Nocturnal enuresis: a suggestive endophenotype marker for a subgroup of inattentive attention-deficit/hyperactivity disorder.
OBJECTIVE
Attention-deficit/hyperactivity disorder (ADHD) and enuresis co-occur at a higher rate than expected; the cause for this is unclear.


METHODS
Diagnostic and demographic variables were compared in 344 children ages 6 to 12 years, with and without enuresis, recruited in an ADHD genetic study. Sleep variables were investigated in a subgroup of 44 enuretic children with age- and sex-matched nonenuretic controls. The association of enuresis with single nucleotide polymorphisms located in regions reported in linkage with enuresis was explored.


RESULTS
The prevalence rate of nocturnal enuresis was 16.9% for the entire cohort. There were no differences in sex, age, socioeconomic status, intelligence quotient, medication treatment, or comorbidities. The enuresis group had a higher likelihood of inattentive symptoms than the nonenuretic group. Night wakings and ability of children to wake themselves in the morning were both significantly decreased in children with enuresis compared with control children in the Child Sleep Habits Questionnaire Night Wakings subscale. No significant association was found with chromosomal regions previously reported in linkage with enuresis.


CONCLUSIONS
Deficits in arousal may contribute to both enuresis and inattentive ADHD. Nocturnal enuresis may be a useful clinical marker in identifying a subgroup of the inattentive phenotype in ADHD genetic studies.
Elia
Josephine
J
Children's Hospital of Philadelphia, Philadelphia, PA 19104-6209, USA. elia@email.chop.edu
Takeda
Toshinobu
T
Deberardinis
Rachel
R
Burke
Judy
J
Accardo
Jennifer
J
Ambrosini
Paul J
PJ
Blum
Nathan J
NJ
Brown
Lawrence W
LW
Lantieri
Francesca
F
Berrettini
Wade
W
Devoto
Marcella
M
Hakonarson
Hakon
H
D001143:Arousal; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000235:genetics*; D016022:Case-Control Studies; D002648:Child; D002877:Chromosomes, Human / Q000235:genetics; D005260:Female; D005819:Genetic Markers; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000453:epidemiology* / Q000235:genetics*; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology
D005819:Genetic Markers