Evaluation of Benign Joint Hypermobility and Serum Prolidase Levels in Children Diagnosed With Attention-Deficit/Hyperactivity Disorder (ADHD) Compared to Healthy Controls

This cross-sectional observational study investigates the clinical and biochemical relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and Benign Joint Hypermobility Syndrome (BJHS) in pediatric patients. The primary objective is to evaluate the prevalence of BJHS in children diagnosed with ADHD and compare serum prolidase levels with those of healthy controls. The study also explores whether the severity of ADHD symptoms correlates with serum prolidase activity. Clinical assessments include the Conners Parent Rating Scale, Beighton Score, and serum prolidase measurement using ELISA. This research aims to provide new insights into the potential connective tissue-neurodevelopmental link and contribute to early screening frameworks for children with ADHD.

Inclusion Criteria: * Children aged between 6 and 12 years * ADHD diagnosis based on DSM-5 criteria (for patient group) * Healthy children with no known psychiatric or systemic disease (for control group) * Willingness of the parents or legal guardians to participate and provide informed consent * Ability to complete the required clinical assessments (CPRS-R:S, Beighton Score, blood sample) Exclusion Criteria: * Presence of chronic systemic diseases (e.g., autoimmune disorders, connective tissue diseases, metabolic syndromes) * History of neurodegenerative or severe neurological disorders Intellectual disability or autism spectrum disorder diagnosis * Use of medications that may affect prolidase enzyme activity (e.g., corticosteroids, immunosuppressants) * Any orthopedic or musculoskeletal condition interfering with Beighton assessment * Incomplete clinical or laboratory data * Refusal to participate or lack of parental consent