The association between attention deficit hyperactivity disorder and general anaesthesia ‐ a narrative review

Attention deficit hyperactivity disorder is a chronic neurodevelopmental disorder, manifesting primarily as attention deficit, hyperactivity and impulsive behaviour. General anaesthetics can be neurotoxic, affecting neuronal differentiation and synaptogenesis, which can lead to abnormalities of cognition, learning and behaviour. We hypothesise that exposure of the immature brain to general anaesthetics predisposes to the development of attention deficit hyperactivity disorder. In this review, we summarise clinical and animal studies that relate attention deficit hyperactivity disorder to general anaesthesia, by actions on neural molecular mechanisms and neural networks. We also describe potential therapeutic approaches to modulate these effects.

• Publication year

  2018

• Venue

  Anaesthesia

• Publication date

  2018-11-22

• Fields of study

  Medicine

• Identifiers
  DOI 10.1111/anae.14496PMID 30511754
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Neuropsychological and Behavioral Outcomes after Exposure of Young Children to Procedures Requiring General Anesthesia: The Mayo Anesthesia Safety in Kids (MASK) Study

  2018cited by this paper
• Disrupted Glutamatergic Transmission in Prefrontal Cortex Contributes to Behavioral Abnormality in an Animal Model of ADHD

  2017cited by this paper
• Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort.

  2017cited by this paper
• Brain molecular changes and behavioral alterations induced by propofol anesthesia exposure in peripubertal rats

  2017cited by this paper
• Effect of Anesthesia on the Developing Brain: Infant and Fetus

  2017cited by this paper
• Modulation of prefrontal cortex excitation/inhibition balance rescues social behavior in CNTNAP2-deficient mice

  2017cited by this paper
• Key role of the dopamine D4 receptor in the modulation of corticostriatal glutamatergic neurotransmission

  2017cited by this paper
• Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis.

  2017cited by this paper
• Maternal Sevoflurane Exposure Causes Abnormal Development of Fetal Prefrontal Cortex and Induces Cognitive Dysfunction in Offspring

  2017cited by this paper
• Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood.

  2016cited by this paper
• The Fas Ligand/Fas Death Receptor Pathways Contribute to Propofol-Induced Apoptosis and Neuroinflammation in the Brain of Neonatal Rats

  2016cited by this paper
• Exposure to Ketamine Anesthesia Affects Rat Impulsive Behavior

  2016cited by this paper
• Abnormal asymmetry in frontostriatal white matter in children with attention deficit hyperactivity disorder

  2016cited by this paper
• Prenatal ketamine exposure causes abnormal development of prefrontal cortex in rat

  2016cited by this paper
• Lasting impact of general anaesthesia on the brain: mechanisms and relevance

  2016cited by this paper
• Disruption of corticocortical information transfer during ketamine anesthesia in the primate brain

  2016cited by this paper
• Anesthetic neurotoxicity--clinical implications of animal models.

  2015cited by this paper
• Psychostimulants and atomoxetine alter the electrophysiological activity of prefrontal cortex neurons, interaction with catecholamine and glutamate NMDA receptors

  2015cited by this paper
• Neonatal propofol anesthesia modifies activity‐dependent processes and induces transient hyperlocomotor response to d‐amphetamine during adolescence in rats

  2015cited by this paper
• Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership

  2015cited by this paper
• Neurotoxicity of generic anesthesia agents in infants and children: an orphan research question in search of a sponsor.

  2015cited by this paper
• Spine Pruning Drives Antipsychotic-sensitive Locomotion via Circuit Control of Striatal Dopamine

  2015cited by this paper
• Aberrant regulation of synchronous network activity by the attention‐deficit/hyperactivity disorder‐associated human dopamine D4 receptor variant D4.7 in the prefrontal cortex

  2015cited by this paper
• Circadian Modulation of Dopamine Levels and Dopaminergic Neuron Development Contributes to Attention Deficiency and Hyperactive Behavior

  2015cited by this paper
• Neuroanatomic and cognitive abnormalities in attention-deficit/hyperactivity disorder in the era of 'high definition' neuroimaging.

  2015cited by this paper
• Anesthesia and the developing brain: a way forward for clinical research

  2015cited by this paper
• Behavioral and emotional effects of repeated general anesthesia in young children

  2015cited by this paper
• Aberrant glutamate signaling in the prefrontal cortex and striatum of the spontaneously hypertensive rat model of attention-deficit/hyperactivity disorder

  2014cited by this paper
• Methylphenidate exerts dose-dependent effects on glutamate receptors and behaviors.

  2014cited by this paper
• Common white matter microstructure alterations in pediatric motor and attention disorders.

  2014cited by this paper
• D1-dopamine and α1-adrenergic receptors co-localize in dendrites of the rat prefrontal cortex.

  2014cited by this paper
• Attention deficit hyperactivity disorder and N-methyl-D-aspartate (NMDA) dysregulation.

  2014cited by this paper
• Isoflurane-induced Apoptosis of Neurons and Oligodendrocytes in the Fetal Rhesus Macaque Brain

  2014cited by this paper
• The Physiology of BDNF and Its Relationship with ADHD

  2014cited by this paper
• BDNF regulation of synaptic structure, function, and plasticity.

  2014cited by this paper
• Exposure to general anesthesia in early life and the risk of attention deficit/hyperactivity disorder development: a nationwide, retrospective matched‐cohort study

  2014cited by this paper
• Electrical Stimulation of the Ventral Tegmental Area Induces Reanimation from General Anesthesia

  2014cited by this paper
• Serotoninergic and dopaminergic modulation of cortico-striatal circuit in executive and attention deficits induced by NMDA receptor hypofunction in the 5-choice serial reaction time task

  2014cited by this paper
• Electroencephalographic effects of ketamine on power, cross-frequency coupling, and connectivity in the alpha bandwidth

  2014cited by this paper
• Brain regional vulnerability to anaesthesia-induced neuroapoptosis shifts with age at exposure and extends into adulthood for some regions.

  2014cited by this paper
• Clinical Research Into Anesthetic Neurotoxicity: Does Anesthesia Cause Neurological Abnormalities in Humans?

  2014cited by this paper
• White matter tract integrity of frontostriatal circuit in attention deficit hyperactivity disorder: Association with attention performance and symptoms

  2014cited by this paper
• Stress effects on BDNF expression: effects of age, sex, and form of stress.

  2013cited by this paper
• Treatment with a clinically-relevant dose of methylphenidate alters NMDA receptor composition and synaptic plasticity in the juvenile rat prefrontal cortex.

  2013cited by this paper
• Changes in plasma Brain-derived neurotrophic factor (BDNF) levels induced by methylphenidate in children with Attention deficit-hyperactivity disorder (ADHD).

  2013cited by this paper
• Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies.

  2012cited by this paper
• Pediatric Anesthesia and Neurodevelopmental Impairments: A Bayesian Meta-analysis

  2012cited by this paper
• Role of Dopamine Receptors in ADHD: A Systematic Meta-analysis

  2012cited by this paper
• The mysterious motivational functions of mesolimbic dopamine.

  2012cited by this paper
• Attention-deficit/hyperactivity disorder after early exposure to procedures requiring general anesthesia.

  2012cited by this paper
• Delayed Environmental Enrichment Reverses Sevoflurane-induced Memory Impairment in Rats

  2012cited by this paper
• Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: disruptions in neurodevelopmental psychiatric disorders.

  2012cited by this paper
• Developmental Stage-dependent Persistent Impact of Propofol Anesthesia on Dendritic Spines in the Rat Medial Prefrontal Cortex

  2011cited by this paper
• Hyperactivity following postnatal NMDA antagonist treatment: Reversal by D-amphetamine

  2009cited by this paper
• Evaluating dopamine reward pathway in ADHD: clinical implications.

  2009cited by this paper
• Neonatal Exposure to a Combination of N-Methyl-d-aspartate and &ggr;-Aminobutyric Acid Type A Receptor Anesthetic Agents Potentiates Apoptotic Neurodegeneration and Persistent Behavioral Deficits

  2007cited by this paper
• Gene–environment interplay in attention-deficit hyperactivity disorder and the importance of a developmental perspective

  2007cited by this paper
• Stimulants: Therapeutic Actions in ADHD

  2006cited by this paper
• Molecular genetics of attention-deficit/hyperactivity disorder.

  2005cited by this paper
• NeuroImage: Clinical

  year unknowncited by this paper

• Vitamin K2 mitigates cognitive, and motor impairments induced by multiple surgery with anesthesia and analgesia in neonatal stage.

  2025cites this paper
• Dihydromyricetin protects sevoflurane‐induced mitochondrial dysfunction in HT22 hippocampal cells

  2024cites this paper
• Dual effects of GABAAR agonist anesthetics in neurodevelopment and vulnerable brains: From neurotoxic to therapeutic effects

  2024cites this paper
• Risk of attention deficit hyperactivity disorder diagnosis following multiple exposures to general anesthesia in the paediatric population: A systematic review and meta-analysis.

  2023cites this paper
• Early childhood general anesthesia and risk of Attention Deficit Hyperactivity Disorder.

  2023cites this paper
• Sevoflurane Exposure in the Developing Brain Induces Hyperactivity, Anxiety–Free, and Enhancement of Memory Consolidation in Mice

  2022cites this paper
• Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review

  2022cites this paper
• Mitochondria-Related Ferroptosis Drives Cognitive Deficits in Neonatal Mice Following Sevoflurane Administration

  2022cites this paper
• ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation

  2021cites this paper
• lncRNA Xist regulates sevoflurane-induced social and emotional impairment by modulating miR-98-5p/EDEM1 signaling axis in neonatal mice

  2021cites this paper
• A National Population Cohort Study Showed That Exposure to General Anesthesia in Early Childhood Is Associated with an Increase in the Risk of Developmental Delay

  2021cites this paper
• MicroRNA-325-3p prevents sevoflurane-induced learning and memory impairment by inhibiting Nupr1 and C/EBPβ/IGFBP5 signaling in rats

  2020cites this paper
• Egr2 upregulation induced mitochondrial iron overload implicating in sevoflurane-induced cognitive deficits in developing mice

  2020cites this paper
• Egr2 Upregulation Induced Mitochondrial Iron Overload Implicating in Cognitive Deficits after Sevoflurane Administration

  2020cites this paper
• Exposure to general anesthesia before 4 years of age did not affect growth and development: A nationwide retrospective cohort study using an early childhood health screening database

  2020cites this paper
• Association Between Behavioral and Learning Outcomes and Single Exposures to Procedures Requiring General Anesthesia Before Age 3: Secondary Analysis of Data From Olmsted County, MN

  2020cites this paper
• Neonatal sevoflurane exposure induces impulsive behavioral deficit through disrupting excitatory neurons in the medial prefrontal cortex in mice

  2020cites this paper
• Tetramethylpyrazine Attenuated Sevoflurane-Induced Neurotoxicity by Enhancing Autophagy through GPR50/CREB Pathway in SH-SY5Y Cells.

  2020cites this paper
• True and pseudo-interdisciplinary researches: The principles of a system-structural approach to the medical-and-psychological projects planning

  2019cites this paper