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Humińska-Lisowska K. Dopamine in Sports: A Narrative Review on the Genetic and Epigenetic Factors Shaping Personality and Athletic Performance. Int J Mol Sci 2024; 25:11602. [PMID: 39519153 PMCID: PMC11546834 DOI: 10.3390/ijms252111602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 10/22/2024] [Accepted: 10/27/2024] [Indexed: 11/16/2024] Open
Abstract
This narrative review examines the relationship between dopamine-related genetic polymorphisms, personality traits, and athletic success. Advances in sports genetics have identified specific single nucleotide polymorphisms (SNPs) in dopamine-related genes linked to personality traits crucial for athletic performance, such as motivation, cognitive function, and emotional resilience. This review clarifies how genetic variations can influence athletic predisposition through dopaminergic pathways and environmental interactions. Key findings reveal associations between specific SNPs and enhanced performance in various sports. For example, polymorphisms such as COMT Val158Met rs4680 and BDNF Val66Met rs6265 are associated with traits that could benefit performance, such as increased focus, stress resilience and conscientiousness, especially in martial arts. DRD3 rs167771 is associated with higher agreeableness, benefiting teamwork in sports like football. This synthesis underscores the multidimensional role of genetics in shaping athletic ability and advocates for integrating genetic profiling into personalized training to optimize performance and well-being. However, research gaps remain, including the need for standardized training protocols and exploring gene-environment interactions in diverse populations. Future studies should focus on how genetic and epigenetic factors can inform tailored interventions to enhance both physical and psychological aspects of athletic performance. By bridging genetics, personality psychology, and exercise science, this review paves the way for innovative training and performance optimization strategies.
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Affiliation(s)
- Kinga Humińska-Lisowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdańsk, Poland
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2
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Lee CG, Moon H, Kang JH, Choi JH, Kwon JH. Long-term effects of adolescent sport experience, DRD2 and COMT genes, and their interaction on sport participation in adulthood. Brain Behav 2022; 12:e2459. [PMID: 34904796 PMCID: PMC8785622 DOI: 10.1002/brb3.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 10/21/2021] [Accepted: 11/26/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The present study investigated the joint impact of adolescent sport experience and dopamine-related genes (i.e., DRD2 and COMT genes) on sport participation in adulthood. METHODS Using the National Longitudinal Study of Adolescent Health (Add Health) data, the hierarchical multivariable logistic regression models for predicting sport participation in wave 3 (around 20 years of age) and wave 4 (around 30 years of age) were conducted separately by gender (male and female) and gene (DRD2 and COMT genes). RESULTS Adolescent sport experience significantly interacted with the number of DRD2 A1 alleles and COMT Met alleles in affecting wave 3 sport participation among male adults. The interaction between adolescent sport experience and DRD2 gene significantly affected wave 4 sport participation in opposite direction to that affected wave 3 sport participation among male participants. Among female participants, there were no significant interaction effects between dopamine-related genes and adolescent sport experience on sport participation in both wave 3 and 4. CONCLUSIONS Since adult sport participation is most likely to be influenced by the joint impact of environmental and genetic factors, it is important to consider gene-by-environment interactions when designing policies or programs to promote adult sport participation.
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Affiliation(s)
- Chung Gun Lee
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.,Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Hyoyoul Moon
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.,Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Joon-Ho Kang
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.,Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Joo Hee Choi
- Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Ju Hyuk Kwon
- Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
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3
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Lee CG, Moon H, Park S. The effects of dopamine receptor genes on the trajectories of sport participation from adolescence through young adulthood. Ann Hum Biol 2020; 47:256-262. [PMID: 32183536 DOI: 10.1080/03014460.2020.1736629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background: Although previous studies suggest that dopamine receptor genes partially affect physical activity-related behaviours, all of these studies were cross-sectional studies that examined the effects of dopamine receptor genes on physical activity-related behaviours at some point in time. Therefore, the nature and extent of this relationship across the lifespan are even more uncertain.Aim: The purpose of this study is to examine the effects of dopamine receptor genes (i.e. DRD2, DRD4 and DRD5) on sport participation trajectories from adolescence to young adulthood.Subjects and methods: This study used the National Longitudinal Study of Adolescent Health data (wave 1-4). Group-based trajectory modelling was used to investigate the effect of dopamine receptor genes on the probability of being in each sport participation trajectory group.Results: A three-group model was the best fitting model for men whereas a two-group model was the best fitting model for women. The more participants possess the A1 allele of the DRD2, the less likely they are to be in the "high-decreasing group" rather than the "low-stable group" in both men and women. In male participants, the more participants carry the A1 allele of the DRD2, the more likely they are to be in the "high-stable group" rather than the "high-decreasing group" (coefficient = 0.206, p<.05).Conclusions: These results can contribute to the literature by providing important information on the effects of dopamine receptor genes on sport participation trajectories from adolescence through young adulthood.
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Affiliation(s)
- Chung Gun Lee
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Hyoyoul Moon
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Seiyeong Park
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
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Meta-analytic method reveal a significant association of theBDNF Val66Met variant with smoking persistence based on a large samples. THE PHARMACOGENOMICS JOURNAL 2019; 20:398-407. [PMID: 31787753 PMCID: PMC7253357 DOI: 10.1038/s41397-019-0124-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 09/10/2019] [Accepted: 11/17/2019] [Indexed: 12/20/2022]
Abstract
Although numerous genetic studies have reported the link between
Val66Met in BDNF gene with smoking, the findings
remain controversial, mainly due to small-to-moderate sample sizes. The main aim of
current investigation is to explore whether the variant of Val66Met has any genetic
functions in the progress of smoking persistence. The Val-based dominant genetic
model considering Val/* (namely, Val/Val + Val/Met) and Met/Met as two genotypes
with comparison of the frequency of each genotype in current smokers and never
smokers. There were seven genetic association articles including eight independent
datasets with 10,160 participants were chosen in current meta-analytic
investigation. In light of the potent effects of ethnicity on homogeneity across
studies, we carried out separated meta-analyses according to the ancestry origin by
using the wide-used tool of Comprehensive Meta-analysis software (V 2.0). Our
meta-analyses results indicated that the Val66Met polymorphism was significantly
linked with smoking persistence based on either all the chosen samples (N = 10,160; Random and fixed models: pooled OR = 1.23;
95% CI = 1.03–1.46; P value = 0.012) or Asian
samples (N = 2,095; Fixed model: pooled
OR = 1.25; 95% CI = 1.01–1.54; P value = 0.044;
Random model: pooled OR = 1.25; 95% CI = 1.001–1.56; P value = 0.049). No significant clue of bias in publications or
heterogeneity across studies was detected. Thus, we conclude that the Val66Met
(rs6265) variant conveys genetic susceptibility to maintaining smoking, and smokers
who carry Val/* genotypes have a higher possibility of maintaining smoking than
those having Met/Met genotype.
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Lacroix E, Tavares H, von Ranson KM. Moving beyond the "eating addiction" versus "food addiction" debate: Comment on Schulte et al. (2017). Appetite 2018; 130:286-292. [PMID: 29936021 DOI: 10.1016/j.appet.2018.06.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 12/21/2022]
Abstract
In a recent commentary, Schulte et al. (2017) argued that addictive-like eating should be conceptualized as a substance use disorder rather than a behavioural addiction, and noted that many parallels that Hebebrand et al. (2014) drew between addictive-like eating and behavioural addictions apply likewise to substance use disorders. However, we argue that many of the arguments advanced by Schulte et al. (2017) in support of a substance-based food addiction model, including the important role played by ingested substances, are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, notably eating disorders, which raises the question of whether the phenomenon of addictive-like eating is encompassed by existing eating disorder diagnoses. Similarities between addictive-like eating and substance use, no matter how compelling, do not ensure the validity or clinical utility of a substance-based food addiction model and should not drive the conceptualization of addictive-like eating. The present commentary discusses problems with Schulte et al.'s (2017) arguments for substance-based food addiction, and draws attention to alternative conceptualizations of addictive-like eating which risk being overlooked when this conversation is framed as a dichotomous debate between the food and eating addiction models.
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Affiliation(s)
- Emilie Lacroix
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
| | - Hermano Tavares
- Department of Psychiatry, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, Sao Paulo, SP, CEP 05403-010, Brazil.
| | - Kristin M von Ranson
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
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Quraishi R, Jain R, Mishra AK, Ambekar A. Association of ankyrin repeats & kinase domain containing 1 ( ANKK1) gene polymorphism with co-morbid alcohol & nicotine dependence: A pilot study from a tertiary care treatment centre in north India. Indian J Med Res 2018; 145:33-38. [PMID: 28574012 PMCID: PMC5460570 DOI: 10.4103/ijmr.ijmr_458_14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES The frequently encountered co-morbidity of alcohol dependence (AD) with nicotine dependence (ND) increases the risk for various diseases. Ankyrin repeats and kinase domain containing 1 (ANKK1) gene polymorphism is reported to be associated with both ND and AD. This study was undertaken to investigate the possible association of alcohol and tobacco use variables with ANKK1 polymorphism in co-morbid alcohol- and nicotine-dependent treatment seekers visiting a tertiary care centre in north India. METHODS Seventy nine male participants (18-65 yr old) fulfilling diagnostic criteria for ND and AD were included in the study. The socio-demographic data, along with alcohol and tobacco use profile, was recorded and ANKK1 profiling was carried out. Both the allele groups, A1 and A2, were compared with respect to demographic and substance dependence profile. Univariate binary logistic regression analysis was performed to determine the risk of high nicotine and alcohol consumption with genotype. RESULTS The A1 carrier group (n=33) reported a significantly higher amount of alcohol and tobacco consumed per day. The scores on parameters of ND were found to be significantly higher in this group. The logistic regression analysis revealed that participants with A1 genotype were 2.5 times more likely to report higher amount of alcohol and nicotine consumption than A2 carriers. INTERPRETATION & CONCLUSIONS The study provides an indication for the association of ANKK1 polymorphism in the form of higher substance consumption among alcohol dependent smokers, who are A1 carriers and thus may require higher attention of the treatment provider.
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Affiliation(s)
- Rizwana Quraishi
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Raka Jain
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ashwani K Mishra
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
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Hodgson K, Almasy L, Knowles EEM, Kent JW, Curran JE, Dyer TD, Göring HHH, Olvera RL, Woolsey MD, Duggirala R, Fox PT, Blangero J, Glahn DC. The genetic basis of the comorbidity between cannabis use and major depression. Addiction 2017; 112:113-123. [PMID: 27517884 PMCID: PMC5148647 DOI: 10.1111/add.13558] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/06/2016] [Accepted: 08/09/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS While the prevalence of major depression is elevated among cannabis users, the role of genetics in this pattern of comorbidity is not clear. This study aimed to estimate the heritability of cannabis use and major depression, quantify the genetic overlap between these two traits and localize regions of the genome that segregate in families with cannabis use and major depression. DESIGN Family-based univariate and bivariate genetic analysis. SETTING San Antonio, Texas, USA. PARTICIPANTS Genetics of Brain Structure and Function study (GOBS) participants: 1284 Mexican Americans from 75 large multi-generation families and an additional 57 genetically unrelated spouses. MEASUREMENTS Phenotypes of life-time history of cannabis use and major depression, measured using the semistructured MINI-Plus interview. Genotypes measured using ~1 M single nucleotide polymorphisms (SNPs) on Illumina BeadChips. A subselection of these SNPs were used to build multi-point identity-by-descent matrices for linkage analysis. FINDINGS Both cannabis use [h2 = 0.614, P = 1.00 × 10-6 , standard error (SE) = 0.151] and major depression (h2 = 0.349, P = 1.06 × 10-5 , SE = 0.100) are heritable traits, and there is significant genetic correlation between the two (ρg = 0.424, P = 0.0364, SE = 0.195). Genome-wide linkage scans identify a significant univariate linkage peak for major depression on chromosome 22 [logarithm of the odds (LOD) = 3.144 at 2 centimorgans (cM)], with a suggestive peak for cannabis use on chromosome 21 (LOD = 2.123 at 37 cM). A significant pleiotropic linkage peak influencing both cannabis use and major depression was identified on chromosome 11 using a bivariate model (LOD = 3.229 at 112 cM). Follow-up of this pleiotropic signal identified a SNP 20 kb upstream of NCAM1 (rs7932341) that shows significant bivariate association (P = 3.10 × 10-5 ). However, this SNP is rare (seven minor allele carriers) and does not drive the linkage signal observed. CONCLUSIONS There appears to be a significant genetic overlap between cannabis use and major depression among Mexican Americans, a pleiotropy that appears to be localized to a region on chromosome 11q23 that has been linked previously to these phenotypes.
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Affiliation(s)
- Karen Hodgson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Correspondence to Karen Hodgson Ph.D., Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Laura Almasy
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - Emma E. M. Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Jack W. Kent
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX
| | - Joanne E. Curran
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - Thomas D. Dyer
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - Harald H. H. Göring
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - Rene L. Olvera
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Mary D. Woolsey
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Ravi Duggirala
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, South Texas Veterans Health System, 7400 Merton Minter, San Antonio, TX
| | - John Blangero
- South Texas Diabetes and Obesity Institute, University of Texas Health Science Center at San Antonio & University of Texas of the Rio Grande Valley, Brownsville, TX
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT
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8
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Predictors of the Onset of Cigarette Smoking: A Systematic Review of Longitudinal Population-Based Studies in Youth. Am J Prev Med 2016; 51:767-778. [PMID: 27180028 DOI: 10.1016/j.amepre.2016.04.003] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/17/2016] [Accepted: 04/01/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT The onset of cigarette smoking typically occurs during childhood or early adolescence. Nicotine dependence symptoms can manifest soon after onset, contributing to sustained, long-term smoking. Previous reviews have not clarified the determinants of onset. EVIDENCE ACQUISITION In 2015, a systematic review of the literature in PubMed and EMBASE was undertaken to identify peer-reviewed prospective longitudinal studies published between January 1984 and August 2015 that investigated predictors of cigarette smoking onset among youth aged <18 years who had never smoked. EVIDENCE SYNTHESIS Ninety-eight conceptually different potential predictors were identified in 53 studies. An increased risk of smoking onset was consistently (i.e., in four or more studies) associated with increased age/grade, lower SES, poor academic performance, sensation seeking or rebelliousness, intention to smoke in the future, receptivity to tobacco promotion efforts, susceptibility to smoking, family members' smoking, having friends who smoke, and exposure to films, whereas higher self-esteem and high parental monitoring/supervision of the child appeared to protect against smoking onset. Methodologic weaknesses were identified in numerous studies, including failure to account for attrition or for clustering in samples, and misidentification of potential confounders, which may have led to biased estimates of associations. CONCLUSIONS Predictors of smoking onset for which there is robust evidence should be considered in the design of interventions to prevent first puff in order to optimize their effectiveness. Future research should seek to define onset clearly as the transition from never use to first use (e.g., first few puffs).
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9
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A Test-Replicate Approach to Candidate Gene Research on Addiction and Externalizing Disorders: A Collaboration Across Five Longitudinal Studies. Behav Genet 2016; 46:608-626. [PMID: 27444553 DOI: 10.1007/s10519-016-9800-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
This study presents results from a collaboration across five longitudinal studies seeking to test and replicate models of gene-environment interplay in the development of substance use and externalizing disorders (SUDs, EXT). We describe an overview of our conceptual models, plan for gene-environment interplay analyses, and present main effects results evaluating six candidate genes potentially relevant to SUDs and EXT (MAOA, 5-HTTLPR, COMT, DRD2, DAT1, and DRD4). All samples included rich longitudinal and phenotypic measurements from childhood/adolescence (ages 5-13) through early adulthood (ages 25-33); sample sizes ranged from 3487 in the test sample, to ~600-1000 in the replication samples. Phenotypes included lifetime symptom counts of SUDs (nicotine, alcohol and cannabis), adult antisocial behavior, and an aggregate externalizing disorder composite. Covariates included the first 10 ancestral principal components computed using all autosomal markers in subjects across the data sets, and age at the most recent assessment. Sex, ancestry, and exposure effects were thoroughly evaluated. After correcting for multiple testing, only one significant main effect was found in the test sample, but it was not replicated. Implications for subsequent gene-environment interplay analyses are discussed.
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10
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Ma Y, Wang M, Yuan W, Su K, Li MD. The significant association of Taq1A genotypes in DRD2/ANKK1 with smoking cessation in a large-scale meta-analysis of Caucasian populations. Transl Psychiatry 2015; 5:e686. [PMID: 26624925 PMCID: PMC5068580 DOI: 10.1038/tp.2015.176] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/11/2015] [Accepted: 09/29/2015] [Indexed: 11/23/2022] Open
Abstract
Although a number of studies have analyzed the relation between the DRD2/ANKK1 gene Taq1A polymorphism and smoking cessation, the results remain controversial. The primary objective of the present study was to determine whether this variant indeed has any effect on smoking cessation. The A1-dominant model that considers A1/* (*=A1 or A2) and A2/A2 as two genotypes and compares their frequencies in current and former smokers was applied. A total of 22 studies with 11,075 subjects were included in the meta-analyses. Considering the potential influence of between-study heterogeneity, we conducted stratified meta-analyses with the Comprehensive Meta-Analysis statistical software (version 2.0). Results based on either cross-sectional or longitudinal studies consistently showed a statistically significant association between Taq1A A1/* genotypes and smoking cessation. Further, a more significant association of the variant with smoking cessation was detected when both types of studies were combined. However, there was marginal evidence of heterogeneity among studies (I(2)=33.9%; P=0.06). By excluding other ethnicities and subjects with cancer, the meta-analysis on the basis of 9487 Caucasians demonstrated that Taq1A A1/* genotypes indeed were significantly associated with smoking cessation under both the fixed- and random-effects models (pooled OR 1.22; 95% CI 1.11-1.34; P=3.9 × 10(-5) for both models). No evidence of between-study heterogeneity or publication bias was observed. Thus, we conclude that the polymorphism of Taq1A has an important role in the process of abstaining from smoking, and smokers carrying A2/A2 genotype have a higher likelihood of smoking cessation than those who carry A1/A1 or A1/A2.
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Affiliation(s)
- Y Ma
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
| | - M Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
| | - W Yuan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
| | - K Su
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
| | - M D Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
- Air Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
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11
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Mayer O, Seidlerová J, Černá V, Kučerová A, Bruthans J, Vágovičová P, Vaněk J, Timoracká K, Wohlfahrt P, Filipovský J, Cífková R, Pešta M. The DRD2/ANKK1 Taq1A polymorphism is associated with smoking cessation failure in patients with coronary heart disease. Per Med 2015; 12:463-473. [PMID: 29749891 DOI: 10.2217/pme.15.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM We speculated whether DRD2 or CHRN subunit polymorphisms might be associated with the risk of smoking cessation failure in subjects after coronary heart disease (CHD) manifestation. METHODS A total of 964 patients with CHD, mean age 64.3 years (standard deviation [SD] 9.0), examined in the EUROASPIRE III and IV surveys were genotyped for rs1800497 (DRD2/ANKK1 Taq1A), rs578776 (CHRNA5-A3-B4), rs16969968 (CHRNA5) and rs1051730 (CHRNA3) SNPs. RESULTS The presence of DRD2/ANKK1 Taq1A minor T allele was independently associated with increased relative risk of smoking persistence (odds ratio: 1.79; 95% CI: 1.13-4.35). We observed no association between CHRN SNPs and smoking habit. CONCLUSION DRD2/ANKK1 Taq1A polymorphism is associated with a decreased likelihood of smoking cessation in patients after CHD manifestation.
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Affiliation(s)
- Otto Mayer
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic.,Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic.,University Hospital, 2nd Department of Internal Medicine, Pilsen, Czech Republic
| | - Jitka Seidlerová
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic.,Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Václava Černá
- Department of Biology, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Alena Kučerová
- Department of Biology, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Jan Bruthans
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic.,Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University & Thomayer Hospital, Prague, Czech Republic
| | - Petra Vágovičová
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Jiří Vaněk
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Katarína Timoracká
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Peter Wohlfahrt
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University & Thomayer Hospital, Prague, Czech Republic.,International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
| | - Jan Filipovský
- 2nd Department of Internal Medicine, Medical Faculty of Charles University, Pilsen, Czech Republic.,Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic
| | - Renata Cífková
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University & Thomayer Hospital, Prague, Czech Republic.,International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
| | - Martin Pešta
- Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic.,Department of Biology, Medical Faculty of Charles University, Pilsen, Czech Republic
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12
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Yang X, Chen H, Li S, Wang Q, Pan L, Jia C. Association between monoamine oxidase gene polymorphisms and smoking behavior: A meta-analysis. Drug Alcohol Depend 2015; 153:350-4. [PMID: 26051160 DOI: 10.1016/j.drugalcdep.2015.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND A number of studies have researched the association between monoamine oxidase gene (MAO) polymorphisms and smoking behavior, but the conclusion is quite inconsistent. A meta-analysis was conducted to assess the association of MAO-A C1460T, MAO-A VNTR and MAO-B G644A polymorphisms with smoking behavior. METHODS A comprehensive search was performed to identify all eligible studies. Meta-analysis was applied to calculate the pooled effect values and their 95% confidence intervals. Meta-regression and the 'leave one out' sensitivity analysis were used to explore potential sources of heterogeneity. The risk of bias was assessed by the Egger regression asymmetry test. RESULTS 11 articles conformed to the inclusion criteria. The meta-analysis showed T allele in MAO-A C1460T reduced the risk of heavy smoking (OR=0.66, 95% CI: 0.52-0.84; I(2)=0.0%), especially in Caucasians; the active group in MAO-A VNTR increased the likelihood of failed smoking cessation in males (OR=1.49, 95% CI: 1.01-2.22; I(2)=0.0%); A allele in MAO-B G644A reduced the risk of heavy smoking in males (OR=0.20, 95% CI: 0.04-0.98). CONCLUSION Our findings indicate that the low activity of monoamine oxidase gene polymorphisms has a protective effect on smoking cessation and heaviness. Some associations and applications should be further confirmed.
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Affiliation(s)
- Xiaorong Yang
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Hui Chen
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Suyun Li
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Qiang Wang
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Lulu Pan
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Chongqi Jia
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China.
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Huang CL, Ou WC, Chen PL, Liu CN, Chen MC, Lu CC, Chen YC, Lin MH, Huang CS. Effects of Interaction Between Dopamine D2 Receptor and Monoamine Oxidase A Genes on Smoking Status in Young Men. Biol Res Nurs 2015; 17:422-8. [PMID: 26015071 DOI: 10.1177/1099800415589366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although the effect of gene-gene interaction on nicotine-dopamine metabolism for smoking behavior has been reported, polymorphisms of dopamine D2 receptor (DRD2) and monoamine oxidase A (MAOA) have not been simultaneously examined among smokers. In this study, 481 young Taiwanese men completed a self-report questionnaire on smoking status, and data were obtained on polymorphisms of DRD2 rs1800497, DRD2 rs1079597, MAOA rs309850, and MAOA rs1137070, urinary nicotine, and urinary cotinine. In a comparison of 261 current smokers and 220 never smokers, odds ratios (ORs) for the development of smoking in all genotypes were not statistically significant. Among smokers with DRD2 rs1079597 GG//MAOA rs309850 3-repeat, the OR of heavier smoking was 2.67 times higher (95% confidence interval [CI]: [1.08, 6.59], p = .031) and the score on the Fagerstrom test for nicotine dependence was higher (4.26 vs. 2.83) than in those with DRD2 rs1079597 AA//MAOA rs309850 3-repeat. Adjusted urinary cotinine concentration was significantly different between those two groups (median value: 95.83 ng/μl vs. 133.24 ng/μl, respectively, p = .045). These findings suggest that the interaction of DRD2 rs1079597 and MAOA rs309850 3-repeat affects smoking intensity in young Taiwanese men.
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Affiliation(s)
- Chih-Ling Huang
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
| | - Wei-Chih Ou
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Pei-Lain Chen
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chen-Nu Liu
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Mei-Chih Chen
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chia-Chen Lu
- Department of Internal Medicine, Erhlin Christian Hospital, Changhua Christian Medical Foundation, Erhlin, Taiwan
| | - Yi-Chun Chen
- Administration Center of Research and Education, Changhua Christian Hospital, Changhua Christian Medical Foundation, Changhua, Taiwan
| | - Min-Hsuan Lin
- Administration Center of Research and Education, Changhua Christian Hospital, Changhua Christian Medical Foundation, Changhua, Taiwan
| | - Ching-Shan Huang
- Administration Center of Research and Education, Changhua Christian Hospital, Changhua Christian Medical Foundation, Changhua, Taiwan
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Ohmoto M, Takahashi T, Kubota Y, Kobayashi S, Mitsumoto Y. Genetic influence of dopamine receptor, dopamine transporter, and nicotine metabolism on smoking cessation and nicotine dependence in a Japanese population. BMC Genet 2014; 15:151. [PMID: 25526961 PMCID: PMC4307219 DOI: 10.1186/s12863-014-0151-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 12/11/2014] [Indexed: 01/04/2023] Open
Abstract
Background This study investigated whether polymorphisms of the ankyrin repeat and kinase domain containing 1 gene (ANKK1), which is adjacent to the dopamine D2 receptor gene (DRD2), and the dopamine transporter (SLC6A3) and cytochrome P450 2A6 (CYP2A6) genes influence smoking cessation and nicotine dependence in a Japanese population. In 96 current and former smokers, genotyping frequencies for the ANKK1/DRD2 TaqIA, SLC6A3 VNTR, and CYP2A6 polymorphisms were subjected to chi-square analysis, and regression analyses were used to determine the association of the genotypes of current smokers with a Heavy Smoking Index, in addition to evaluating the effect of the subjects’ smoking history on the association. Results Genotyping results suggested that nicotine dependence among current smokers homozygous for the SLC6A3 10r allele was lower than that of smokers carrying the minor alleles, and that the CYP2A6 polymorphism might mediate this association. Furthermore, the age at which current smokers began smoking might moderate the association between their genetic polymorphisms and nicotine dependence. Conclusions This study provides preliminary findings on the influence of genetic variants on the smoking phenotypes in a Japanese population.
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Affiliation(s)
- Masanori Ohmoto
- Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa, 920-1181, Japan.
| | - Tatsuo Takahashi
- Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa, 920-1181, Japan.
| | - Yoko Kubota
- Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa, 920-1181, Japan.
| | - Shinjiro Kobayashi
- Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa, 920-1181, Japan.
| | - Yasuhide Mitsumoto
- Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa, 920-1181, Japan.
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Association between DRD2/ANKK1 TaqIA polymorphism and common illicit drug dependence: evidence from a meta-analysis. Hum Immunol 2014; 76:42-51. [PMID: 25500252 DOI: 10.1016/j.humimm.2014.12.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/27/2014] [Accepted: 12/03/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Growing evidence indicated conflicting results about the dopamine receptor D2 (DRD2)/kinase domain containing 1 gene (ANKK1) TaqIA single nucleotide polymorphism (rs1800497) and common illicit drug dependence risk including stimulants, opioid and marijuana. We conducted a meta-analysis to evaluate the association between the polymorphism and common illicit drug dependence risk. METHOD A total of 25 available studies (26 subgroups) testing the association between the polymorphism and common illicit drug dependence were examined through Oct 2013. Pooled odds ratios (ORs) and 95% confidence intervals (CI) were estimated using fixed- and random-effects models when appropriate. Heterogeneity and publication bias were evaluated. RESULTS We found the DRD2/ANKK1 TaqIA polymorphism was significantly associated with increased risk of opioid dependence under homozygote, dominant, and recessive genetic model, respectively (homozygote: OR=1.546, 95%CI=1.279-1.87; dominant: OR=1.265, 95%CI=1.055-1.516; recessive: OR=1.409, 95%CI=1.182-1.680). Subgroup analyses were similar to the results of the total population by ethnicity and quality score. Besides, we also found that Caucasian and low-quality studies were major sources of heterogeneity for opioid dependence. We failed to find any significant association between the polymorphism and stimulants or marijuana neither in total population nor subgroup analyses under any genetic model. CONCLUSIONS The current meta-analysis suggested that DRD2/ANKK1 TaqIA polymorphism might be associated with opioid dependence risk, but not associated with stimulants or marijuana dependence.
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Blum K, Thanos PK, Gold MS. Dopamine and glucose, obesity, and reward deficiency syndrome. Front Psychol 2014; 5:919. [PMID: 25278909 PMCID: PMC4166230 DOI: 10.3389/fpsyg.2014.00919] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/01/2014] [Indexed: 01/08/2023] Open
Abstract
Obesity as a result of overeating as well as a number of well described eating disorders has been accurately considered to be a world-wide epidemic. Recently a number of theories backed by a plethora of scientifically sound neurochemical and genetic studies provide strong evidence that food addiction is similar to psychoactive drug addiction. Our laboratory has published on the concept known as Reward Deficiency Syndrome (RDS) which is a genetic and epigenetic phenomena leading to impairment of the brain reward circuitry resulting in a hypo-dopaminergic function. RDS involves the interactions of powerful neurotransmitters and results in abnormal craving behavior. A number of important facts which could help translate to potential therapeutic targets espoused in this focused review include: (1) consumption of alcohol in large quantities or carbohydrates binging stimulates the brain’s production of and utilization of dopamine; (2) in the meso-limbic system the enkephalinergic neurons are in close proximity, to glucose receptors; (3) highly concentrated glucose activates the calcium channel to stimulate dopamine release from P12 cells; (4) a significant correlation between blood glucose and cerebrospinal fluid concentrations of homovanillic acid the dopamine metabolite; (5) 2-deoxyglucose (2DG), the glucose analog, in pharmacological doses is associated with enhanced dopamine turnover and causes acute glucoprivation. Evidence from animal studies and fMRI in humans support the hypothesis that multiple, but similar brain circuits are disrupted in obesity and drug dependence and for the most part, implicate the involvement of DA-modulated reward circuits in pathologic eating behaviors. Based on a consensus of neuroscience research treatment of both glucose and drug like cocaine, opiates should incorporate dopamine agonist therapy in contrast to current theories and practices that utilizes dopamine antagonistic therapy. Considering that up until now clinical utilization of powerful dopamine D2 agonists have failed due to chronic down regulation of D2 receptors newer targets based on novel less powerful D2 agonists that up-regulate D2 receptors seems prudent. We encourage new strategies targeted at improving DA function in the treatment and prevention of obesity a subtype of reward deficiency.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
| | - Panayotis K Thanos
- Behavior Neuropharmacology and Neuroimaging Lab, Department of Psychology, State University of New York Stony Brook, NY, USA
| | - Mark S Gold
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
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BLUM KENNETH, FEBO MARCELO, MCLAUGHLIN THOMAS, CRONJÉ FRANSJ, HAN DAVID, GOLD SMARK. Hatching the behavioral addiction egg: Reward Deficiency Solution System (RDSS)™ as a function of dopaminergic neurogenetics and brain functional connectivity linking all addictions under a common rubric. J Behav Addict 2014; 3:149-56. [PMID: 25317338 PMCID: PMC4189308 DOI: 10.1556/jba.3.2014.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/04/2014] [Accepted: 07/04/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Following the first association between the dopamine D2 receptor gene polymorphism and severe alcoholism, there has been an explosion of research reports in the psychiatric and behavioral addiction literature and neurogenetics. With this increased knowledge, the field has been rife with controversy. Moreover, with the advent of Whole Genome-Wide Studies (GWAS) and Whole Exome Sequencing (WES), along with Functional Genome Convergence, the multiple-candidate gene approach still has merit and is considered by many as the most prudent approach. However, it is the combination of these two approaches that will ultimately define real, genetic allelic relationships, in terms of both risk and etiology. Since 1996, our laboratory has coined the umbrella term Reward Deficiency Syndrome (RDS) to explain the common neurochemical and genetic mechanisms involved with both substance and non-substance, addictive behaviors. METHODS This is a selective review of peer-reviewed papers primary listed in Pubmed and Medline. RESULTS A review of the available evidence indicates the importance of dopaminergic pathways and resting-state, functional connectivity of brain reward circuits. DISCUSSION Importantly, the proposal is that the real phenotype is RDS and impairments in the brain's reward cascade, either genetically or environmentally (epigenetically) induced, influence both substance and non-substance, addictive behaviors. Understanding shared common mechanisms will ultimately lead to better diagnosis, treatment and prevention of relapse. While, at this juncture, we cannot as yet state that we have "hatched the behavioral addiction egg", we are beginning to ask the correct questions and through an intense global effort will hopefully find a way of "redeeming joy" and permitting homo sapiens live a life, free of addiction and pain.
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Affiliation(s)
- KENNETH BLUM
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Department of Clinical Medicine, Malibu Beach Recovery Center, Malibu Beach, CA, USA,Department of Personalized Medicine, IGENE, LLC, Austin, TX, USA,Corresponding author: Kenneth Blum, PhD; Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, PO Box 103424 Gainesville, Florida, USA, 32610-3424; Phone: +-619-890-2167; Fax: +-352-392-9887; E-mail:
| | - MARCELO FEBO
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | | | | | - DAVID HAN
- Department of Management Science and Statistics, University of Texas at San Antonio, Texas, USA
| | - S. MARK GOLD
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Department of Clinical Medicine, Malibu Beach Recovery Center, Malibu Beach, CA, USA
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Hiemstra M, Kleinjan M, van Schayck OCP, Engels RCME, Otten R. Environmental smoking and smoking onset in adolescence: the role of dopamine-related genes. Findings from two longitudinal studies. PLoS One 2014; 9:e86497. [PMID: 24466121 PMCID: PMC3897729 DOI: 10.1371/journal.pone.0086497] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 12/14/2013] [Indexed: 01/21/2023] Open
Abstract
Although environmental smoking (i.e., paternal and maternal smoking, sibling smoking, and peer smoking) is one of the most important factors for explaining adolescent smoking behavior, not all adolescents are similarly affected. The extent to which individuals are vulnerable to smoking in their environment might depend on genetic factors. The aim of this study was to examine the interplay between environmental smoking and genes encoding components of the dopaminergic system (i.e., dopamine receptor D2, D4, and dopamine transporter DAT1) in adolescent smoking onset. Data from two longitudinal studies were used. Study 1 consisted of 991 non-smoking early adolescents (mean age = 12.52, SD = .57) whereas study 2 consisted of 365 non-smoking middle to late adolescents (mean age = 14.16, SD = 1.07) who were followed for 16 and 48 months, respectively. Logistic regression analyses were conducted using Mplus. In study 1, we found positive associations between parents' and friends' smoking at the first measurement and smoking status 16 months later. In study 2 we found a positive association between friends' smoking and smoking onset 48 months later. Neither study demonstrated any interaction effects of the DRD2, DRD4, or DAT1 genotypes. In conclusion, the effects of environmental smoking on smoking onset are similar for adolescent carriers and non-carriers of these specific genes related to the dopaminergic system.
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Affiliation(s)
- Marieke Hiemstra
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marloes Kleinjan
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Onno C. P. van Schayck
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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