Asunto(s)
Infecciones/diagnóstico , Anorexia/inmunología , Anorexia/microbiología , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Enfermedades Autoinmunes , Niño , Preescolar , Terapia Cognitivo-Conductual , Femenino , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/administración & dosificación , Factores Inmunológicos/uso terapéutico , Infecciones/microbiología , Infecciones/psicología , Infecciones/terapia , Masculino , Trastorno Obsesivo Compulsivo/inmunología , Trastorno Obsesivo Compulsivo/microbiología , Plasmaféresis , Infecciones Estreptocócicas , Streptococcus/aislamiento & purificación , Trastornos de Tic/inmunología , Trastornos de Tic/microbiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
AIM: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). METHODS: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners' Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. RESULTS: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners' total score. In oppositional children (n = 48), CTRS total score improved ≥25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), ≥25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved ≥25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). CONCLUSION: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.