Exploring central sensitization symptoms in children with ADHD and their parents: a case-control study

Background Emerging research suggests a link between attention deficit hyperactivity disorder (ADHD) and central sensitization (CS), a condition characterized by heightened sensitivity to pain and sensory stimuli. This study aimed to measure the severity of CS symptoms in children with ADHD and in their parents; compare results with those of a neurotypical group; and explore associations between CS symptoms and pain intensity as well as potential familial patterns. Methods Participants included 37 children with ADHD (mean age = 11.54 years; 62.2% male) and 29 neurotypical children (mean age = 13.07 years; 58.6% male). Children completed the Central Sensitization Inventory (CSI) – Child and Adolescent Version and rated their pain intensity at the time of assessment and over the past week. One parent per child completed the adult version of the CSI. Results Children with ADHD reported significantly higher CSI-indexed CS symptom scores than those in the comparison group ( p < 0.001). In categorical analyses, neurotypical children were significantly more likely to fall into the subclinical (lowest symptom) CS range (adjusted p < 0.005). Children with ADHD also reported significantly greater pain intensity both currently ( p = 0.016) and over the past week ( p = 0.003). Stronger correlations between CSI-indexed CS and self-reported pain were observed in the ADHD group, particularly for current pain (ρ = 0.66, p = 0.002). Parents of children with ADHD also had elevated CS scores ( p = 0.003), with the majority falling in the severe range. A moderate correlation between parent and child CSI-indexed CS scores was observed across the entire sample (ρ = 0.47, p = 0.002), while a strong correlation between parents’ CS scores and their own medical conditions was found only in the ADHD group (ρ = 0.66, p = 0.002). Conclusions Children with ADHD, and their parents, reported elevated CSI-indexed CS symptoms and pain intensity, suggesting that CS symptoms may represent a clinically relevant feature in some ADHD presentations. These findings support the value of considering sensory and pain-related assessments in ADHD evaluations and highlight the need for further research into potential mechanisms and integrative interventions that may improve outcomes and reduce functional impairment in pediatric neuropsychiatric conditions. Clinical trial number Not applicable.