AttentionDeficit Hyperactivity Disorder and narcolepsy in childhood

【摘要】：Objective:To explore theco-occurrence of narcolepsy and Attention Deficit Hyperactivity Disorder(ADHD)symptoms and compare the damage of cognitive function and improvement after treatment of Methylphenidate Hydrochloride for 8-16 weeks between narcolepsy with and without ADHD.Method:278children narcolepsy patients(205 males and 73 females,with a range between 5andl7 years old) were selected from outpatients at the People's Hospital,Peking University,from February2011 to July 2013.AII of them underwent polysomnography(PSG) followed by the multiple sleep latency test(MSLT).Pediatric Sleep Questionnaire(PSQ)was completed.All patients were interviewed by a psychiatristusing DSM-IV diagnostic criteria from the Mini International Neuropsychiatric Interview for children and adolescents(MINI Kid).Meanwhile,wecompared Psychological questionnaire between narcolepsy patients with and without ADHDusing inventory of subjective life quality(ISLQ),the Depression Self-Rating Scale for Children(DSRS-C),Screen for Child Anxiety Related Emotional Disorders(SCARED),Barrattlmpulsiveness Scale(BIS) and Behavior Rating Inventory of Executive Function—ParentsVersion(BRIEF-P).Narcolepsy with ADHD symptoms were treated with 9-18 mg Methylphenidate Hydrochloride for 16 weeks and completed ADHD rating scale(ADHD-RS) and ESS.Result:Narcolepsy with ADHD symptoms was 28.8%(80/278).Subtype:ADHD-1:95%(76/80),ADHD-C:5%(4/80),ADHD-H:0%(0/80).Narcolepsy with ADHD symptoms had a statistically significant 3.611-fold increase in anxiety symptoms.They alsohad higher levels of impulsive symptoms and lower health-related quality of life,lower executive function(p0.05).56 of 80(65%)got Methylphenidate Hydrochloride for 16 weeks.After treatment,score of PSQ.was lower(13±2) than before(17±2)(t:7.951,p0.001) but no change before and after therapy in ADHDRS,ISLQ,DSRS-C,SCARED,BIS(P0.05).Conclusion:ADHD is very common in children with narcolepsy.Narcolepsy with ADHD symptoms had higher levels of anxiety and impulsive symptoms and lower health-related quality of life,lower executive function.Treatment strategies need to be adjusted change for narcolepsy with ADHD