Hyperventilation response in the electroencephalogram and psychiatric problems in children with primary monosymptomatic nocturnal enuresis

Abstract

Objectives: The aim of this study was to determine the frequency of an increased hyperventilation (HV) response in the electroencephalogram and to compare the results of psychometric assessments and electroencephalography (EEG) patterns in children with and without primary monosymptomatic nocturnal enuresis and in dry siblings of enuretics. We also compared the results of psychometric assessments and EEG patterns between enuretic and non‐enuretic children.

Material and Methods: The study included 89 children divided into three groups: 41 with primary monosymptomatic nocturnal enuresis, their 29 dry siblings and 19 with no history of voiding dysfunction (controls). Resting EEG changes were evaluated in all children. In addition to a psychiatric evaluation, the Maudsley Obsessive Compulsive Questionnaire, the Beck Child Depression Inventory and the State and Trait Anxiety Inventory for Children were used to assess obsessive—compulsive disorder, depression and anxiety, respectively.

Results: The time at which real words were first spoken occurred significantly later in enuretic children (p < 0.01). The frequency of EEG abnormalities was significantly higher in the enuresis group and in their dry siblings than in the control group (p < 0.01). Additionally, as an indicator of cortical dysmaturity, an increased HV response was observed more often in enuretic children and their dry siblings than in the control group (p < 0.001). Anxiety scores for the enuretic children were higher than those for the controls (p < 0.01). There was no significant difference in psychiatric problems between the enuresis and control groups (p > 0.05).

Conclusions: The increased frequency of a high‐level HV response in resting‐state EEG recordings and the anxiety scores suggested that delayed cortical maturity and high anxiety may be important factors in the pathogenesis of primary monosymptomatic nocturnal enuresis. The HV responses in the dry siblings of the enuretic children may emphasize the relationship between insufficient cerebral maturation and the genetic origin of nocturnal enuresis.

• dry siblings
• electroencephalography
• hyperventilation response
• psychiatric problems
• primary monosymptomatic nocturnal enuresis