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7 – Summary
Attention deficit hyper-activity disorder (ADHD) is a neuro-behavioral disorder that typically manifested during childhood and often persists into adulthood. Gene and environmental influences work together in complex way where there is an increasing link evidence that gene-environment correlation interaction could play an important role in the psychopathological etiology (Buitelaar, 2010).
ADHD is a complex disorder influenced by many genes, genetic and environmental risk factors co-occurring in a non-random fashion because of the heritable characteristics of the individual or parents carrying the risk of exposure to certain environmental risk factors. The genetic element may increase the ADHD risk via influencing the exposure to risk or protective environmental factors (Lifford et al., 2008).
Scanty literatures studied the association of MTHFR C677T and A1298C gene polymorphism and ADHD syndrome. Accordingly, this study was conducted on 30 children of well diagnosed ADHD and 30 controls matched for age and gender.
All enrolled participants were subjected to physical and neurological examination, genetic assessment and psychiatric evaluation using the following assessment tools;
1) Diagnostic criteria DSM-IV TR Arabic version (Desouky, 2004).
2) IQ assessment using Stanford-Binet Intelligence Scale V5 Arabic version (Abu El-Neil, 2011).
3) Pediatric symptom checklist (PSCL).
4) Conner’s parent rating scale revised (CRS-R).
5) ADHD Rating scale -IV.
This study revealed a male predominance of ADHD represented by 86.7% with female to male ratio of 1:6.5. The ADHD patients age range was from 6- to 12-year-old with mean value of 8.469±SD 2.02.
This study demonstrated a significant positive family history of medical and psychiatric illness where 16.67% of the ADHD parents were consanguineous. There was a high significant increase in the mean age value of bladder control in the ADHD cases compared to the control (p=0.005).
There was heterozygous advantage (Heterosis) regarding C677T allele genotype, a statistically significant association was found among controls compared to ADHD cases (p = 0.0112), however, a high significant association found between mutant MTHFR A1298C allele in the ADHD group compared to the control (p=0.0002).
There was significant expression of A1298C polymorphism in ADHD females as well as in ADHD males at p=0.0015 and p=0.02 respectively.
There was no statistically significant association found between different A1298C genotypes and ADHD subtypes, but it was more encountered among severe inattentive patients according to Conner’s parent rating scale revised (CRS-R).