US EPA

2718066 

Journal Article 

Association between phthalates and externalizing behaviors and cortical thickness in children with attention deficit hyperactivity disorder 

Park, S; Lee, JM; Kim, JW; Cheong, JH; Yun, HJ; Hong, YC; Kim, Y; Han, DH; Yoo, HJ; Shin, MS; Cho, SC; Kim, BN 

2015 

1 

Psychological Medicine
ISSN: 0033-2917
EISSN: 1469-8978 

Cambridge University Press 

NEW YORK 

Psychol Med. 

45 

8 

1601-1612 

English 

25388623 

10.1017/S0033291714002694 

WOS:000354035000004 

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929094390&doi=10.1017%2fS0033291714002694&partnerID=40&md5=a994eb66205d2cb05e25dd44c96f272b
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is supplemented by 2803559 Supplementary figure S1. Correlation analysis between CT and urine DEHP metabolite concentrations in 115 patients with ADHD, controlling for age, sex, intracranial volume, and ADHD-RS and DBDS scores. Supplementary table S1. Brain areas of negative correlation of CT with urine DEHP metabolite concentrations in 115 patients with ADHD, controlling for age, sex, intracranial volume, and ADHD-RS and DBDS scores

Background. Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children. Method. A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated. Results. Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri. Conclusions. The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD. 

Attention-deficit hyperactivity disorder; cortical thickness; neuropsychology; phthalate