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Baum L, Lee CC, Ye R, Zhong Y, Hung SF, Tang CP, Ho TP, Swanson JM, Moyzis RK, Sham PC, Leung PWL. Attention-deficit/hyperactivity disorder and dopamine receptor D4 (DRD4) exon 3 variable number of tandem repeats (VNTR) 2-repeat allele. Ann Hum Genet 2024; 88:382-391. [PMID: 38624263 DOI: 10.1111/ahg.12560] [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: 10/07/2023] [Revised: 01/19/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
To investigate the association of attention-deficit/hyperactivity disorder (ADHD) with the 48-base pair (bp) variable number of tandem repeats (VNTR) in exon 3 of the dopamine receptor D4 (DRD4) gene, we genotyped 240 ADHD patients and their parents from Hong Kong. The 4R allele was most common, followed by 2R. We examined association between the 2R allele (relative to 4R) and ADHD by Transmission Disequilibrium Test (TDT). The odds ratio (OR) (95% confidence interval) was 0.90 (0.64-1.3). The p-value was 0.6. Examining subgroups revealed nominally significant association of 2R with inattentive ADHD: OR = 0.33 (0.12-0.92) and p = 0.03. Because our study used TDT analysis, we meta-analyzed the association of 2R with ADHD in Asians (1329 patient alleles), revealing results similar to ours: OR = 0.97 (0.80-1.2) and p = 0.8. To examine the association of 2R with inattentive ADHD, we meta-analyzed all studies (regardless of analysis type or ethnicity, in order to increase statistical power): 702 patient alleles, 1420 control alleles, OR = 0.81 (0.57-1.1) and p = 0.2. Overall, there is no evidence of association between ADHD and the 2R allele, but the suggestive association with the inattentive type warrants further investigation.
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Affiliation(s)
- Larry Baum
- Department of Psychiatry, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Chi Chiu Lee
- Department of Psychiatry, Kwai Chung Hospital, Hospital Authority, Hong Kong, China
| | - Rui Ye
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Yuanxin Zhong
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Se Fong Hung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Chun Pan Tang
- Department of Psychiatry, Kwai Chung Hospital, Hospital Authority, Hong Kong, China
| | - Ting Pong Ho
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - James M Swanson
- Department of Pediatrics, University of Irvine, Irvine, California, USA
| | - Robert K Moyzis
- Department of Biological Chemistry, University of California, Irvine, California, USA
| | - Pak-Chung Sham
- Department of Psychiatry, The State Key Laboratory of Brain and Cognitive Sciences, Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong, China
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Dopamine Receptor Expression and the Pathogenesis of Attention-Deficit Hyperactivity Disorder: a Scoping Review of the Literature. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2022. [DOI: 10.1007/s40474-022-00253-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thursina C, Nurputra DK, Harahap ISK, Harahap NIF, Sa'adah N, Wibowo S, Sutarni S, Sadewa AH, Hanjaya H, Nishio H. Determining the association between polymorphisms of the DAT1 and DRD4 genes with attention deficit hyperactivity disorder in children from Java Island. Neurol Int 2020; 12:8292. [PMID: 32774820 PMCID: PMC7378541 DOI: 10.4081/ni.2020.8292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioural in the children. Genetic factor is known one of the factors which contributed in ADHD development. VNTR polymorphism in 3'UTR exon 15 of DAT1 gene and exon 3 of DRD4 gene are reported to be associated in ADHD. In this study we examine the association of ADHD with VNTR polymorphism of DAT1 and DRD4 gene in Indonesian children. Sixty-five ADHD children and 70 normal children (6-13 years of age), were included in the study, we matched by age and gender. ADHD was diagnosed by DSM-IV. We performed a casecontrol study to found the association between ADHD and VNTR polymorphism of DAT1 and DRD4 genes. The 10-repeat allele of DAT1 and 2-repeat allele of DRD4 were higher in Indonesian children. Although the frequency of these allele was higher, but it was similar both in ADHD and control groups. Neither DAT1 nor DRD4 gene showed showed significant difference in genotype distribution and frequency allele between both groups (p > 0.05). No association between ADHD and VNTR polymorphism of DAT1 and DRD4 genes found in Indonesian children. This data suggest that DAT1 and DRD4 do not contribute to etiology of ADHD in Indonesian children. Further studies are needed to clarify association between VNTR polymorphism of DAT1 and DRD4 genetic with ADHD of Indonesian children in larger sample size and family based study.
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Affiliation(s)
- Cempaka Thursina
- Doctoral Programme of Medical and Health Science, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Neurology, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dian Kesumapramudya Nurputra
- Department of Pediatrics, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Community Medicine and Social Health Care Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Nur Imma Fatimah Harahap
- Department of Community Medicine and Social Health Care Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nihayatus Sa'adah
- Department of Biochemistry, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Samekto Wibowo
- Department of Neurology, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sri Sutarni
- Department of Neurology, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ahmad Hamim Sadewa
- Department of Biochemistry, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hermawan Hanjaya
- Department of Neurology, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hisahide Nishio
- Department of Community Medicine and Social Health Care Science, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Pediatrics, Kobe University Graduate school of Medicine, Kobe, Japan
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Hong JH, Hwang IW, Lim MH, Kwon HJ, Jin HJ. Genetic associations between ADHD and dopaminergic genes (DAT1 and DRD4) VNTRs in Korean children. Genes Genomics 2018; 40:1309-1317. [PMID: 30099719 DOI: 10.1007/s13258-018-0726-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/08/2018] [Indexed: 01/01/2023]
Abstract
It is well known that dopaminergic genes affect the development of attention deficit hyperactivity disorder (ADHD) in various populations. Many studies have shown that variable number tandem repeats (VNTRs) located within the 3'-untranslated region of DAT1 and in exon 3 of DRD4 are associated with ADHD development; however, these results were inconsistent. Therefore, we investigated the genetic association between two VNTRs and ADHD in Korean children. We determined the VNTRs using PCR. We examined genotype and allele frequency differences between the experimental and control groups, along with the odds ratios, using Chi square and exact tests. We observed a significant association between the children with ADHD and the control group in the 10R/10R genotype of DAT1 VNTRs (p = 0.025). In addition, the 11R allele of DAT1 VNTRs showed a higher frequency in the control group than in the ADHD group (p = 0.023). Also, the short repeat (without 11R) and long repeat alleles (including 11R) were associated with ADHD (p < 0.05). The analysis of DRD4 VNTRs revealed that the 2R allele is associated with ADHD (p = 0.025). A significant result was also observed in long and short repeats (p < 0.05). Additionally, ADHD subtypes showed that the DRD4 VNTRs are associated with combined and hyperactive-impulsive subtype groups (p < 0.05). Therefore, our results suggest that DAT1 VNTRs and DRD4 VNTRs play a role in the genetic etiology of ADHD in Korean children.
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Affiliation(s)
- Jun Ho Hong
- Department of Biological Sciences, College of Natural Science, Dankook University, Cheonan, 330-714, Republic of Korea
| | - In Wook Hwang
- Department of Biological Sciences, College of Natural Science, Dankook University, Cheonan, 330-714, Republic of Korea
- Enviromental Health Center, Dankook Medical Hospital, Cheonan, Republic of Korea
| | - Myung Ho Lim
- Department of Psychology and Psychotherapy, College of Health Sciences, Dankook University, Cheonan, Republic of Korea
- Enviromental Health Center, Dankook Medical Hospital, Cheonan, Republic of Korea
| | - Ho Jang Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
- Enviromental Health Center, Dankook Medical Hospital, Cheonan, Republic of Korea
| | - Han Jun Jin
- Department of Biological Sciences, College of Natural Science, Dankook University, Cheonan, 330-714, Republic of Korea.
- Enviromental Health Center, Dankook Medical Hospital, Cheonan, Republic of Korea.
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DRD4 Gene Polymorphisms as a Risk Factor for Children with Attention Deficit Hyperactivity Disorder in Iranian Population. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2017. [PMID: 28630890 PMCID: PMC5463114 DOI: 10.1155/2017/2494537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and Objective Dopamine dysfunction is known to be associated with attention deficit hyperactivity disorder (ADHD). Dopamine D4 receptor gene (DRD4) is one of the important genes in this pathway. This study intended to investigate the variable number of tandem repeats (VNTR) in exon 3 of the DRD4 gene in Iranian children and adolescents. Materials and Methods In this study, 130 children with ADHD, aged 6–14 years, and 130 healthy children, within the same age range, were enrolled. All children were selected from northwest of Iran which have Caucasian ethnic background and are of a Turkic ethnic group. VNTR polymorphisms of the DRD4 gene were evaluated by PCR using exon 3-specific primers followed by agarose gel electrophoresis. Findings The Hardy-Weinberg principle and Chi-square test showed a significant difference in 4-repetition (4R) alleles between the ADHD (76.2%) and control (53.8%) groups (p = 0.004; X2 = 17.39; df = 5). The least percentage of repetition alleles in both groups was 2R. Conclusion There is a significant correlation between the 4R alleles of DRD4 and ADHD in the northwest of Iran.
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Family-based association study of DRD4 gene in methylphenidate-responded Attention Deficit/Hyperactivity Disorder. PLoS One 2017; 12:e0173748. [PMID: 28282463 PMCID: PMC5345875 DOI: 10.1371/journal.pone.0173748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 02/24/2017] [Indexed: 11/24/2022] Open
Abstract
The 48-basepair (48-bp) variable number tandem repeat (VNTR) polymorphism in exon 3 of the dopamine receptor D4 gene (DRD4) is implicated in the etiology of attention-deficit/ hyperactivity disorder (ADHD). In particular, ADHD in European-ancestry population is associated with an increased prevalence of the 7-repeat (7R) allele of the exon 3 VNTR. However, it is intriguing to note that the 7R allele has been found to be of very low prevalence in the Chinese general population. In a previous case-control study, our research team had found that the 7R allele was similarly absent in Chinese ADHD children in Hong Kong. Instead, there was an increased prevalence of the 2R allele in Chinese ADHD children. Interestingly, in Asian samples, the 2R allele had been found to be an evolutionary derivative of the 7R allele with equivalent biochemical functionality. So, the finding of an association between ADHD and 2R allele in Chinese population does not exactly contradict the original 7R allele finding in European-ancestry population. However, given the potential pitfall of population stratification in the previous case-control design, this current study tested the 2R allele and ADHD association using a methodologically more rigorous family-based approach on 33 Chinese ADHD probands who had favorable clinical responses to stimulant medication (methylphenidate). Haplotype Relative Risk (HRR) analysis and Transmission Disequilibrium Test (TDT) both showed a significant preferential transmission of the 2R allele from the biological parents to ADHD probands (pone-tailed = 0.038, OR = 2.04; pone-tailed = 0.048, OR = 2.29, respectively). A second hypothesis speculates that it is the deviation, including 7R and 2R alleles, from the conserved ancestral 4R allele which confers risk to ADHD. Thus, a preferential transmission of non-4R alleles, against the 4R allele, from biological parents to their ADHD probands is predicted. Both HRR analysis and TDT confirmed such prediction (pone-tailed = 0.029, OR = 2.07; pone-tailed = 0.032, OR = 2.43, respectively). This study re-confirmed the original finding of a previous study that in Chinese population, the 2R allele of the DRD4 exon 3 VNTR was related to ADHD. This endorses the general thesis that DRD4 exon 3 VNTR polymorphism is related to ADHD, despite that the exact length or number of repeats of the associated alleles varies across ethnicity. This in turn supports the dopamine dysregulation theory of ADHD.
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Ercan ES, Suren S, Bacanlı A, Yazici KU, Callı C, Ozyurt O, Aygunes D, Kosova B, Franco AR, Rohde LA. Decreasing ADHD phenotypic heterogeneity: searching for neurobiological underpinnings of the restrictive inattentive phenotype. Eur Child Adolesc Psychiatry 2016; 25:273-82. [PMID: 26058607 DOI: 10.1007/s00787-015-0731-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/30/2015] [Indexed: 11/25/2022]
Abstract
During the process of developing the DSM-5, a new phenotype of ADHD was proposed-the ADHD restrictive inattentive presentation (ADHD-RI), describing subjects with high endorsement of inattentive symptoms and a low level of hyperactivity. However, this phenotype was not included in the DSM-5 because of the lack of robust neurobiological data. We aimed to assess the specific neurobiological underpinnings of individuals presenting ADHD-RI. We compared a sample of 301 subjects (101 ADHD-Combined; 50 ADHD-RI; 50 ADHD predominantly inattentive type and 100 typically developing subjects) aged 8-15 years, using a complete neuropsychological battery, molecular genetic data (DRD4 and DAT1 most studied polymorphisms) and functional MRI during a Go-No/Go task. Subjects with ADHD-RI had a significantly different neuropsychological profile compared with the other groups, including lower psychomotor speeds, longer reaction times and the worst overall performance in the global neurocognitive index. The proportion of subjects with the presence of DRD4-7 repeat allele was significantly higher in ADHD-RI. The fMRI data suggested that more attention-related posterior brain regions (especially temporo-occipital areas) are activated in ADHD-RI during both Go and No-Go cues compared to TD controls and ADHD predominantly inattentive type. ADHD-RI may represent a different phenotype than other types of ADHD. In addition, our results suggest that reducing the phenotypic heterogeneity may aid in the search for the neurobiological underpinnings of ADHD.
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Affiliation(s)
- Eyup Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey.
| | | | | | - Kemal Utku Yazici
- Child and Adolescent Psychiatry Department, Medical Faculty, Fırat University, Elazig, Turkey
| | - Cem Callı
- Radiology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Onur Ozyurt
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Duygu Aygunes
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Buket Kosova
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Alexandre Rosa Franco
- Brain Institute of Rio Grande do Sul (InsCer), PUCRS, Porto Alegre, Brazil.,School of Engineering, PUCRS, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
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Shahin O, Meguid NA, Raafat O, Dawood RM, Doss M, Bader El Din NG, El Awady MK. Polymorphism in variable number of tandem repeats of dopamine d4 gene is a genetic risk factor in attention deficit hyperactive egyptian children: pilot study. Biomark Insights 2015; 10:33-8. [PMID: 25983551 PMCID: PMC4426936 DOI: 10.4137/bmi.s18519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 09/04/2014] [Accepted: 09/08/2014] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The variable number of tandem repeats (VNTR) of the dopamine receptor D4 (DRD4) gene among humans may elucidate individual differences in susceptibility to neuropsychiatric diseases. Dopamine dysfunction may be involved with Attention Deficit Hyperactivity Disorder (ADHD) symptoms. In this study, we report the association between the phenotype of ADHD, a condition characterized by inattentiveness, hyperactivity, and impulsiveness, and a 48-base pair VNTR in exon 3 of the DRD4 polymorphism. SUBJECTS AND METHODS We used a case control approach conducted on 29 ADHD and 31 ethnically matched control Egyptian children (ages 6-12 years). Cases were assessed by a psychiatric semi-structured interview and the Conners' Parent Rating Scale. VNTR polymorphisms of the DRD4 gene were done by touchdown PCR program using exon 3-specific primers followed by agarose gel electrophoresis. RESULTS We observed a significant association between the existence of D4.4 allele of DRD4 and ADHD (P, 0.002); 6.9% of cases showed a single D4.4 and 10.3% showed a double D4.4 as compared to controls in whom D4.4 has never been detected. CONCLUSION Children with smaller number of repeat alleles (two to four repeats) of the DRD4 gene have higher possibility to develop ADHD in Egyptian children.
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Affiliation(s)
- Ola Shahin
- Professor of Psychiatry, Faculty of Medicine, Cairo University, Egypt
| | - Nagwa A Meguid
- Professor of Human Genetics, National Research Center, Giza, Egypt
| | - Omnia Raafat
- Professor of Psychiatry, Faculty of Medicine, Cairo University, Egypt
| | - Reham M Dawood
- Researcher of Molecular Genetics, Department of Microbial Biotechnology, National Research Center, Giza, Egypt
| | - Malak Doss
- Assistant Researcher of Psychiatry, National Research Center, Giza, Egypt
| | - Noha G Bader El Din
- Assistant Professor of Molecular Genetics, Department of Microbial Biotechnology, National Research Center, Giza, Egypt
| | - Mostafa K El Awady
- Professor of Molecular Genetics, Department of Microbial Biotechnology, National Research Center, Giza, Egypt
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Hopkins EE, Wallace ML, Conley YP, Marazita ML. Symptoms of attention-deficit hyperactivity disorder, nonsyndromic orofacial cleft children, and dopamine polymorphisms: a pilot study. Biol Res Nurs 2014; 17:257-62. [PMID: 25271118 DOI: 10.1177/1099800414552186] [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: 01/21/2023]
Abstract
PURPOSE Attention-deficit hyperactivity disorder (ADHD) is a common childhood neurobehavioral disorder characterized by inattention, poor impulse control, and motor restlessness. Risk factors include familial stressors, anxiety disorders, learning disabilities, abnormal brain development, heritability, and dopamine polymorphisms. Children with an orofacial clefting (OFC) history are at increased risk of familial stressors, anxiety disorders, learning disabilities, and abnormal brain development. Given this overlap, we present a conceptual model proposing that children with OFC may be more likely to exhibit ADHD symptoms than children without and explore this relationship using pilot data. DESIGN This cross-sectional pilot study included 29 children with OFC or a first-degree relative with OFC recruited through a cleft research registry. METHODS The Disruptive Behavior Disorder Scale was used to collect data on children's ADHD symptoms. Saliva or whole blood samples were collected from children and parents for DNA analyses. ADHD-associated dopamine polymorphisms within the DRD4, DRD2, and DAT1 genes were genotyped. We tested for associations between presence of OFC and dopamine polymorphisms. Mixed-effects models tested whether children with OFC and dopamine polymorphisms had more ADHD symptoms. RESULTS The DRD4 4-repeat allele was associated with increased inattentive ADHD symptoms (p = .03). Having the DRD2 Taq1A1 allele and OFC predicted fewer (p = .02) inattentive ADHD symptoms. Children with OFC were significantly less likely to have the DAT1 10-repeat allele (p = .04). CONCLUSIONS Results indicate that further investigation among a larger sample of children with OFC is warranted, particularly for relationships with inattentive ADHD.
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Affiliation(s)
- Emily E Hopkins
- College of Continuing and Professional Studies, Chatham University, Pittsburgh, PA, USA
| | - Meredith L Wallace
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yvette P Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary L Marazita
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Department of Oral Biology, Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, USA School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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GAO Q, LIU L, QIAN Q, WANG Y. Advances in molecular genetic studies of attention deficit hyperactivity disorder in China. SHANGHAI ARCHIVES OF PSYCHIATRY 2014; 26:194-206. [PMID: 25317006 PMCID: PMC4194002 DOI: 10.3969/j.issn.1002-0829.2014.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 07/16/2014] [Indexed: 12/05/2022]
Abstract
SUMMARY Attention deficit hyperactivity disorder (ADHD) is a common psychiatric condition in children worldwide that typically includes a combination of symptoms of inattention and hyperactivity/impulsivity. Genetic factors are believed to be important in the development and course of ADHD so many candidate genes studies and genome-wide association studies (GWAS) have been conducted in search of the genetic mechanisms that cause or influence the condition. This review provides an overview of gene association and pharmacogenetic studies of ADHD from mainland China and elsewhere that use Han Chinese samples. To date, studies from China and elsewhere remain inconclusive so future studies need to consider alternative analytic techniques and test new biological hypotheses about the relationship of neurotransmission and neurodevelopment to the onset and course of this disabling condition.
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Affiliation(s)
- Qian GAO
- Peking University Sixth Hospital Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Lu LIU
- Peking University Sixth Hospital Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Qiujin QIAN
- Peking University Sixth Hospital Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yufeng WANG
- Peking University Sixth Hospital Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
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Tanaka Y, Rohde LA, Jin L, Feldman PD, Upadhyaya HP. A meta-analysis of the consistency of atomoxetine treatment effects in pediatric patients with attention-deficit/hyperactivity disorder from 15 clinical trials across four geographic regions. J Child Adolesc Psychopharmacol 2013; 23:262-70. [PMID: 23683141 DOI: 10.1089/cap.2012.0049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Atomoxetine has been approved as a treatment for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in the United States, throughout Europe, and in other countries. This meta-analysis was to assess the consistency of the treatment effect of atomoxetine across four global geographic regions. METHODS Data from 15 acute, double-blind, placebo-controlled trials were pooled (2 in Asia, 4 in Europe, 8 in North America, and 1 in Russia), yielding 2569 pediatric patients with ADHD. Improvements during 6-10 weeks of atomoxetine treatment were evaluated using the ADHD Rating Scale-IV or the Swanson, Nolan, and Pelham Scale-Revised. Consistency across regions was assessed by an interaction test and Higgins I(2). Consistency of one region versus other regions was assessed by effect sizes of individual regions and pairwise differences. RESULTS Patient demographics were generally similar across regions. More patients from Asia met diagnostic criteria for ADHD inattentive subtype and fewer for combined subtype compared with patients from Europe, North America, or Russia. Asian patients had a lower mean baseline ADHD total score and mean hyperactivity/impulsivity subscore. Treatment effects showed marginal inconsistency and moderate heterogeneity among the regions (percentage of patients achieving a 40% decrease from baseline ADHD scores, atomoxetine versus placebo: Asia 39.6%, 24.0%; Europe 40.2%, 12.1%; North America 45.3%, 21.7%; Russia 54.2%, 33.3%). Inconsistency was observed primarily in Asia versus the other regions. Completion rates with atomoxetine were higher in Asia and Russia (94.4% and 94.3%, respectively) than in Europe (84.3%) or North America (80.4%). CONCLUSIONS Atomoxetine was demonstrated as an effective treatment for ADHD in 15 clinical trials from four global regions. The current meta-analysis has revealed a degree of heterogeneity in treatment efficacy across regions, most notably in the comparison of Asian patients relative to those from the other regions.
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Affiliation(s)
- Yoko Tanaka
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA.
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Wu J, Xiao H, Sun H, Zou L, Zhu LQ. Role of dopamine receptors in ADHD: a systematic meta-analysis. Mol Neurobiol 2012; 45:605-20. [PMID: 22610946 DOI: 10.1007/s12035-012-8278-5] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 05/07/2012] [Indexed: 01/11/2023]
Abstract
The dopaminergic system plays a pivotal role in the central nervous system via its five diverse receptors (D1-D5). Dysfunction of dopaminergic system is implicated in many neuropsychological diseases, including attention deficit hyperactivity disorder (ADHD), a common mental disorder that prevalent in childhood. Understanding the relationship of five different dopamine (DA) receptors with ADHD will help us to elucidate different roles of these receptors and to develop therapeutic approaches of ADHD. This review summarized the ongoing research of DA receptor genes in ADHD pathogenesis and gathered the past published data with meta-analysis and revealed the high risk of DRD5, DRD2, and DRD4 polymorphisms in ADHD.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics and Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Smith TF. Meta-analysis of the heterogeneity in association of DRD4 7-repeat allele and AD/HD: stronger association with AD/HD combined type. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1189-99. [PMID: 20468072 DOI: 10.1002/ajmg.b.31090] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this meta-analysis was to examine whether association studies between attention deficit/hyperactivity disorder (AD/HD) and the dopamine receptor 4 gene 7-repeat (DRD4 7R) allele vary systematically based on study characteristics. A total of 27 empirical studies with 28 distinct samples using either case-control or family-based association analyses were included. Consistent with previous meta-analytic work [Gizer et al. (2009), Hum Genet 126:51-90], the DRD4 7R allele was associated with AD/HD across studies (OR = 1.33; 95% CI = 1.16-1.53, z = 4.04, P = 0.00005) and there was significant systematic variability among studies (Q = 54.24; P = 0.001; I(2) = 50.22). To account for the variability among studies, sample and study level covariates were examined. No differences in overall effect size emerged between family-based and case-control studies. However, the risk allele frequency in the control population accounted for a significant portion of the variance in overall effect size within case-control studies. In addition, evidence for the association between the DRD4 7R allele and distinct AD/HD subtypes emerged across family-based and case-control studies. The proportion of AD/HD, combined type individuals within the AD/HD sample was associated with a significant increase in the magnitude of association between the DRD4 7R allele and AD/HD. Conversely, an increase in the proportion of AD/HD, predominantly inattentive type individuals within the AD/HD sample was associated with a decrease in study effect size. Implications regarding AD/HD etiological and phenotypic heterogeneity are discussed.
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Affiliation(s)
- Taylor F Smith
- Department of Psychology, University of North Carolina at Greensboro, 1100 W. Market Street, Greensboro, NC 27402, USA.
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14
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Coghill D, Banaschewski T. The genetics of attention-deficit/hyperactivity disorder. Expert Rev Neurother 2009; 9:1547-65. [PMID: 19831843 DOI: 10.1586/ern.09.78] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that almost certainly represents the common outcome of multiple causal pathways and it is now generally accepted that genetic factors make a significant contribution to these pathways. Behavioral studies suggest a heritability of approximately 0.76. While molecular genetic approaches have identified a range of potential candidate genes, it is now clear that the genetics of ADHD are characterized by a number of genes each of which makes a small but significant contribution to the overall risk. Several genome-wide linkage studies have been conducted and, although there are considerable differences in findings between studies, several regions have been supported across several studies (bin 16.4, 5p13, 11q22-25, 17p11). The contribution of several candidate genes has been supported by meta-analyses (DRD4, DRD5, DAT1, HTR1B and SNAP25). Genome-wide association scans are starting to appear but have not yet had sufficient power to produce conclusive results. Gene-environment interactions, which are as yet relatively understudied, are likely to be of importance in fully understanding the role of genes in ADHD and will be discussed.
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Affiliation(s)
- David Coghill
- Centre for Neuroscience, Division of Medical Sciences, University of Dundee, Centre for Child Health, 19 Dudhope Terrace, Dundee, DD3 6HH, UK.
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15
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Nikolaidis A, Gray JR. ADHD and the DRD4 exon III 7-repeat polymorphism: an international meta-analysis. Soc Cogn Affect Neurosci 2009; 5:188-93. [PMID: 20019071 DOI: 10.1093/scan/nsp049] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We sought to elucidate the relationship of ADHD (Attention-Deficit Hyperactivity Disorder) to the DRD4 exon III VNTR 7R allele worldwide using analytic techniques and to relate these findings to the field of cultural neuroscience. To focus on a potential moderating role of race/ethnicity, we excluded over 30 papers that have explored the relationship between the DRD4 7R and ADHD but had unclear or lax racial-ethnic inclusion criteria. The papers in this meta-analysis were only included if a single race made up 95% or more of their sample. We searched for and translated papers not published in English, and found a significant difference in the relationship of ADHD and DRD4 7R in people of European-Caucasian (Odds ratio 1.635, Z = 3.936, P < 0.00001) and South American (Odds ratio 2.407, Z = 3.317, P = 0.001) descent vs people of Middle Eastern ancestry (Odds ratio 0.717, Z = -2.466; P = 0.014). We also examined the moderating effect of differing ADHD diagnoses, subject recruitment, control recruitment and male to female ratio. Finally, we consider the implications of these data for cultural neuroscience.
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Affiliation(s)
- Aki Nikolaidis
- Department of Psychology, Yale University, New Haven, CT, USA.
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16
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Gizer IR, Ficks C, Waldman ID. Candidate gene studies of ADHD: a meta-analytic review. Hum Genet 2009; 126:51-90. [PMID: 19506906 DOI: 10.1007/s00439-009-0694-x] [Citation(s) in RCA: 688] [Impact Index Per Article: 45.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 05/27/2009] [Indexed: 02/07/2023]
Affiliation(s)
- Ian R Gizer
- Department of Genetics, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Room 5015 Genetic Medicine Building CB 7264, Chapel Hill, NC 27599-7264, USA.
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17
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Mansoor A, Mazhar K, Qamar R. VNTR Polymorphism of the DRD4 Locus in Different Pakistani Ethnic Groups. ACTA ACUST UNITED AC 2008; 12:299-304. [DOI: 10.1089/gte.2007.0120] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Atika Mansoor
- Institute of Biomedical and Genetic Engineering, Dr. A.Q. Khan Research Laboratories, Islamabad, Pakistan
| | - Kehkashan Mazhar
- Institute of Biomedical and Genetic Engineering, Dr. A.Q. Khan Research Laboratories, Islamabad, Pakistan
| | - Raheel Qamar
- COMSATS Institute of Information Technology, Islamabad, Pakistan
- Shifa College of Medicine, Islamabad, Pakistan
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