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High-Dose Eicosapentaenoic Acid 1 (EPA) Improves Attention and Vigilance 2 in Children and Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) 3 and Low Endogenous EPA Levels

Research output: Contribution to journalArticle

Carmine Maria Pariante, Pei-Chen Chang, Kuan-Pin Su, Valeria Mondelli, Satyanarayanan Senthil Kumaran, Hui-Ting Yang, Yi-Ju Chiang, Hui-Ting Chen

Original languageEnglish
JournalTranslational psychiatry
Accepted/In press5 Sep 2019

King's Authors


No studies have examined the relationship between endogenous polyunsaturated fatty acids 3 (PUFAs) levels and treatment response to PUFAs. We conducted a 12-week, double-blind,4 placebo-controlled trial comparing the effects of high-dose eicosapentaenoic acid (EPA, 1.2 5 g) and placebo on cognitive function (continuous performance test) in n = 92 youth (age 6-18 6 years-old) with Attention Deficit Hyperactivity Disorder (ADHD). Blood erythrocytes 7 PUFAs were measured before and after treatment, to examine the effects of baseline 8 endogenous EPA levels on treatment response and the effects of EPA treatment on PUFAs 9 levels. Secondary measures included other ADHD symptoms, emotional symptoms, and 10 levels of plasma high-sensitivity c-reactive protein (hs-CRP) and brain-derive neurotrophic
11 factor (BDNF). Overall, EPA group improved more than placebo group on focused attention 12 (variability, Effect size (ES) = .38, p =.041); moreover, within youth with the lowest baseline 13 endogenous EPA levels, EPA group improved more than placebo group in another measure 14 of focused attention (hit reaction time, HRT, ES = .89 p = .015) and in vigilance (HRT 15 interstimulus interval changes, HRTISIC, ES = .83, p = .036). Interestingly, EPA group 16 improved less than placebo group in impulsivity (commission errors), both overall and in 17 youth with the highest baseline EPA levels, who also showed less improvement in other 18 ADHD and emotional symptoms. EPA increased blood erythrocytes EPA by 1.6-fold but not 19 DHA levels, and did not affect hs-CRP and BDNF plasma levels. In conclusion, EPA 20 treatment improves cognitive symptoms in ADHD youth, especially if they have a low 21 baseline endogenous EPA level, while youth with high EPA levels may be negatively 22 affected by this treatment.

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