الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 133 |  |  |
| | | from | 133 | | |
Abstract
Introduction: Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder characterized by inattention, hyperactivity, and impulsivity that begin in childhood. It has negative effects on the children’s normal development, academic and social functioning. Aluminum and Manganese are abundant elements in nature. Several studies provided evidence that Mn and Al in large doses are potential neurotoxicants, which affects cognition, behavior, and motor function in children.Material and Methods: Based on the investigated disorder, This case-control study was conducted on 200 Egyptian children who included 100 ADHD treatment-naive patients and 100 healthy control subjects. The cases were subdivided according to the DSM-V clinical classification to the following groups: group (H): hyperkinetic presentation (20 patients), group (I): inattentive presentation (36 patients) and group (C): combined presentation (44 patients). All participants were subjected to a detailed history taking through a questionnaire to assess the environmental exposure to Mn and Al, then they were clinically assessed for ADHD using An Arabic version of Conners’ Parent Rating Scale-Revised Long Form. Al and Mn hair level were determined using Optima™ 7000 DV ICP-OES apparatus – Perkin Elmer Company, Germany at the central laboratory in Tanta University. Results: The present work showed that hair Mn level was significantly higher in ADHD cases than the control subjects, with higher Mn mean in the cases than in controls. Meanwhile, hair Al level was slightly higher in the control group than in the cases but with no statistical significance. In order to assess the validity of Mn and Al hair level to discriminate cases from controls, the ROC curve showed fair validity for Mn and poor validity for Al. Manganese level was significantly higher in hyperactive and combined presentations groups than the inattentive group. While Al level was significantly higher in inattentive than hyperactive and combined groups, also it was higher in the combined group than hyperactive. As regards the severity of ADHD symptoms, it significantly positively correlated to age, hair Mn and Al levels in cases, this correlation is moderate with age but it is weakly correlated with Mn level and Al level.Summary: In conclusion, the present study provides evidence that, exposure to Mn is a risk factor for the development of ADHD particularly the hyperactive presentation, and that Al and Mn potentially play a role in the clinical presentation and severity of the disorder in the studied population.