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Item The relationship between serum ferritine levels and subtypes and the severity of symptoms on non-anemic adult ADHD(2020) Tunel, Munevver; 0000-0001-7140-1803; AAD-8660-2021Objective: To compare serum ferritin levels in non anemic adult patients who were diagnosed as attention deficit hyperactivity disorder (ADHD) with a matched healthy control group, and to evaluate the relationship between serum ferritin levels and the severity of ADHD symptoms and ADHD subtypes. Methods: A prospective study was performed on 91 adult non-anemic and cognitively normal ADHD patients (according to the DSM-5 criteria) and 51 healthy controls. They were divided into three subgroups according to the clinical interview and the results of the scale; Group 1, 31 patients with compound type; Group 2, 30 patients with attention deficit subtype; Group 3, 30 patients with impulsivity-hyperactivity subtype. Wender-Utah Rating Scale and Adult Attention Deficit Hyperactivity Assessment Scale were used. Serum ferritin levels were determined. Results: The ferritin levels of the patient groups were found to be significantly lower than the control group. Mean ferritin level was 23 ng/ml in ADHD compound type, 37 ng/ml in attention deficit subtype, 46 ng/ml in hyperactivity and impulsivity subtype, and 65 ng/ml in the control group. Ferritin level was not different between Group 1, Group 2, and Group 3 while the ferritin level of the patients in Group 4 (control group) was significantly higher than the other groups. Conclusion: Our findings revealed the low ferritin levels in ADHD patients. Low ferritin levels without anemia may play a role in the pathophysiology of the disorder. Testing for the ferritin levels may be considered during the general evaluation of this disorder.Item Atomoxetine associated red ear: A case report(2020) Taner, Hande Ayraler; Sari, Burcu Akin; 0000-0002-9730-7206; 0000-0003-2106-7928; A-7296-2013; W-9188-2019Red ear syndrome is defined as mostly unilateral burning pain and redness of external ear. It has two forms idiopathic and secondary. Idiopathic red ear syndrome is mostly seen in young people and associated with migraine. Secondary red ear syndrome is more frequent in adults and releated with cervical disorder. Our patient was a 10 year old boy diagnosed with attention deficit hyperactivity disorder (ADHD) and spesific learning disorder. He had a complaint of redness in his ear, following the atomoxetine treatment for ADHD. The redness was appearing after taking atomoxetine in 1 hour. The redness in his ear was unilateral and lasted in 4 hours. Sometimes headaches were accompanied with red ear. After atomoxetine treatment was ceased the redness and the headache in his ear were dissappered. In the pathophysiology of red ear sydrome there is a disregulation of sympathic outflow. Atomoxetine has a high selectivity for noradrenergic receptors and also has an effect on periferic noradrenergic receptors. Atomoxetine could change the sympathic vasodilation/vasoconstruction balance and cause red ear. Although the red ear is not a life threating situation, it could cause discomfort and anxiety, so the clinicians should keep in mind red ear syndrome while using atomoxetine. To our best knowledge this is the first red ear case associated with atomoxetinein literature.Item Effects of methylphenidate treatment in children with ADHD: a multimodal EEG/fNIRS approach(2019) Dolu, Nazan; Altinkaynak, Miray; Guven, Aysegul; Ozmen, Sevgi; Demirci, Esra; Izzetoglu, Meltem; Pektas, Ferhat; 0000-0002-3104-7587; AAG-4494-2019OBJECTIVE In this study we investigated the stimulant methylphenidate (MPH) effects in Attention deficit hyperactivity disorder (ADHD) from neuroimaging and neurophysiological perspective by simultaneous recording functional near infrared spectroscopy (fNIRS) and electroencephalography (EEG) during attention task. METHODS Using fNIRS we obtained frontal cortex hemodynamic responses and using event related potentials (ERP) we obtained amplitude values of P3 component of 18 children with ADHD and gender matched 18 healthy controls performing an oddball task. Same recordings were repeated 3 months after extended-release MPH (OROS-MPH) administration for ADHD group. Prefrontal cortex oxygenation and P3 amplitude were compared between control and pre-MPH ADHD groups and between Pre-MPH and post-MPH ADHD groups. RESULTS fNIRS indicated that the healthy controls exhibited higher right prefrontal activation than pre-MPH children with ADHD. Reduced P3 amplitude values were found in children with ADHD compared the control group. Reduced right prefrontal activation and P3 amplitude was normalized in ADHD group after MPH therapy. CONCLUSION Recently multimodal neuroimaging which combine signals from different brain modalities have started to be considered as a potential to improve the accuracy of diagnosis. The current study provides MPH effect assessment in children with ADHD using multimodal EEG/fNIRS system for the first time. This study suggests combination of neuroimaging and electrophysiological parameters is a promising approach to investigate MPH effect assessment in children with ADHD.