ORIGINAL RESEARCH article
Front. Psychiatry
Sec. ADHD
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1621767
Novel Hematologic Ratios and Systemic Inflammation Index in ADHD: Effects of Methylphenidate Treatment
Provisionally accepted
- 1Ankara Etlik City Hospital, Ankara, Türkiye
- 2Uşak Training and Research Hospital, Uşak, Türkiye
- 3Dörtyol State Hospital, Hatay, Türkiye
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Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, and recent research suggests systemic inflammation contributes to its pathophysiology. This study aimed to evaluate novel inflammatory markers—neutrophil-to-HDL ratio (NHR), lymphocyte-to-HDL ratio (LHR), monocyte-to-HDL ratio (MHR), platelet-to-HDL ratio (PHR), and systemic immune-inflammation index (SII)—in children with ADHD compared to healthy controls. Additionally, it assessed changes in these markers after 12 weeks of long-acting methylphenidate treatment and potential differences among ADHD subtypes.Methods: This prospective study included 114 newly diagnosed, treatment-naive ADHD patients (aged 6–12) and 52 matched controls. Blood samples were obtained at baseline and after 12 weeks of treatment. Inflammatory markers were calculated from complete blood count and HDL levels. ADHD symptom severity was assessed using the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S), and anxiety and depression were measured with the Revised Child Anxiety and Depression Scale (RCADS).Results: ADHD patients showed significantly elevated baseline levels of NHR, LHR, MHR, PHR, and SII compared to controls (Cohen’s d range = 0.17–0.69). NHR independently predicted ADHD. Post-treatment, all inflammatory markers significantly decreased, suggesting a potential anti-inflammatory effect of methylphenidate (Cohen’s d range = 0.17–0.91). Post-treatment LHR was higher in the combined ADHD subtype.Conclusions: This study underscores inflammation’s role in ADHD and suggests these markers may reflect systemic inflammation in ADHD, but their clinical utility requires further investigation.
Keywords: Attention Deficit Hyperactivity Disorder, Inflammation, Methylphenidate, Blood parameters, NHR, SII
Received: 01 May 2025; Accepted: 18 Jun 2025.
Copyright: © 2025 Kaşak, Günal Okumuş, Çelik, Kırşan, Öztürk and Efe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Meryem Kaşak, Ankara Etlik City Hospital, Ankara, Türkiye
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