Search Results (4)

Attention-deficit/hyperactivity disorder (ADHD), brain–derived neurotrophic factor (BDNF), and enuresis are interconnected in several ways, primarily through their potential links to neurodevelopmental factors and brain function. ADHD is considered a neurobehavioral and neuropsychiatric condition characterized by numerous comorbidities, and it represents one of the most frequently encountered neuropsychiatric disorders in clinical practice. Enuresis constitutes a subgroup of intermittent incontinence occurring during sleep that can be further subdivided into monosymptomatic (MNE) and non-monosymptomatic enuresis (NMNE). BDNF plays a crucial role in neurodevelopment, including neuronal growth, proliferation, survival, differentiation, and synaptic plasticity. This narrative review synthesized available literature identified through a systematic search of PubMed/MEDLINE, Science Direct, and Scopus databases (January 2000–December 2025). However, the evidence base is heterogeneous, and findings regarding BDNF in ADHD are inconsistent. Studies examining BDNF in enuresis often involve urinary BDNF, which reflects local bladder production rather than central BDNF activity. Further research is needed to clarify the specific roles of BDNF in the development and manifestation of these conditions and to fully elucidate the complex relationship between BDNF, ADHD, and enuresis. Full article

Objectives: To evaluate the effects of age, body mass index, and treatment duration on treatment response in children with primary monosymptomatic nocturnal enuresis and to determine the contribution of these variables to clinical outcomes. Methods: Data from 560 pediatric patients treated with desmopressin due to primary monosymptomatic nocturnal enuresis were retrospectively analyzed. Patient demographics, body mass index classifications, early treatment response, and dryness rates at 3 and 6 months were evaluated. Categorical variables were analyzed using the chi-square or Fisher’s exact test, and continuous variables were evaluated using Spearman correlation analysis. Significant factors predicting treatment success were investigated using multivariable analyses. Results: Treatment success was significantly higher in younger age groups, with increased early response rates and shorter treatment duration (p < 0.001). Higher body mass index was associated with a delay in early treatment response and the need for longer treatment (p < 0.0001). While the likelihood of treatment success decreased with increasing age, higher body mass index demonstrated a modest positive association with treatment response after multivariable adjustment. Conclusions: The findings indicate that age and body mass index are important determinants of treatment response in pediatric monosymptomatic nocturnal enuresis. These results suggest that treatment strategies should be individualized by considering both age and body mass index. Full article

Introduction: Nocturnal enuresis is defined as involuntary urination during sleep in children, particularly those aged 5 years or older. Primary monosymptomatic nocturnal enuresis (PMNE) involves nighttime wetting without daytime symptoms, and although factors like reduced bladder capacity, nocturnal polyuria, and impaired arousal contribute, predictors of long-term relapse remain uncertain. Methods: This retrospective cohort study included 227 children aged ≥5 years with strictly defined PMNE who achieved complete remission following a standardized 3-month treatment protocol (alarm therapy, desmopressin, or desmopressin plus oxybutynin). All children underwent ICCS-based assessment, including physical examination, urinalysis, ultrasonography, UFM, a 48 h frequency/volume (F/V) diary, and post-void residual measurement. One year after treatment discontinuation, patients were reassessed using a 14-day wet-night diary. Predictors of relapse were analyzed using comparative statistics. Result: At 1-year follow-up, 48.5% of children experienced relapse. Age, sex, treatment modality, family history, and baseline wet-night frequency were not associated with relapse (p > 0.05). Diary-based FBC was significantly higher than UFM-based capacity (p < 0.001). Reduced diary-based mean FBC/EBC ratios were significantly more common among relapsing children (p < 0.001), whereas UFM-derived ratios showed no significant difference (p = 0.052). ROC analysis demonstrated moderate discriminatory performance for diary-based FBC/EBC (AUC 0.671). A ratio > 79% predicted sustained remission with 83.6% specificity and a positive predictive value of 73.5%. Conclusions: Diary-derived bladder capacity is the strongest predictor of long-term relapse in PMNE and outperforms UFM-based assessment. A mean FBC/EBC ratio > 79% provides a clinically useful threshold for identifying children at low risk of recurrence. Those with reduced diary-based capacity may benefit from closer follow-up or extended maintenance therapy. Full article

Background/Objectives: Primary nocturnal enuresis (PNE) is a common condition that adversely affects the quality of life of both children and their families. It is known to have a multifactorial pathogenesis. This study aimed to evaluate serum levels of 25-hydroxyvitamin D (25OHD), vitamin B12, folic acid, and ferritin in children diagnosed with PNE and to investigate the impact of correcting detected deficiencies on the number of wet nights. Methods: A total of 150 pediatric patients diagnosed with monosymptomatic primary nocturnal enuresis (PNE) who had previously undergone standard urotherapy without clinical improvement were included in this study. Serum levels of vitamin B12 and 25-hydroxyvitamin D (25OHD) were assessed, and patients with deficiencies were identified. Vitamin supplementation was administered to those with deficient/insufficient levels. The number of wet nights was recorded at monthly follow-up visits to monitor clinical response. Results: Only 14% of the 150 patients had no detectable vitamin deficiencies. A deficiency in serum vitamin B12 levels was observed in 78.6% of patients, while 41.3% had reduced 25-hydroxyvitamin D (25OHD) levels. Concurrent deficiencies in both 25OHD and vitamin B12 were detected in 34% of the patients. No folate deficiency was observed in any patient. Notably, vitamin supplementation alone resulted in successful enuresis management in 77.6% of the patients. Conclusions: A high prevalence of vitamin B12 and 25-hydroxyvitamin D (25OHD) deficiencies was identified among patients diagnosed with primary nocturnal enuresis (PNE). Significant improvements in nocturnal dryness were achieved solely through correction of these deficiencies, without the use of desmopressin therapy. These findings suggest that targeted vitamin supplementation may play a crucial role in enhancing the success rate of standard urotherapy in the management of PNE. Full article