The Journal of Clinical Endocrinology & Metabolism Vol. 89, 2004, No. 12 6054-6060.
Attention Deficit and Hyperactivity Disorders in the Offspring
of Mothers Exposed to
Mild-Moderate Iodine Deficiency: A Possible Novel Iodine Deficiency Disorder
in Developed Countries
F. Vermiglio, V. P. Lo Presti, M. Moleti, M. Sidoti, G. Tortorella, G. Scaffidi,
M. G. Castagna,F. Mattina, M. A. Violi, A. Crisà, A. Artemisia and F. Trimarchi.
Dipartimento Clinico-Sperimentale di Medicina e Farmacologia-Sezione di Endocrinologia (F.V., V.P.L.P., M.M., G.S., M.G.C., F.M., M.A.V., F.T.), Dipartimento di Scienze Pediatriche-Sezione di Neuropsichiatria Infantile (M.S., G.T., A.C.), and Dipartimento di Diagnostica di Laboratorio-Servizio di Biochimica Clinica (A.A.), University of Messina, Messina 98125, Italy
Address all correspondence and requests for reprints to:
Prof. Francesco Vermiglio, M.D., Cattedra di Endocrinologia, Policlinico Universitario
Via Consolare Valeria 98125 Messina, Italy. E-mail: francesco.vermiglio@unime.it.
Over a period of almost 10 yr, we carried out a prospective study of the neuropsychological development of the offspring of 16 women from a moderately iodine-deficient area (area A) and of 11 control women from a marginally iodine-sufficient area (area B) whose thyroid function had been monitored during early gestation. Attention deficit and hyperactivity disorder (ADHD) was diagnosed in 11 of 16 area A children (68.7%) but in none from area B. Total intelligence quotient score was lower in area A than in area B children (92.1 ± 7.8 vs. 110 ± 10) and in ADHD children when compared with both non-ADHD children from the same area and control children (88.0 ± 6.9 vs. 99.0 ± 2.0 and 110 ± 10, respectively). Seven of 11 ADHD children (63.6%) were born to the seven of eight area A mothers who became hypothyroxinemic at early gestation, whereas only one of five non-ADHD children was born to a woman who was hypothyroxinemic at 20 wk of gestation. So far, a similar prevalence of ADHD has been reported only in children with generalized resistance to thyroid hormones. This might suggest a common ADHD pathogenetic mechanism consisting either of reduced sensitivity of the nuclear receptors to thyroid hormone (generalized resistance to thyroid hormones) or reduced availability of intracellular T3 for nuclear receptor binding. The latter would be the ultimate consequence of maternal hypothyroxinemia (due to iodine deficiency), resulting in a critical reduction of the source of the intracellular T3 available to the developing fetal brain.
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