Complete blood count inflammatory ratios in attention-deficit hyperactivity disorder children

Abstract

Background
Attention-deficit hyperactivity disorder (ADHD) is considered one of the most common neuropsychiatric disorders in children. Many researchers have suggested that changes in pro-inflammatory and anti-inflammatory cytokines could play a major role in the pathogenesis of ADHD. We aimed in this study to assess the relationship between complete blood count (CBC) inflammatory markers [neutrophil–lymphocyte ratio (NLR), monocyte–lymphocytic ratio (MLR), platelet–lymphocyte ratio (PLR), and mean platelet volume], and ADHD. In addition, we also correlate them with symptom severity of ADHD in children.


Patients and method
This study was a case–control study carried out on 80 ADHD children and 40 healthy children as the control group. A complete blood count was obtained (white blood cells (WBC), neutrophil count, lymphocyte count, monocyte count, eosinophil and basophil counts, platelets, and mean platelet volume. Based on these counts, the NLR, PLR, and MLR were calculated.


Results

CBC inflammatory ratios (NLR, MLR, and PLR) were considerably higher among children with ADHD (unmedicated and medicated) than in the control group (
P
=0.0001, 0.006, 0.0001, 0.001, and 0.004, respectively); moreover, a significant positive correlation was observed between CBC inflammatory ratios (neutrophil/lymphocyte, monocyte/lymphocyte) and ADHD symptom severity assessed by Conner’s parent rating scale scores (total ADHD score, hyperactivity, impulsivity, and inattention scores) (
P
=0.019, 0.026, 0.012, 0.044, 0.008, 0.006, 0.022, 0.021, respectively, and r=0.371,0.357, 0.394, 0.324, 0.412, 0.433, 0.361, and 0.368, respectively).



Conclusions
The results of our study suggest that inflammation may play a significant role in the intricate pathophysiology of ADHD and suggest that CBC inflammatory ratios can be used as an indicator for ADHD severity, which is easily obtainable and a reliable laboratory test.