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Hubers N, Hagenbeek FA, Pool R, Déjean S, Harms AC, Roetman PJ, van Beijsterveldt CEM, Fanos V, Ehli EA, Vermeiren RRJM, Bartels M, Hottenga JJ, Hankemeier T, van Dongen J, Boomsma DI. Integrative multi-omics analysis of genomic, epigenomic, and metabolomics data leads to new insights for Attention-Deficit/Hyperactivity Disorder. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32955. [PMID: 37534875 DOI: 10.1002/ajmg.b.32955] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 06/13/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023]
Abstract
The evolving field of multi-omics combines data and provides methods for simultaneous analysis across several omics levels. Here, we integrated genomics (transmitted and non-transmitted polygenic scores [PGSs]), epigenomics, and metabolomics data in a multi-omics framework to identify biomarkers for Attention-Deficit/Hyperactivity Disorder (ADHD) and investigated the connections among the three omics levels. We first trained single- and next multi-omics models to differentiate between cases and controls in 596 twins (cases = 14.8%) from the Netherlands Twin Register (NTR) demonstrating reasonable in-sample prediction through cross-validation. The multi-omics model selected 30 PGSs, 143 CpGs, and 90 metabolites. We confirmed previous associations of ADHD with glucocorticoid exposure and the transmembrane protein family TMEM, show that the DNA methylation of the MAD1L1 gene associated with ADHD has a relation with parental smoking behavior, and present novel findings including associations between indirect genetic effects and CpGs of the STAP2 gene. However, out-of-sample prediction in NTR participants (N = 258, cases = 14.3%) and in a clinical sample (N = 145, cases = 51%) did not perform well (range misclassification was [0.40, 0.57]). The results highlighted connections between omics levels, with the strongest connections between non-transmitted PGSs, CpGs, and amino acid levels and show that multi-omics designs considering interrelated omics levels can help unravel the complex biology underlying ADHD.
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Affiliation(s)
- Nikki Hubers
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development (AR&D) Research Institute, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Fiona A Hagenbeek
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - René Pool
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Sébastien Déjean
- Toulouse Mathematics Institute, UMR 5219, University of Toulouse, CNRS, Toulouse, France
| | - Amy C Harms
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
- The Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Peter J Roetman
- LUMC-Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari and Neonatal Intensive Care Unit, Cagliari, Italy
| | - Erik A Ehli
- Avera Institute for Human Genetics, Sioux Falls, South Dakota, USA
| | - Robert R J M Vermeiren
- LUMC-Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
- Youz, Parnassia Group, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Jouke Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
- The Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Jenny van Dongen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development (AR&D) Research Institute, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development (AR&D) Research Institute, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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2
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Faraone SV, Bellgrove MA, Brikell I, Cortese S, Hartman CA, Hollis C, Newcorn JH, Philipsen A, Polanczyk GV, Rubia K, Sibley MH, Buitelaar JK. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 2024; 10:11. [PMID: 38388701 DOI: 10.1038/s41572-024-00495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/24/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD; also known as hyperkinetic disorder) is a common neurodevelopmental condition that affects children and adults worldwide. ADHD has a predominantly genetic aetiology that involves common and rare genetic variants. Some environmental correlates of the disorder have been discovered but causation has been difficult to establish. The heterogeneity of the condition is evident in the diverse presentation of symptoms and levels of impairment, the numerous co-occurring mental and physical conditions, the various domains of neurocognitive impairment, and extensive minor structural and functional brain differences. The diagnosis of ADHD is reliable and valid when evaluated with standard diagnostic criteria. Curative treatments for ADHD do not exist but evidence-based treatments substantially reduce symptoms and/or functional impairment. Medications are effective for core symptoms and are usually well tolerated. Some non-pharmacological treatments are valuable, especially for improving adaptive functioning. Clinical and neurobiological research is ongoing and could lead to the creation of personalized diagnostic and therapeutic approaches for this disorder.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA.
| | - Mark A Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chris Hollis
- National Institute for Health and Care Research (NIHR) MindTech MedTech Co-operative and NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jeffrey H Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
- Department of Child & Adolescent Psychiatry, Transcampus Professor KCL-Dresden, Technical University, Dresden, Germany
| | | | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands
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3
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O'Connor L, Carbone S, Gobbo A, Gamble H, Faraone SV. Pediatric attention deficit hyperactivity disorder (ADHD): 2022 updates on pharmacological management. Expert Rev Clin Pharmacol 2023; 16:799-812. [PMID: 37587841 DOI: 10.1080/17512433.2023.2249414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Pediatric attention-deficit disorder (ADHD) impacts a significant percentage of the population world-wide. Pharmacologic treatments have been shown to be safe and effective for managing symptoms. Various medication formulations exist, and new medication agents are continually approved each year. AREAS COVERED This article offers an overview of ADHD, an overview of both stimulant and non-stimulant medication options as well as an overview of stimulant misuse. It explores the medication mechanisms of action and side effect profiles, as well as offering an in-depth summary of the novel agents recently approved and soon-to-be approved for use in youth. PubMed and Medline were utilized. Search terms included children, adolescents, ADHD, and medication. FDA package inserts were reviewed for all medications. EXPERT OPINION New formulations of medications include an evening administered, extended, and delayed-release form of methylphenidate (DR/ER MPH), a methylphenidate pro-drug (serdexmethylphenidate) and an amphetamine patch. The availability of a new SNRI (selective norepinephrine reuptake inhibitor), viloxazine extended-release (VER), and the pending approval of a triple reuptake inhibitor (centanafadine) provides welcome additions to the prescriber's toolbox.
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Affiliation(s)
- Lisa O'Connor
- Department of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephanie Carbone
- Department of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA
| | - Anthony Gobbo
- Department of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA
| | - Hilary Gamble
- Department of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen V Faraone
- Department of Psychiatry, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, NY, USA
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Zhu XN, Li J, Qiu GL, Wang L, Lu C, Guo YG, Yang KX, Cai F, Xu T, Yuan TF, Hu J. Propofol exerts anti-anhedonia effects via inhibiting the dopamine transporter. Neuron 2023; 111:1626-1636.e6. [PMID: 36917979 DOI: 10.1016/j.neuron.2023.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/02/2022] [Accepted: 02/10/2023] [Indexed: 03/15/2023]
Abstract
Lasker's award-winning drug propofol is widely used in general anesthesia. The recreational use of propofol is reported to produce a well-rested feeling and euphoric state; yet, the neural mechanisms underlying such pleasant effects remain unelucidated. Here, we report that propofol actively and directly binds to the dopamine transporter (DAT), but not the serotonin transporter (SERT), which contributes to the rapid relief of anhedonia. Then, we predict the binding mode of propofol by molecular docking and mutation of critical binding residues on the DAT. Fiber photometry recording on awake freely moving mice and [18F] FP-CIT-PET scanning further establishes that propofol administration evokes rapid and lasting dopamine accumulation in nucleus accumbens (NAc). The enhanced dopaminergic tone drives biased activation of dopamine-receptor-1-expressing medium spiny neurons (D1-MSNs) in NAc and reverses anhedonia in chronically stressed animals. Collectively, these findings suggest the therapeutic potential of propofol against anhedonia, which warrants future clinical investigations.
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Affiliation(s)
- Xiao-Na Zhu
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Jie Li
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Gao-Lin Qiu
- Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Lin Wang
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Chen Lu
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Yi-Ge Guo
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Ke-Xin Yang
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Fang Cai
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Tao Xu
- Department of Anesthesiology, Affiliated Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Ji Hu
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China.
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Capuzzi E, Caldiroli A, Auxilia AM, Borgonovo R, Capellazzi M, Clerici M, Buoli M. Biological Predictors of Treatment Response in Adult Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review. J Pers Med 2022; 12:jpm12101742. [PMID: 36294881 PMCID: PMC9605680 DOI: 10.3390/jpm12101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent condition with onset in childhood and in many cases persisting into adulthood. Even though an increasing number of studies have investigated the efficacy of pharmacotherapy in the management of adult ADHD, few authors have tried to identify the biological predictors of treatment response. Objectives: To summarize the available data about the biological markers of treatment response in adults affected by ADHD. Methods: A search on the main biomedical and psychological archives (PubMed, Embase, Scopus, and PsycINFO) was performed. Manuscripts in English, published up to May 2022 and having the biological predictors of treatment response in adults with ADHD as their main topic, were included. Results: A total of 3855 articles was screened. Twenty-two articles were finally included. Most of the manuscripts studied neuroimaging and electrophysiological factors as potential predictors of treatment response in adult ADHD patients. No reliable markers were identified until now. Promising findings on this topic regard genetic polymorphisms in snap receptor (SNARE) proteins and default mode network-striatum connectivity. Conclusions: Even though some biological markers seem promising for the prediction of treatment response in adults affected by ADHD, further studies are needed to confirm the available data in the context of precision medicine.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0392339670
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Riccardo Borgonovo
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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6
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Khoury NM, Radonjić NV, Albert AB, Faraone SV. From Structural Disparities to Neuropharmacology: A Review of Adult Attention-Deficit/Hyperactivity Disorder Medication Treatment. Child Adolesc Psychiatr Clin N Am 2022; 31:343-361. [PMID: 35697389 DOI: 10.1016/j.chc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Adult attention-deficit/hyperactivity disorder (ADHD) is an early-onset disorder with many functional impairments and psychiatric comorbidities. Although no treatment fully mitigates impairments associated with ADHD, effective management is possible with pharmacologic and nonpharmacologic treatments. The etiology and pathophysiology of ADHD are remarkably complex and the disorder is continuously distributed in the population. While these findings have been well documented in studies with predominantly white samples, ADHD may affect racial and ethnic minorities differentially, given diagnostic and treatment disparities. This review provides an updated overview of the epidemiology, etiology, neurobiology, and neuropharmacology of ADHD, addressing racial and ethnic disparities whereby data are available.
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Affiliation(s)
- Nayla M Khoury
- Department of Psychiatry and Behavioral Sciences, Upstate Medical University, Syracuse, NY, USA
| | - Nevena V Radonjić
- Department of Psychiatry and Behavioral Sciences, Upstate Medical University, Syracuse, NY, USA
| | - Avery B Albert
- Clinical Psychology, Syracuse University, Syracuse, NY, USA
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Science, SUNY Upstate Medical University, Institute for Human Performance, Room 3707, 505 Irving Avenue, Syracuse, NY 13210, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Institute for Human Performance, Room 3707, 505 Irving Avenue, Syracuse, NY 13210, USA.
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7
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Balogh L, Pulay AJ, Réthelyi JM. Genetics in the ADHD Clinic: How Can Genetic Testing Support the Current Clinical Practice? Front Psychol 2022; 13:751041. [PMID: 35350735 PMCID: PMC8957927 DOI: 10.3389/fpsyg.2022.751041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/03/2022] [Indexed: 12/12/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with a childhood prevalence of 5%. In about two-thirds of the cases, ADHD symptoms persist into adulthood and often cause significant functional impairment. Based on the results of family and twin studies, the estimated heritability of ADHD approximates 80%, suggests a significant genetic component in the etiological background of the disorder; however, the potential genetic effects on disease risk, symptom severity, and persistence are unclear. This article provides a brief review of the genome-wide and candidate gene association studies with a focus on the clinical aspects, summarizing findings of ADHD disease risk, ADHD core symptoms as dimensional traits, and other traits frequently associated with ADHD, which may contribute to the susceptibility to other comorbid psychiatric disorders. Furthermore, neuropsychological impairment and measures from neuroimaging and electrophysiological paradigms, emerging as potential biomarkers, also provide a prominent target for molecular genetic studies, since they lie in the pathway from genes to behavior; therefore, they can contribute to the understanding of the underlying neurobiological mechanisms and the interindividual heterogeneity of clinical symptoms. Beyond the aforementioned aspects, throughout the review, we also give a brief summary of the genetic results, including polygenic risk scores that can potentially predict individual response to different treatment options and may offer a possibility for personalized treatment for the therapy of ADHD in the future.
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Affiliation(s)
- Lívia Balogh
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Attila J Pulay
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
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Kittel-Schneider S, Arteaga-Henriquez G, Vasquez AA, Asherson P, Banaschewski T, Brikell I, Buitelaar J, Cormand B, Faraone SV, Freitag CM, Ginsberg Y, Haavik J, Hartman CA, Kuntsi J, Larsson H, Matura S, McNeill RV, Ramos-Quiroga JA, Ribases M, Romanos M, Vainieri I, Franke B, Reif A. Non-mental diseases associated with ADHD across the lifespan: Fidgety Philipp and Pippi Longstocking at risk of multimorbidity? Neurosci Biobehav Rev 2021; 132:1157-1180. [PMID: 34757108 DOI: 10.1016/j.neubiorev.2021.10.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022]
Abstract
Several non-mental diseases seem to be associated with an increased risk of ADHD and ADHD seems to be associated with increased risk for non-mental diseases. The underlying trajectories leading to such brain-body co-occurrences are often unclear - are there direct causal relationships from one disorder to the other, or does the sharing of genetic and/or environmental risk factors lead to their occurring together more frequently or both? Our goal with this narrative review was to provide a conceptual synthesis of the associations between ADHD and non-mental disease across the lifespan. We discuss potential shared pathologic mechanisms, genetic background and treatments in co-occurring diseases. For those co-occurrences for which published studies with sufficient sample sizes exist, meta-analyses have been published by others and we discuss those in detail. We conclude that non-mental diseases are common in ADHD and vice versa and add to the disease burden of the patient across the lifespan. Insufficient attention to such co-occurring conditions may result in missed diagnoses and suboptimal treatment in the affected individuals.
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Affiliation(s)
- Sarah Kittel-Schneider
- Center of Mental Health, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany.
| | - Gara Arteaga-Henriquez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - Alejandro Arias Vasquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Phil Asherson
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Isabell Brikell
- National Centre for Register-based Research, Department of Economics and Business Economics Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Aarhus, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, 171 77, Stockholm, Sweden
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, the Netherlands
| | - Bru Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, D-60528 Frankfurt am Main, Germany
| | - Ylva Ginsberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden
| | - Jan Haavik
- Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, 171 77, Stockholm, Sweden; Örebro University, School of Medical Sciences, Campus USÖ, S-701 82 Örebro, Sweden
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany
| | - Rhiannon V McNeill
- Center of Mental Health, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribases
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany
| | - Isabella Vainieri
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Barbara Franke
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany
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Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, Newcorn JH, Gignac M, Al Saud NM, Manor I, Rohde LA, Yang L, Cortese S, Almagor D, Stein MA, Albatti TH, Aljoudi HF, Alqahtani MMJ, Asherson P, Atwoli L, Bölte S, Buitelaar JK, Crunelle CL, Daley D, Dalsgaard S, Döpfner M, Espinet S, Fitzgerald M, Franke B, Gerlach M, Haavik J, Hartman CA, Hartung CM, Hinshaw SP, Hoekstra PJ, Hollis C, Kollins SH, Sandra Kooij JJ, Kuntsi J, Larsson H, Li T, Liu J, Merzon E, Mattingly G, Mattos P, McCarthy S, Mikami AY, Molina BSG, Nigg JT, Purper-Ouakil D, Omigbodun OO, Polanczyk GV, Pollak Y, Poulton AS, Rajkumar RP, Reding A, Reif A, Rubia K, Rucklidge J, Romanos M, Ramos-Quiroga JA, Schellekens A, Scheres A, Schoeman R, Schweitzer JB, Shah H, Solanto MV, Sonuga-Barke E, Soutullo C, Steinhausen HC, Swanson JM, Thapar A, Tripp G, van de Glind G, van den Brink W, Van der Oord S, Venter A, Vitiello B, Walitza S, Wang Y. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neurosci Biobehav Rev 2021; 128:789-818. [PMID: 33549739 PMCID: PMC8328933 DOI: 10.1016/j.neubiorev.2021.01.022] [Citation(s) in RCA: 422] [Impact Index Per Article: 140.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. METHODS We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. RESULTS We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. CONCLUSIONS Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, Psychiatry Research Division, SUNY Upstate Medical University, Syracuse, NY, USA; World Federation of ADHD, Switzerland; American Professional Society of ADHD and Related Disorders (APSARD), USA.
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Child and Adolescent Psychiatrist's Representative, Zentrales-ADHS-Netz, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing, China; Beijing Key Laboratory of Mental Disorders, Beijing, China; Beijing Institute for Brain Disorders, Beijing, China; Asian Federation of ADHD, China; Chinese Society of Child and Adolescent Psychiatry, China
| | - Joseph Biederman
- Clinical & Research Programs in Pediatric Psychopharmacology & Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Jeffrey H Newcorn
- American Professional Society of ADHD and Related Disorders (APSARD), USA; Departments of Psychiatry and Pediatrics, Division of ADHD and Learning Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martin Gignac
- Department of Child and Adolescent Psychiatry, Montreal Children's Hospital, MUHC, Montreal, Canada; Child and Adolescent Psychiatry Division, McGill University, Montreal, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | | | - Iris Manor
- Chair, Israeli Society of ADHD (ISA), Israel; Co-chair of the neurodevelopmental section in EPA (the European Psychiatric Association), France
| | - Luis Augusto Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - Li Yang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton,UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; University of Nottingham, Nottingham, UK
| | - Doron Almagor
- University of Toronto, SickKids Centre for Community Mental Health, Toronto, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | - Mark A Stein
- University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Turki H Albatti
- Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Haya F Aljoudi
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Mohammed M J Alqahtani
- Clinical Psychology, King Khalid University, Abha, Saudi Arabia; Saudi ADHD Society, Saudi Arabia
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Science, Moi University School of Medicine, Eldoret, Kenya; Brain and Mind Institute, and Department of Internal Medicine, Medical College East Africa, the Aga Khan University, Kenya; African College of Psychopharmacology, Kenya; African Association of Psychiatrists, Kenya
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Sweden; Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Cleo L Crunelle
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Dept. of Psychiatry, Brussel, Belgium; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine University of Nottingham, Nottingham, UK; NIHR MindTech Mental Health MedTech Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany; Zentrales-ADHS-Netz, Germany
| | | | | | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Professional Board, ADHD Europe, Belgium
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Catharina A Hartman
- University of Groningen, Groningen, the Netherlands; University Medical Center Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; ADHD Across the Lifespan Network from European College of Neuropsychopharmacology(ECNP), the Netherlands
| | | | - Stephen P Hinshaw
- University of California, Berkeley, CA, USA; University of California, San Francisco, CA, USA
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Chris Hollis
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK; NIHR MindTech MedTech Co-operative, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Scott H Kollins
- Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - J J Sandra Kooij
- Amsterdam University Medical Center (VUMc), Amsterdam, the Netherlands; PsyQ, The Hague, the Netherlands; European Network Adult ADHD, the Netherlands; DIVA Foundation, the Netherlands; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Tingyu Li
- Growth, Development and Mental Health Center for Children and Adolescents, Children's Hospital of Chongqing Medical University, Chongqing, China; National Research Center for Clinical Medicine of Child Health and Disease, Chongqing, China; The Subspecialty Group of Developmental and Behavioral Pediatrics, the Society of Pediatrics, Chinese Medical Association, China
| | - Jing Liu
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; The Chinese Society of Child and Adolescent Psychiatry, China; The Asian Society for Child and Adolescent Psychiatry and Allied Professions, China
| | - Eugene Merzon
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Leumit Health Services, Tel Aviv, Israel; Israeli Society of ADHD, Israel; Israeli National Diabetes Council, Israel
| | - Gregory Mattingly
- Washington University, St. Louis, MO, USA; Midwest Research Group, St Charles, MO, USA
| | - Paulo Mattos
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Brazilian Attention Deficit Association (ABDA), Brazil
| | | | | | - Brooke S G Molina
- Departments of Psychiatry, Psychology, Pediatrics, Clinical & Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joel T Nigg
- Center for ADHD Research, Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Diane Purper-Ouakil
- University of Montpellier, CHU Montpellier Saint Eloi, MPEA, Medical and Psychological Unit for Children and Adolescents (MPEA), Montpellier, France; INSERM U 1018 CESP-Developmental Psychiatry, France
| | - Olayinka O Omigbodun
- Centre for Child & Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Child & Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
| | | | - Yehuda Pollak
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Israel; The Israeli Society of ADHD (ISA), Israel
| | - Alison S Poulton
- Brain Mind Centre Nepean, University of Sydney, Sydney, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Ravi Philip Rajkumar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany; German Psychiatric Association, Germany
| | - Katya Rubia
- World Federation of ADHD, Switzerland; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany
| | - Julia Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany; Zentrales-ADHS-Netz, Germany
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France; International Collaboration on ADHD and Substance Abuse (ICASA), the Netherlands; DIVA Foundation, the Netherlands
| | - Arnt Schellekens
- Radboud University Medical Centre, Donders Institute for Brain, Cognition, and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - Anouk Scheres
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Renata Schoeman
- University of Stellenbosch Business School, Cape Town, South Africa; South African Special Interest Group for Adult ADHD, South Africa; The South African Society of Psychiatrists/Psychiatry Management Group Management Guidelines for ADHD, South Africa; World Federation of Biological Psychiatry, Germany; American Psychiatric Association, USA; Association for NeuroPsychoEconomics, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and the MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Henal Shah
- Topiwala National Medical College & BYL Nair Ch. Hospital, Mumbai, India
| | - Mary V Solanto
- The Zucker School of Medicine at Hofstra-Northwell, Northwell Health, Hemstead, NY, USA; Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), USA; American Professional Society of ADHD and Related Disorders (APSARD), USA; National Center for Children with Learning Disabilities (NCLD), USA
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - César Soutullo
- American Professional Society of ADHD and Related Disorders (APSARD), USA; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany; Louis A. Faillace MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hans-Christoph Steinhausen
- University of Zurich, CH, Switzerland; University of Basel, CH, Switzerland; University of Southern Denmark, Odense, Denmark; Centre of Child and Adolescent Mental Health, Copenhagen, Denmark
| | - James M Swanson
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Wales, UK
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Geurt van de Glind
- Hogeschool van Utrecht/University of Applied Sciences, Utrecht, the Netherlands
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, the Netherlands
| | - Saskia Van der Oord
- Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; European ADHD Guidelines Group, Germany
| | - Andre Venter
- University of the Free State, Bloemfontein, South Africa
| | - Benedetto Vitiello
- University of Torino, Torino, Italy; Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Yufeng Wang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
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Cortisol and inflammatory biomarker levels in youths with attention deficit hyperactivity disorder (ADHD): evidence from a systematic review with meta-analysis. Transl Psychiatry 2021; 11:430. [PMID: 34413283 PMCID: PMC8377148 DOI: 10.1038/s41398-021-01550-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022] Open
Abstract
Several studies reported abnormal cortisol and inflammatory biomarker levels in youths with attention deficit hyperactivity disorder (ADHD), but the results have not been conclusive. We conducted a systematic review followed by a meta-analysis of case-control studies assessing blood or saliva cortisol levels and blood levels of inflammatory biomarkers in youth with ADHD. The effect sizes (ES) were synthesized by using a random-effects model. In the 19 studies on cortisol levels (totaling n = 916 youth with ADHD and n = 947 typically developing (TD), healthy youth), youth with ADHD have lower basal cortisol levels at any time-points during the day (effect size: .68; p = 0.004) and lower cumulative levels of cortisol (ES: .39, p = .008) throughout the day than TD youth. Moreover, morning cortisol levels were lower in ADHD youth when compared with TD youth (14 studies, n = 1679, ES: .84, p = 0.003), while there is no difference for the afternoon cortisol levels (p = 0.48). The meta-analysis on inflammation biomarker was conducted on 4 studies (totaling n = 404 youth) showed that Tumour Necrosis Factor-alpha (TNF-α) was lower in ADHD when compared with TD (3 studies, n = 257 youth, p = 0.004), while no differences for Interleukin-1β(IL-1β) (p = 0.21), IL-6 (p = 0.09) and IL-10 (p = 0.77). The lower cortisol in the context of low TNF-α levels may indicate a specific pattern of biomarkers in ADHD, and further investigation is warranted.
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Bilgiç A, Ferahkaya H, Kilinç İ, Energin VM. Serum Brain-Derived Neurotrophic Factor, Glial-Derived Neurotrophic Factor, Nerve Growth Factor and Neurotrophin-3 Levels in Preschool Children with Language Disorder. Noro Psikiyatr Ars 2021; 58:128-132. [PMID: 34188595 PMCID: PMC8214752 DOI: 10.29399/npa.27274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/25/2020] [Indexed: 06/13/2023] Open
Abstract
INTRODUCTION Accumulating studies demonstrate that neurotrophins may play a crucial role in a variety of neurodevelopmental disorders. However, little data are available regarding the potential role of neurotrophins in language disorder (LD). This study aimed to investigate serum brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), nerve growth factor (NGF) and neurotrophin-3 (NTF3) levels in preschool children with LD. METHODS A total of 43 cases with LD and 43 healthy controls aged 18 to 60 months were enrolled in the study. The development levels and psychiatric symptoms of the children were determined by the Ankara Developmental Screening Inventory and Child Behavior Checklist 1.5-5, respectively. Serum neurotrophin levels were assessed by enzyme-linked immunosorbent assay kits. RESULTS Serum GDNF and NGF levels were significantly higher, serum BDNF and NTF3 levels were significantly lower in the LD group than in the control group. However, with logistic regression analyses, only negative relationship of BDNF and NTF3 levels with the presence of LD remained significant after accounting for the confounders including development level and coexisting psychiatric symptoms. CONCLUSIONS These results suggest that low BDNF and NTF3 levels have independent negative relationships with LD, which could be contribute to etiopathogenesis of the disorder.
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Affiliation(s)
- Ayhan Bilgiç
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Hurşit Ferahkaya
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - İbrahim Kilinç
- Department of Biochemistry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Vesile Meltem Energin
- Department of Pediatrics, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Bolat H, Ercan ES, Ünsel-Bolat G, Tahillioğlu A, Yazici KU, Bacanli A, Pariltay E, Aygüneş Jafari D, Kosova B, Özgül S, Rohde LA, Akin H. DRD4 genotyping may differentiate symptoms of attention-deficit/hyperactivity disorder and sluggish cognitive tempo. ACTA ACUST UNITED AC 2020; 42:630-637. [PMID: 32491038 PMCID: PMC7678899 DOI: 10.1590/1516-4446-2019-0630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 01/17/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Studies to reduce the heterogeneity of attention-deficit/hyperactivity disorder (ADHD) have increased interest in the concept of sluggish cognitive tempo (SCT). The aim of this study was to investigate if the prevalence of two variable-number tandem repeats (VNTRs) located within the 3'-untranslated region of the DAT1 gene and in exon 3 of the dopamine D4 receptor (DRD4) gene differ among four groups (31 subjects with SCT but no ADHD, 146 individuals with ADHD but no SCT, 67 subjects with SCT + ADHD, and 92 healthy controls). METHODS We compared the sociodemographic profiles, neurocognitive domains, and prevalence of two VNTRs in SCT and ADHD subjects versus typically developing (TD) controls. RESULTS The SCT without ADHD group had a higher proportion of females and lower parental educational attainment. Subjects in this group performed worse on neuropsychological tests, except for psychomotor speed and commission errors, compared to controls. However, the ADHD without SCT group performed significantly worse on all neuropsychological domains than controls. We found that 4R homozygosity for the DRD4 gene was most prevalent in the ADHD without SCT group. The SCT without ADHD group had the highest 7R allele frequency, differing significantly from the ADHD without SCT group. CONCLUSION The 7R allele of DRD4 gene was found to be significantly more prevalent in SCT cases than in ADHD cases. No substantial neuropsychological differences were found between SCT and ADHD subjects.
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Affiliation(s)
- Hilmi Bolat
- Department of Medical Genetics, Balikesir Atatürk City Hospital, Balikesir, Turkey
| | - Eyüp S Ercan
- Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
| | - Gül Ünsel-Bolat
- Department of Child and Adolescent Psychiatry, Balikesir University Faculty of Medicine, Balikesir, Turkey
| | - Akin Tahillioğlu
- Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
| | - Kemal U Yazici
- Department of Child and Adolescent Psychiatry, Firat University, Izmir, Turkey
| | - Ali Bacanli
- Department of Child and Adolescent Psychiatry, Baskent University, Izmir, Turkey
| | - Erhan Pariltay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | | | - Buket Kosova
- Department of Medical Biology, Ege University, Izmir, Turkey
| | - Semiha Özgül
- Department of Bioistatistics and Medical Informatics, Ege University, Izmir, Turkey
| | - Luis A Rohde
- Programa de Transtornos de Déficit de Atenção/Hiperatividade (ProDAH), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, São Paulo, SP, Brazil
| | - Haluk Akin
- Department of Medical Genetics, Ege University, Izmir, Turkey
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Cipollone G, Gehrman P, Manni C, Pallucchini A, Maremmani AGI, Palagini L, Perugi G, Maremmani I. Exploring the Role of Caffeine Use in Adult-ADHD Symptom Severity of US Army Soldiers. J Clin Med 2020; 9:jcm9113788. [PMID: 33238642 PMCID: PMC7700297 DOI: 10.3390/jcm9113788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022] Open
Abstract
There is a growing trend of using energy drinks and caffeinated beverages to improve cognitive performance that is widespread and well-studied among children and teenagers with Attention Deficit Hyperactive Disorder (ADHD), but little is known about adult ADHD (A-ADHD). As a consequence, the use of highly caffeinated drinks and their impact on ADHD symptoms are poorly understood. This is especially true in populations where A-ADHD and the use of these beverages are largely represented, such as in military samples. From the All Army Study (AAS) of the Army Study to Assess Risk and Resilience in Service members (STARRS) data, 1,239 A-ADHD soldiers and 17,674 peers without any psychiatric comorbidity were selected. The two groups were compared on: (1) the presence of substance use disorder (SUD) diagnosis both over their lifetime and in the previous 30 days; (2) patterns of alcohol and caffeine use using chi-square analyses. Lastly, the relationship between substance use and severity of A-ADHD symptoms was assessed using Pearson’s correlations. Soldiers with a diagnosis of A-ADHD had a higher prevalence of SUD diagnosis compared to their peers without psychiatric comorbidity. They also tended to use more alcohol, caffeine pills, energy drinks, and other caffeinated drinks. Alcohol use was positively correlated with A-ADHD symptoms; on the contrary, energy drinks, caffeine pills and other caffeinated drinks showed negative correlations with some aspects of A-ADHD symptomatology. The use of caffeinated compounds appears to be increased among military soldiers with ADHD, and they may help reducing A-ADHD symptoms and improve cognitive performance. These results suggest a possible role for caffeine as a potential pharmacological tool in the treatment of adult ADHD.
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Affiliation(s)
- Giada Cipollone
- PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy; (G.C.); (C.M.); (A.P.); (A.G.I.M.)
| | - Philip Gehrman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Corrado Manni
- PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy; (G.C.); (C.M.); (A.P.); (A.G.I.M.)
| | - Alessandro Pallucchini
- PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy; (G.C.); (C.M.); (A.P.); (A.G.I.M.)
| | - Angelo G. I. Maremmani
- PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy; (G.C.); (C.M.); (A.P.); (A.G.I.M.)
- Department of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, 55049 Viareggio, Italy
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Lucca, Italy
| | - Laura Palagini
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy; (L.P.); (G.P.)
| | - Giulio Perugi
- 2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy; (L.P.); (G.P.)
| | - Icro Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Lucca, Italy
- Vincent P. Dole Dual Disorder Unit, 2nd Psychiatric Unit, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy
- Correspondence: ; Tel.: +39-050-993045
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Meftahi GH, Moafi M, Mirbehbahani SH, Fotouhi F, Toreyhi H, Ezi S, Aghajanpour F, Forouzannia A, Boroujeni ME, Peirouvi T, Abbaszadeh HA, Aliaghaei A. Chronic administration of methylphenidate did not affect memory and GDNF levels but increase astrogliosis in adult male rat’s hippocampus. J Chem Neuroanat 2020; 108:101818. [DOI: 10.1016/j.jchemneu.2020.101818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/02/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
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Rovira P, Demontis D, Sánchez-Mora C, Zayats T, Klein M, Mota NR, Weber H, Garcia-Martínez I, Pagerols M, Vilar-Ribó L, Arribas L, Richarte V, Corrales M, Fadeuilhe C, Bosch R, Martin GE, Almos P, Doyle AE, Grevet EH, Grimm O, Halmøy A, Hoogman M, Hutz M, Jacob CP, Kittel-Schneider S, Knappskog PM, Lundervold AJ, Rivero O, Rovaris DL, Salatino-Oliveira A, da Silva BS, Svirin E, Sprooten E, Strekalova T, Arias-Vasquez A, Sonuga-Barke EJS, Asherson P, Bau CHD, Buitelaar JK, Cormand B, Faraone SV, Haavik J, Johansson SE, Kuntsi J, Larsson H, Lesch KP, Reif A, Rohde LA, Casas M, Børglum AD, Franke B, Ramos-Quiroga JA, Soler Artigas M, Ribasés M. Shared genetic background between children and adults with attention deficit/hyperactivity disorder. Neuropsychopharmacology 2020; 45:1617-1626. [PMID: 32279069 PMCID: PMC7419307 DOI: 10.1038/s41386-020-0664-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by age-inappropriate symptoms of inattention, impulsivity, and hyperactivity that persist into adulthood in the majority of the diagnosed children. Despite several risk factors during childhood predicting the persistence of ADHD symptoms into adulthood, the genetic architecture underlying the trajectory of ADHD over time is still unclear. We set out to study the contribution of common genetic variants to the risk for ADHD across the lifespan by conducting meta-analyses of genome-wide association studies on persistent ADHD in adults and ADHD in childhood separately and jointly, and by comparing the genetic background between them in a total sample of 17,149 cases and 32,411 controls. Our results show nine new independent loci and support a shared contribution of common genetic variants to ADHD in children and adults. No subgroup heterogeneity was observed among children, while this group consists of future remitting and persistent individuals. We report similar patterns of genetic correlation of ADHD with other ADHD-related datasets and different traits and disorders among adults, children, and when combining both groups. These findings confirm that persistent ADHD in adults is a neurodevelopmental disorder and extend the existing hypothesis of a shared genetic architecture underlying ADHD and different traits to a lifespan perspective.
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Affiliation(s)
- Paula Rovira
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Ditte Demontis
- Department of Biomedicine (Human Genetics), and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Tetyana Zayats
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT, and Harvard, Cambridge, MA, USA
| | - Marieke Klein
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- University Medical Center Utrecht, UMC Utrecht Brain Center, Department of Psychiatry, Utrecht, The Netherlands
| | - Nina Roth Mota
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heike Weber
- Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Iris Garcia-Martínez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Banc de Sang i Teixits (BST), Barcelona, Spain
- Grup de Medicina Transfusional, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
| | - Mireia Pagerols
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Lorena Arribas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Montserrat Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Rosa Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Español Martin
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Peter Almos
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Alysa E Doyle
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Eugenio Horacio Grevet
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anne Halmøy
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Martine Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mara Hutz
- Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Christian P Jacob
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Per M Knappskog
- Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Olga Rivero
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Diego Luiz Rovaris
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Angelica Salatino-Oliveira
- Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Santos da Silva
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Evgeniy Svirin
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, IM Sechenov First Moscow State Medical University, Moscow, Russia
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Tatyana Strekalova
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, IM Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Alejandro Arias-Vasquez
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Edmund J S Sonuga-Barke
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Claiton Henrique Dotto Bau
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - Bru Cormand
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry, of Neuroscience, and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Stefan E Johansson
- Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- School of medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, IM Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Luis Augusto Rohde
- Division of Child Psychiatry, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miquel Casas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Anders D Børglum
- Department of Biomedicine (Human Genetics), and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health, and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.
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Miranda P, Cox CD, Alexander M, Danev S, Lakey JRT. In Quest of Pathognomonic/Endophenotypic Markers of Attention Deficit Hyperactivity Disorder (ADHD): Potential of EEG-Based Frequency Analysis and ERPs to Better Detect, Prevent and Manage ADHD. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:115-137. [PMID: 32547262 PMCID: PMC7250294 DOI: 10.2147/mder.s241205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the “characterizing ADHD” and on the quest for objective “pathognomonic/endophenotypic diagnostic markers of ADHD”. The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.
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Affiliation(s)
- Priya Miranda
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | - Christopher D Cox
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Michael Alexander
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | | | - Jonathan R T Lakey
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
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Tengeler AC, Dam SA, Wiesmann M, Naaijen J, van Bodegom M, Belzer C, Dederen PJ, Verweij V, Franke B, Kozicz T, Arias Vasquez A, Kiliaan AJ. Gut microbiota from persons with attention-deficit/hyperactivity disorder affects the brain in mice. MICROBIOME 2020; 8:44. [PMID: 32238191 PMCID: PMC7114819 DOI: 10.1186/s40168-020-00816-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/02/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND The impact of the gut microbiota on host physiology and behavior has been relatively well established. Whether changes in microbial composition affect brain structure and function is largely elusive, however. This is important as altered brain structure and function have been implicated in various neurodevelopmental disorders, like attention-deficit/hyperactivity disorder (ADHD). We hypothesized that gut microbiota of persons with and without ADHD, when transplanted into mice, would differentially modify brain function and/or structure. We investigated this by colonizing young, male, germ-free C57BL/6JOlaHsd mice with microbiota from individuals with and without ADHD. We generated and analyzed microbiome data, assessed brain structure and function by magnetic resonance imaging (MRI), and studied mouse behavior in a behavioral test battery. RESULTS Principal coordinate analysis showed a clear separation of fecal microbiota of mice colonized with ADHD and control microbiota. With diffusion tensor imaging, we observed a decreased structural integrity of both white and gray matter regions (i.e., internal capsule, hippocampus) in mice that were colonized with ADHD microbiota. We also found significant correlations between white matter integrity and the differentially expressed microbiota. Mice colonized with ADHD microbiota additionally showed decreased resting-state functional MRI-based connectivity between right motor and right visual cortices. These regions, as well as the hippocampus and internal capsule, have previously been reported to be altered in several neurodevelopmental disorders. Furthermore, we also show that mice colonized with ADHD microbiota were more anxious in the open-field test. CONCLUSIONS Taken together, we demonstrate that altered microbial composition could be a driver of altered brain structure and function and concomitant changes in the animals' behavior. These findings may help to understand the mechanisms through which the gut microbiota contributes to the pathobiology of neurodevelopmental disorders. Video abstract.
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Affiliation(s)
- Anouk C Tengeler
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
| | - Sarita A Dam
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 EN, Nijmegen, The Netherlands
| | - Maximilian Wiesmann
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 EN, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 EN, Nijmegen, The Netherlands
| | - Miranda van Bodegom
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
| | - Clara Belzer
- Dept. Agrotechnology and Food Sciences, Wageningen UR (University & Research), 6708WE, Wageningen, The Netherlands
| | - Pieter J Dederen
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
| | - Vivienne Verweij
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GC, Nijmegen, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Tamas Kozicz
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, 55902, USA
| | - Alejandro Arias Vasquez
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GC, Nijmegen, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Amanda J Kiliaan
- Department of Anatomy, Donders Institute for Brain, Cognition & Behaviour, Preclinical Imaging Centre PRIME, Radboud University Medical Center, Geert Grooteplein noord 21, 6525 EZ, Nijmegen, The Netherlands.
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Lugoboni F, Bertoldi A, Casari R, Mantovani E, Morbioli L, Tamburin S. Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users. Eur Addict Res 2020; 26:274-282. [PMID: 32570244 DOI: 10.1159/000507852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Problematic high-dose benzodiazepine (BZD) and related Z-drug use for a long period is a substance use disorder previously found to be associated with adult attention-deficit/hyperactivity disorder (ADHD) and worse quality of life (QoL). Whether adult ADHD impacts QoL in high-dose BZD/Z-drug users has not been explored. AIM The aim of the study was to explore the impact of adult ADHD on QoL in high-dose BZD and related Z-drug users. METHODS We recruited 393 patients (205 men and 188 women) consecutively admitted to the Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Italy, from July 2016 to July 2019 for detoxification from high-dose BZD or Z-drug dependence. Demographic and clinical variables and QoL measures were recorded. The World Health Organization ADHD Self-Report Scale version 1.1 Symptom Checklist Part A was used to detect adult ADHD. RESULTS In our sample, 39.4% of patients were positive to adult ADHD testing (ADHD+), with some clinical features differing in comparison to patients negative to ADHD testing (ADHD-). QoL was worse in high-dose BZD/Z-drug users than the general population. The ADHD+ group showed significantly worse QoL measures than the ADHD- group. Multivariate analysis, including potential covariates showed adult ADHD and age to have the most robust and consistent positive effect for age (i.e., higher QoL) and negative effect for ADHD (i.e., lower QoL) on QoL measures. CONCLUSIONS Adult ADHD is associated with worse QoL measures in high-dose BZD/Z-drug users. Future studies should explore whether appropriate BZD/Z-drug detoxification might improve QoL measures and whether the most appropriate detoxification protocol differs in ADHD+ versus ADHD- populations.
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Affiliation(s)
- Fabio Lugoboni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Anna Bertoldi
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Rebecca Casari
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Laura Morbioli
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy,
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Oakes HV, Ketchem S, Hall AN, Ensley T, Archibald KM, Pond BB. Chronic methylphenidate induces increased quinone production and subsequent depletion of the antioxidant glutathione in the striatum. Pharmacol Rep 2019; 71:1289-1292. [PMID: 31693968 DOI: 10.1016/j.pharep.2019.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Methylphenidate (Ritalin®) is a psychostimulant used chronically to treat attention deficit hyperactivity disorder. Methylphenidate acts by preventing the reuptake of dopamine and norepinephrine, resulting in an increase in these neurotransmitters in the synaptic cleft. Excess dopamine can be autoxidized to a quinone that may lead to oxidative stress. The antioxidant, glutathione helps to protect the cell against quinones via conjugation reactions; however, depletion of glutathione may result from excess quinone formation. Chronic exposure to methylphenidate appears to sensitize dopaminergic neurons to the Parkinsonian toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). We hypothesized that oxidative stress caused by the autooxidation of the excess dopamine renders dopaminergic neurons within the nigrostriatal pathway to be more sensitive to MPTP. METHODS To test this hypothesis, male mice received chronic low or high doses of MPH and were exposed to saline or MPTP following a 1-week washout. Quinone formation in the striatum was examined via dot blot, and striatal GSH was quantified using a glutathione assay. RESULTS Indeed, quinone formation increased with increasing doses of methylphenidate. Additionally, methylphenidate dose-dependently resulted in a depletion of glutathione, which was further depleted following MPTP treatment. CONCLUSIONS Thus, the increased sensitivity of dopamine neurons to MPTP toxicity following chronic methylphenidate exposure may be due to quinone production and subsequent depletion of glutathione.
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Affiliation(s)
- Hannah V Oakes
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Shannon Ketchem
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Alexis N Hall
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Tucker Ensley
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Kristen M Archibald
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Brooks B Pond
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA.
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20
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Wang X, Martinez MP, Chow T, Walthall JC, Guber KM, Xiang AH. Attention-Deficit Hyperactivity Disorder Risk: Interaction Between Parental Age and Maternal History of Attention-Deficit Hyperactivity Disorder. J Dev Behav Pediatr 2019; 40:321-329. [PMID: 31206451 DOI: 10.1097/dbp.0000000000000669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the interaction between maternal attention-deficit/hyperactivity disorder (ADHD) history and young parental age on child's ADHD risk. METHODS The study included 321,272 singleton children born between 1995 and 2012 from hospitals within a single integrated health care organization. The children were prospectively followed up through electronic medical record systems from birth until the first date of the following: date of clinical diagnosis of ADHD, last date of continuous health plan membership, death due to any cause, or December 31, 2017. Risks of ADHD associated with a maternal history of ADHD before pregnancy and young parental age were assessed by using Cox regression adjusting for potential confounders. RESULTS The children were followed up for a median (interquartile range) of 8.9 (6.2, 13.6) years from birth. Among them, 5.1% had ADHD diagnosis, 1.8% had a maternal history of ADHD before the pregnancy, and 4.4% had mothers <20 years and 2.3% had fathers <20 years at date of birth. The hazard ratio (HR) of ADHD in children associated with parental age <20 years varied by maternal history of ADHD (p < 0.005 for both multiplicative and additive interactions). For children without a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.14 (95% confidence interval 1.04-1.24). However, for children with a maternal history of ADHD, the HR associated with at least 1 parent <20 years was 1.92 (95% confidence interval 1.31-2.82). CONCLUSION High ADHD risk in offspring associated with young parenthood was predominantly observed among children with a maternal history of ADHD.
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Affiliation(s)
| | | | - Ting Chow
- Departments of Research & Evaluation and
| | | | - Kevin M Guber
- Psychiatry, Kaiser Permanente Southern California, Pasadena, CA
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21
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Genetic risk factors and gene–environment interactions in adult and childhood attention-deficit/hyperactivity disorder. Psychiatr Genet 2019; 29:63-78. [DOI: 10.1097/ypg.0000000000000220] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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22
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Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry 2019; 24:562-575. [PMID: 29892054 PMCID: PMC6477889 DOI: 10.1038/s41380-018-0070-0] [Citation(s) in RCA: 467] [Impact Index Per Article: 93.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/31/2018] [Accepted: 02/19/2018] [Indexed: 02/07/2023]
Abstract
Decades of research show that genes play an vital role in the etiology of attention deficit hyperactivity disorder (ADHD) and its comorbidity with other disorders. Family, twin, and adoption studies show that ADHD runs in families. ADHD's high heritability of 74% motivated the search for ADHD susceptibility genes. Genetic linkage studies show that the effects of DNA risk variants on ADHD must, individually, be very small. Genome-wide association studies (GWAS) have implicated several genetic loci at the genome-wide level of statistical significance. These studies also show that about a third of ADHD's heritability is due to a polygenic component comprising many common variants each having small effects. From studies of copy number variants we have also learned that the rare insertions or deletions account for part of ADHD's heritability. These findings have implicated new biological pathways that may eventually have implications for treatment development.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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23
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Luo Y, Weibman D, Halperin JM, Li X. A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD). Front Hum Neurosci 2019; 13:42. [PMID: 30804772 PMCID: PMC6378275 DOI: 10.3389/fnhum.2019.00042] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/25/2019] [Indexed: 12/24/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects approximately 8%–12% of children worldwide. Throughout an individual’s lifetime, ADHD can significantly increase risk for other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. The multifactorial causation of ADHD is reflected in the heterogeneity of this disorder, as indicated by its diversity of psychiatric comorbidities, varied clinical profiles, patterns of neurocognitive impairment and developmental trajectories, and the wide range of structural and functional brain anomalies. Although evidence-based treatments can reduce ADHD symptoms in a substantial portion of affected individuals, there is yet no curative treatment for ADHD. A number of theoretical models of the emergence and developmental trajectories of ADHD have been proposed, aimed at providing systematic guides for clinical research and practice. We conducted a comprehensive review of the current status of research in understanding the heterogeneity of ADHD in terms of etiology, clinical profiles and trajectories, and neurobiological mechanisms. We suggest that further research focus on investigating the impact of the etiological risk factors and their interactions with developmental neural mechanisms and clinical profiles in ADHD. Such research would have heuristic value for identifying biologically homogeneous subgroups and could facilitate the development of novel and more tailored interventions that target underlying neural anomalies characteristic of more homogeneous subgroups.
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Affiliation(s)
- Yuyang Luo
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Dana Weibman
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Jeffrey M Halperin
- Department of Psychology, Queens College of the City University of New York, Flushing, NY, United States
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States.,Department of Electric and Computer Engineering, New Jersey Institute of Technology, Newark, NJ, United States
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24
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Prehn-Kristensen A, Zimmermann A, Tittmann L, Lieb W, Schreiber S, Baving L, Fischer A. Reduced microbiome alpha diversity in young patients with ADHD. PLoS One 2018; 13:e0200728. [PMID: 30001426 PMCID: PMC6042771 DOI: 10.1371/journal.pone.0200728] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 07/02/2018] [Indexed: 12/16/2022] Open
Abstract
ADHD is a psychiatric disorder which is characterized by hyperactivity, impulsivity and attention problems. Due to recent findings of microbial involvement in other psychiatric disorders like autism and depression, a role of the gut microbiota in ADHD pathogenesis is assumed but has not yet been investigated. In this study, the gut microbiota of 14 male ADHD patients (mean age: 11.9 yrs.) and 17 male controls (mean age: 13.1 yrs.) was examined via next generation sequencing of 16S rDNA and analyzed for diversity and biomarkers. We found that the microbial diversity (alpha diversity) was significantly decreased in ADHD patients compared to controls (pShannon = 0.036) and that the composition (beta diversity) differed significantly between patients and controls (pANOSIM = 0.033, pADONIS = 0.006, pbetadisper = 0.002). In detail, the bacterial family Prevotellacae was associated with controls, while patients with ADHD showed elevated levels of Bacteroidaceae, and both Neisseriaceae and Neisseria spec. were found as possible biomarkers for juvenile ADHD. Our results point to a possible link of certain microbiota with ADHD, with Neisseria spec. being a very promising ADHD-associated candidate. This finding provides the basis for a systematic, longitudinal assessment of the role of the gut microbiome in ADHD, yielding promising potential for both prevention and therapeutic intervention.
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Affiliation(s)
- Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Alexandra Zimmermann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lukas Tittmann
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfgang Lieb
- Institute for Epidemiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
- Clinic of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lioba Baving
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Annegret Fischer
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
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25
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Dragic LL, Wegrzyn EL, Schatman ME, Fudin J. Pharmacogenetic guidance: individualized medicine promotes enhanced pain outcomes. J Pain Res 2017; 11:37-40. [PMID: 29317847 PMCID: PMC5743122 DOI: 10.2147/jpr.s144560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of pharmacogenomics has become more prevalent over the past several years in treating many disease states. Several cytochrome P450 enzymes play a role in the metabolism of many pain medications including opioids and antidepressants. Noncytochrome P450 enzymes such as methylenetetrahydrofolate reductase (MTHFR) and catechol-O-methyl transferase (COMT) also play a role in the explanation of opioid dosage requirements as well as in response to certain antidepressants. We present the case of a patient with reduced COMT and MTHFR expression treated with leucovorin 10 mg daily for the management of chronic pain. The use of leucovorin in this patient decreased pain scores, which were clinically significant and increased functionality. This case demonstrates the importance of pharmacogenetics testing in patients, as this can help direct providers to better therapeutic options for their patients.
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Affiliation(s)
- Lisa Lynn Dragic
- Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Erica L Wegrzyn
- Department of Pharmacy, Albany Stratton VA Medical Center, Albany, NY, USA
| | - Michael E Schatman
- Research and Network Development, Boston Pain Care, Waltham, MA, USA.,Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.,Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Jeffrey Fudin
- Department of Pharmacy, Albany Stratton VA Medical Center, Albany, NY, USA.,Scientific and Clinical Affairs, Remitigate, LLC, Delmar, NY, USA
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26
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Puts NAJ, Harris AD, Mikkelsen M, Tommerdahl M, Edden RAE, Mostofsky SH. Altered tactile sensitivity in children with attention-deficit hyperactivity disorder. J Neurophysiol 2017; 118:2568-2578. [PMID: 28768738 DOI: 10.1152/jn.00087.2017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/22/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is characterized by an inability to concentrate, heightened activity, and hypermotoric behavior, but sensory (e.g., tactile) problems are common. The literature on tactile impairments in ADHD is limited, with most work employing clinical observations or questionnaires. We studied tactile processing in children with ADHD and hypothesized that children with ADHD would show reduced performance in tasks closely linked to inhibition. Sixty-seven children with ADHD and 62 typically developing children (TDC) performed a battery of tasks grouped in domains: simple and choice reaction time; static and dynamic detection threshold (probing feedforward inhibition); amplitude discrimination without adaptation and with dual and single-site adaptation (probing lateral inhibition and adaptation); sequential and simultaneous frequency discrimination (previously linked to GABA); and temporal order judgment with and without a synchronous carrier stimulus. Children with ADHD could discriminate different amplitudes without adaptation, suggesting lateral inhibition is intact, but were negatively affected in all adaptation conditions, whereas TDC were only affected during single-site adaptation. Children with ADHD also showed normal frequency discrimination. Children with ADHD showed slower reaction times and higher detection threshold, likely driven by IQ and inattention, because reaction time and detection thresholds correlated with IQ and subtle motor signs. Children with ADHD showed a pattern of altered tactile processing on specific tasks, suggesting that higher cognitive function and cortical mechanisms related to adaptation are affected in ADHD, but no clear conclusion can be drawn toward impaired inhibition.NEW & NOTEWORTHY This manuscript presents the first tactile psychophysical study testing different aspects of tactile processing in attention-deficit hyperactivity disorder (ADHD), using large cohort sizes of 67 children with ADHD and 65 Typically Developing Children. This study demonstrates impaired tactile processing in children with ADHD, on some, but not all tasks (showing this is not just due to attention), related to impaired cortical mechanisms. Furthermore, both IQ and soft motor skill abnormalities (common in ADHD) are correlated with tactile abnormalities.
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Affiliation(s)
- Nicolaas A J Puts
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland; .,F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Ashley D Harris
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland.,Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,The Child and Adolescent Imaging Research Program, Alberta Children's Hospital Research Institute, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.,Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Mark Mikkelsen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Mark Tommerdahl
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Stewart H Mostofsky
- Center for Neurocognitive and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland.,Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; and.,Department of Behavioral Science and Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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27
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Janenaite E, Vengeliene V, Bespalov A, Behl B. Potential role of tyrosine hydroxylase in the loss of psychostimulant effect of amphetamine under conditions of impaired dopamine transporter activity. Behav Brain Res 2017; 334:105-108. [PMID: 28750831 DOI: 10.1016/j.bbr.2017.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/17/2017] [Accepted: 07/22/2017] [Indexed: 12/28/2022]
Abstract
Amphetamine and methylphenidate are known to have stimulatory effect in healthy subjects but not in humans with attention deficit hyperactivity disorder and in rodents with impaired dopamine transporter (DAT) function. This phenomenon is called the paradoxical calming effect of psychostimulants. It has been previously demonstrated that psychostimulants may regulate the enzymatic activity of tyrosine hydroxylase (TH). Hence, the objective of the present study was to determine whether the lack of activity-stimulating effects of amphetamine in hyperactive rats is associated with changes in TH activity. To model hyperactivity in rats, acute administration of DAT inhibitor GBR12909 was used. Changes in TH activity, assessed as L-DOPA accumulation and TH phosphorylation levels, were measured in amphetamine treated rats with or without pretreatment with GBR12909. Our results showed that amphetamine treatment alone increased locomotor activity in rats, whereas pretreatment of rats with GBR12909 counteracted this effect, a finding consistent with the paradoxical calming effect. GBR12909, while having no effect on its own, blocked amphetamine-induced elevation of TH activity in dorsal striatum and nucleus accumbens, measured as increased tissue L-DOPA concentration. However, the phosphorylation levels of TH were not affected by treatment with amphetamine, GBR12909 or the combination of both. Our findings indicate that other mechanisms than phosphorylation-regulated TH activity changes are responsible for the paradoxical calming effect of amphetamine under conditions of impaired DAT activity.
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Affiliation(s)
- Egle Janenaite
- Department of Neurobiology and Biophysics, Institute of Biosciences, Life Sciences Center, Vilnius University, Lithuania; Neuroscience Research, AbbVie, Ludwigshafen, Germany
| | - Valentina Vengeliene
- Department of Neurobiology and Biophysics, Institute of Biosciences, Life Sciences Center, Vilnius University, Lithuania.
| | - Anton Bespalov
- Pavlov Medical University, St Petersburg, Russia; Neuroscience Research, AbbVie, Ludwigshafen, Germany
| | - Berthold Behl
- Neuroscience Research, AbbVie, Ludwigshafen, Germany
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28
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Banegas I, Prieto I, Segarra AB, Vives F, de Gasparo M, Duran R, de Dios Luna J, Ramírez-Sánchez M. Bilateral distribution of enkephalinase activity in the medial prefrontal cortex differs between WKY and SHR rats unilaterally lesioned with 6-hydroxydopamine. Prog Neuropsychopharmacol Biol Psychiatry 2017; 75:213-218. [PMID: 28232066 DOI: 10.1016/j.pnpbp.2017.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/09/2017] [Accepted: 02/17/2017] [Indexed: 11/26/2022]
Abstract
Changes in the basal brain bilateral morphologic, neurochemical and/or functional patterns may be partly responsible for some brain disorders such as those involving mood. WKY and SHR strains as well as 6-hydroxydopamine (6-OHDA)-lesioned animals are validated models for the study of mood disorders. Because dopamine and enkephalins are involved in anxiety-related behaviors, the aim of our study was to analyze enkephalinase activity, assayed as aminopeptidase M activity, in the left and right medial prefrontal cortex (mPFC) of WKY and SHR treated with saline (sham group) or following left or right intrastriatal injections of the neurotoxic 6-OHDA. Sham left and sham right WKY exhibited a significant left predominance. Left 6-OHDA-lesioned rats inverted the left predominance of sham to right predominance. In right 6-OHDA-lesioned rats, the left predominance in sham right rats disappeared. Sham left as well as sham right SHR did not show any bilateral differences. In contrast, while the left lesion demonstrated a highly significant left predominance, the right lesion showed a slight but significant right predominance. A significant negative correlation between enkephalinase activity of the right mPFC and blood pressure and heart rate was observed only in left-lesioned SHR. Our results demonstrate that unilateral nigrostriatal injections of 6-OHDA influence the bilateral distribution of enkephalinase activity depending on both the side of the lesion and the strain analyzed. These results support the hypothesis that DA pathways may interact asymmetrically with enkephalins in the mPFC and that enkephalinase activity may play a role in the regulatory mechanisms underlying this interaction.
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Affiliation(s)
- Inmaculada Banegas
- Unit of Physiology,Department of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Isabel Prieto
- Unit of Physiology,Department of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Ana B Segarra
- Unit of Physiology,Department of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Francisco Vives
- Institute of Neurosciences, "Federico Olóriz" University of Granada, Granada, Spain
| | - Marc de Gasparo
- Cardiovascular and Metabolic Syndrome Adviser, Rue es Planches 5, 2842 Rossemaison, Switzerland
| | - Raquel Duran
- Institute of Neurosciences, "Federico Olóriz" University of Granada, Granada, Spain
| | - Juan de Dios Luna
- Department of Biostatistic, Medical School, University of Granada, Granada, Spain
| | - Manuel Ramírez-Sánchez
- Unit of Physiology,Department of Health Sciences, University of Jaén, 23071 Jaén, Spain.
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Karagiannidis I, Tsetsos F, Padmanabhuni SS, Alexander J, Georgitsi M, Paschou P. The Genetics of Gilles de la Tourette Syndrome: a Common Aetiological Basis with Comorbid Disorders? Curr Behav Neurosci Rep 2016. [DOI: 10.1007/s40473-016-0088-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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