Research Article
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An Examination of the 2D:4D Ratio, Handedness and Footedness in Attention Deficit Hyperactivity Disorder

Year 2023, Volume: 7 Issue: 3, 249 - 253, 31.12.2023
https://doi.org/10.30565/medalanya.1393223

Abstract

Aim: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition more common in boys than girls, although this gender variation has yet to be explained. The purpose of this study was to examine hand 2D:4D ratios and their association with ADHD. The study was also intended to compare hand 2D:4D ratios according to hand and foot dominance in individuals with ADHD.

Methods: 168 children were included in the study, 91 diagnosed with ADHD and 77 healthy volunteers. All participants were evaluated via DSM-5 based psychiatric examinations, and their sociodemographic data were collected using forms prepared by the authors. The participants’ ADHD symptoms were assessed using the Conners’ Parent Rating Scale-Revised Short Form. 2D:4D ratios were determined by measuring the lengths of the bilateral second and fourth fingers using a digital compass. Hand and foot dominances were determined by evaluation in a clinical setting. The scores obtained were then compared.

Results: Lower right and left hand 2D:4D ratios were determined in the individuals with ADHD than in the healthy controls (p=0.001 for both). No correlation was found between ADHD subscales and right or left hand 2D:4D ratios in the case group. No differences in 2D:4D ratios were also observed according to hand and foot dominances in the case group.

Conclusion: This study produced important findings concerning whether hand 2D:4D ratios can be used as a marker of ADHD. We think that the data obtained may be of assistance to other studies assessing the phenotype characteristics of individuals with ADHD.

Ethical Statement

In this study, national and international ethical rules are observed.

References

  • 1. Sanwo O, Huzair H. What’s new in attention-deficit/hyperactivity disorder: updates on assessment and management. Paediatr Child Health. 2022;32(8):282-9. doi: 10.1016/j.paed.2022.05.002.
  • 2. Gül H, Öncü Çetinkaya B. Environmental Factors in the Etiology of Attention Deficit Hyperactivity Disorder. Current Approaches in Psychiatry. 2018;10(2):138-75. doi: 10.18863/pgy.358094.
  • 3. Davies W. Sex differences in Attention Deficit Hyperactivity Disorder: Candidate genetic and endocrine mechanisms. Front Neuroendocrinol. 2014;35(3):331-46. doi:10.1016/j.yfrne.2014.03.003.
  • 4. Else-Quest NM, Hyde JS, Goldsmith HH, Van Hulle CA. Gender differences in temperament: A meta-analysis. Psychol Bull. 2006;132(1):33-72. doi: 10.1037/0033-2909.132.1.33.
  • 5. Li M, Usui N, Shimada S. Prenatal Sex Hormone Exposure Is Associated with the Development of Autism Spectrum Disorder. Int J Mol Sci. 2023;24(3):2203. doi: 10.3390/ijms24032203.
  • 6. Işık Ü, Kılıç F, Aktepe E, Tanrıtanır B. The relationship between second-to-fourth digit ratios, attention-deficit/hyperactivity disorder symptoms, aggression, and intelligence levels in boys with attention-deficit/hyperactivity disorder. Psychiatry Investig. 2020;17(6):596-602. doi: 10.30773/pi.2020.0003.
  • 7. Manning J, Kilduff L, Cook C, Crewther B, Fink B. Digit Ratio (2D:4D): A Biomarker for Prenatal Sex Steroids and Adult Sex Steroids in Challenge Situations. Front Endocrinol (Lausanne). 2014;5:9. doi: 10.3389/fendo.2014.00009.
  • 8. Martel MM, Gobrogge KL, Breedlove SM, Nigg JT. Masculinized Finger-Length Ratios of Boys, but Not Girls, Are Associated With Attention-Deficit/Hyperactivity Disorder. Behav Neurosci. 2008;122(2):273-81. doi: 10.1037/0735-7044.122.2.273
  • 9. Lemiere J, Boets B, Danckaerts M. No association between the 2D:4D fetal testosterone marker and multidimensional attentional abilities in children with ADHD. Dev Med Child Neurol. 2010;52(9):e202-8. doi: 10.1111/J.1469-8749.2010.03684.X.
  • 10. Soysal AŞ, Arhan E, Aktürk A, Can H. Hand Dominance and Factors Determining Hand Dominance. Türkiye Çocuk Hastalıkları Dergisi. 2007;1(2):60-68.
  • 11. Nastou E, Ocklenburg S, Hoogman M, Papadatou-Pastou M. Handedness in ADHD: Meta-Analyses. Neuropsychol Rev. 2022;32(4):877-92. doi: 10.1007/s11065-021-09530-3.
  • 12. Lin HL, Tsuang HC. Handedness and Attention Deficit/Hyperactivity Disorder Symptoms in College Students. Psychiatr Q. 2018;89(1):103-10. doi: 10.1007/s11126-017-9517-8.
  • 13. Rodriguez A, Kaakinen M, Moilanen I, et al. Mixed-handedness is linked to mental health problems in children and adolescents. Pediatrics. 2010;125(2):e340-8. doi: 10.1542/peds.2009-1165.
  • 14. Ghanizadeh A. Lack of association of handedness with inattention and hyperactivity symptoms in ADHD. J Atten Disord. 2013;17(4):302-7. doi: 10.1177/1087054711429789.
  • 15. Richards G, Medland SE, Beaton AA. Digit ratio (2D:4D) and handedness: A meta-analysis of the available literature. Laterality. 2021;26(4):421-84. doi: 10.1080/1357650X.2020.1862141.
  • 16. Conners CK, Sitarenios G, Parker JDA, Epstein JN. The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26(4):257-68. doi: 10.1023/a:1022602400621.
  • 17. Kaner S, Büyüköztürk Ş, İşeri E. Conners Parent Rating Scale-Revised Short: Turkish Standardization Study. Archives of Neuropsychiatry. 2013;50(2):100-109. doi: 10.4274/npa.y 6219.
  • 18. Stevenson JC, Everson PM, Williams DC, Hipskind G, Grimes M, Mahoney ER. Attention deficit/hyperactivity disorder (ADHD) symptoms and digit ratios in a college sample. Am J Hum Biol. 2007;19(1):41-50. doi: 10.1002/ajhb.20571.
  • 19. Wang LJ, Lee SY, Chou MC, Lee MJ, Chou WJ. Dehydroepiandrosterone sulfate, free testosterone, and sex hormone-binding globulin on susceptibility to attention-deficit/hyperactivity disorder. Psychoneuroendocrinology. 2019;103:212-8. doi: 10.1016/j.psyneuen.2019.01.025.
  • 20. Fink B, Manning JT, Williams JHG, Podmore-Nappin C. The 2nd to 4th digit ratio and developmental psychopathology in school-aged children. Pers Individ Dif. 2007;42(2):369-379. doi: 10.1016/j.paid.2006.07.018.
  • 21. Wang LJ, Chou MC, Chou WJ, et al. Potential role of pre- and postnatal testosterone levels in attention-deficit/hyperactivity disorder: Is there a sex difference? Neuropsychiatr Dis Treat. 2017;13:1331-9. doi: 10.2147/NDT.S136717
  • 22. Williams JHG, Greenhalgh KD, Manning JT. Second to fourth finger ratio and possible precursors of developmental psychopathology in preschool children. Early Hum Dev. 2003;72(1):57-65. doi: 10.1016/S0378-3782(03)00012-4.
  • 23. Xu Y, Zheng Y. The digit ratio (2D:4D) in China: A meta-analysis. Am J Hum Biol. 2015;27(3):304-9. doi: 10.1002/ajhb.22639.
  • 24. Hale TS, Smalley SL, Walshaw PD, et al. Atypical EEG beta asymmetry in adults with ADHD. Neuropsychologia. 2010;48(12):3532-9. doi: 10.1016/j.neuropsychologia.2010.08.002.
  • 25. Tran US, Voracek M. Footedness Is Associated With ADHD Symptoms in the Adult General Population. J Atten Disord. 2018;22(3):261-8. doi: 10.1177/1087054715586570.

Dikkat Eksikliği ve Hiperaktivite Bozukluğu Olan Çocuk ve Ergenlerde 2d:4d Oranı, El ve Ayak Dominansının İncelenmesi

Year 2023, Volume: 7 Issue: 3, 249 - 253, 31.12.2023
https://doi.org/10.30565/medalanya.1393223

Abstract

Amaç: Bu çalışmada fetal testosteron maruziyetinin göstergesi olan el 2D:4D oranları ile DEHB arasındaki ilişkinin incelenmesi amaçlanmıştır. Ayrıca DEHB olanlarda el ve ayak tercihlerine göre el 2D:4D oranlarının karşılaştırılması amaçlanmıştır.

Yöntem: Çalışmaya 91 DEHB tanılı ve 77 sağlıklı gönüllü olmak üzere 168 katılımcı ergen alındı. Tüm katılımcılar DSM-5 temelli psikiyatrik muayene ile değerlendirildi ve sosyodemografik verileri araştırmacılar tarafında hazırlanan formlar ile elde edildi. Katılımcıların DEHB belirtileri Conners Anababa Dereceleme Ölçeği-Yenilenmiş Kısa Form (CADÖ-YK) ile değerlendirildi. 2D:4D oranları, her iki elin 2. ve 4. parmak uzunlukları dijital kumpas ile ölçülerek belirlendi. El ve ayak tercihleri klinik ortamda değerlendirilerek belirlendi. Elde edilen skorlar istatistiksel olarak karşılaştırıldı.

Bulgular: DEHB olan bireylerde sağlıklı kontrollere göre sağ ve sol elde daha düşük 2D:4D oranları saptandı (sırasıyla p=0,001, p=0,001). Olgu grubunda DEHB alt ölçekleri ile sağ ve sol el 2D:4D oranları arasında ilişki bulunmadı (p>0.05). Olgu grubunda 2D:4D oranları ile el ve ayak tercihleri arasında fark saptanmadı (p>0.05).

Sonuç: Çalışmamızda 2D:4D oranlarının DEHB de bir belirteç olarak kullanılabileceğine dair önemli sonuçlar elde edilmiştir. Elde ettiğimiz veriler gelecekte DEHB li bireylerin fenotipik özelliklerini değerlendiren diğer çalışmalara katkıda bulunabileceği kanaatindeyiz.

Ethical Statement

Bu çalışmada ulusal ve uluslararası etik kurallara uyulmuştur.

References

  • 1. Sanwo O, Huzair H. What’s new in attention-deficit/hyperactivity disorder: updates on assessment and management. Paediatr Child Health. 2022;32(8):282-9. doi: 10.1016/j.paed.2022.05.002.
  • 2. Gül H, Öncü Çetinkaya B. Environmental Factors in the Etiology of Attention Deficit Hyperactivity Disorder. Current Approaches in Psychiatry. 2018;10(2):138-75. doi: 10.18863/pgy.358094.
  • 3. Davies W. Sex differences in Attention Deficit Hyperactivity Disorder: Candidate genetic and endocrine mechanisms. Front Neuroendocrinol. 2014;35(3):331-46. doi:10.1016/j.yfrne.2014.03.003.
  • 4. Else-Quest NM, Hyde JS, Goldsmith HH, Van Hulle CA. Gender differences in temperament: A meta-analysis. Psychol Bull. 2006;132(1):33-72. doi: 10.1037/0033-2909.132.1.33.
  • 5. Li M, Usui N, Shimada S. Prenatal Sex Hormone Exposure Is Associated with the Development of Autism Spectrum Disorder. Int J Mol Sci. 2023;24(3):2203. doi: 10.3390/ijms24032203.
  • 6. Işık Ü, Kılıç F, Aktepe E, Tanrıtanır B. The relationship between second-to-fourth digit ratios, attention-deficit/hyperactivity disorder symptoms, aggression, and intelligence levels in boys with attention-deficit/hyperactivity disorder. Psychiatry Investig. 2020;17(6):596-602. doi: 10.30773/pi.2020.0003.
  • 7. Manning J, Kilduff L, Cook C, Crewther B, Fink B. Digit Ratio (2D:4D): A Biomarker for Prenatal Sex Steroids and Adult Sex Steroids in Challenge Situations. Front Endocrinol (Lausanne). 2014;5:9. doi: 10.3389/fendo.2014.00009.
  • 8. Martel MM, Gobrogge KL, Breedlove SM, Nigg JT. Masculinized Finger-Length Ratios of Boys, but Not Girls, Are Associated With Attention-Deficit/Hyperactivity Disorder. Behav Neurosci. 2008;122(2):273-81. doi: 10.1037/0735-7044.122.2.273
  • 9. Lemiere J, Boets B, Danckaerts M. No association between the 2D:4D fetal testosterone marker and multidimensional attentional abilities in children with ADHD. Dev Med Child Neurol. 2010;52(9):e202-8. doi: 10.1111/J.1469-8749.2010.03684.X.
  • 10. Soysal AŞ, Arhan E, Aktürk A, Can H. Hand Dominance and Factors Determining Hand Dominance. Türkiye Çocuk Hastalıkları Dergisi. 2007;1(2):60-68.
  • 11. Nastou E, Ocklenburg S, Hoogman M, Papadatou-Pastou M. Handedness in ADHD: Meta-Analyses. Neuropsychol Rev. 2022;32(4):877-92. doi: 10.1007/s11065-021-09530-3.
  • 12. Lin HL, Tsuang HC. Handedness and Attention Deficit/Hyperactivity Disorder Symptoms in College Students. Psychiatr Q. 2018;89(1):103-10. doi: 10.1007/s11126-017-9517-8.
  • 13. Rodriguez A, Kaakinen M, Moilanen I, et al. Mixed-handedness is linked to mental health problems in children and adolescents. Pediatrics. 2010;125(2):e340-8. doi: 10.1542/peds.2009-1165.
  • 14. Ghanizadeh A. Lack of association of handedness with inattention and hyperactivity symptoms in ADHD. J Atten Disord. 2013;17(4):302-7. doi: 10.1177/1087054711429789.
  • 15. Richards G, Medland SE, Beaton AA. Digit ratio (2D:4D) and handedness: A meta-analysis of the available literature. Laterality. 2021;26(4):421-84. doi: 10.1080/1357650X.2020.1862141.
  • 16. Conners CK, Sitarenios G, Parker JDA, Epstein JN. The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26(4):257-68. doi: 10.1023/a:1022602400621.
  • 17. Kaner S, Büyüköztürk Ş, İşeri E. Conners Parent Rating Scale-Revised Short: Turkish Standardization Study. Archives of Neuropsychiatry. 2013;50(2):100-109. doi: 10.4274/npa.y 6219.
  • 18. Stevenson JC, Everson PM, Williams DC, Hipskind G, Grimes M, Mahoney ER. Attention deficit/hyperactivity disorder (ADHD) symptoms and digit ratios in a college sample. Am J Hum Biol. 2007;19(1):41-50. doi: 10.1002/ajhb.20571.
  • 19. Wang LJ, Lee SY, Chou MC, Lee MJ, Chou WJ. Dehydroepiandrosterone sulfate, free testosterone, and sex hormone-binding globulin on susceptibility to attention-deficit/hyperactivity disorder. Psychoneuroendocrinology. 2019;103:212-8. doi: 10.1016/j.psyneuen.2019.01.025.
  • 20. Fink B, Manning JT, Williams JHG, Podmore-Nappin C. The 2nd to 4th digit ratio and developmental psychopathology in school-aged children. Pers Individ Dif. 2007;42(2):369-379. doi: 10.1016/j.paid.2006.07.018.
  • 21. Wang LJ, Chou MC, Chou WJ, et al. Potential role of pre- and postnatal testosterone levels in attention-deficit/hyperactivity disorder: Is there a sex difference? Neuropsychiatr Dis Treat. 2017;13:1331-9. doi: 10.2147/NDT.S136717
  • 22. Williams JHG, Greenhalgh KD, Manning JT. Second to fourth finger ratio and possible precursors of developmental psychopathology in preschool children. Early Hum Dev. 2003;72(1):57-65. doi: 10.1016/S0378-3782(03)00012-4.
  • 23. Xu Y, Zheng Y. The digit ratio (2D:4D) in China: A meta-analysis. Am J Hum Biol. 2015;27(3):304-9. doi: 10.1002/ajhb.22639.
  • 24. Hale TS, Smalley SL, Walshaw PD, et al. Atypical EEG beta asymmetry in adults with ADHD. Neuropsychologia. 2010;48(12):3532-9. doi: 10.1016/j.neuropsychologia.2010.08.002.
  • 25. Tran US, Voracek M. Footedness Is Associated With ADHD Symptoms in the Adult General Population. J Atten Disord. 2018;22(3):261-8. doi: 10.1177/1087054715586570.
There are 25 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Article
Authors

Orhan Kocaman 0000-0002-7504-5604

Tayfun Kara 0000-0002-2156-3457

Pınar Aydoğan Avşar 0000-0001-5938-3243

Tacettin Kuru 0000-0002-0313-558X

Publication Date December 31, 2023
Submission Date November 20, 2023
Acceptance Date November 30, 2023
Published in Issue Year 2023 Volume: 7 Issue: 3

Cite

Vancouver Kocaman O, Kara T, Aydoğan Avşar P, Kuru T. An Examination of the 2D:4D Ratio, Handedness and Footedness in Attention Deficit Hyperactivity Disorder. Acta Med. Alanya. 2023;7(3):249-53.

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