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Sleep Med. 2007 Nov;8(7-8):711-5. Epub 2007 Jul 20.

Impact of restless legs syndrome and iron deficiency on attention-deficit/hyperactivity disorder in children.

Author information

1
Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, 48 boulevard Sérurier, 75019 Paris, France. eric.konofal@rdb.aphp.fr

Abstract

OBJECTIVE:

Increasing evidence suggests a significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and restless legs syndrome (RLS). Iron deficiency may underlie common pathophysiological mechanisms in subjects with ADHD plus RLS (ADHD+RLS). To date, the impact of iron deficiency, RLS and familial history of RLS on ADHD severity has been scarcely examined in children. These issues are addressed in the present study.

METHODS:

Serum ferritin levels, familial history of RLS (diagnosed using National Institutes of Health (NIH) criteria) and previous iron supplementation in infancy were assessed in 12 ADHD+RLS children, 10 ADHD children and 10 controls. RLS was diagnosed using NIH-specific pediatric criteria, and ADHD severity was assessed using the Conners' Parent Rating scale.

RESULTS:

ADHD symptom severity was higher, although not significantly, in children with ADHD+RLS compared to ADHD. The mean serum ferritin levels were significantly lower in children with ADHD than in the control group (p<0.0005). There was a trend for lower ferritin levels in ADHD+RLS subjects versus ADHD. Both a positive family history of RLS and previous iron supplementation in infancy were associated with more severe ADHD scores.

CONCLUSIONS:

Children with ADHD and a positive family history of RLS appear to represent a subgroup particularly at risk for severe ADHD symptoms. Iron deficiency may contribute to the severity of symptoms. We suggest that clinicians consider assessing children with ADHD for RLS, a family history of RLS, and iron deficiency.

PMID:
17644481
DOI:
10.1016/j.sleep.2007.04.022
[Indexed for MEDLINE]

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