P4.030: The Association Between Skin Barrier Integrity and Symptoms of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Healthy and Allergic Children

Background: To evaluate skin integrity in allergic and healthy children by electrical impedance spectroscopy (EIS) and to investigate its relationship with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) symptoms.

Methods: Skin permeability was measured in the left forearm and antecubital area with EIS in healthy and allergic children, and Z1 and MIX scores were obtained. The Autism Spectrum Screening Questionnaire (ASSQ) and ADHD scale questionnaire were answered by the parents of the participants. A total score greater than 16 on the ASSQ was considered a cut-off value for autism risk.

Results: Sixty-one allergic children and 10 healthy children with a median (age of 109 (84-163) and 154 (102-185) months participated in the study. In allergic children, ADHD total and ASSQ social scores [ADHD:10 (5-16), ASSQ Social:2 (0-3)] were higher compared to healthy children [ADHD:5 (0-12), ASSQ Social:1 (0-2)] (pADHD=0.002, pASSQSocial=0.035). The frequency of children with a high risk of autism (ASSQ Total Score16) was higher in the group with allergic diseases (16.8%) compared to healthy subjects (0%) (p=0.044). In EIS measurements performed in the antecubital area, Z1 and MIX scores were lower in allergic children [Z1:64.9 (43.9-97.6), MIX:7.7 (6.4-8.9)] compared to healthy children [Z1:83.6 (62.8-180.2), MIX:8.8 (7.1-9.7)] (pZ1=0.010, pMIX=0.040). A significant negative correlation was observed between antecubital EIS Z1 and ADHD questionnaire scores (r=-0.3, p< 0.001).

Conclusion: The lower Z1 and MIX scores obtained by the EIS method in allergic children compared to healthy children indicate that skin epithelial integrity is decreased in allergic children. The higher ADHD and ASD symptom scores in allergic children compared to healthy children and the significant negative correlation of Z1 and MIX scores with ADHD questionnaire scores suggest that skin permeability parameters may have the potential to function as a biomarker to identify children at risk for ADHD and ASD. Given the increasing role of digital health technologies in pediatrics, integrating a simple measurement like EIS into clinical practice may enhance early screening and monitoring of neurodevelopmental disorders in allergic children.