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Salazar de Pablo G, Iniesta R, Bellato A, Caye A, Dobrosavljevic M, Parlatini V, Garcia-Argibay M, Li L, Cabras A, Haider Ali M, Archer L, Meehan AJ, Suleiman H, Solmi M, Fusar-Poli P, Chang Z, Faraone SV, Larsson H, Cortese S. Individualized prediction models in ADHD: a systematic review and meta-regression. Mol Psychiatry 2024:10.1038/s41380-024-02606-5. [PMID: 38783054 DOI: 10.1038/s41380-024-02606-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
There have been increasing efforts to develop prediction models supporting personalised detection, prediction, or treatment of ADHD. We overviewed the current status of prediction science in ADHD by: (1) systematically reviewing and appraising available prediction models; (2) quantitatively assessing factors impacting the performance of published models. We did a PRISMA/CHARMS/TRIPOD-compliant systematic review (PROSPERO: CRD42023387502), searching, until 20/12/2023, studies reporting internally and/or externally validated diagnostic/prognostic/treatment-response prediction models in ADHD. Using meta-regressions, we explored the impact of factors affecting the area under the curve (AUC) of the models. We assessed the study risk of bias with the Prediction Model Risk of Bias Assessment Tool (PROBAST). From 7764 identified records, 100 prediction models were included (88% diagnostic, 5% prognostic, and 7% treatment-response). Of these, 96% and 7% were internally and externally validated, respectively. None was implemented in clinical practice. Only 8% of the models were deemed at low risk of bias; 67% were considered at high risk of bias. Clinical, neuroimaging, and cognitive predictors were used in 35%, 31%, and 27% of the studies, respectively. The performance of ADHD prediction models was increased in those models including, compared to those models not including, clinical predictors (β = 6.54, p = 0.007). Type of validation, age range, type of model, number of predictors, study quality, and other type of predictors did not alter the AUC. Several prediction models have been developed to support the diagnosis of ADHD. However, efforts to predict outcomes or treatment response have been limited, and none of the available models is ready for implementation into clinical practice. The use of clinical predictors, which may be combined with other type of predictors, seems to improve the performance of the models. A new generation of research should address these gaps by conducting high quality, replicable, and externally validated models, followed by implementation research.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Raquel Iniesta
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
- King's Institute for Artificial Intelligence, King's College London, London, UK
| | - Alessio Bellato
- School of Psychology, University of Nottingham, Nottingham, Malaysia
- Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, Southampton, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - Arthur Caye
- Post-Graduate Program of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Center for Research and Innovation (CISM), University of São Paulo, São Paulo, Brazil
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maja Dobrosavljevic
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Valeria Parlatini
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, Southampton, UK
- School of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
| | - Miguel Garcia-Argibay
- Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, Southampton, UK
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lin Li
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Cabras
- Department of Neurology and Psychiatry, University of Rome La Sapienza, Rome, Italy
| | - Mian Haider Ali
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Lucinda Archer
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR), Birmingham Biomedical Research Centre, Birmingham, UK
| | - Alan J Meehan
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Halima Suleiman
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, Syracuse, NY, USA
| | - Marco Solmi
- Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, Southampton, UK
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ontario, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, Syracuse, NY, USA
| | - Henrik Larsson
- School of Psychology, University of Southampton, Southampton, UK
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Samuele Cortese
- Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, Southampton, UK.
- Solent NHS Trust, Southampton, UK.
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, 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.
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Cervantes-Henríquez ML, Acosta-López JE, Martinez AF, Arcos-Burgos M, Puentes-Rozo PJ, Vélez JI. Machine Learning Prediction of ADHD Severity: Association and Linkage to ADGRL3, DRD4, and SNAP25. J Atten Disord 2022; 26:587-605. [PMID: 34009035 DOI: 10.1177/10870547211015426] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate whether single nucleotide polymorphisms (SNPs) in the ADGRL3, DRD4, and SNAP25 genes are associated with and predict ADHD severity in families from a Caribbean community. METHOD ADHD severity was derived using latent class cluster analysis of DSM-IV symptomatology. Family-based association tests were conducted to detect associations between SNPs and ADHD severity latent phenotypes. Machine learning algorithms were used to build predictive models of ADHD severity based on demographic and genetic data. RESULTS Individuals with ADHD exhibited two seemingly independent latent class severity configurations. SNPs harbored in DRD4, SNAP25, and ADGRL3 showed evidence of linkage and association to symptoms severity and a potential pleiotropic effect on distinct domains of ADHD severity. Predictive models discriminate severe from non-severe ADHD in specific symptom domains. CONCLUSION This study supports the role of DRD4, SNAP25, and ADGRL3 genes in outlining ADHD severity, and a new prediction framework with potential clinical use.
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Affiliation(s)
| | | | | | | | - Pedro J Puentes-Rozo
- Universidad Simón Bolívar, Barranquilla, Colombia
- Universidad del Atlántico, Barranquilla, Colombia
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Acosta-López JE, Suárez I, Pineda DA, Cervantes-Henríquez ML, Martínez-Banfi ML, Lozano-Gutiérrez SG, Ahmad M, Pineda-Alhucema W, Noguera-Machacón LM, Hoz MDL, Mejía-Segura E, Jiménez-Figueroa G, Sánchez-Rojas M, Mastronardi CA, Arcos-Burgos M, Vélez JI, Puentes-Rozo PJ. Impulsive and Omission Errors: Potential Temporal Processing Endophenotypes in ADHD. Brain Sci 2021; 11:1218. [PMID: 34573239 PMCID: PMC8467181 DOI: 10.3390/brainsci11091218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
Temporal processing (TP) is associated with functions such as perception, verbal skills, temporal perspective, and future planning, and is intercorrelated with working memory, attention, and inhibitory control, which are highly impaired in individuals with attention deficit hyperactivity disorder (ADHD). Here we evaluate TP measures as potential endophenotypes in Caribbean families ascertained from probands affected by ADHD. A total of 232 individuals were recruited and clinically evaluated using an extensive battery of neuropsychological tasks and reaction time (RT)-based task paradigms. Further, the heritability (genetic variance underpinning phenotype) was estimated as a measure of the genetics apportionment. A predictive framework for ADHD diagnosis was derived using these tasks. We found that individuals with ADHD differed from controls in neuropsychological tasks assessing mental control, visual-verbal memory, verbal fluency, verbal, and semantic fluency. In addition, TP measures such as RT, errors, and variability were also affected in individuals with ADHD. Moreover, we determined that only omission and commission errors had significant heritability. In conclusion, we have disentangled omission and commission errors as possible TP endophenotypes in ADHD, which can be suitable to assess the neurobiological and genetic basis of ADHD. A predictive model using these endophenotypes led to remarkable sensitivity, specificity, precision and classification rate for ADHD diagnosis, and may be a useful tool for patients' diagnosis, follow-up, and longitudinal assessment in the clinical setting.
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Affiliation(s)
- Johan E. Acosta-López
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Isabel Suárez
- Universidad del Norte, Barranquilla 081007, Colombia;
| | - David A. Pineda
- Neuropsychology and Conduct Research Group, University of San Buenaventura, Medellín 050010, Colombia;
| | - Martha L. Cervantes-Henríquez
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
- Universidad del Norte, Barranquilla 081007, Colombia;
| | - Martha L. Martínez-Banfi
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Semiramis G. Lozano-Gutiérrez
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Mostapha Ahmad
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Wilmar Pineda-Alhucema
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Luz M. Noguera-Machacón
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Moisés De La Hoz
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Elsy Mejía-Segura
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Giomar Jiménez-Figueroa
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | - Manuel Sánchez-Rojas
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
| | | | - Mauricio Arcos-Burgos
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | | | - Pedro J. Puentes-Rozo
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (M.L.C.-H.); (M.L.M.-B.); (S.G.L.-G.); (M.A.); (W.P.-A.); (L.M.N.-M.); (M.D.L.H.); (E.M.-S.); (G.J.-F.); (M.S.-R.); (P.J.P.-R.)
- Grupo de Neurociencias del Caribe, Universidad del Atlántico, Barranquilla 081007, Colombia
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Mosquera-Heredia MI, Morales LC, Vidal OM, Barceló E, Silvera-Redondo C, Vélez JI, Garavito-Galofre P. Exosomes: Potential Disease Biomarkers and New Therapeutic Targets. Biomedicines 2021; 9:1061. [PMID: 34440265 PMCID: PMC8393483 DOI: 10.3390/biomedicines9081061] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023] Open
Abstract
Exosomes are extracellular vesicles released by cells, both constitutively and after cell activation, and are present in different types of biological fluid. Exosomes are involved in the pathogenesis of diseases, such as cancer, neurodegenerative diseases, pregnancy disorders and cardiovascular diseases, and have emerged as potential non-invasive biomarkers for the detection, prognosis and therapeutics of a myriad of diseases. In this review, we describe recent advances related to the regulatory mechanisms of exosome biogenesis, release and molecular composition, as well as their role in health and disease, and their potential use as disease biomarkers and therapeutic targets. In addition, the advantages and disadvantages of their main isolation methods, characterization and cargo analysis, as well as the experimental methods used for exosome-mediated drug delivery, are discussed. Finally, we present potential perspectives for the use of exosomes in future clinical practice.
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Affiliation(s)
- Maria I. Mosquera-Heredia
- Department of Medicine, Universidad del Norte, Barranquilla 081007, Colombia; (L.C.M.); (O.M.V.); (C.S.-R.)
| | - Luis C. Morales
- Department of Medicine, Universidad del Norte, Barranquilla 081007, Colombia; (L.C.M.); (O.M.V.); (C.S.-R.)
| | - Oscar M. Vidal
- Department of Medicine, Universidad del Norte, Barranquilla 081007, Colombia; (L.C.M.); (O.M.V.); (C.S.-R.)
| | - Ernesto Barceló
- Instituto Colombiano de Neuropedagogía, Barranquilla 080020, Colombia;
| | - Carlos Silvera-Redondo
- Department of Medicine, Universidad del Norte, Barranquilla 081007, Colombia; (L.C.M.); (O.M.V.); (C.S.-R.)
| | - Jorge I. Vélez
- Department of Industrial Engineering, Universidad del Norte, Barranquilla 081007, Colombia;
| | - Pilar Garavito-Galofre
- Department of Medicine, Universidad del Norte, Barranquilla 081007, Colombia; (L.C.M.); (O.M.V.); (C.S.-R.)
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Martinez-Banfi M, Vélez JI, Mebarak Chams MR, Arcos-Holzinger M, Acosta-López JE, García R, Perea MV, Arcos-Burgos M, Ladera V. Utility of a Short Neuropsychological Protocol for Detecting HIV-Associated Neurocognitive Disorders in Patients with Asymptomatic HIV-1 Infection. Brain Sci 2021; 11:1037. [PMID: 34439656 PMCID: PMC8394998 DOI: 10.3390/brainsci11081037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 12/31/2022] Open
Abstract
Human Immunodeficiency Virus type 1 (HIV-1) infection is a chronic disease that affects ~40 million people worldwide. HIV-associated neurocognitive disorders (HAND) are common in individuals with HIV-1 Infection, and represent a recent public health problem. Here we evaluate the performance of a recently proposed short protocol for detecting HAND by studying 60 individuals with HIV-1-Infection and 60 seronegative controls from a Caribbean community in Barranquilla, Colombia. The short evaluation protocol used significant neuropsychological tests from a previous study of asymptomatic HIV-1 infected patients and a group of seronegative controls. Brief screening instruments, i.e., the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS), were also applied. Using machine-learning techniques, we derived predictive models of HAND status, and evaluated their performance with the ROC curves. The proposed short protocol performs exceptionally well yielding sensitivity, specificity, and overall prediction values >90%, and better predictive capacity than that of the MMSE and IHDS. Community-specific cut-off values for HAND diagnosis, based on the MMSE and IHDS, make this protocol suitable for HAND screening in individuals from this Caribbean community. This study shows the effectivity of a recently proposed short protocol to detect HAND in individuals with asymptomatic HIV-1-Infection. The application of community-specific cut-off values for HAND diagnosis in the clinical setting may improve HAND screening accuracy and facilitate patients' treatment and follow-up. Further studies are needed to assess the performance of this protocol in other Latin American populations.
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Affiliation(s)
- Martha Martinez-Banfi
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia;
| | - Jorge I. Vélez
- Department of Industrial Engineering, Universidad del Norte, Barranquilla 081007, Colombia;
| | | | - Mauricio Arcos-Holzinger
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia; (M.A.-H.); (M.A.-B.)
| | - Johan E. Acosta-López
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia;
| | - Ricardo García
- Facultad de Psicología, Universidad de Salamanca, 37008 Salamanca, Spain; (R.G.); (M.V.P.); (V.L.)
| | - María Victoria Perea
- Facultad de Psicología, Universidad de Salamanca, 37008 Salamanca, Spain; (R.G.); (M.V.P.); (V.L.)
| | - Mauricio Arcos-Burgos
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia; (M.A.-H.); (M.A.-B.)
| | - Valentina Ladera
- Facultad de Psicología, Universidad de Salamanca, 37008 Salamanca, Spain; (R.G.); (M.V.P.); (V.L.)
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6
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Cervantes-Henriquez ML, Acosta-López JE, Ahmad M, Sánchez-Rojas M, Jiménez-Figueroa G, Pineda-Alhucema W, Martinez-Banfi ML, Noguera-Machacón LM, Mejía-Segura E, De La Hoz M, Arcos-Holzinger M, Pineda DA, Puentes-Rozo PJ, Arcos-Burgos M, Vélez JI. ADGRL3, FGF1 and DRD4: Linkage and Association with Working Memory and Perceptual Organization Candidate Endophenotypes in ADHD. Brain Sci 2021; 11:854. [PMID: 34206913 PMCID: PMC8301925 DOI: 10.3390/brainsci11070854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a highly heritable neurobehavioral disorder that affects children worldwide, with detrimental long-term consequences in affected individuals. ADHD-affected patients display visual-motor and visuospatial abilities and skills that depart from those exhibited by non-affected individuals and struggle with perceptual organization, which might partially explain impulsive responses. Endophenotypes (quantifiable or dimensional constructs that are closely related to the root cause of the disease) might provide a more powerful and objective framework for dissecting the underlying neurobiology of ADHD than that of categories offered by the syndromic classification. In here, we explore the potential presence of the linkage and association of single-nucleotide polymorphisms (SNPs), harbored in genes implicated in the etiology of ADHD (ADGRL3, DRD4, and FGF1), with cognitive endophenotypes related to working memory and perceptual organization in 113 nuclear families. These families were ascertained from a geographical area of the Caribbean coast, in the north of Colombia, where the community is characterized by its ethnic diversity and differential gene pool. We found a significant association and linkage of markers ADGRL3-rs1565902, DRD4-rs916457 and FGF1-rs2282794 to neuropsychological tasks outlining working memory and perceptual organization such as performance in the digits forward and backward, arithmetic, similarities, the completion of figures and the assembly of objects. Our results provide strong support to understand ADHD as a combination of working memory and perceptual organization deficits and highlight the importance of the genetic background shaping the neurobiology, clinical complexity, and physiopathology of ADHD. Further, this study supplements new information regarding an ethnically diverse community with a vast African American contribution, where ADHD studies are scarce.
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Affiliation(s)
- Martha L. Cervantes-Henriquez
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
- Universidad del Norte, Barranquilla 081007, Colombia
| | - Johan E. Acosta-López
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Mostapha Ahmad
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Manuel Sánchez-Rojas
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Giomar Jiménez-Figueroa
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Wilmar Pineda-Alhucema
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Martha L. Martinez-Banfi
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Luz M. Noguera-Machacón
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Elsy Mejía-Segura
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Moisés De La Hoz
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (J.E.A.-L.); (M.A.); (M.S.-R.); (G.J.-F.); (W.P.-A.); (M.L.M.-B.); (L.M.N.-M.); (E.M.-S.); (M.D.L.H.)
| | - Mauricio Arcos-Holzinger
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Mxdicas, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia; (M.A.-H.); (M.A.-B.)
| | - David A. Pineda
- Grupo de Neuropsicología y Conducta, Universidad de San Buenaventura, Medellín 050010, Colombia;
| | - Pedro J. Puentes-Rozo
- Grupo de Neurociencias del Caribe, Universidad del Atlántico, Barranquilla 081001, Colombia;
| | - Mauricio Arcos-Burgos
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Mxdicas, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia; (M.A.-H.); (M.A.-B.)
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7
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Vidal OM, Acosta-Reyes J, Padilla J, Navarro-Lechuga E, Bravo E, Viasus D, Arcos-Burgos M, Vélez JI. Chikungunya outbreak (2015) in the Colombian Caribbean: Latent classes and gender differences in virus infection. PLoS Negl Trop Dis 2020; 14:e0008281. [PMID: 32492017 PMCID: PMC7304630 DOI: 10.1371/journal.pntd.0008281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/19/2020] [Accepted: 04/08/2020] [Indexed: 12/26/2022] Open
Abstract
Chikungunya virus (CHIKV), a mosquito-borne alphavirus of the Togaviridae family, is part of a group of emergent diseases, including arbovirus, constituting an increasing public health problem in tropical areas worldwide. CHIKV causes a severe and debilitating disease with high morbidity. The first Colombian autochthonous case was reported in the Colombian Caribbean region in September 2014. Within the next two to three months, the CHIKV outbreak reached its peak. Although the CHIKV pattern of clinical symptomatology has been documented in different epidemiological studies, understanding of the relationship between clinical symptomatology and variation in phenotypic response to CHIKV infection in humans remains limited. We performed a cross sectional study following 1160 individuals clinically diagnosed with CHIKV at the peak of the Chikungunya outbreak in the Colombian Caribbean region. We examined the relationship between symptomatology and diverse phenotypic responses. Latent Class Cluster Analysis (LCCA) models were used to characterize patients’ symptomatology and further identify subgroups of individuals with differential phenotypic response. We found that most individuals presented fever (94.4%), headache (73.28%) and general discomfort (59.4%), which are distinct clinical symptoms of a viral infection. Furthermore, 11/26 (43.2%) of the categorized symptoms were more frequent in women than in men. LCCA disclosed seven distinctive phenotypic response profiles in this population of CHIKV infected individuals. Interestingly, 282 (24.3%) individuals exhibited a lower symptomatic “extreme” phenotype and 74 (6.4%) patients were within the severe complex “extreme” phenotype. Although clinical symptomatology may be diverse, there are distinct symptoms or group of symptoms that can be correlated with differential phenotypic response and perhaps susceptibility to CHIKV infection, especially in the female population. This suggests that, comparatively to men, women are a CHIKV at-risk population. Further study is needed to validate these results and determine whether the distinct LCCA profiles are a result of the immune response or a mixture of genetic, lifestyle and environmental factors. Our findings could contribute to the development of machine learning approaches to characterizing CHIKV infection in other populations. Preliminary results have shown prediction models achieving up to 92% accuracy overall, with substantial sensitivity, specificity and accuracy values per LCCA-derived cluster. The Chikungunya virus (CHIKV) infection is a mosquito-borne virus of the Togaviridae family, part of the arbovirus group of mosquito-transmitted pathogens. CHIKV causes a severe and debilitating disease with high morbidity. In this study, we comprehensively analysed clinical data from 1160 individuals from the Colombian Caribbean, who were diagnosed with CHIKV infection during the 2014 epidemic peak and before the Zika epidemic (registered back in 2015). Further, the presence of latent classes and predictors of CHIKV susceptibility and severity of the CHIKV infection were analysed. Although it is well known that people respond differently to infection, our results showed that these differences are not arbitrary and may come from the specific orchestration of our immune response and specific genetic makeup. For example, we identified that females infected with CHIKV exhibited significant and heterogeneous phenotypic response patterns compared to men. Overall, these results inform about potential predictors and outlining strategies to study the natural history of CHIKV infection. Future studies assessing the contribution of demographic, immunological and genetic factors to symptom co-occurrence could shed some light on the severity of the clinical symptomatology and, ultimately, lead to more accurate, more efficient and differential diagnosis. These results could contribute to the development of machine learning approaches to characterizing CHIKV infection in other populations and provide more accurate and differential diagnosis.
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Affiliation(s)
- Oscar M. Vidal
- Universidad del Norte, Barranquilla, Colombia
- * E-mail: (OMV); (JIV)
| | | | | | | | - Elsa Bravo
- Epidemiological Surveillance Team, Health Secretary Program, Barranquilla, Colombia
| | | | - Mauricio Arcos-Burgos
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jorge I. Vélez
- Universidad del Norte, Barranquilla, Colombia
- * E-mail: (OMV); (JIV)
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Genetic Variation Underpinning ADHD Risk in a Caribbean Community. Cells 2019; 8:cells8080907. [PMID: 31426340 PMCID: PMC6721689 DOI: 10.3390/cells8080907] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/07/2019] [Accepted: 08/12/2019] [Indexed: 12/13/2022] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a highly heritable and prevalent neurodevelopmental disorder that frequently persists into adulthood. Strong evidence from genetic studies indicates that single nucleotide polymorphisms (SNPs) harboured in the ADGRL3 (LPHN3), SNAP25, FGF1, DRD4, and SLC6A2 genes are associated with ADHD. We genotyped 26 SNPs harboured in genes previously reported to be associated with ADHD and evaluated their potential association in 386 individuals belonging to 113 nuclear families from a Caribbean community in Barranquilla, Colombia, using family-based association tests. SNPs rs362990-SNAP25 (T allele; p = 2.46 × 10−4), rs2282794-FGF1 (A allele; p = 1.33 × 10−2), rs2122642-ADGRL3 (C allele, p = 3.5 × 10−2), and ADGRL3 haplotype CCC (markers rs1565902-rs10001410-rs2122642, OR = 1.74, Ppermuted = 0.021) were significantly associated with ADHD. Our results confirm the susceptibility to ADHD conferred by SNAP25, FGF1, and ADGRL3 variants in a community with a significant African American component, and provide evidence supporting the existence of specific patterns of genetic stratification underpinning the susceptibility to ADHD. Knowledge of population genetics is crucial to define risk and predict susceptibility to disease.
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