesby J, Harms L, Ko P, et al. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology. 2009;34(Suppl 1):S247–57.

    Article  PubMed  CAS  Google Scholar 

  13. Neyestani TR, Hajifaraji M, Omidvar N, Eshraghian MR, Shariatzadeh N, Kalayi A, et al. High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert. Public Health Nutr. 2012;15:324–30.

    Article  PubMed  Google Scholar 

  14. Conners CK, Sitarenios G, Parker JD, Epstein JN. The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26:257–68.

    Article  PubMed  CAS  Google Scholar 

  15. Meyer T, Becker A, Sundermann J, Rothenberger A, Herrmann-Lingen C. Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Eur Child Adolesc Psychiatry. 2017;26:165–75.

    Article  PubMed  Google Scholar 

  16. Shang-Guan LL, Zhao YR. Serum levels of 25-hydroxyvitamin D in children with attention deficit hyperactivity disorder. Zhongguo Dang Dai Er Ke Za Zhi. 2015;17:837–40 (in Chinese).

    PubMed  CAS  Google Scholar 

  17. Noorazar G, Mehdizadeh G, Ghaffari A, Dehbokri N, Khodayari MT, Ghaffary S. Association between level of vitamin D with environmental and bioelement factors in children with attention deficit hyperactivity disorder (ADHD). Pharm Sci. 2018;24:193–8.

    Article  Google Scholar 

  18. Morales E, Julvez J, Torrent M, Ballester F, Rodríguez-Bernal CL, Andiarena A, et al. Vitamin D in pregnancy and attention deficit hyperactivity disorder-like symptoms in childhood. Epidemiology. 2015;26:458–65.

    Article  PubMed  Google Scholar 

  19. Strøm M, Halldorsson TI, Hansen S, Granström C, Maslova E, Petersen SB, et al. Vitamin D measured in maternal serum and offspring neurodevelopmental outcomes: a prospective study with long-term follow-up. Ann Nutr Metab. 2014;64:254–61.

    Article  PubMed  CAS  Google Scholar 

  20. Gustafsson P, Rylander L, Lindh CH, Jönsson BA, Ode A, Olofsson P, et al. Vitamin D status at birth and future risk of attention deficit/hyperactivity disorder (ADHD). PLoS One. 2015;10:e0140164.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Burne TH, Becker A, Brown J, Eyles DW, Mackay-Sim A, McGrath JJ. Transient prenatal Vitamin D deficiency is associated with hyperlocomotion in adult rats. Behav Brain Res. 2004;154:549–55.

    Article  PubMed  CAS  Google Scholar 

  22. Ubbenhorst A, Striebich S, Lang F, Lang UE. Exploring the relationship between vitamin D and basic personality traits. Psychopharmacology. 2011;215:733–7.

    Article  PubMed  CAS  Google Scholar 

  23. Tolppanen AM, Sayers A, Fraser WD, Lewis G, Zammit S, Lawlor DA. The association of 25-hydroxyvitamin D3 and D2 with behavioural problems in childhood. PLoS One. 2012;7:e40097.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  24. Vazquez G, de Boland AR, Boland RL. Involvement of calmodulin in 1α, 25-dihydroxyvitamin D3 stimulation of store-operated Ca2+ influx in skeletal muscle cells. J Biol Chem. 2000;275:16134–8.

    Article  PubMed  CAS  Google Scholar 

  25. Sepehrmanesh Z, Kolahdooz F, Abedi F, Mazroii N, Assarian A, Asemi Z, et al. Vitamin D supplementation affects the beck depression inventory, insulin resistance, and biomarkers of oxidative stress in patients with major depressive disorder: a randomized, controlled clinical trial. J Nutr. 2016;146:243–8.

    Article  PubMed  CAS  Google Scholar 

  26. Cui X, Pertile R, Liu P, Eyles DW. Vitamin D regulates tyrosine hydroxylase expression: N-cadherin a possible mediator. Neuroscience. 2015;304:90–100.

    Article  PubMed  CAS  Google Scholar 

  27. Orme RP, Bhangal MS, Fricker RA. Calcitriol imparts neuroprotection in vitro to midbrain dopaminergic neurons by upregulating GDNF expression. PLoS One. 2013;8:e62040.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  28. Tekes K, Gyenge M, Folyovich A, Csaba G. Influence of neonatal vitamin A or vitamin D treatment on the concentration of biogenic amines and their metabolites in the adult rat brain. Horm Metab Res. 2009;41:277–80.

    Article  PubMed  CAS  Google Scholar 

  29. Jiang P, Zhang LH, Cai HL, Li HD, Liu YP, Tang MM, et al. Neurochemical effects of chronic administration of calcitriol in rats. Nutrients. 2014;6:6048–59.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Allen SJ, Watson JJ, Shoemark DK, Barua NU, Patel NK. GDNF, NGF and BDNF as therapeutic options for neurodegeneration. Pharmacol Ther. 2013;138:155–75.

    Article  PubMed  CAS  Google Scholar 

  31. Faraone SV, Bonvicini C, Scassellati C. Biomarkers in the diagnosis of ADHD–promising directions. Curr Psychiatry Rep. 2014;16:497.

    Article  PubMed  Google Scholar 

  32. Taurines R, Grünblatt E, Schecklmann M, Schwenck C, Albantakis L, Reefschläger L, et al. Altered mRNA expression of monoaminergic candidate genes in the blood of children with attention deficit hyperactivity disorder and autism spectrum disorder. World J Biol Psychiatry. 2011;12(Suppl 1):104–8.

    Article  PubMed  Google Scholar 

  33. Peeyush KT, Savitha B, Sherin A, Anju T, Jes P, Paulose C. Cholinergic, dopaminergic and insulin receptors gene expression in the cerebellum of streptozotocin-induced diabetic rats: functional regulation with Vitamin D3 supplementation. Pharmacol Biochem Behav. 2010;95:216–22.

    Article  PubMed  CAS  Google Scholar 

  34. Kesby JP, Cui X, O’Loan J, McGrath JJ, Burne TH, Eyles DW. Developmental vitamin D deficiency alters dopamine-mediated behaviors and dopamine transporter function in adult female rats. Psychopharmacology. 2010;208:159–68.

    Article  PubMed  CAS  Google Scholar 

  35. Humble MB. Vitamin D, light and mental health. J Photochem Photobiol B. 2010;101:142–9.

    Article  PubMed  CAS  Google Scholar 

  36. Kent L, Doerry U, Hardy E, Parmar R, Gingell K, Hawi Z, et al. Evidence that variation at the serotonin transporter gene influences susceptibility to attention deficit hyperactivity disorder (ADHD): analysis and pooled analysis. Mol Psychiatry. 2002;7:908–12.

    Article  PubMed  CAS  Google Scholar 

  37. Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015;29:2207–22.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors would like to thank the Dana pharmaceutical company for providing pearl of vitamin D and its placebo for this research. We are sincerely grateful for the constructive comments and valuable suggestions of the anonymous reviewers.

Funding

This study was funded by Tabriz University of Medical Sciences as a PharmD thesis. No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Author information

Authors and Affiliations

Authors

Contributions

ND contributed to the conception, data collation and manuscript preparation. GN conducted the study design and data collation. AG conducted the statistical analysis and manuscript preparation. GM contributed in the conception and data collation. PS conducted the statistical analysis. SG contributed in the design of the study, gave revisions of the manuscript and supervised the study. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Saba Ghaffary.

Ethics declarations

Ethical approval

The research protocol of this study was approved by the local Ethics Committee of Tabriz University of Medical Sciences, Tabriz, Iran, on February 2016. This clinical trial was attributed in the Iranian Registry of Clinical Trials (IRCT2017012826998N2). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Dehbokri, N., Noorazar, G., Ghaffari, A. et al. Effect of vitamin D treatment in children with attention-deficit hyperactivity disorder. World J Pediatr 15, 78–84 (2019). https://doi.org/10.1007/s12519-018-0209-8

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  • DOI: https://doi.org/10.1007/s12519-018-0209-8

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