Browse > Article
http://dx.doi.org/10.5765/jkacap.2012.23.2.63

Analysis of Heavy Metals in the Hair of Children with Attention-Deficit Hyperactivity Disorder and Tourette's Syndrome  

Cho, Sung-Yun (Department of Psychiatry, Inha University College of Medicine)
Ock, Sun-Myeong (Department of Family Medicine, The Catholic University of Korea College of Medicine)
Lee, Myung-Hoon (Department of Psychiatry, Inha University College of Medicine)
Kang, Min-Hee (Department of Psychiatry, Inha University College of Medicine)
Kim, Chul-Eung (Department of Psychiatry, Inha University College of Medicine)
Bae, Jae-Nam (Department of Psychiatry, Inha University College of Medicine)
Lee, Jeong-Seop (Department of Psychiatry, Inha University College of Medicine)
Publication Information
Journal of the Korean Academy of Child and Adolescent Psychiatry / v.23, no.2, 2012 , pp. 63-68 More about this Journal
Abstract
Objectives : The purpose of this study was to examine the association of exposures to heavy metals with positive diagnosis for attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS). Methods : Study participants included 27 children diagnosed with ADHD ($9.9{\pm}2.9$ years of age), 21 diagnosed with Tourette's disorder ($10.7{\pm}2.2$ years of age), and 45 normal control children ($9.6{\pm}0.5$ years of age). A Perkin-Elmer mass spectrometer was used to measure the concentrations of 5 heavy metals (Pb, Cd, U, Be, Hg) in hair samples obtained from each participant. Each heavy metal concentration was compared among the groups by use of a Kruskal-Wallis test. Results : The levels of lead (p=.006) and cadmium (p=.037) observed in the hair of children diagnosed with ADHD were significantly higher than those found in the control subjects. There were no significant differences observed for heavy metal levels when comparing TS and control subjects. Conclusion : We confirmed that lead exposure is a risk factor for ADHD. We also identified that cadmium may be a new candidate risk factor for manifestation of ADHD. We did not find an association between heavy metals and manifestation of TS.
Keywords
Attention-Deficit Hyperactivity Disorder; Tourette's Syndrome; Lead; Cadmium;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Marlowe M, Errera J, Jacobs J. Increased lead and cadmium burdens among mentally retarded children and children with borderline intelligence. Am J Ment Defic 1983;87:477-483.
2 Viaene MK, Roels HA, Leenders J, De Groof M, Swerts LJ, Lison D, et al. Cadmium: a possible etiological factor in peripheral polyneuropathy. Neurotoxicology 1999;20:7-16.
3 Viaene MK, Masschelein R, Leenders J, De Groof M, Swerts LJ, Roels HA. Neurobehavioural effects of occupational exposure to cadmium: a cross sectional epidemiological study. Occup Environ Med 2000;57:19-27.   DOI
4 Faro LR, Rodrigues KJ, Santana MB, Vidal L, Alfonso M, Durán R. Comparative effects of organic and inorganic mercury on in vivo dopamine release in freely moving rats. Braz J Med Biol Res 2007;40: 1361-1365.   DOI
5 Li AM, Chan MH, Leung TF, Cheung RC, Lam CW, Fok TF. Mercury intoxication presenting with tics. Arch Dis Child 2000;83:174-175.   DOI
6 Mahaffey KR. Nutrition and lead: strategies for public health. Environ Health Perspect 1995;103 Suppl 6:191-196.   DOI
7 Yiin LM, Lioy PJ, Rhoads GG. Impact of home carpets on childhood lead intervention study. Environ Res 2003;92:161-165.   DOI   ScienceOn
8 Kostrzewa RM, Kostrzewa JP, Kostrzewa RA, Nowak P, Brus R. Pharmacological models of ADHD. J Neural Transm 2008;115:287-298.   DOI   ScienceOn
9 Kim JW. Environmental risk factors for attention deficit hyperactivity disorder and implications for clinical practice. J Kor Acad Child Adolesc Psychiatry 2011;22:10-15.   과학기술학회마을   DOI   ScienceOn
10 Cortese S, Lecendreux M, Bernardina BD, Mouren MC, Sbarbati A, Konofal E. Attention-deficit/hyperactivity disorder, Tourette's syndrome, and restless legs syndrome: the iron hypothesis. Med Hypotheses 2008;70:1128-1132.   DOI   ScienceOn
11 Kessler RC, Adler LA, Barkley R, Biederman J, Conners CK, Faraone SV, et al. Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biol Psychiatry 2005;57:1442-1451.   DOI   ScienceOn
12 Yu YA, Jeong MH. A study on the association between mineral concentration in children`s hair and attention-deficit hyperactivity disorder. Korean J Environ Health 2004;30:41-49.   과학기술학회마을
13 Cho CS. Attention deficit hyperactivity disorder. J Korean Med Assoc 1997;40:1122-1134.   DOI
14 Rampello L, Alvano A, Battaglia G, Bruno V, Raffaele R, Nicoletti F. Tic disorders: from pathophysiology to treatment. J Neurol 2006; 253:1-15.   DOI
15 Mejia NI, Jankovic J. Secondary tics and tourettism. Rev Bras Psiquiatr 2005;27:11-17.   DOI
16 Gotti C, Cabrini D, Sher E, Clementi F. Effects of long-term in vitro exposure to aluminum, cadmium or lead on differentiation and cholinergic receptor expression in a human neuroblastoma cell line. Cell Biol Toxicol 1987;3:431-440.   DOI
17 Nicolescu R, Petcu C, Cordeanu A, Fabritius K, Schlumpf M, Krebs R, et al. Environmental exposure to lead, but not other neurotoxic metals, relates to core elements of ADHD in Romanian children: performance and questionnaire data. Environ Res 2010;110:476-483.   DOI   ScienceOn
18 Schoeters G, Den Hond E, Zuurbier M, Naginiene R, van den Hazel P, Stilianakis N, et al. Cadmium and children: exposure and health effects. Acta Paediatr Suppl 2006;95:50-54.
19 U.S Agency for Toxic Substances and Disease Registry. Draft Interaction profile for arsenic, cadmium, chromium and lead. 2002. Available from URL:http://www.elaw.org/node/2155
20 Wright RO, Amarasiriwardena C, Woolf AD, Jim R, Bellinger DC. Neuropsychological correlates of hair arsenic, manganese, and cadmium levels in school-age children residing near a hazardous waste site. Neurotoxicology 2006;27:210-216.   DOI   ScienceOn
21 Werbach M. Nutritional influences on aggressive behavior. J Orthomol Med 1992;7:45-51.
22 Hart RP, Rose CS, Hamer RM. Neuropsychological effects of occupational exposure to cadmium. J Clin Exp Neuropsychol 1989;11: 933-943.   DOI
23 Rogan WJ, Ware JH. Exposure to lead in children--how low is low enough? N Engl J Med 2003;348:1515-1516.   DOI   ScienceOn
24 Manton WI, Angle CR, Stanek KL, Reese YR, Kuehnemann TJ. Acquisition and retention of lead by young children. Environ Res 2000; 82:60-80.   DOI   ScienceOn
25 Hwang JW. Association of hair metals and minerals concentrations on ADHD. Seoul: Seoul Univ.;2002.
26 Jakubowski M. Low-level environmental lead exposure and intellectual impairment in children--the current concepts of risk assessment. Int J Occup Med Environ Health 2011;24:1-7.   DOI   ScienceOn
27 Rai A, Maurya SK, Khare P, Srivastava A, Bandyopadhyay S. Characterization of developmental neurotoxicity of As, Cd, and Pb mixture: synergistic action of metal mixture in glial and neuronal functions. Toxicol Sci 2010;118:586-601.   DOI   ScienceOn
28 Minder B, Das-Smaal EA, Brand EF, Orlebeke JF. Exposure to lead and specific attentional problems in schoolchildren. J Learn Disabil 1994;27:393-399.   DOI
29 Bellinger DC. Very low lead exposures and children's neurodevelopment. Curr Opin Pediatr 2008;20:172-177.   DOI   ScienceOn
30 Rogan WJ, Ware JH. Exposure to lead in children--how low is low enough? N Engl J Med 2003;348:1515-1516.   DOI   ScienceOn
31 Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP. Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children. Environ Health Perspect 2006;114:1904-1909.
32 Nigg JT, Knottnerus GM, Martel MM, Nikolas M, Cavanagh K, Karmaus W, et al. Low blood lead levels associated with clinically diagnosed attention-deficit/hyperactivity disorder and mediated by weak cognitive control. Biol Psychiatry 2008;63:325-331.   DOI   ScienceOn
33 Grimaldi BL. The central role of magnesium deficiency in Tourette's syndrome: causal relationships between magnesium deficiency, altered biochemical pathways and symptoms relating to Tourette's syndrome and several reported comorbid conditions. Med Hypotheses 2002;58:47-60.   DOI   ScienceOn
34 Watts DL. The nutritional relationships of iron. J Orthomolec Med 1988;3:110-116.
35 Thatcher RW, Lester ML, McAlaster R, Horst R. Effects of low levels of cadmium and lead on cognitive functioning in children. Arch Environ Health 1982;37:159-166.   DOI
36 Stellern J, Marlowe M, Cossairt A, Errera J. Low lead and cadmium levels and childhood visual-perception development. Percept Mot Skills 1983;56:539-544.   DOI   ScienceOn
37 Bloch M, State M, Pittenger C. Recent advances in Tourette syndrome. Curr Opin Neurol 2011;24:119-125.   DOI   ScienceOn
38 Bloch MH, Panza KE, Landeros-Weisenberger A, Leckman JF. Meta- analysis: treatment of attention-deficit/hyperactivity disorder in children with comorbid tic disorders. J Am Acad Child Adolesc Psychiatry 2009;48:884-893.   DOI   ScienceOn
39 Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009;67:497-501.   DOI   ScienceOn
40 Kracke KR. Biochemical bases for behavior disorders in children. J Orthomolecular Psychiat 1982;11:289-296.
41 Lee EJ, Kim SM. The Association of Hair Zinc with Metabolic Risk Factors for selected Women in Korea. Korean J Obes 2005;14:170-177.
42 Maugh TH 2nd. Hair: a diagnostic tool to complement blood serum and urine. Science 1978;202:1271-1273.   DOI   ScienceOn
43 Lanphear BP, Dietrich K, Auinger P, Cox C. Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents. Public Health Rep 2000;115:521-529.   DOI   ScienceOn
44 Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 2003;348: 1517-1526.   DOI   ScienceOn