Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case-control study.

Autor:	Quadt L; Department of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UK l.quadt@bsms.ac.uk., Csecs J; Berkshire Healthcare NHS Foundation Trust, Bracknell, Bracknell Forest, UK., Bond R; School of Psychology, University of Sussex, Brighton, UK., Harrison NA; Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK., Critchley HD; Department of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UK., Davies KA; Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK., Eccles J; Department of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UK.; Sussex Partnership NHS Foundation Trust, Worthing, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jul 22; Vol. 14 (7), pp. e084203. Date of Electronic Publication: 2024 Jul 22.
DOI:	10.1136/bmjopen-2024-084203
Abstrakt:	Objectives: To test whether inflammatory processes link the expression of childhood neurodivergent traits to chronic disabling fatigue in adolescence. Design: Longitudinal case-control study. Setting: We analysed data from The Avon Longitudinal Study of Parents and Children (ALSPAC). Participants: 8115 and 8036 children of the ALSPAC cohort at ages 7 and 9 years, respectively, 4563 of whom also completed self-report measures at age 18 years. Primary and Secondary Outcome Measures: We assessed if children scoring above screening threshold for autism/attention deficit hyperactivity disorder (ADHD) at ages 7 and 9 years had increased risk of chronic disabling fatigue at age 18 years, computing ORs and CIs for effects using binary logistic regression. Mediation analyses were conducted to test if an inflammatory marker (interleukin 6 (IL-6)) at age 9 years linked neurodivergent traits to chronic disabling fatigue at age 18 years. Results: Children with neurodivergent traits at ages 7 and 9 years were two times as likely to experience chronic disabling fatigue at age 18 years (likely ADHD OR=2.18 (95% CI=1.33 to 3.56); p=0.002; likely autism OR=1.78 (95% CI=1.17 to 2.72); p=0.004). Levels of IL-6 at age 9 were associated with chronic disabling fatigue at age 18 (OR=1.54 (95% CI=1.13 to 2.11); p=0.006). Inflammation at age 9 years mediated effects of neurodivergent traits on chronic disabling fatigue (indirect effect via IL-6: ADHD b=1.08 (95% CI=1.01 to 1.15); autism b=1.06; (95% CI=1.03 to 1.10)). All effects remained significant when controlling for the presence of depressive symptoms. Conclusions: Our results indicate higher risk of chronic disabling fatigue for children with neurodivergent traits, likely linked to higher levels of inflammation. The implementation of transdiagnostic screening criteria to inform support strategies to counteract risk early in life is recommended. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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