Relationships Between ADHD, Autism, and Sensory Issues in the Context of Hypermobility and Ehlers-Danlos Syndrome

Prevalence and Symptoms

Recent research suggests a significant overlap between Ehlers-Danlos Syndrome (EDS), particularly hypermobile EDS (hEDS), and neurodiverse conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and various sensory processing issues. This intersection has led to increased interest in understanding the shared mechanisms and the impact these conditions have on individuals with EDS. Medical research and investigation has only just begun to see the relationship.

Prevalence:

• Studies indicate that ADHD may be more prevalent among individuals with hEDS than in the general population, with some estimates suggesting rates as high as 30-50% [Source: https://pubmed.ncbi.nlm.nih.gov/28164292/].
• Autism Spectrum Disorder (ASD) is also observed at higher rates in the EDS population, with research indicating that children with hEDS are more likely to be diagnosed with ASD compared to their non-hypermobile peers [Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826936/].
• Sensory processing issues, including hyper- or hypo-sensitivity to stimuli such as light, sound, and touch, are frequently reported by individuals with EDS, often complicating the management of other symptoms.

Symptoms associated with these neurodiverse conditions in the context of EDS include:

• ADHD: Inattention, hyperactivity, impulsivity, difficulty organizing tasks, and problems with time management.
• Autism Spectrum Disorder (ASD): Challenges with social interaction and communication, repetitive behaviors, and heightened sensitivity to sensory input.
• Sensory Processing Disorder (SPD): Overreaction or underreaction to sensory stimuli, difficulty with coordination and balance, and discomfort in certain environments.

Theories on the Link Between Neurodiversity and EDS

Several theories have been proposed to explain the link between neurodiverse conditions like ADHD, ASD, and sensory issues in individuals with EDS, but no research yet has provided answers:

1. Neurological Development: The same genetic factors that contribute to the connective tissue abnormalities seen in EDS may also affect the development and function of the nervous system, leading to a higher likelihood of neurodevelopmental conditions like ADHD and ASD.
2. Autonomic Nervous System Dysfunction: Dysautonomia, a common comorbidity in EDS, can influence brain function and may exacerbate symptoms of ADHD, ASD, and sensory processing issues. Autonomic dysfunction can affect blood flow and oxygenation to the brain, potentially contributing to cognitive and sensory processing challenges.
3. Sensory Integration and Connective Tissue: The connective tissue abnormalities in EDS may impact the proprioceptive and vestibular systems, which are essential for sensory integration. This can lead to difficulties in processing sensory information, in proprioception (the sense of our body in space) and interoception (awareness of our internal systems such as hunger) issues, contributing to the sensory issues commonly seen in this population.
4. Inflammatory and Immune Responses: Emerging research suggests that immune dysregulation and chronic inflammation, which are seen in both EDS and neurodiverse conditions, may play a role in the co-occurrence of these conditions. Inflammatory processes could affect brain development and function, leading to neurodiverse traits.

Latest Medical Research

Recent studies have provided new insights into the relationship between EDS, neurodiversity, and associated conditions:

• Neuroimaging Studies: Advances in neuroimaging are helping to identify structural and functional differences in the brains of individuals with neurodiverse conditions. These studies are revealing potential biomarkers that could explain the overlap or correlation yet to be determined [Source: https://www.frontiersin.org/articles/10.3389/fnins.2018.00403/full].
• Genetic Research: Genetic studies are investigating the shared genetic pathways that may predispose individuals to both EDS and neurodiverse conditions. Researchers are exploring how specific gene mutations associated with connective tissue disorders may also influence neurodevelopment [Source: https://www.nature.com/articles/s41576-019-0091-6].
• Sensory Processing Interventions: Research into sensory processing therapies for individuals with EDS is ongoing, with studies focusing on occupational therapy approaches that can help manage sensory issues using Occupational Therapy (OT) [Source: https://journals.sagepub.com/doi/10.1177/0308022617751550].
• Behavioral and Pharmacological Treatments: There is growing interest in the effectiveness of both behavioral interventions and pharmacological treatments for managing ADHD and ASD symptoms in individuals with EDS. These studies aim to tailor therapies to the unique needs of this population [Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721899/].

Primary Nonprofits and Advocacy Organizations

Several nonprofits and advocacy organizations are actively involved in researching and supporting individuals with EDS and related neurodiverse conditions:

1. CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder): While focused on ADHD, CHADD provides resources and support for individuals with ADHD and related conditions, including those who may also have EDS.
2. Autism Society: This organization supports individuals with autism and their families, offering resources and advocating for better understanding and treatment of ASD, including in the context of EDS.
3. Sensory Processing Disorder Foundation: Dedicated to advancing research and treatment for sensory processing disorders, this organization provides resources for those affected by SPD, including individuals with EDS.
4. Neurodiversity Foundation: This organization promotes awareness and acceptance of neurodiversity, supporting individuals with ADHD, ASD, and other neurodiverse conditions, including those with comorbid EDS.

The intersection of EDS, hypermobility, and neurodiverse conditions such as ADHD, ASD, and sensory processing issues is an emerging area of research fascinating many. Stay tuned for more research to come out of the UK’s Brighton and Sussex Medical School with Dr. Jessica Eccles.