• I-Ching Chou, Yu-Tzu Chang, Zheng-Nan Chin, Chih-Hsin Muo, Fung-Chang Sung, Huang-Tsung Kuo, Chang-Hai Tsai, and Chia-Hung Kao.
• Children's Medical Center, China Medical University Hospital, Taichung, Taiwan.
• Plos One. 2013 Jan 1; 8 (3): e57926.

BackgroundThis study presents an evaluation of the bidirectional correlation between attention deficit hyperactivity disorder (ADHD) and epilepsy using 2 cohorts from the same population database.MethodsWe used data from the Taiwan National Health Insurance Research Database to establish 2 separate cohort studies with participants <19 years old. We subdivided Cohort 1 in 2 groups: (1) 2468 patients initially diagnosed with epilepsy during the period 1999-2008, and (2) 9810 randomly selected sex- and age-matched non-epileptic controls. We subdivided Cohort 2 into 2 groups: (1) 3664 patients with newly diagnosed ADHD and (2) 14 522 sex- and age-matched non-ADHD patients. We evaluated the risk of subsequent ADHD in relationship to epilepsy and vice versa in the 2 cohorts at the end of 2008.ResultsThe ADHD incidence in Cohort 1 was 7.76 in patients with epilepsy and 3.22 in those without epilepsy (per 1000 person-years) after a median follow-up of 7-7.5 years. The adjusted hazard ratio (HR) for ADHD was 2.54 (95% CI 2.02-3.18) in the epilepsy group compared to the non-epilepsy group. In Cohort 2, the incidence of epilepsy was 3.24 in patients with ADHD and 0.78 in those without ADHD (per 1000 person-years) after a median follow-up of 3-3.5 years and an HR of 3.94 (95% CI 2.58-6.03).ConclusionThis study shows a bidirectional association between ADHD and epilepsy in the 2 cohort studies. Causative factors may be common between these 2 disorders, leading to a cascade of transcriptional changes in the brain that alter behavior or cognition prior to seizures.

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