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Meta-Analysis
. 2015 Nov;19(11):915-24.
doi: 10.1177/1087054713510354. Epub 2013 Nov 14.

Oxidative Stress and ADHD: A Meta-Analysis

Nidhin Joseph  1 , Yanli Zhang-James  1 , Andras Perl  1 , Stephen V Faraone  2
Affiliations
Meta-Analysis

Oxidative Stress and ADHD: A Meta-Analysis

Nidhin Joseph et al. J Atten Disord. 2015 Nov.

Abstract

Objective: To clarify the role of oxidative stress and antioxidant activity in ADHD.

Method: We examined the association of ADHD and oxidative stress by applying random effects meta-analysis to studies of oxidative stress and antioxidant status in medication naive patients with ADHD and controls.

Results: Six studies of a total of 231 ADHD patients and 207 controls met our selection criteria. The association between ADHD and antioxidant status was not significant. We found a significant association between ADHD and oxidative stress that could not be accounted for by publication bias. The significant association lost significance after correcting for intrastudy clustering. No one observation accounted for the positive result.

Conclusion: These results are preliminary given the small number of studies. They suggest that patients with ADHD have normal levels of antioxidant production, but that their response to oxidative stress is insufficient, leading to oxidative damage.

Keywords: ADHD; meta-analysis.

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Conflict of interest statement

Declaration of Conflicting Interests The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: In the past year, Dr. Faraone received consulting income and/or research support from Shire, Akili Interactive Labs, and Alcobra, and research support from the National Institutes of Health (NIH). His institution is seeking a patent for the use of sodium–hydrogen exchange inhibitors in the treatment of ADHD. In previous years, he received consulting fees or was on Advisory Boards or participated in continuing medical education programs sponsored by Shire, Alcobra, Otsuka, McNeil, Janssen, Novartis, Pfizer, and Eli Lilly. Dr. Faraone receives royalties from books published by Guilford Press: Straight Talk about Your Child’s Mental Health and Oxford University Press: Schizophrenia: The Facts.

Figures

Figure 1
Figure 1
PRISMA flow diagram. Note. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses (http://www.prisma-statement.org/).
Figure 2
Figure 2
Meta-analysis comparing measures of oxidative stress and antioxidant activity in ADHD and control participants. Note. SMDs greater than zero indicate increasing support for the hypothesis that oxidative stress, or low antioxidant activity are associated with ADHD. For each comparison, the dot gives the relative risk and the horizontal line gives the 95% confidence interval. The center of the diamond at the bottom gives the weighted relative risk across all studies and the width of the diamond gives its 95% confidence interval. The subtotals give the SMD stratified by type of measure (antioxidant activity vs. oxidative stress). SMD = standardized mean difference.
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