Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study

• Published in: PloS one Vol. 8; no. 3; p. e57926
• Main Authors: Chou, I-Ching, Chang, Yu-Tzu, Chin, Zheng-Nan, Muo, Chih-Hsin, Sung, Fung-Chang, Kuo, Huang-Tsung, Tsai, Chang-Hai, Kao, Chia-Hung
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.03.2013; Public Library of Science (PLoS)
• Subjects: Adolescent; Age; Ambulatory care; Analysis; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Behavior; Biology; Brain; Brain research; Child; Child, Preschool; Children & youth; Cognition; Cohort analysis; Cohort Studies; Correlation; Demography; Epilepsy; Epilepsy - complications; Epilepsy - epidemiology; Female; Health care; Health insurance; Hospitals; Humans; Hyperactivity; Incidence; Infant; Infant, Newborn; Male; Medical research; Medicine; National health insurance; Online databases; Patients; Pediatrics; Population; Population studies; Population-based studies; Proportional Hazards Models; Psychiatry; Risk Factors; Schizophrenia; Seizures; Seizures (Medicine); Sex; Statistical analysis; Studies; Taiwan - epidemiology; Transcription; Taiwan; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0057926

This study presents an evaluation of the bidirectional correlation between attention deficit hyperactivity disorder (ADHD) and epilepsy using 2 cohorts from the same population database. We used data from the Taiwan National Health Insurance Research Database to establish 2 separate cohort studies with participants <19 years old. We subdivided Cohort 1 in 2 groups: (1) 2468 patients initially diagnosed with epilepsy during the period 1999-2008, and (2) 9810 randomly selected sex- and age-matched non-epileptic controls. We subdivided Cohort 2 into 2 groups: (1) 3664 patients with newly diagnosed ADHD and (2) 14 522 sex- and age-matched non-ADHD patients. We evaluated the risk of subsequent ADHD in relationship to epilepsy and vice versa in the 2 cohorts at the end of 2008. The ADHD incidence in Cohort 1 was 7.76 in patients with epilepsy and 3.22 in those without epilepsy (per 1000 person-years) after a median follow-up of 7-7.5 years. The adjusted hazard ratio (HR) for ADHD was 2.54 (95% CI 2.02-3.18) in the epilepsy group compared to the non-epilepsy group. In Cohort 2, the incidence of epilepsy was 3.24 in patients with ADHD and 0.78 in those without ADHD (per 1000 person-years) after a median follow-up of 3-3.5 years and an HR of 3.94 (95% CI 2.58-6.03). This study shows a bidirectional association between ADHD and epilepsy in the 2 cohort studies. Causative factors may be common between these 2 disorders, leading to a cascade of transcriptional changes in the brain that alter behavior or cognition prior to seizures.