PT558. Environmental Lead and Tobacco Smoke Exposure and Neurocognitive Performance in Attention-Deficit/Hyperactivity Disorder

Purpose: Omega-3 polyunsaturated fatty acids (PUFAs), which include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are important to mental health and physical health. In recent years, A lower level of omega-3 PUFAs has been proposed to be linked with mental disorders that are schizophrenia, depression, dementia, bipolar disorder and attention-deficit / hyperactivity disorder (ADHD). Medications, such as atomoxetine (ATX) and methylphenidate (MPH), improve daily living performance of patients with ADHD. However, Psychotropic drug are not preferred by some patients or families. If a success in achieving a therapeutic effect with the omega-3 fatty acids, that may be compensated from the dietary supplementation. We report as a pre-stage of replacement therapy study on omega-3 PUFA, since examined for blood PUFA’s concentration youth ADHD patient. Methods: At Nagasaki University Hospital Department of Psychiatry, on November 2010 to May 2015, The subject were ADHD patients aged 9 to 18 years (N = 28). From their medical records of PUFA in blood serum EPA, DHA, Arachidonic acid (AA), date of birth, drug treatment (ATX or MPH), The Global Assessment of Functioning (GAF), Clinical Global Impressions (CGI), ADHD-RS4 were investigated. Results: In ADHD patients at the Nagasaki University Hospital, it has been clear that the blood omega-3 PUFAs concentration is significantly lower (P<0.01). On the other hand, AA that are classified as omega-6 PUFAs concentration is significantly higher (P<0.01). In addition, From the association with the GAF scores and blood concentration of EPA. Conclusions: The youth ADHD patients has revealed that the balance of omega-3 and omega-6 PUFAs are collapsed, and the height of the blood EPA levels may relate to these therapeutic sensitivity. From the above facts, We expected to have the usefulness of treatment with omega-3 unsaturated fatty acid supplementation on youth ADHD patients. PT558 Environmental Lead and Tobacco Smoke Exposure and Neurocognitive Performance in AttentionDeficit/Hyperactivity Disorder Jae-Won Choi, Jae-Won Kim Seoul National University Hospital, Republic of Korea Abstract Background: Previous studies have suggested that concentrations of lead in the blood and cotinine in the urine are associated with attention-deficit/hyperactivity disorder (ADHD) in youth. Lead is a heavy metal constituent contained in tobacco. Cotinine is a metabolite of nicotine, and it is used as a biomarker for exposure to tobacco smoke. However, only a few studies have analyzed what specific neurocognitive functions are associated with the concentrations of lead and cotinine in youth with ADHD. Methods: Ninety four youth diagnosed with ADHD and thirty controls (aged 5 to 18 years) participated in this study. A structured diagnostic interview (K-SADS-PL) was conducted with each participant of both groups for psychiatric diagnostic evaluation, and concentrations of blood lead and urinary cotinine were measured. All participants were assessed using the ADHD Rating Scale-IV (ADHD-RS), and they also took the continuous performance test (CPT) and the Stroop color-word test (SCWT). Multivariable linear regression model was used to evaluate associations of blood lead and urinary cotinine concentrations with the results of ADHD-RS, CPT, and SCWT; IQ, age, and gender were adjusted. Results: There was a significant difference in blood lead concentrations between the ADHD and control groups (1.5 ± 0.4 μg/dL vs. 1.2 ± 0.3 μg/dL, p=0.008). Blood lead concentrations showed a positive correlation with the CPT scores of omission errors (r=0.31, p<0.05) and response time variability (r=0.25, p<0.05). On the other hand, urinary cotinine concentrations did not demonstrate a meaningful correlation with any of the variables. In the multivariable linear regression model, blood lead concentrations were associated with CPT omission errors (B=0.274, p=0.009). Conclusions: Our results showed that high blood lead concentrations are associated with poor neurocognitive performance in ADHD, but urinary cotinine concentrations did not show any significant difference in between the ADHD and control groups and any association with the results of neurocognitive tests.Background: Previous studies have suggested that concentrations of lead in the blood and cotinine in the urine are associated with attention-deficit/hyperactivity disorder (ADHD) in youth. Lead is a heavy metal constituent contained in tobacco. Cotinine is a metabolite of nicotine, and it is used as a biomarker for exposure to tobacco smoke. However, only a few studies have analyzed what specific neurocognitive functions are associated with the concentrations of lead and cotinine in youth with ADHD. Methods: Ninety four youth diagnosed with ADHD and thirty controls (aged 5 to 18 years) participated in this study. A structured diagnostic interview (K-SADS-PL) was conducted with each participant of both groups for psychiatric diagnostic evaluation, and concentrations of blood lead and urinary cotinine were measured. All participants were assessed using the ADHD Rating Scale-IV (ADHD-RS), and they also took the continuous performance test (CPT) and the Stroop color-word test (SCWT). Multivariable linear regression model was used to evaluate associations of blood lead and urinary cotinine concentrations with the results of ADHD-RS, CPT, and SCWT; IQ, age, and gender were adjusted. Results: There was a significant difference in blood lead concentrations between the ADHD and control groups (1.5 ± 0.4 μg/dL vs. 1.2 ± 0.3 μg/dL, p=0.008). Blood lead concentrations showed a positive correlation with the CPT scores of omission errors (r=0.31, p<0.05) and response time variability (r=0.25, p<0.05). On the other hand, urinary cotinine concentrations did not demonstrate a meaningful correlation with any of the variables. In the multivariable linear regression model, blood lead concentrations were associated with CPT omission errors (B=0.274, p=0.009). Conclusions: Our results showed that high blood lead concentrations are associated with poor neurocognitive performance in ADHD, but urinary cotinine concentrations did not show any significant difference in between the ADHD and control groups and any association with the results of neurocognitive tests. DEMENTIA: PT559 – PT599 PT559 The Effect of Escitalopram on Mood and Cognition in Depressive Alzheimer’s Disease Subjects Hoyoung An1, Booyeol Choi1, Seol-Heui Han2, Chang Hyung Hong3, 1Asan Medical Center, Republic of Korea, 2Konkuk University College of Medicine, Republic of Korea, 3Ajou University School of Medicine,