Evaluation of Benign Joint Hypermobility and Serum Prolidase Levels in Children Diagnosed With Attention-Deficit/Hyperactivity Disorder (ADHD) Compared to Healthy Controls
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 171
- 试验地点
- 1
研究概览
简要总结
This cross-sectional observational study investigates the clinical and biochemical relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and Benign Joint Hypermobility Syndrome (BJHS) in pediatric patients. The primary objective is to evaluate the prevalence of BJHS in children diagnosed with ADHD and compare serum prolidase levels with those of healthy controls. The study also explores whether the severity of ADHD symptoms correlates with serum prolidase activity. Clinical assessments include the Conners Parent Rating Scale, Beighton Score, and serum prolidase measurement using ELISA. This research aims to provide new insights into the potential connective tissue-neurodevelopmental link and contribute to early screening frameworks for children with ADHD.
详细描述
Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, often presenting in early childhood. Although traditionally viewed as a purely behavioral and neurochemical condition, increasing evidence suggests a potential overlap with systemic and somatic findings, including those related to connective tissue disorders. One such condition is Benign Joint Hypermobility Syndrome (BJHS), a clinical entity involving increased joint flexibility due to altered collagen structure or metabolism.
Recent hypotheses have proposed a shared pathophysiological basis between neurodevelopmental disorders and connective tissue abnormalities, possibly mediated by enzymatic and inflammatory pathways. Prolidase is a cytosolic exopeptidase that plays a key role in collagen turnover and proline recycling. It has been implicated in various connective tissue disorders and may also influence neuroinflammatory processes. Thus, prolidase activity may serve as a biochemical bridge between BJHS and ADHD.
This cross-sectional observational study was conducted to investigate the clinical and biochemical associations between ADHD and BJHS in a pediatric population. Specifically, the study aimed to:
- determine the frequency and severity of joint hypermobility in children diagnosed with ADHD,
- compare Beighton Scores between ADHD and healthy control groups,
- measure and compare serum prolidase enzyme levels between both groups, and
- assess whether prolidase activity and hypermobility scores correlate with ADHD symptom severity and subtype (predominantly inattentive, hyperactive/impulsive, or combined presentation).
A total of 171 children aged 6 to 12 years participated in the study: 86 with a clinical diagnosis of ADHD (based on DSM-5 criteria) and 85 age- and sex-matched healthy controls without psychiatric or systemic illnesses. Participants in the ADHD group were recruited from the Child and Adolescent Psychiatry Department of Antalya Training and Research Hospital. Control subjects were selected from the general pediatric outpatient population, ensuring the absence of known neurodevelopmental or rheumatological disorders.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Prospective
入排标准
- 年龄范围
- 6 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Children aged between 6 and 12 years
- •ADHD diagnosis based on DSM-5 criteria (for patient group)
- •Healthy children with no known psychiatric or systemic disease (for control group)
- •Willingness of the parents or legal guardians to participate and provide informed consent
- •Ability to complete the required clinical assessments (CPRS-R:S, Beighton Score, blood sample)
排除标准
- •Presence of chronic systemic diseases (e.g., autoimmune disorders, connective tissue diseases, metabolic syndromes)
- •History of neurodegenerative or severe neurological disorders Intellectual disability or autism spectrum disorder diagnosis
- •Use of medications that may affect prolidase enzyme activity (e.g., corticosteroids, immunosuppressants)
- •Any orthopedic or musculoskeletal condition interfering with Beighton assessment
- •Incomplete clinical or laboratory data
- •Refusal to participate or lack of parental consent