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Happer JP, Beaton LE, Wagner LC, Hodgkinson CA, Goldman D, Marinkovic K. Neural indices of heritable impulsivity: Impact of the COMT Val158Met polymorphism on frontal beta power during early motor preparation. Biol Psychol 2024; 191:108826. [PMID: 38862067 DOI: 10.1016/j.biopsycho.2024.108826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/14/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Studies of COMT Val158Met suggest that the neural circuitry subserving inhibitory control may be modulated by this functional polymorphism altering cortical dopamine availability, thus giving rise to heritable differences in behaviors. Using an anatomically-constrained magnetoencephalography method and stratifying the sample by COMT genotype, from a larger sample of 153 subjects, we examined the spatial and temporal dynamics of beta oscillations during motor execution and inhibition in 21 healthy Met158/Met158 (high dopamine) or 21 Val158/Val158 (low dopamine) genotype individuals during a Go/NoGo paradigm. While task performance was unaffected, Met158 homozygotes demonstrated an overall increase in beta power across regions essential for inhibitory control during early motor preparation (∼100 ms latency), suggestive of a global motor "pause" on behavior. This increase was especially evident on Go trials with slow response speed and was absent during inhibition failures. Such a pause could underlie the tendency of Met158 allele carriers to be more cautious and inhibited. In contrast, Val158 homozygotes exhibited a beta drop during early motor preparation, indicative of high response readiness. This decrease was associated with measures of behavioral disinhibition and consistent with greater extraversion and impulsivity observed in Val homozygotes. These results provide mechanistic insight into genetically-determined interindividual differences of inhibitory control with higher cortical dopamine associated with momentary response hesitation, and lower dopamine leading to motor impulsivity.
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Affiliation(s)
- Joseph P Happer
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Lauren E Beaton
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Laura C Wagner
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - David Goldman
- Laboratory of Neurogenetics, NIAAA, NIH, Bethesda, MD, USA
| | - Ksenija Marinkovic
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychology, San Diego State University, San Diego, CA, USA; Department of Radiology, University of California, La Jolla, San Diego, CA, USA.
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2
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Kant T, Koyama E, Zai CC, Sanches M, Beitchman JH, Kennedy JL. COMT Val/Met, stressful life events and externalizing behaviors in youth: A longitudinal study from the ABCD sample. Heliyon 2023; 9:e21126. [PMID: 38027832 PMCID: PMC10665666 DOI: 10.1016/j.heliyon.2023.e21126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Early adolescence is a crucial time for understanding and detecting the risk factors that may influence youth externalizing/disruptive behaviors and disorders. Previous literature reported evidence that risk factors for disruptive behaviors include catechol-O-methyltransferase (COMT) Val158Met (rs4680) polymorphism and environmental influences. An unanswered question is whether there is a change in these risk factors over stages of youth development. This longitudinal study examines the interaction effect of Val158Met and stressful life events (SLE) on youth externalizing behaviors from ages 9-11. Participants were 2363 children of European ancestry recruited as part of the Adolescent Brain Cognitive Development study. Repeated measures linear mixed models were used to examine the effect of the interaction between Val158Met and SLE (G × E) on disruptive behaviors over development. Externalizing behaviors were analyzed at both baseline and two-year follow-up. Both Val158Met genotype and SLE scores demonstrated significant main effects on disruptive behaviors in youth, and those effects were consistent at both time points. G × E was not associated with externalizing behaviors. Youth who carried the Val allele and/or were exposed to higher SLE consistently had increased externalizing behavior scores. To our knowledge, this is the first study to longitudinally examine the interaction effects of Val158Met and SLE on externalizing behaviors in youth. The results highlight the importance of understanding the genetic and environmental factors underlying externalizing behaviors for better detection of at-risk youth, helping further with early prevention efforts. The findings propose that COMT Val158Met genotype may act as a biomarker for development of novel treatment strategies for disruptive behaviors.
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Affiliation(s)
- Tuana Kant
- Institute of Medical Science, University of Toronto, Toronto, M5S 1A8, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, M5S 1A8, Canada
- Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
| | - Emiko Koyama
- Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
- Laboratory for Molecular Pathology of Psychiatric Disorders, RIKEN Center for Brain Science, Saitama, 351-0198, Japan
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
| | - Clement C. Zai
- Institute of Medical Science, University of Toronto, Toronto, M5S 1A8, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, M5S 1A8, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, M5S 1A8, Canada
| | - Marcos Sanches
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
| | - Joseph H. Beitchman
- Institute of Medical Science, University of Toronto, Toronto, M5S 1A8, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, M5S 1A8, Canada
| | - James L. Kennedy
- Institute of Medical Science, University of Toronto, Toronto, M5S 1A8, Canada
- Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, M5S 1A8, Canada
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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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Tang Girdwood SC, Rossow KM, Van Driest SL, Ramsey LB. Perspectives from the Society for Pediatric Research: pharmacogenetics for pediatricians. Pediatr Res 2022; 91:529-538. [PMID: 33824446 PMCID: PMC8492778 DOI: 10.1038/s41390-021-01499-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/12/2021] [Indexed: 12/26/2022]
Abstract
This review evaluates the pediatric evidence for pharmacogenetic associations for drugs that are commonly prescribed by or encountered by pediatric clinicians across multiple subspecialties, organized from most to least pediatric evidence. We begin with the pharmacogenetic research that led to the warning of increased risk of death in certain pediatric populations ("ultrarapid metabolizers") who are prescribed codeine after tonsillectomy or adenoidectomy. We review the evidence for genetic testing for thiopurine metabolism, which has become routine in multiple pediatric subspecialties. We discuss the pharmacogenetic research in proton pump inhibitors, for which clinical guidelines have recently been made available. With an increase in the prevalence of behavioral health disorders including attention deficit hyperactivity disorder (ADHD), we review the pharmacogenetic literature on selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, and ADHD medications. We will conclude this section on the current pharmacogenetic data on ondansetron. We also provide our perspective on how to integrate the current research on pharmacogenetics into clinical care and what further research is needed. We discuss how institutions are managing pharmacogenetic test results and implementing them clinically, and how the electronic health record can be leveraged to ensure testing results are available and taken into consideration when prescribing medications. IMPACT: While many reviews of pharmacogenetics literature are available, there are few focused on pediatrics. Pediatricians across subspecialties will become more comfortable with pharmacogenetics terminology, know resources they can use to help inform their prescribing habits for drugs with known pharmacogenetic associations, and understand the limitations of testing and where further research is needed.
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Affiliation(s)
- Sonya C. Tang Girdwood
- Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Katelyn M. Rossow
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Sara L. Van Driest
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Laura B. Ramsey
- Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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Caffrey AR, Borrelli EP. The art and science of drug titration. Ther Adv Drug Saf 2021; 11:2042098620958910. [PMID: 33796256 PMCID: PMC7967860 DOI: 10.1177/2042098620958910] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
A “one-size-fits-all” approach has been the standard for drug dosing, in
particular for agents with a wide therapeutic index. The scientific
principles of drug titration, most commonly used for medications with
a narrow therapeutic index, are to give the patient adequate and
effective treatment, at the lowest dose possible, with the aim of
minimizing unnecessary medication use and side effects. The art of
drug titration involves the interplay of scientific drug titration
principles with the clinical expertise of the healthcare provider, and
an individualized, patient-centered partnership between the provider
and the patient to review the delicate balance of perceived benefits
and risks from both perspectives. Drug titration may occur as up-,
down-, or cross-titration depending on whether the goal is to reach or
maintain a therapeutic outcome, decrease the risk of adverse effects,
or prevent withdrawal/discontinuation syndromes or recurrence of
disease. Drug titration introduces additional complexities surrounding
the conduct of clinical trials and real-world studies, confounding our
understanding of the true effect of medications. In clinical practice,
wide variations in titration schedules may exist due to a lack of
evidence and consensus on titration approaches that achieve an optimal
benefit-harm profile. Further, drug titration may be challenging for
patients to follow, resulting in suboptimal adherence and may require
increased healthcare-related visits and coordination of care amongst
providers. Despite the challenges associated with drug titration, it
is a personalized approach to drug dosing that blends science with
art, and with supportive real-world outcomes-based evidence, can be
effective for optimizing pharmacotherapeutic outcomes and improving
drug safety.
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Affiliation(s)
- Aisling R Caffrey
- University of Rhode Island College of Pharmacy, 7 Greenhouse Road, Kingston, RI 02881, USA
| | - Eric P Borrelli
- University of Rhode Island College of Pharmacy, Kingston, RI, USA
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Kang P, Luo L, Peng X, Wang Y. Association of Val158Met polymorphism in COMT gene with attention-deficit hyperactive disorder: An updated meta-analysis. Medicine (Baltimore) 2020; 99:e23400. [PMID: 33235119 PMCID: PMC7710242 DOI: 10.1097/md.0000000000023400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The results of published articles on the relationship between the Val158Met polymorphism in the (Catechol-O-methyltransferase) COMT gene and the susceptibility of attention-deficit hyperactive disorder (ADHD) are controversial. We conducted an updated meta-analysis of case-control studies to assess the relationship between Val158Met polymorphism in COMT gene and ADHD susceptibility. METHODS A comprehensive literature search was conducted to identify all the case-control studies on the relationship between the COMT gene Val158Met polymorphism and ADHD susceptibility. According to the heterogeneity test results among studies evaluated with I, the fixed effect model or random effect model was selected as the pooling method. Meta-regression as well as sensitive analysis were used to explore possible causes of between-study heterogeneity. The funnel plot and Harbord test were used to estimate publication bias. RESULTS Finally, seventeen studies that met the inclusion criteria were included. The Val158Met genotype distributions of COMT gene in controls were in Hardy-Weinberg equilibrium in all studies. In general, there was no significant association between the COMT gene Val158Met polymorphism and ADHD susceptibility in dominant, recessive, and codominant models. The recessive genetic model (I = 60.8%) showed strong heterogeneity among studies, and still no significant association was found after sensitivity analysis. Subgroup analysis stratified by ethnicity (Asian and Caucasian) also showed that there was no significant association in the above-mentioned three models. CONCLUSIONS This updated meta-analysis indicated that the Val158Met polymorphism in the COMT gene may not be related to the risk of ADHD. Further researches are needed to confirm these results.
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Affiliation(s)
- Peipei Kang
- Department of Public Health, Shandong Mental Health Center
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital, PR China
| | - Xiling Peng
- Department of Public Health, Shandong Mental Health Center
| | - Yanhu Wang
- Department of Public Health, Shandong Mental Health Center
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Yu B. [Pharmacogenomics: precision tool in routine prescription]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:1143-1148. [PMID: 33172545 PMCID: PMC7666388 DOI: 10.7499/j.issn.1008-8830.2006032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
Pharmacogenomics is an emerging tool to improve the efficacy and safety of drug treatment through the DNA analysis in the genes related to drug concentrations (pharmacokinetics) and drug actions (pharmacodynamics). Clinicians need to integrate the genomic data in their benefit-risk assessment and then provide the right drug to the right patient at the right time. This tool can help to prevent an ineffective treatment, select right dose and reduce adverse drug reactions that are common in the current practice under the trial-observation-adjustment model. Pharmacogenomics may have extensive impacts on unique paediatric patients to enhance a better relationship between medical professionals and affected children or their guardians and to improve the drug compliance. Clinicians should embrace the advancements in pharmacogenomics and actively participate in clinical research to identify the ancestor-related alleles and develop the population-specific gene panel. It will allow patients to enjoy more achievements in pharmacogenomics by implementing it in first line clinical practice.
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Affiliation(s)
- Bing Yu
- Central Clinical School, Faculty of Medicine and Health, University of Sydney/Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney NSW 2050, Australia.
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Park JH, Son YD, Kim Y, Han DH. Brain Network Connectivity and Association with Catechol-O-Methyltransferase Gene Polymorphism in Korean Attention-Deficit Hyperactivity Disorder Children. Psychiatry Investig 2020; 17:925-933. [PMID: 32894926 PMCID: PMC7538244 DOI: 10.30773/pi.2020.0132] [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: 04/10/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We sought to determine if the links between and within the default mode network (DMN) and dorsal attention network (DAT) exhibited different conditions according to catechol-O-methyltransferase (COMT) gene polymorphism in relationship to attention-deficit hyperactivity disorder (ADHD) symptoms. METHODS Fifty-seven children with ADHD and 48 healthy controls (HCs) were administered an intelligence test, the Children's Depression Inventory, the Korean ADHD rating scale, and continuous performance test. Resting-state brain functional MRI scans were obtained, and COMT genotyping was performed to distinguish valine carriers and methionine homozygotes. RESULTS Compared to controls, children with ADHD showed increased ADHD scale scores, increased visual commission errors, and increased functional connectivity (FC) within the DMN and DAT. Compared to all children with ADHD, children with the methionine homozygote and those who were valine carriers showed increased FC within the DMN and DAT and decreased FC between the DMN and DAT. FC within the DMN was also increased in HC valine carriers compared to HC children with the methionine homozygote, and in children with ADHD who were valine carriers compared to HC valine carriers. CONCLUSION We observed increased brain connectivity within the DMN and DAT and altered brain connectivity within and between the DMN and DAT associated with COMT polymorphism in children with ADHD.
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Affiliation(s)
- Jeong Ha Park
- Department of Psychiatry, Woorisoa Children's Hospital, Seoul, Republic of Korea
| | - Young Don Son
- Department of Health Sciences & Technology, Gachon University, Incheon, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
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9
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Abraham E, Scott MA, Blair C. Catechol- O-methyltransferase Val158Met Genotype and Early-Life Family Adversity Interactively Affect Attention-Deficit Hyperactivity Symptoms Across Childhood. Front Genet 2020; 11:724. [PMID: 32765586 PMCID: PMC7381281 DOI: 10.3389/fgene.2020.00724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/15/2020] [Indexed: 12/22/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is among the most commonly diagnosed psychiatric disorders of childhood. The dopaminergic system has been shown to have substantial effects on its etiology, with both functional Catechol-O-methyltransferase (COMT) Val158Met genotype and early-life environmental adversity involved in the risk of inattention and hyperactivity/impulsivity symptoms. In this prospective longitudinal study, we examined for the first time the impact of proximal and distal early-life family adversity and COMT Val158Met polymorphism gene - both the direct and the interactive effects, on children's ADHD symptoms across childhood. Data came from the Family Life Project, a prospective longitudinal study of 1,292 children and families in high poverty from birth to 11 years. In infancy, data regarding socioeconomic (SES)-risk-factors, observed-caregiving behaviors, and DNA genotyping were collected. In early and middle childhood teachers rated the occurrence and severity of the child's ADHD symptoms. Multilevel growth curve models revealed independent effects of COMT, early-life SES-risk and negative caregiving on ADHD symptoms in early and middle childhood. Significant gene-environment interactions were found, indicating that overall, carriers of at least one COMT158Met allele were more sensitive to early-life adversity, showing higher inattention and hyperactivity/impulsivity symptoms severity in childhood when exposed to high SES-risk factors in infancy, compared to Val-Val carriers. Findings provide new insights into the complex etiology of ADHD and underline the need for further investigation of the neuronal mechanisms underlying gene-environment interactions. Findings might have implications for prevention and intervention strategies with a focus on early-life family relationships in genetically at-risk children.
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Affiliation(s)
- Eyal Abraham
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, United States
- Department of Applied Psychology, New York University, New York, NY, United States
| | - Marc A. Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, United States
| | - Clancy Blair
- Department of Applied Psychology, New York University, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
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Namerow LB, Walker SA, Loftus M, Bishop JR, Ruaño G, Malik S. Pharmacogenomics: an Update for Child and Adolescent Psychiatry. Curr Psychiatry Rep 2020; 22:26. [PMID: 32377970 DOI: 10.1007/s11920-020-01145-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW This paper aims to acquaint child and adolescent psychiatrists with the field of pharmacogenomics (PGX) and review the most up-to-date evidence-based practices to guide the application of this field in clinical care. RECENT FINDINGS Despite much research being done in this area, the field of PGX continues to yield controversial findings. In the adult world, studies have focused on the impact of combinatorial gene panels that guide medication selection by providing reports that estimate the impact of multiple pharmacodynamic and pharmacokinetic genes, but to date, these have not been directly examined in younger patient populations. Pharmacokinetic genes, CYP2D6 and CYP2C19, and hypersensitivity genes, HLA-A and HLA-B, have the strongest evidence base for application to pharmacotherapy in children. Although the field is evolving, and the evidence is mixed, there may be a role for PGX testing in children to help guide dosing and monitoring strategies. However, evidence-based medicine, rather than PGX testing, continues to play the lead role in guiding medication selection in pediatric psychopharmacology.
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Affiliation(s)
- Lisa B Namerow
- Associate Professor of Pediatrics and Psychiatry, University of Connecticut School of Medicine, Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Ave, Hartford, CT, 06019, USA.
| | - Sophia A Walker
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06032, USA
| | - Mirela Loftus
- Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Ave, Hartford, CT, 06019, USA
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Department of Psychiatry, University of Minnesota Medical School, 508 Harvard St SE, Minneapolis, MN, 55455, USA
| | - Gualberto Ruaño
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06032, USA.,Institute of Living at Hartford Hospital, Genomas Laboratory of Personalized Health, 67 Jefferson Street, Hartford, CT, 06106, USA
| | - Salma Malik
- Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, 200 Retreat Ave, Hartford, CT, 06019, USA
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Enge S, Sach M, Reif A, Lesch KP, Miller R, Fleischhauer M. Cumulative Dopamine Genetic Score predicts behavioral and electrophysiological correlates of response inhibition via interactions with task demand. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:59-75. [PMID: 31802408 PMCID: PMC7012812 DOI: 10.3758/s13415-019-00752-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Functional genetic polymorphisms in the brain dopamine (DA) system have been suggested to underlie individual differences in response inhibition, namely the suppression of a prepotent or inappropriate action. However, findings on associations between single DA polymorphisms and inhibitory control often are mixed, partly due to their small effect sizes. In the present study, a cumulative genetic score (CGS) was used: alleles previously associated with both impulsive behavior and lower baseline DA level, precisely the DRD4 Exon III 7-repeat, DAT1 VNTR 10-repeat and the COMT 158val allele, each added a point to the DA-CGS. Participants (N = 128) completed a Go/No-Go task varying in difficulty and EEG recordings were made with focus on the NoGo-P3, an ERP that reflects inhibitory response processes. We found a higher DA-CGS (lower basal/tonic DA level) to be associated with better performance (lower %FA and more adaptive responding) in the very demanding/rapid than in the less demanding/rapid condition, whereas the reverse pattern was true for individuals with a lower DA-CGS. A similar interaction pattern of DA-CGS and task condition was found for NoGo-P3 amplitude. In line with assumptions of distinct optimum DA levels for different cognitive demands, a DA-CGS-dependent variation of tonic DA levels could have modulated the balance between cognitive stability and flexibility, thereby affecting the optimal DA level required for the specific task condition. Moreover, a task demand-dependent phasic DA release might have added to the DA-CGS-related basal/tonic DA levels, thereby additionally affecting the balance between flexibility and stability, in turn influencing performance and NoGo-P3.
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Affiliation(s)
- Sören Enge
- Department of Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Calandrellistraße 1-9, 12247, Berlin, Germany.
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany.
| | - Mareike Sach
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, Center of Mental Health, University of Würzburg, Würzburg, Germany
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Translational Neuroscience, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Robert Miller
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Monika Fleischhauer
- Department of Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Calandrellistraße 1-9, 12247, Berlin, Germany
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Naumova D, Grizenko N, Sengupta SM, Joober R. DRD4 exon 3 genotype and ADHD: Randomised pharmacodynamic investigation of treatment response to methylphenidate. World J Biol Psychiatry 2019; 20:486-495. [PMID: 29182037 DOI: 10.1080/15622975.2017.1410221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Dopamine plays an important role in modulating attention and motor behaviours, dimensions altered in attention deficit/hyperactivity disorder (ADHD). Numerous association studies have linked dopamine receptor 4 (DRD4) to increased risk of ADHD. This study investigated the effect of DRD4 exon 3 polymorphism on child behaviours in response to treatment with methylphenidate. Methods: A total of 374 children diagnosed with ADHD (ages 6-12 years) were evaluated under three experimental conditions: baseline, placebo and MPH (0.5 mg/kg/day). This was a 2-week prospective within-subject, placebo-controlled, crossover trial. The Conners' Global Index for parents and for teachers was used to evaluate the behaviours of the children. One-way repeated measures analysis of variance was used to test the effect of the interaction between DRD4 genotype and experimental conditions. Results: A significant interaction between DRD4 genotype and treatment was detected when the child's behaviour was evaluated by the parents (P = 0.035, effect size of 0.014), driven by a better treatment response in children homozygous for long 7-repeat allele. Conclusions: According to the parent assessment, children homozygous for the long 7-repeat allele were more responsive to experimental condition. This is the largest pharmacogenetic investigation of the effect of DRD4 exon 3 polymorphism in childhood ADHD. Trial Registration: clinicaltrials.gov, identifier NCT00483106.
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Affiliation(s)
- Darya Naumova
- Department of Human Genetics, McGill University , Montreal , QC , Canada
| | - Natalie Grizenko
- Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada
| | - Sarojini M Sengupta
- Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada
| | - Ridha Joober
- Department of Human Genetics, McGill University , Montreal , QC , Canada.,Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada.,Department of Neurology and Neurosurgery, McGill University , Montreal , QC , Canada
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13
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PharmGKB summary: methylphenidate pathway, pharmacokinetics/pharmacodynamics. Pharmacogenet Genomics 2019; 29:136-154. [PMID: 30950912 DOI: 10.1097/fpc.0000000000000376] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Grünblatt E, Werling AM, Roth A, Romanos M, Walitza S. Association study and a systematic meta-analysis of the VNTR polymorphism in the 3'-UTR of dopamine transporter gene and attention-deficit hyperactivity disorder. J Neural Transm (Vienna) 2019; 126:517-529. [PMID: 30923918 PMCID: PMC6456487 DOI: 10.1007/s00702-019-01998-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/24/2019] [Indexed: 01/21/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) has been postulated to associate with dopaminergic dysfunction, including the dopamine transporter (DAT1). Several meta-analyses showed small but significant association between the 10-repeat allele in the DAT1 gene in 3'-untranslated region variant number tandem repeat polymorphism and child and adolescent ADHD, whereas in adult ADHD the 9-repeat allele was suggested to confer as risk allele. Interestingly, recent evidence indicated that the long-allele variants (10 repeats and longer) might confer to lower expression of the transporter in comparison to the short-allele. Therefore, we assessed here the association in samples consisting of families with child and adolescent ADHD as well as a case-control sample, using either the 10- versus 9-repeat or the long- versus short-allele approach. Following, we conducted a systematic review and meta-analysis, including family and case-control studies, using the two aforementioned approaches as well as stratifying to age and ethnicity. The first approach (10-repeat) resulted in nominal significant association in child and adolescent ADHD (OR 1.1050 p = 0.0128), that became significant stratifying to European population (OR 1.1301 p = 0.0085). The second approach (long-allele) resulted in significant association with the whole ADHD population (OR 1.1046 p = 0.0048), followed by significant association for child and adolescent ADHD (OR 1.1602 p = 0.0006) and in Caucasian and in European child and adolescent ADHD (OR 1.1310 p = 0.0114; OR 1.1661 p = 0.0061; respectively). We were not able to confirm the association reported in adults using both approaches. In conclusion, we found further indication for a possible DAT1 gene involvement; however, further studies should be conducted with stringent phenotyping to reduce heterogeneity, a limitation observed in most included studies.
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Affiliation(s)
- Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
- Translational Molecular Psychiatry, Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Child and Adolescent Psychiatry Research, University Hospital of Psychiatry Zurich, Wagistrasse 12, 8952, Schlieren, Switzerland.
| | - Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander Roth
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Würzburg, Germany
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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Landolt HP, Holst SC, Valomon A. Clinical and Experimental Human Sleep-Wake Pharmacogenetics. Handb Exp Pharmacol 2019; 253:207-241. [PMID: 30443785 DOI: 10.1007/164_2018_175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sleep and wakefulness are highly complex processes that are elegantly orchestrated by fine-tuned neurochemical changes among neuronal and non-neuronal ensembles, nuclei, and networks of the brain. Important neurotransmitters and neuromodulators regulating the circadian and homeostatic facets of sleep-wake physiology include melatonin, γ-aminobutyric acid, hypocretin, histamine, norepinephrine, serotonin, dopamine, and adenosine. Dysregulation of these neurochemical systems may cause sleep-wake disorders, which are commonly classified into insomnia disorder, parasomnias, circadian rhythm sleep-wake disorders, central disorders of hypersomnolence, sleep-related movement disorders, and sleep-related breathing disorders. Sleep-wake disorders can have far-reaching consequences on physical, mental, and social well-being and health and, thus, need be treated with effective and rational therapies. Apart from behavioral (e.g., cognitive behavioral therapy for insomnia), physiological (e.g., chronotherapy with bright light), and mechanical (e.g., continuous positive airway pressure treatment of obstructive sleep apnea) interventions, pharmacological treatments often are the first-line clinical option to improve disturbed sleep and wake states. Nevertheless, not all patients respond to pharmacotherapy in uniform and beneficial fashion, partly due to genetic differences. The improved understanding of the neurochemical mechanisms regulating sleep and wakefulness and the mode of action of sleep-wake therapeutics has provided a conceptual framework, to search for functional genetic variants modifying individual drug response phenotypes. This article will summarize the currently known genetic polymorphisms that modulate drug sensitivity and exposure, to partly determine individual responses to sleep-wake pharmacotherapy. In addition, a pharmacogenetic strategy will be outlined how based upon classical and opto-/chemogenetic strategies in animals, as well as human genetic associations, circuit mechanisms regulating sleep-wake functions in humans can be identified. As such, experimental human sleep-wake pharmacogenetics forms a bridge spanning basic research and clinical medicine and constitutes an essential step for the search and development of novel sleep-wake targets and therapeutics.
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Affiliation(s)
- Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zürich, Zürich, Switzerland.
- Zürich Center for Interdisciplinary Sleep Research (ZiS), University of Zürich, Zürich, Switzerland.
| | - Sebastian C Holst
- Neurobiology Research Unit and Neuropharm, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Amandine Valomon
- Wisconsin Institute for Sleep and Consciousness, University of Wisconsin Madison, Madison, WI, USA
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Lee YH, Song GG. BDNF 196 G/A and COMT Val158Met Polymorphisms and Susceptibility to ADHD: A Meta-Analysis. J Atten Disord 2018; 22:872-877. [PMID: 25691534 DOI: 10.1177/1087054715570389] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether the brain-derived neurotrophic factor ( BDNF) 196 G/A or catechol- O-methyltransferase ( COMT) Val158Met polymorphisms is associated with susceptibility to ADHD. METHOD We conducted a meta-analysis of the associations between the BDNF 196 G/A and COMT Val158Met polymorphisms and ADHD. RESULTS Sixteen studies consisting of 3,594 patients with ADHD and 4,040 controls were included in this meta-analysis. Our results showed no association between ADHD and the BDNF 196A allele in all participants (odds ratio [OR] = 0.958, 95% confidence interval [CI] = [0.800, 1.146], p = .638), European or Asian population. Meta-analysis indicated no association between ADHD and the COMT G allele in all study participants (OR = 1.078, 95% CI = [0.962, 1.207], p = .196), European or Asian population. CONCLUSION This meta-analysis showed a lack of association between the BDNF 196 G/A and COMT Val158Met polymorphisms and ADHD.
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Affiliation(s)
- Young Ho Lee
- 1 Korea University College of Medicine, Seoul, Korea
| | - Gwan Gyu Song
- 1 Korea University College of Medicine, Seoul, Korea
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Angyal N, Horvath EZ, Tarnok Z, Richman MJ, Bognar E, Lakatos K, Sasvari-Szekely M, Nemoda Z. Association analysis of norepinephrine transporter polymorphisms and methylphenidate response in ADHD patients. Prog Neuropsychopharmacol Biol Psychiatry 2018; 84:122-128. [PMID: 29374517 DOI: 10.1016/j.pnpbp.2018.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/27/2017] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
Abstract
AIMS Methylphenidate (MPH) is the most frequently prescribed drug in Attention Deficit Hyperactivity Disorder (ADHD). Hitherto mostly the dopamine transporter gene has been studied in MPH-response and only a few studies analyzed the norepinephrine transporter (NET, SLC6A2) gene, although MPH is a potent inhibitor of both dopamine and norepinephrine transporters. We aimed to analyze this monoamine transporter gene in relation to ADHD per se and MPH-response in particular to gain further knowledge in ADHD pharmacogenetics using a Caucasian sample. METHODS Six single nucleotide polymorphisms (rs28386840, rs2242446, rs3785143, rs3785157, rs5569, rs7194256 SNP) were studied across the NET gene in 163 ADHD children (age: 9.3±2.6; 86.5% male) using ADHD-RS hyperactivity-impulsivity and inattention scales. For case-control analysis 486 control subjects were also genotyped. At the MPH-response analysis responders had minimum 25% decrease of ADHD-RS total score after 2months of treatment, and chi-square test compared 90 responders and 32 non-responders, whereas ANOVA was used to assess symptom improvement after the first month among the 122 ADHD patients. RESULTS The classical case-control analysis did not yield any association with ADHD diagnosis, which was supported by meta-analysis conducted on the available genetic data (combining previously published and the present studies). On the other hand, the intronic rs3785143 showed nominal association with inattention symptoms (p=0.01). The haplotype analysis supported this association, and indicated the importance of the first haploblock encompassing the intronic and 2 promoter SNPs. With MPH-response only the promoter rs28386840 showed nominal association: Those with at least one T-allele were overrepresented in the responder group (42% vs 19%, p=0.08), and they had better improvement on the hyperactivity-impulsivity scale compared to the AA genotype (p=0.04). CONCLUSION Although none of our single SNP findings remained significant after correcting for multiple testing, our results from the MPH-response analysis indicate the potential importance of promoter variants in the NET gene.
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Affiliation(s)
- Nora Angyal
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Erzsebet Zsofia Horvath
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Mara J Richman
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
| | - Emese Bognar
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Krisztina Lakatos
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Maria Sasvari-Szekely
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsofia Nemoda
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary.
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Storebø OJ, Pedersen N, Ramstad E, Kielsholm ML, Nielsen SS, Krogh HB, Moreira‐Maia CR, Magnusson FL, Holmskov M, Gerner T, Skoog M, Rosendal S, Groth C, Gillies D, Buch Rasmussen K, Gauci D, Zwi M, Kirubakaran R, Håkonsen SJ, Aagaard L, Simonsen E, Gluud C. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies. Cochrane Database Syst Rev 2018; 5:CD012069. [PMID: 29744873 PMCID: PMC6494554 DOI: 10.1002/14651858.cd012069.pub2] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood. The psychostimulant methylphenidate is the most frequently used medication to treat it. Several studies have investigated the benefits of methylphenidate, showing possible favourable effects on ADHD symptoms, but the true magnitude of the effect is unknown. Concerning adverse events associated with the treatment, our systematic review of randomised clinical trials (RCTs) demonstrated no increase in serious adverse events, but a high proportion of participants suffered a range of non-serious adverse events. OBJECTIVES To assess the adverse events associated with methylphenidate treatment for children and adolescents with ADHD in non-randomised studies. SEARCH METHODS In January 2016, we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, 12 other databases and two trials registers. We also checked reference lists and contacted authors and pharmaceutical companies to identify additional studies. SELECTION CRITERIA We included non-randomised study designs. These comprised comparative and non-comparative cohort studies, patient-control studies, patient reports/series and cross-sectional studies of methylphenidate administered at any dosage or formulation. We also included methylphenidate groups from RCTs assessing methylphenidate versus other interventions for ADHD as well as data from follow-up periods in RCTs. Participants had to have an ADHD diagnosis (from the 3rd to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders or the 9th or 10th edition of theInternational Classification of Diseases, with or without comorbid diagnoses. We required that at least 75% of participants had a normal intellectual capacity (intelligence quotient of more than 70 points) and were aged below 20 years. We excluded studies that used another ADHD drug as a co-intervention. DATA COLLECTION AND ANALYSIS Fourteen review authors selected studies independently. Two review authors assessed risk of bias independently using the ROBINS-I tool for assessing risk of bias in non-randomised studies of interventions. All review authors extracted data. We defined serious adverse events according to the International Committee of Harmonization as any lethal, life-threatening or life-changing event. We considered all other adverse events to be non-serious adverse events and conducted meta-analyses of data from comparative studies. We calculated meta-analytic estimates of prevalence from non-comparative cohorts studies and synthesised data from patient reports/series qualitatively. We investigated heterogeneity by conducting subgroup analyses, and we also conducted sensitivity analyses. MAIN RESULTS We included a total of 260 studies: 7 comparative cohort studies, 6 of which compared 968 patients who were exposed to methylphenidate to 166 controls, and 1 which assessed 1224 patients that were exposed or not exposed to methylphenidate during different time periods; 4 patient-control studies (53,192 exposed to methylphenidate and 19,906 controls); 177 non-comparative cohort studies (2,207,751 participants); 2 cross-sectional studies (96 participants) and 70 patient reports/series (206 participants). Participants' ages ranged from 3 years to 20 years. Risk of bias in the included comparative studies ranged from moderate to critical, with most studies showing critical risk of bias. We evaluated all non-comparative studies at critical risk of bias. The GRADE quality rating of the evidence was very low.Primary outcomesIn the comparative studies, methylphenidate increased the risk ratio (RR) of serious adverse events (RR 1.36, 95% confidence interval (CI) 1.17 to 1.57; 2 studies, 72,005 participants); any psychotic disorder (RR 1.36, 95% CI 1.17 to 1.57; 1 study, 71,771 participants); and arrhythmia (RR 1.61, 95% CI 1.48 to 1.74; 1 study, 1224 participants) compared to no intervention.In the non-comparative cohort studies, the proportion of participants on methylphenidate experiencing any serious adverse event was 1.20% (95% CI 0.70% to 2.00%; 50 studies, 162,422 participants). Withdrawal from methylphenidate due to any serious adverse events occurred in 1.20% (95% CI 0.60% to 2.30%; 7 studies, 1173 participants) and adverse events of unknown severity led to withdrawal in 7.30% of participants (95% CI 5.30% to 10.0%; 22 studies, 3708 participants).Secondary outcomesIn the comparative studies, methylphenidate, compared to no intervention, increased the RR of insomnia and sleep problems (RR 2.58, 95% CI 1.24 to 5.34; 3 studies, 425 participants) and decreased appetite (RR 15.06, 95% CI 2.12 to 106.83; 1 study, 335 participants).With non-comparative cohort studies, the proportion of participants on methylphenidate with any non-serious adverse events was 51.2% (95% CI 41.2% to 61.1%; 49 studies, 13,978 participants). These included difficulty falling asleep, 17.9% (95% CI 14.7% to 21.6%; 82 studies, 11,507 participants); headache, 14.4% (95% CI 11.3% to 18.3%; 90 studies, 13,469 participants); abdominal pain, 10.7% (95% CI 8.60% to 13.3%; 79 studies, 11,750 participants); and decreased appetite, 31.1% (95% CI 26.5% to 36.2%; 84 studies, 11,594 participants). Withdrawal of methylphenidate due to non-serious adverse events occurred in 6.20% (95% CI 4.80% to 7.90%; 37 studies, 7142 participants), and 16.2% were withdrawn for unknown reasons (95% CI 13.0% to 19.9%; 57 studies, 8340 participants). AUTHORS' CONCLUSIONS Our findings suggest that methylphenidate may be associated with a number of serious adverse events as well as a large number of non-serious adverse events in children and adolescents, which often lead to withdrawal of methylphenidate. Our certainty in the evidence is very low, and accordingly, it is not possible to accurately estimate the actual risk of adverse events. It might be higher than reported here.Given the possible association between methylphenidate and the adverse events identified, it may be important to identify people who are most susceptible to adverse events. To do this we must undertake large-scale, high-quality RCTs, along with studies aimed at identifying responders and non-responders.
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Affiliation(s)
- Ole Jakob Storebø
- Region ZealandChild and Adolescent Psychiatric DepartmentBirkevaenget 3RoskildeDenmark4300
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
- University of Southern DenmarkDepartment of Psychology, Faculty of Health ScienceCampusvej 55OdenseDenmark5230
| | - Nadia Pedersen
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
| | - Erica Ramstad
- Region ZealandChild and Adolescent Psychiatric DepartmentBirkevaenget 3RoskildeDenmark4300
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
| | | | | | - Helle B Krogh
- Region ZealandChild and Adolescent Psychiatric DepartmentBirkevaenget 3RoskildeDenmark4300
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
| | - Carlos R Moreira‐Maia
- Federal University of Rio Grande do SulDepartment of PsychiatryRua Ramiro Barcelos, 2350‐2201APorto AlegreRSBrazil90035‐003
| | | | | | - Trine Gerner
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
| | - Maria Skoog
- Clinical Studies Sweden ‐ Forum SouthClinical Study SupportLundSweden
| | - Susanne Rosendal
- Psychiatric Centre North ZealandThe Capital Region of DenmarkDenmark
| | - Camilla Groth
- Herlev University HospitalPediatric DepartmentCapital RegionHerlevDenmark
| | | | | | - Dorothy Gauci
- Department of HealthDirectorate for Health Information and Research95 G'Mangia HillG'MangiaMaltaPTA 1313
| | - Morris Zwi
- Whittington HealthIslington Child and Adolescent Mental Health Service580 Holloway RoadLondonLondonUKN7 6LB
| | - Richard Kirubakaran
- Christian Medical CollegeCochrane South Asia, Prof. BV Moses Centre for Evidence‐Informed Healthcare and Health PolicyCarman Block II FloorCMC Campus, BagayamVelloreIndia632002
| | - Sasja J Håkonsen
- Aalborg UniversityDepartment of Health Science and TechnologyNiels Jernes Vej 14AalborgDenmark9220
| | | | - Erik Simonsen
- Region Zealand PsychiatryPsychiatric Research UnitSlagelseDenmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalCochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
- Copenhagen University HospitalCopenhagen Trial Unit, Centre for Clinical Intervention ResearchCopenhagenDenmark
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Pekcanlar Akay A, Eresen Yazıcıoğlu Ç, Alşen Güney S, Özek Erkuran H, Kızıldağ S, Baykara B, Özyurt G, Yıldırımcan Kadıçeşme Ş, Miral S, İnal Emiroğlu N. Allele frequencies of dopamine D4 receptor gene (DRD4) and Catechol-O-methyltransferase (COMT) Val158Met polymorphism are associated with methylphenidate response in adolescents with attention deficit/hyperactivity disorder: a case control preliminary study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2017.1418134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | | | - Sevay Alşen Güney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Handan Özek Erkuran
- Deparment of Child and Adolescent Psychiatry, Child Psychiatry Specialist, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training Hospital, Izmir, Turkey
| | - Sefa Kızıldağ
- Department of Molecular Biology and Genetics, Dokuz Eylul University, Izmir, Turkey
| | - Burak Baykara
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Katip Çelebi University Medical Faculty, Izmir, Turkey
| | | | - Süha Miral
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
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Soleimani R, Salehi Z, Soltanipour S, Hasandokht T, Jalali MM. SLC6A3 polymorphism and response to methylphenidate in children with ADHD: A systematic review and meta-analysis. Am J Med Genet B Neuropsychiatr Genet 2018; 177:287-300. [PMID: 29171685 DOI: 10.1002/ajmg.b.32613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/13/2017] [Indexed: 01/29/2023]
Abstract
Methylphenidate (MPH) is the most commonly used treatment for attention-deficit hyperactivity disorder (ADHD) in children. However, the response to MPH is not similar in all patients. This meta-analysis investigated the potential role of SLC6A3 polymorphisms in response to MPH in children with ADHD. Clinical trials or naturalistic studies were selected from electronic databases. A meta-analysis was conducted using a random-effects model. Cohen's d effect size and 95% confidence intervals (CIs) were determined. Sensitivity analysis and meta-regression were performed. Q-statistic and Egger's tests were conducted to evaluate heterogeneity and publication bias, respectively. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence. Sixteen studies with follow-up periods of 1-28 weeks were eligible. The mean treatment acceptability of MPH was 97.2%. In contrast to clinical trials, the meta-analysis of naturalistic studies indicated that children without 10/10 repeat carriers had better response to MPH (Cohen's d: -0.09 and 0.44, respectively). The 9/9 repeat polymorphism had no effect on the response rate (Cohen's d: -0.43). In the meta-regression, a significant association was observed between baseline severity of ADHD, MPH dosage, and combined type of ADHD in some genetic models. Sensitivity analysis indicated the robustness of our findings. No publication bias was observed in our meta-analysis. The GRADE evaluations revealed very low levels of confidence for each outcome of response to MPH. The results of clinical trials and naturalistic studies regarding the effect size between different polymorphisms of SLC6A3 were contradictory. Therefore, further research is recommended.
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Affiliation(s)
- Robabeh Soleimani
- Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, Shafa Hospital, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Zivar Salehi
- Molecular Genetics, Department of Biology, University of Guilan, Rasht, Guilan, Iran
| | - Soheil Soltanipour
- Public Health and Preventive Medicine, Medical Faculty, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Tolou Hasandokht
- Public Health and Preventive Medicine, Medical Faculty, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Mir Mohammad Jalali
- Otolaryngology, RhinoSinus diseases Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Guilan, Iran
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Wehry AM, Ramsey L, Dulemba SE, Mossman SA, Strawn JR. Pharmacogenomic Testing in Child and Adolescent Psychiatry: An Evidence-Based Review. Curr Probl Pediatr Adolesc Health Care 2018; 48:40-49. [PMID: 29325731 PMCID: PMC5828875 DOI: 10.1016/j.cppeds.2017.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Significant advances have been made in the application of pharmacogenomic testing for the treatment of patients with psychiatric disorders. Over the past decade, a number of studies have evaluated the utility of pharmacogenomic testing in pediatric patients with psychiatric disorders. The evidence base for pharmacogenomic testing in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) is reviewed in this article. General pharmacogenomic principles are summarized and functional polymorphisms in P450 enzymes (and associated metabolizer phenotypes), the serotonin transporter promoter polymorphisms, serotonin 2A receptor genes (e.g., HT2AR) and catecholamine pathway genes (e.g., COMT) are reviewed. These commonly tested pharmacogenomic markers are discussed with regard to studies of drug levels, efficacy and side effects. The translation of pharmacogenomics to individualized/precision medicine in pediatric patients with ADHD, anxiety and depressive disorders has accelerated; however, its application remains challenging given that there are numerous divergent pathways between medication/medication dose and clinical response and side effects. Nonetheless, by leveraging variations in individual genes that may be relevant to medication metabolism or medication target engagement, pharmacogenomic testing may have a role in predicting treatment response, side effects and medication selection in youth with ADHD, depressive and anxiety disorders.
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Affiliation(s)
- Anna M Wehry
- University of Cincinnati, College of Medicine, Box 0559, Cincinnati, OH 45267-0559
| | - Laura Ramsey
- Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Shane E Dulemba
- Division of Child and Adolescent, Cincinnati Children's Hospital, Cincinnati, OH
| | - Sarah A Mossman
- University of Cincinnati, College of Medicine, Box 0559, Cincinnati, OH 45267-0559
| | - Jeffrey R Strawn
- University of Cincinnati, College of Medicine, Box 0559, Cincinnati, OH 45267-0559.
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22
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Shim SH, Yoon HJ, Bak J, Hahn SW, Kim YK. Clinical and neurobiological factors in the management of treatment refractory attention-deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2016; 70:237-44. [PMID: 27103462 DOI: 10.1016/j.pnpbp.2016.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/09/2016] [Accepted: 04/09/2016] [Indexed: 01/08/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent mental disorder of childhood, which often continues into adolescence and adulthood. Stimulants such as methylphenidate (MPH) and non-stimulants such as atomoxetine are effective medications for the treatment of ADHD. However, about 30% of patients do not respond to these medications. Pharmacological treatment for ADHD, although highly effective, is associated with marked variabilities in clinical response, optimal dosage needed and tolerability. This article provides an overview of up-to-date knowledge regarding the clinical and neurobiological factors which contribute to and help predict treatment-refractory ADHD. Pharmacogenetic, pharmacogenomics and neuroimaging studies are still controversial with respect to determining the associations between response to medication and genetic factors, thereby resulting in hypotheses that differences in the genetic factors and neuroimaging findings contribute to treatment outcome. Much research on the potential role of genotype in pharmacological effects has focused on the catecholaminergic gene related to executive functions. Many neuroimaging studies have also reported a relationship between treatment response and common patterns of brain structure or activity according to various genetic polymorphisms. When children, adolescents and adults with ADHD do not respond to MPH, we should consider additional pharmacological options, including other classes of psychostimulants, the nonstimulant atomoxetine, bupropion, tricyclic antidepressant, clonidine, guanfacine and lisdexamphetamine. Prudent choice of an appropriate medication and active engagement of children, parents, and teachers in daily management may help to ensure long-term adherence. Therefore, additional research might help to optimize the treatment of children, adolescents and adults with ADHD and to find new options for the treatment of patients who do not respond to stimulants and the other medications. Because these findings should be interpreted cautiously, further studies are needed to elucidate these issues more clearly.
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Affiliation(s)
- Se-Hoon Shim
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Choongnam Province, South Korea
| | - Hee-Jung Yoon
- Department of Internal Medicine, Seoul Metropolitan Seobuk Hospital, Seoul, South Korea
| | - Jeongjae Bak
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Choongnam Province, South Korea
| | - Sang-Woo Hahn
- Department of Psychiatry, Soonchunhyang University Hospital, Seoul, South Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Kyunggi Province, South Korea.
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Unal D, Unal MF, Alikasifoglu M, Cetinkaya A. Genetic Variations in Attention Deficit Hyperactivity Disorder Subtypes and Treatment Resistant Cases. Psychiatry Investig 2016; 13:427-33. [PMID: 27482244 PMCID: PMC4965653 DOI: 10.4306/pi.2016.13.4.427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/26/2015] [Accepted: 12/30/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE ObjectiveaaWe evaluated the distribution of alpha-2A adrenergic receptor (ADRA2A) and catechol-o-methyltransferase (COMT) single nucleotide polymorphisms (SNPs) among ADHD subtypes and other homogeneous patient populations including treatment-resistant cases and patients with high symptom severity. METHODS Methodsaa121 ADHD patients aged 6-18 years were included in the study. Diagnosis and subtypes designation were confirmed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and symptoms were evaluated using the Conners' Parent (CPRS) and Teacher Rating Scales (CTRS). The response to methylphenidate was assessed objectively using the Clinical Global Impression-Severity Scale (CGI-S) and Global Assessment of Functioning Scale (GAS) as well as the Continuous Performance (CPT) and Trail Making tests (TMT-A, B). Patients were genotyped for ADRA2A (rs1800544) and COMT (rs4680) SNPs by PCR/RFLP and compared to a gender-matched control group. RESULTS Although there was no association of COMT (rs4680) SNP with symptoms or diagnosis, the ADRA2A polymorphism, low socioeconomic status (SES), and comorbid psychiatric diagnosis were all associated with poor response to methylphenidate in logistic regression analysis. CONCLUSION Clinicians may consider adjuvant strategies when these negative factors are present to increase the success of tailored ADHD treatments in the future.
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Affiliation(s)
- Dilek Unal
- Department of Child and Adolescent Psychiatry, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mehmet Fatih Unal
- Department of Child and Adolescent Psychiatry, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mehmet Alikasifoglu
- Department of Medical Genetics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Arda Cetinkaya
- Department of Medical Genetics, Hacettepe University School of Medicine, Ankara, Turkey
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COMT val158met moderation of dopaminergic drug effects on cognitive function: a critical review. THE PHARMACOGENOMICS JOURNAL 2016; 16:430-8. [PMID: 27241058 PMCID: PMC5028240 DOI: 10.1038/tpj.2016.43] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/29/2016] [Accepted: 05/04/2016] [Indexed: 12/20/2022]
Abstract
The relationship between dopamine (DA) tone in the prefrontal cortex (PFC) and PFC-dependent cognitive functions (for example, working memory, selective attention, executive function) may be described by an inverted-U-shaped function, in which both excessively high and low DA is associated with impairment. In the PFC, the COMT val158met single nucleotide polymorphism (rs4680) confers differences in catechol-O-methyltransferase (COMT) efficacy and DA tone, and individuals homozygous for the val allele display significantly reduced cortical DA. Many studies have investigated whether val158met genotype moderates the effects of dopaminergic drugs on PFC-dependent cognitive functions. A review of 25 such studies suggests evidence for this pharmacogenetic effect is mixed for stimulants and COMT inhibitors, which have greater effects on D1 receptors, and strong for antipsychotics, which have greater effects on D2 receptors. Overall, COMT val158met genotype represents an enticing target for identifying individuals who are more likely to respond positively to dopaminergic drugs.
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Jawinski P, Tegelkamp S, Sander C, Häntzsch M, Huang J, Mauche N, Scholz M, Spada J, Ulke C, Burkhardt R, Reif A, Hegerl U, Hensch T. Time to wake up: No impact of COMT Val158Met gene variation on circadian preferences, arousal regulation and sleep. Chronobiol Int 2016; 33:893-905. [PMID: 27148829 DOI: 10.1080/07420528.2016.1178275] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Dopamine has been implicated in the regulation of sleep-wake states and the circadian rhythm. However, there is no consensus on the impact of two established dopaminergic gene variants: the catechol-O-methyltransferase Val158Met (COMT Val158Met; rs4680) and the dopamine D4 receptor Exon III variable-number-of-tandem-repeat polymorphism (DRD4 VNTR). Pursuing a multi-method approach, we examined their potential effects on circadian preferences, arousal regulation and sleep. Subjects underwent a 7-day actigraphy assessment (SenseWear Pro3), a 20-minute resting EEG (analyzed using VIGALL 2.0) and a body mass index (BMI) assessment. Further, they completed the Morningness-Eveningness Questionnaire (MEQ), the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). The sample comprised 4625 subjects (19-82 years) genotyped for COMT Val158Met, and 689 elderly subjects (64-82 years) genotyped for DRD4 VNTR. The number of subjects varied across phenotypes. Power calculations revealed a minimum required phenotypic variance explained by genotype ranging between 0.5% and 1.5% for COMT Val158Met and between 3.3% and 6.0% for DRD4 VNTR. Analyses did not reveal significant genotype effects on MEQ, ESS, PSQI, BMI, actigraphy and EEG variables. Additionally, we found no compelling evidence in sex- and age-stratified subsamples. Few associations surpassed the threshold of nominal significance (p < .05), providing some indication for a link between DRD4 VNTR and daytime sleepiness. Taken together, in light of the statistical power obtained in the present study, our data particularly suggest no impact of the COMT Val158Met polymorphism on circadian preferences, arousal regulation and sleep. The suggestive link between DRD4 VNTR and daytime sleepiness, on the other hand, might be worth investigation in a sample enriched with younger adults.
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Affiliation(s)
- Philippe Jawinski
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany.,c Depression Research Center of the German Depression Foundation , Leipzig , Germany
| | - Sophie Tegelkamp
- b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Christian Sander
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany.,c Depression Research Center of the German Depression Foundation , Leipzig , Germany
| | - Madlen Häntzsch
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,d Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics , University Hospital Leipzig , Leipzig , Germany
| | - Jue Huang
- b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Nicole Mauche
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Markus Scholz
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,e Institute for Medical Informatics, Statistics and Epidemiology , University of Leipzig , Leipzig , Germany
| | - Janek Spada
- b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany.,c Depression Research Center of the German Depression Foundation , Leipzig , Germany
| | - Christine Ulke
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,c Depression Research Center of the German Depression Foundation , Leipzig , Germany
| | - Ralph Burkhardt
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,d Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics , University Hospital Leipzig , Leipzig , Germany
| | - Andreas Reif
- f Department of Psychiatry , Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt , Frankfurt , Germany
| | - Ulrich Hegerl
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany.,c Depression Research Center of the German Depression Foundation , Leipzig , Germany
| | - Tilman Hensch
- a LIFE - Leipzig Research Center for Civilization Diseases , University of Leipzig , Leipzig , Germany.,b Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany
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26
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Ozturk O, Alacam H, Basay BK, Basay O, Buber A, Ay OI, Agladıoglu K, Erdal ME, Herken H. The Effect of Single Dose Methylphenidate on Neurometabolites according to COMT Gene Val158Met Polymorphism in the Patient with Attention Deficit Hyperactivity Disorder: A Study Using Magnetic Resonance Spectroscopy. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2016; 14:184-93. [PMID: 27121430 PMCID: PMC4857871 DOI: 10.9758/cpn.2016.14.2.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/07/2015] [Accepted: 12/08/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Thus, the present study aimed to determine the effects of a single dose of methylphenidate (Mph) on neurometabolite levels according to polymorphisms of the catechol-O-methyltransferase (COMT) gene. METHODS This study evaluated the neurometabolite levels including N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) of ADHD patients, before and after treatment with Mph (10 mg) according to the presence of COMT polymorphisms. The spectra were obtained from the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), cerebellum, and striatum. RESULTS The NAA levels of the val/val and val genotype carriers (val/val and val/met genotypes) increased in the DLPFC and ACC, respectively, following Mph treatment. The NAA/Cr ratio was lower in the DLPFC of val carriers than in the met/met genotype carriers prior to Mph administration. The Cho levels of the val/met genotype and val carriers increased in the striatum following Mph treatment. Following Mph treatment, the Cr levels of the met/met genotype carriers were higher than those of the val/met genotype and val carriers. Additionally, after Mph treatment, there was a significant increase in Cr levels in the DLPFC of the met/met genotype carriers but a significant decrease in such levels in the striatum of val/val genotype carriers. CONCLUSION These findings suggest that polymorphisms of the COMT gene can account for individual differences in neurochemical responses to Mph among ADHD patients. Therefore, further studies are needed to fully characterize the effects of the Val158met polymorphism of the COMT gene on treatment outcomes in patients with ADHD.
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Affiliation(s)
- Onder Ozturk
- Department of Child and Adolescent Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
| | - Huseyin Alacam
- Department of Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
| | - Burge Kabukcu Basay
- Department of Child and Adolescent Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
| | - Omer Basay
- Department of Child and Adolescent Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
| | - Ahmet Buber
- Department of Child and Adolescent Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
| | - Ozlem Izci Ay
- Department of Medical Biology and Genetics, Medical Faculty, Mersin University, Mersin, Turkey
| | - Kadir Agladıoglu
- Department of Radiology, Medical Faculty, Pamukkale University, Denizli
| | - Mehmet Emin Erdal
- Department of Medical Biology and Genetics, Medical Faculty, Mersin University, Mersin, Turkey
| | - Hasan Herken
- Department of Psychiatry, Medical Faculty, Mersin University, Mersin, Turkey
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Pagerols M, Richarte V, Sánchez-Mora C, Garcia-Martínez I, Corrales M, Corominas M, Cormand B, Casas M, Ribasés M, Ramos-Quiroga JA. Pharmacogenetics of methylphenidate response and tolerability in attention-deficit/hyperactivity disorder. THE PHARMACOGENOMICS JOURNAL 2016; 17:98-104. [DOI: 10.1038/tpj.2015.89] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/15/2015] [Accepted: 11/02/2015] [Indexed: 01/06/2023]
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28
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Holst SC, Valomon A, Landolt HP. Sleep Pharmacogenetics: Personalized Sleep-Wake Therapy. Annu Rev Pharmacol Toxicol 2016; 56:577-603. [DOI: 10.1146/annurev-pharmtox-010715-103801] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sebastian C. Holst
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
| | - Amandine Valomon
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology and Zürich Center for Interdisciplinary Sleep Research, University of Zürich, CH-8057 Zürich, Switzerland;
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Abstract
The etiology and pathogenesis of attention-deficit/hyperactivity disorder (ADHD) are unclear and a more valid diagnosis would certainly be welcomed. Starting from the literature, we built an hypothetical pyramid representing a putative set of biomarkers where, at the top, variants in DAT1 and DRD4 genes are the best candidates for their associations to neuropsychological tasks, activation in specific brain areas, methylphenidate response and gene expression levels. Interesting data come from the noradrenergic system (norepinephrine transporter, norepinephrine, 3-methoxy-4-hydroxyphenylglycol, monoamine oxidase, neuropeptide Y) for their altered peripheral levels, their association with neuropsychological tasks, symptomatology, drugs effect and brain function. Other minor putative genetic biomarkers could be dopamine beta hydroxylase and catechol-O-methyltransferase. In the bottom, we placed endophenotype biomarkers. A more deep integration of "omics" sciences along with more accurate clinical profiles and new high-throughput computational methods will allow us to identify a better list of biomarkers useful for diagnosis and therapies.
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Affiliation(s)
- Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
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30
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Yatsuga C, Toyohisa D, Fujisawa TX, Nishitani S, Shinohara K, Matsuura N, Ikeda S, Muramatsu M, Hamada A, Tomoda A. No association between catechol-O-methyltransferase (COMT) genotype and attention deficit hyperactivity disorder (ADHD) in Japanese children. Brain Dev 2014; 36:620-5. [PMID: 24035255 DOI: 10.1016/j.braindev.2013.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 08/06/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study ascertained the association between attention deficit/hyperactivity disorder (ADHD) in Japanese children and a polymorphism of catechol-O-methyltransferase (COMT), a dopamine-control gene. The secondary aim of the study was the evaluation of a putative association between methylphenidate (MPH) effect/adverse effects and the COMT genotype. METHODS To ascertain the distribution of the Val158Met variant of COMT, 50 children meeting ADHD inclusion criteria were compared with 32 healthy children. Clinical improvement and the occurrence of adverse effects were measured before and 3 months after MPH administration in children with ADHD, and analyzed for genotype association. Wechsler Intelligence Scale for Children-Third Edition (WISC-III), age, MPH dose were included as co-variables. RESULTS The occurrence of the COMT Val/Val genotype was significantly higher in children with ADHD (χ(2)(1)=7.13, p<0.01). However, there was no significant difference in the Val/Val genotype according to disorder, and WISC and ADHD rating scale scores, after correcting for the interaction between disorder and COMT genotype. Furthermore, no significant difference in MPH effect/adverse effects was observed in association with the COMT genotype in the ADHD group. CONCLUSIONS These results showed a lack of association between the COMT Val/Val genotype and ADHD in Japan.
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Affiliation(s)
- Chiho Yatsuga
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Daiki Toyohisa
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shota Nishitani
- Department of Neurobiology and Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuyuki Shinohara
- Department of Neurobiology and Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Naomi Matsuura
- School of Education, Tokyo University and Graduate School of Social Welfare, Tokyo, Japan
| | - Shinobu Ikeda
- Tokyo Medical and Dental University, Medical Research Institute, Medical Genomics, Molecular Epidemiology, Tokyo, Japan
| | - Masaaki Muramatsu
- Tokyo Medical and Dental University, Medical Research Institute, Medical Genomics, Molecular Epidemiology, Tokyo, Japan
| | - Akinobu Hamada
- Division of Integrative Omics and Bioinformatics, National Cancer Center Research Institute, Tokyo, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
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31
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Park S, Kim JW, Kim BN, Shin MS, Yoo HJ, Cho SC. Catechol-O-methyltransferase Val158-Met polymorphism and a response of hyperactive-impulsive symptoms to methylphenidate: A replication study from South Korea. J Psychopharmacol 2014; 28:671-6. [PMID: 24763183 DOI: 10.1177/0269881114527654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the association between the catechol-O-methyltransferase (COMT) Val(158)-Met (rs4680) genotype and both subjective and objective treatment responses to methylphenidate in Korean children with attention-deficit/hyperactivity disorder (ADHD). We enrolled 120 medication-naïve children with ADHD in an open-label, 8-week trial of methylphenidate. The participants were genotyped and evaluated using the Clinical Global Impression Scale and the ADHD Rating Scale-IV (ADHD-RS), and completed the Continuous Performance Test (CPT) before and after treatment. We found a significant association between the COMT Val/Val genotype and a good response, in terms of hyperactive-impulsive scores on the ADHD-RS (odds ratio (OR) = 2.61; p = 0.044) and response-time variability on the CPT (OR = 2.66; p = 0.028). The association of the COMT Val/Val genotype with a good response, in terms of response time variability, was significant in both the sub-sample of combined-type (OR = 3.45; p = 0.026) and sub-sample of inattentive-type (OR = 5.52; p = 0.029); but the association with a good response in terms of hyperactive-impulsive scores was not significant in sub-sample analyses. Although the reported nominally significant associations did not stay significant after correcting for multiple testing, our results support previous findings about the possible involvement of the COMT (Val(158)-Met) polymorphism in the treatment response to methylphenidate in children with ADHD.
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Affiliation(s)
- Subin Park
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Sup Shin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee-Jeong Yoo
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Churl Cho
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Di Pino G, Maravita A, Zollo L, Guglielmelli E, Di Lazzaro V. Augmentation-related brain plasticity. Front Syst Neurosci 2014; 8:109. [PMID: 24966816 PMCID: PMC4052974 DOI: 10.3389/fnsys.2014.00109] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/23/2014] [Indexed: 12/11/2022] Open
Abstract
Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyses the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain. Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools. Augmentation modifies function and structure of a number of areas, i.e., primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the sense of the self.
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Affiliation(s)
- Giovanni Di Pino
- Institute of Neurology and Fondazione Alberto Sordi - Research Institute for Ageing, Campus Bio Medico University of Rome Rome, Italy ; Laboratory of Biomedical Robotics and Biomicrosystems CIR - Centre for Integrated Research, Campus Bio Medico University of Rome Rome, Italy
| | - Angelo Maravita
- Department of Psycology, Università di Milano-Bicocca Milano, Italy
| | - Loredana Zollo
- Laboratory of Biomedical Robotics and Biomicrosystems CIR - Centre for Integrated Research, Campus Bio Medico University of Rome Rome, Italy
| | - Eugenio Guglielmelli
- Laboratory of Biomedical Robotics and Biomicrosystems CIR - Centre for Integrated Research, Campus Bio Medico University of Rome Rome, Italy
| | - Vincenzo Di Lazzaro
- Institute of Neurology and Fondazione Alberto Sordi - Research Institute for Ageing, Campus Bio Medico University of Rome Rome, Italy
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Bruxel EM, Akutagava-Martins GC, Salatino-Oliveira A, Contini V, Kieling C, Hutz MH, Rohde LA. ADHD pharmacogenetics across the life cycle: New findings and perspectives. Am J Med Genet B Neuropsychiatr Genet 2014; 165B:263-82. [PMID: 24804845 DOI: 10.1002/ajmg.b.32240] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 04/14/2014] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a complex and heterogeneous disorder, affecting individuals across the life cycle. Although its etiology is not yet completely understood, genetics plays a substantial role. Pharmacological treatment is considered effective and safe for children and adults, but there is considerable inter-individual variability among patients regarding response to medication, required doses, and adverse events. We present here a systematic review of the literature on ADHD pharmacogenetics to provide a critical discussion of the existent findings, new approaches, limitations, and recommendations for future research. Our main findings are: first, the number of studies continues to grow, making ADHD one of the mental health areas with more pharmacogenetic studies. Second, there has been a focus shift on ADHD pharmacogenetic studies in the last years. There is an increasing number of studies assessing gene-gene and gene-environment interactions, using genome-wide association approaches, neuroimaging, and assessing pharmacokinetic properties. Third and most importantly, the heterogeneity in methodological strategies employed by different studies remains impressive. The question whether pharmacogenetics studies of ADHD will improve clinical management by shifting from trial-and-error approach to a pharmacological regimen that takes into account the individual variability remains unanswered. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Estela Maria Bruxel
- Genetics Department, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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34
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McCracken JT, Badashova KK, Posey DJ, Aman MG, Scahill L, Tierney E, Arnold LE, Vitiello B, Whelan F, Chuang SZ, Davies M, Shah B, McDougle CJ, Nurmi EL. Positive effects of methylphenidate on hyperactivity are moderated by monoaminergic gene variants in children with autism spectrum disorders. THE PHARMACOGENOMICS JOURNAL 2014; 14:295-302. [PMID: 23856854 PMCID: PMC4034115 DOI: 10.1038/tpj.2013.23] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 04/21/2013] [Accepted: 04/26/2013] [Indexed: 11/09/2022]
Abstract
Methylphenidate (MPH) reduces hyperactive-impulsive symptoms common in children with autism spectrum disorders (ASDs), however, response and tolerability varies widely. We hypothesized monoaminergic gene variants may moderate MPH effects in ASD, as in typically developing children with attention-deficit/hyperactivity disorder. Genotype data were available for 64 children with ASD and hyperactivity who were exposed to MPH during a 1-week safety/tolerability lead-in phase and 58 who went on to be randomized to placebo and three doses of MPH during a 4-week blinded, crossover study. Outcome measures included the Clinical Global Impression-Improvement (CGI-I) scale and the Aberrant Behavior Checklist (ABC-hyperactivity index). A total of 14 subjects discontinued the study because of MPH side effects. Subjects were genotyped for variants in DRD1-DRD5, ADRA2A, SLC6A3, SLC6A4, MAOA and MAOB, and COMT. Forty-nine percent of the sample met positive responder criteria. In this modest but relatively homogeneous sample, significant differences by DRD1 (P=0.006), ADRA2A (P<0.02), COMT (P<0.04), DRD3 (P<0.05), DRD4 (P<0.05), SLC6A3 (P<0.05) and SLC6A4 (P<0.05) genotypes were found for responders versus non-responders. Variants in DRD2 (P<0.001) and DRD3 (P<0.04) were associated with tolerability in the 14 subjects who discontinued the trial. For this first MPH pharmacogenetic study in children with ASD, multiple monoaminergic gene variants may help explain individual differences in MPH's efficacy and tolerability.
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Affiliation(s)
- J T McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - K K Badashova
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - D J Posey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M G Aman
- Departments of Psychiatry and Psychology, The Nisonger Center UCEDD, Ohio State University, Columbus, OH, USA
| | - L Scahill
- Child Study Center, Yale University, New Haven, CT, USA
| | - E Tierney
- Department of Psychiatry, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | - L E Arnold
- Departments of Psychiatry and Psychology, The Nisonger Center UCEDD, Ohio State University, Columbus, OH, USA
| | - B Vitiello
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - F Whelan
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - S Z Chuang
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - M Davies
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - B Shah
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - C J McDougle
- Department of Psychiatry, Lurie Autism Center, Massachusetts General Hospital, Boston, MA, USA
| | - E L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA
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Valomon A, Holst SC, Bachmann V, Viola AU, Schmidt C, Zürcher J, Berger W, Cajochen C, Landolt HP. Genetic polymorphisms of DAT1 and COMT differentially associate with actigraphy-derived sleep-wake cycles in young adults. Chronobiol Int 2014; 31:705-14. [PMID: 24625311 DOI: 10.3109/07420528.2014.896376] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Accumulating evidence suggests that dopamine plays a key role in sleep-wake regulation. Cerebral dopamine levels are regulated primarily by the dopamine transporter (DAT) in the striatum and by catechol-O-methyl-transferase (COMT) in the prefrontal cortex. We hypothesized that the variable-number-tandem-repeat (VNTR) polymorphism in the 3'-untranslated region of the gene encoding DAT (DAT1, SLC6A3; rs28363170) and the Val158Met polymorphism of COMT (rs4680) differently affect actigraphy-derived rest-activity cycles and sleep estimates in healthy adults (65 men; 45 women; age range: 19-35 years). Daytime sleepiness, continuous rest-actigraphy and sleep diary data during roughly 4-weeks were analyzed. Nine-repeat (9R) allele carriers of DAT1 (n = 48) more often reported elevated sleepiness (Epworth sleepiness score ≥10) than 10-repeat (10R) allele homozygotes (n = 62, p < 0.02). Moreover, male 9R allele carriers showed higher wrist activity, whereas this difference was not present in women ("DAT1 genotype" × "gender" interaction: p < 0.005). Rest-activity patterns did not differ among COMT genotypes. Nevertheless, a significant "COMT genotype" × "type of day" (workdays vs. rest days) interaction for sleep duration was observed (p = 0.04). The Val/Val (n = 36) and Met/Met (n = 24) homozygotes habitually prolonged sleep on rest days compared to workdays by more than 30 min, while Val/Met heterozygotes (n = 50) did not significantly extend their sleep (mean difference: 7 min). Moreover, whereas the proportion of women among the genotype groups did not differ, COMT genotype affected body-mass-index (BMI), such that Val/Met individuals had lower BMI than the homozygous genotypes (p < 0.04). While awaiting independent replication and confirmation, our data support an association of genetically-determined differences in cerebral dopaminergic neurotransmission with daytime sleepiness and individual rest-activity profiles, as well as other sleep-associated health characteristics such as the regulation of BMI. The differential associations of DAT1 and COMT polymorphisms may reflect the distinct local expression of the encoded proteins in the brain.
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Affiliation(s)
- Amandine Valomon
- Institute of Pharmacology and Toxicology, University of Zürich , Zürich , Switzerland
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Johnson KA, Barry E, Lambert D, Fitzgerald M, McNicholas F, Kirley A, Gill M, Bellgrove MA, Hawi Z. Methylphenidate side effect profile is influenced by genetic variation in the attention-deficit/hyperactivity disorder-associated CES1 gene. J Child Adolesc Psychopharmacol 2013; 23:655-64. [PMID: 24350812 DOI: 10.1089/cap.2013.0032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE A naturalistic, prospective study of the influence of genetic variation on dose prescribed, clinical response, and side effects related to stimulant medication in 77 children with attention-deficit/hyperactivity disorder (ADHD) was undertaken. The influence of genetic variation of the CES1 gene coding for carboxylesterase 1A1 (CES1A1), the major enzyme responsible for the first-pass, stereoselective metabolism of methylphenidate, was investigated. METHODS Parent- and teacher-rated behavioral questionnaires were collected at baseline when the children were medication naïve, and again at 6 weeks while they were on medication. Medication dose, prescribed at the discretion of the treating clinician, and side effects, were recorded at week 6. Blood and saliva samples were collected for genotyping. Single nucleotide polymorphisms (SNPs) were selected in the coding, non-coding and the 3' flanking region of the CES1 gene. Genetic association between CES1 variants and ADHD was investigated in an expanded sample of 265 Irish ADHD families. Analyses were conducted using analysis of covariance (ANCOVA) and logistic regression models. RESULTS None of the CES1 gene variants were associated with the dose of methylphenidate provided or the clinical response recorded at the 6 week time point. An association between two CES1 SNP markers and the occurrence of sadness as a side effect of short-acting methylphenidate was found. The two associated CES1 markers were in linkage disequilibrium and were significantly associated with ADHD in a larger sample of ADHD trios. The associated CES1 markers were also in linkage disequilibrium with two SNP markers of the noradrenaline transporter gene (SLC6A2). CONCLUSIONS This study found an association between two CES1 SNP markers and the occurrence of sadness as a side effect of short-acting methylphenidate. These markers were in linkage disequilibrium together and with two SNP markers of the noradrenaline transporter gene.
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Meta-analysis of the association between dopamine transporter genotype and response to methylphenidate treatment in ADHD. THE PHARMACOGENOMICS JOURNAL 2013; 14:77-84. [PMID: 23588108 DOI: 10.1038/tpj.2013.9] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/12/2013] [Accepted: 02/04/2013] [Indexed: 12/14/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent childhood-onset neuropsychiatric disorder. Treatment with methylphenidate, which blocks dopamine and noradrenaline transporters, is clinically efficacious in reducing the symptoms of ADHD. However, a considerable proportion of patients show no or only insufficient response to methylphenidate. Following a pharmacogenetic approach, a number of studies have suggested that heterogeneity in treatment response across subjects might to some extent be due to genetic factors. In particular, a variable number tandem repeat (VNTR) polymorphism in the 3' untranslated region of the SLC6A3 gene, which codes for the dopamine transporter, has been considered as a predictor of treatment success. However, the literature has so far been inconsistent. Here we present results of a meta-analysis of studies investigating the moderating effect of the SLC6A3 VNTR on response to methylphenidate treatment in subjects with ADHD. Outcome measures from 16 studies including data from 1572 subjects were entered into a random-effects model. There was no significant summary effect for the SLC6A3 VNTR on the response to methylphenidate treatment (P>0.5) and no effect on specific symptom dimensions of hyperactivity/impulsivity and inattention (all P>0.2). However, in a subanalysis of naturalistic trials, we observed a significant effect of d=-0.36 (P=0.03), indicating that 10R homozygotes show less improvement in symptoms following treatment than the non-10/10 carriers. This meta-analysis indicates that SLC6A3 VNTR is not a reliable predictor of methylphenidate treatment success in ADHD. Our study leaves unanswered the question of whether other genetic polymorphisms or nongenetic factors may contribute to the observed heterogeneity in treatment response across ADHD subjects.
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Abstract
OBJECTIVE To review literature relevant to a possible prediction of stimulant side effects in attention deficit hyperactivity disorder (ADHD), with implications for guidelines. METHOD Recent literature on inverted-U effects of dopamine in the prefrontal cortex (PFC), default mode processing, and motor circuits relevant to stimulant side effects is reviewed. RESULTS The literature on inverted-U effects in the PFC suggests that catechol-O-methyltransferase (COMT) Met versus Val polymorphisms may predict excess dopaminergic effects, including headache and introversion in Met/Met subjects, but therapeutic effects in Val/Val subjects, while dopamine transporter polymorphisms may predict motor side effects. In particular, an understanding of 'inverted-U' effects helps to explain why some children may experience side effects while others show improvements at similar dose ranges. CONCLUSION Genetic prediction of stimulant side effects should be investigated, particularly given recent controversies in relation to National Health and Medical Research Council guidelines for stimulant use. A better understanding of treatment-emergent effects will also provide a better understanding of therapeutic effects.
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Affiliation(s)
- Florence Levy
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Randwick, Australia.
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Armagan E, Almacıoglu M, Yakut T, Köse A, Karkucak M, Köksal O, Gorukmez O. Cathecol-O-methyl transferase Val158Met genotype is not a risk factor for conversion disorder. GENETICS AND MOLECULAR RESEARCH 2013; 12:852-8. [DOI: 10.4238/2013.march.19.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wall CA, Croarkin PE, Swintak C, Koplin BA. Psychiatric pharmacogenomics in pediatric psychopharmacology. Child Adolesc Psychiatr Clin N Am 2012; 21:773-88. [PMID: 23040901 DOI: 10.1016/j.chc.2012.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This article provides an overview of where psychiatric pharmacogenomic testing stands as an emerging clinical tool in modern psychotropic prescribing practice, specifically in the pediatric population. This practical discussion is organized around the state of psychiatric pharmacogenomics research when choosing psychopharmacologic interventions in the most commonly encountered mental illnesses in youth. As with the rest of the topics on psychopharmacology for children and adolescents in this publication, a clinical vignette is presented, this one highlighting a clinical case of a 16 year old genotyped during hospitalization for recalcitrant depression.
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Affiliation(s)
- Christopher A Wall
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA.
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Witte AV, Flöel A. Effects of COMT polymorphisms on brain function and behavior in health and disease. Brain Res Bull 2012; 88:418-28. [DOI: 10.1016/j.brainresbull.2011.11.012] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 11/03/2011] [Accepted: 11/15/2011] [Indexed: 12/24/2022]
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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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COMT Val(158)Met genotype determines the direction of cognitive effects produced by catechol-O-methyltransferase inhibition. Biol Psychiatry 2012; 71:538-44. [PMID: 22364739 PMCID: PMC3314969 DOI: 10.1016/j.biopsych.2011.12.023] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 12/23/2011] [Accepted: 12/23/2011] [Indexed: 01/06/2023]
Abstract
BACKGROUND Catechol-O-methyltransferase (COMT) metabolizes dopamine. The COMT Val(158)Met polymorphism influences its activity, and multiple neural correlates of this genotype on dopaminergic phenotypes, especially working memory, have been reported. COMT activity can also be regulated pharmacologically by COMT inhibitors. The inverted-U relationship between cortical dopamine signaling and working memory predicts that the effects of COMT inhibition will differ according to COMT genotype. METHODS Thirty-four COMT Met(158)Met (Met-COMT) and 33 COMT Val(158)Val (Val-COMT) men were given a single 200-mg dose of the brain-penetrant COMT inhibitor tolcapone or placebo in a randomized, double-blind, between-subjects design. They completed the N-back task of working memory and a gambling task. RESULTS In the placebo group, Met-COMT subjects outperformed Val-COMT subjects on the 2- back, and they were more risk averse. Tolcapone had opposite effects in the two genotype groups: it worsened N-back performance in Met-COMT subjects but enhanced it in Val-COMT subjects. Tolcapone made Met-COMT subjects less risk averse but Val-COMT subjects more so. In both tasks, tolcapone reversed the baseline genotype differences. CONCLUSIONS Depending on genotype, COMT inhibition can enhance or impair working memory and increase or decrease risky decision making. To our knowledge, the data are the clearest demonstration to date that the direction of effect of a drug can be influenced by a polymorphism in its target gene. The results support the inverted-U model of dopamine function. The findings are of translational relevance, because COMT inhibitors are used in the adjunctive treatment of Parkinson's disease and are under evaluation in schizophrenia and other disorders.
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Froehlich TE, Epstein JN, Nick TG, Melguizo Castro MS, Stein MA, Brinkman WB, Graham AJ, Langberg JM, Kahn RS. Pharmacogenetic predictors of methylphenidate dose-response in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2011; 50:1129-1139.e2. [PMID: 22024001 PMCID: PMC3225067 DOI: 10.1016/j.jaac.2011.08.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 08/03/2011] [Accepted: 08/04/2011] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Because of significant individual variability in attention-deficit/hyperactivity disorder (ADHD) medication response, there is increasing interest in identifying genetic predictors of treatment effects. This study examined the role of four catecholamine-related candidate genes in moderating methylphenidate (MPH) dose-response. METHOD Eighty-nine stimulant-naive children with ADHD 7 to 11 years old participated in a randomized, double-blind, crossover trial of long-acting MPH. Parents and teachers assessed each child's response on placebo and three MPH dosage levels using the Vanderbilt ADHD rating scales. Children were genotyped for polymorphisms in the 3' untranslated region of dopamine transporter (DAT), exon 3 on dopamine receptor D(4) (DRD4), codon 158 on catechol-O-methyltransferase, and the adrenergic α(2A)-receptor promoter. Linear mixed models evaluated gene, dose (milligrams per kilogram per day), and gene-by-dose effects on inattentive and hyperactive-impulsive domain outcomes. RESULTS The most statistically significant gene-by-dose interactions were observed on hyperactive-impulsive symptoms for DRD4 and DAT polymorphisms, with participants lacking the DAT 10-repeat allele showing greater improvements in symptoms with increasing dose compared with 10-repeat carriers (p = .008) and those lacking the DRD4 4-repeat allele showing less improvement across MPH doses compared with 4-repeat carriers (p = 0.02). CONCLUSIONS This study suggests that DAT and DRD4 polymorphisms may be associated with individual variability in MPH dose-response, although further research in larger samples is required to confirm these findings and their clinical utility. CLINICAL TRIAL REGISTRATION INFORMATION Response Variability in Children with Attention-Deficit/Hyperactivity Disorder (ADHD); http://www.clinicaltrials.gov; NCT01238822.
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Salatino-Oliveira A, Genro JP, Zeni C, Polanczyk GV, Chazan R, Guimarães AP, Callegari-Jacques SM, Rohde LA, Hutz MH. Catechol-O-methyltransferase valine158methionine polymorphism moderates methylphenidate effects on oppositional symptoms in boys with attention-deficit/hyperactivity disorder. Biol Psychiatry 2011; 70:216-21. [PMID: 21550019 DOI: 10.1016/j.biopsych.2011.03.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 03/10/2011] [Accepted: 03/12/2011] [Indexed: 12/31/2022]
Abstract
BACKGROUND The catechol-O-methyltransferase enzyme plays a key role in the function of prefrontal cortex, accounting for most of the degradation of dopamine. Previous studies have documented the improvement of oppositional symptoms in attention-deficit/hyperactivity disorder (ADHD) patients with methylphenidate (MPH) treatment. However, the effect of the COMT gene in the response to MPH on oppositional symptoms has not been investigated. METHODS A total of 251 children with ADHD fulfilled inclusion criteria to participate in the study. Dosages of short-acting MPH were augmented until no further clinical improvement was detected or until there were significant adverse events (MPH dose always > .3 mg/kg/day). The outcome measure was the parent-rated oppositional subscale of the Swanson, Nolan and Pelham Scale-Version IV (SNAP-IV). The scale was applied by child psychiatrists blinded to genotype at baseline and in the first and third months. The COMT valine158methionine polymorphism was genotyped by polymerase chain reaction based methods. RESULTS We detected significant improvement in SNAP-IV oppositional scores from baseline to the first and three months of treatment [n = 112; F(2,231) = 5.35, p = .005]. A significant effect of the presence of methionine allele in oppositional defiant disorder scores during treatment [F(1,148) = 5.02, p = .027] and a significant interaction between the methionine allele and treatment over time for the SNAP-IV oppositional scores during this period of treatment [F(2,229) = 6.40, p = .002] were both observed. CONCLUSIONS These results suggest an effect of the COMT genotype on the trajectory of oppositional defiant disorder symptoms improvement with MPH treatment in boys with ADHD.
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Archer T, Oscar-Berman M, Blum K. Epigenetics in Developmental Disorder: ADHD and Endophenotypes. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2011; 2:1000104. [PMID: 22224195 PMCID: PMC3250517 DOI: 10.4172/2157-7412.1000104] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Heterogeneity in attention-deficit/hyperactivity disorder (ADHD), with complex interactive operations of genetic and environmental factors, is expressed in a variety of disorder manifestations: severity, co-morbidities of symptoms, and the effects of genes on phenotypes. Neurodevelopmental influences of genomic imprinting have set the stage for the structural-physiological variations that modulate the cognitive, affective, and pathophysiological domains of ADHD. The relative contributions of genetic and environmental factors provide rapidly proliferating insights into the developmental trajectory of the condition, both structurally and functionally. Parent-of-origin effects seem to support the notion that genetic risks for disease process debut often interact with the social environment, i.e., the parental environment in infants and young children. The notion of endophenotypes, markers of an underlying liability to the disorder, may facilitate detection of genetic risks relative to a complex clinical disorder. Simple genetic association has proven insufficient to explain the spectrum of ADHD. At a primary level of analysis, the consideration of epigenetic regulation of brain signalling mechanisms, dopamine, serotonin, and noradrenaline is examined. Neurotrophic factors that participate in the neurogenesis, survival, and functional maintenance of brain systems, are involved in neuroplasticity alterations underlying brain disorders, and are implicated in the genetic predisposition to ADHD, but not obviously, nor in a simple or straightforward fashion. In the context of intervention, genetic linkage studies of ADHD pharmacological intervention have demonstrated that associations have fitted the "drug response phenotype," rather than the disorder diagnosis. Despite conflicting evidence for the existence, or not, of genetic associations between disorder diagnosis and genes regulating the structure and function of neurotransmitters and brain-derived neurotrophic factor (BDNF), associations between symptoms-profiles endophenotypes and single nucleotide polymorphisms appear reassuring.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, Box 500, SE-40530 Gothenburg, Sweden
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Kenneth Blum
- Department of Psychiatry, University of Florida College of Medicine, and McKnight Brain Institute, Gainesville, FL, USA
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Husain M, Mehta MA. Cognitive enhancement by drugs in health and disease. Trends Cogn Sci 2011; 15:28-36. [PMID: 21146447 PMCID: PMC3020278 DOI: 10.1016/j.tics.2010.11.002] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 10/19/2010] [Accepted: 11/08/2010] [Indexed: 01/09/2023]
Abstract
Attempts to improve cognitive function in patients with brain disorders have become the focus of intensive research efforts. A recent emerging trend is the use of so-called cognitive enhancers by healthy individuals. Here, we consider some of the effects - positive and negative - that current drugs have in neurological conditions and healthy people. We conclude that, to date, experimental and clinical studies have demonstrated relatively modest overall effects, most probably because of substantial variability in response both across and within individuals. We discuss biological factors that might account for such variability and highlight the need to improve testing methods and to extend our understanding of how drugs modulate specific cognitive processes at the systems or network level.
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Affiliation(s)
- Masud Husain
- UCL Institute of Cognitive Neuroscience and UCL Institute of Neurology, 17 Queen Square, London WC1N 3AR, UK.
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Russo R, Capasso M, Paolucci P, Iolascon A. Pediatric pharmacogenetic and pharmacogenomic studies: the current state and future perspectives. Eur J Clin Pharmacol 2010; 67 Suppl 1:17-27. [PMID: 21069522 DOI: 10.1007/s00228-010-0931-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 10/16/2010] [Indexed: 11/26/2022]
Abstract
Genetic differences among individuals can explain some of the variability observed during drug treatment. Many studies have correlated the different pharmacological response to genetic variability, but most of them have been conducted on adult populations. Much less attention has been given to the pediatric population. Pediatric patients constitute a vulnerable group with regard to rational drug prescribing since they present differences arising from the various stages of development. However, only a few steps have been made in developmental pharmacogenomics. This review attempts to describe the current methods for pharmacogenetic and pharmacogenomic studies, providing some of the most studied examples in pediatric patients. It also gives an overview on the implication and importance of microRNA polymorphisms, transcriptomics, metabonomics, and proteomics in pharmacogenetics and pharmacogenomics studies.
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Affiliation(s)
- Roberta Russo
- Department of Biochemistry and Medical Biotechnologies, University Federico II of Naples and CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, Naples, Italy.
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Nijmeijer JS, Hartman CA, Rommelse NN, Altink ME, Buschgens CJ, Fliers EA, Franke B, Minderaa RB, Ormel J, Sergeant JA, Verhulst FC, Buitelaar JK, Hoekstra PJ. Perinatal risk factors interacting with catechol O-methyltransferase and the serotonin transporter gene predict ASD symptoms in children with ADHD. J Child Psychol Psychiatry 2010; 51:1242-50. [PMID: 20868372 PMCID: PMC2970704 DOI: 10.1111/j.1469-7610.2010.02277.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Symptoms of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur. Given the previously found familiality of ASD symptoms in children with ADHD, addressing these symptoms may be useful for genetic association studies, especially for candidate gene findings that have not been consistently replicated for ADHD. METHODS We studied the association of the catechol O-methyltransferase (COMT) Val158Met polymorphism and the serotonin transporter (SLC6A4/SERT/5-HTT) 5-HTTLPR insertion/deletion polymorphism with ASD symptoms in children with ADHD, and whether these polymorphisms would interact with pre- and perinatal risk factors, i.e., maternal smoking during pregnancy and low birth weight. Analyses were performed using linear regression in 207 Dutch participants with combined type ADHD of the International Multicenter ADHD Genetics (IMAGE) study, and repeated in an independent ADHD sample (n =439) selected from the TRracking Adolescents' Individual Lives Survey (TRAILS). Dependent variables were the total and subscale scores of the Children's Social Behavior Questionnaire (CSBQ). RESULTS No significant main effects of COMT Val158Met, 5-HTTLPR, maternal smoking during pregnancy and low birth weight on ASD symptoms were found. However, the COMT Val/Val genotype interacted with maternal smoking during pregnancy in increasing stereotyped behavior in the IMAGE sample (p =.008); this interaction reached significance in the TRAILS sample after correction for confounders (p =.02). In the IMAGE sample, the 5-HTTLPR S/S genotype interacted with maternal smoking during pregnancy, increasing problems in social interaction (p =.02), and also interacted with low birth weight, increasing rigid behavior (p =.03). Findings for 5-HTTLPR in the TRAILS sample were similar, albeit for related CSBQ subscales. CONCLUSIONS These findings suggest gene-environment interaction effects on ASD symptoms in children with ADHD.
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Affiliation(s)
- Judith S. Nijmeijer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Catharina A. Hartman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nanda N.J. Rommelse
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marieke E. Altink
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Karakter, Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen, The Netherlands
| | - Cathelijne J.M. Buschgens
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ellen A. Fliers
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Youth Department, Lucertis, Parnassia-Bavo-Group, Rotterdam, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Department of Human Genetics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ruud B. Minderaa
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan Ormel
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joseph A. Sergeant
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Frank C. Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus-MC Sophia, Rotterdam, The Netherlands
| | - Jan K. Buitelaar
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Karakter, Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Demetrovics Z, Varga G, Szekely A, Vereczkei A, Csorba J, Balazs H, Hoffman K, Sasvari-Szekely M, Barta C. Association between Novelty Seeking of opiate-dependent patients and the catechol-O-methyltransferase Val(158)Met polymorphism. Compr Psychiatry 2010; 51:510-5. [PMID: 20728009 DOI: 10.1016/j.comppsych.2009.11.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 11/12/2009] [Accepted: 11/18/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Candidate genes of the dopaminergic system have been reported as key elements in shaping human temperament. Catechol-O-methyltransferase (COMT) plays a vital role in dopamine inactivation, and the Val(158)Met single nucleotide polymorphism (rs4680) in its gene has been recently associated with the Novelty Seeking (NS) temperament scale of the Temperament and Character Inventory in studies of healthy adults, as well as methamphetamine abusers. METHOD Our goal was to examine the association between temperament dimensions of the Temperament and Character Inventory and the COMT Val(158)Met variation in a Hungarian sample of 117 heroin-dependent patients and 124 nondependent controls. RESULTS Case-control analysis did not show any significant difference in allele or genotype distributions. However, dimensional approach revealed an association between the COMT Val(158)Met and NS (P = .01): both controls and opiate users with Met/Met genotypes showed higher NS scores compared to those with the Val allele. The NS scores are also significantly higher among opiate users; however, no interaction was found between group status and COMT genotype. CONCLUSION Association of the COMT polymorphism and NS temperament scale has been shown for heroin-dependent patients and controls regardless of group status.
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Affiliation(s)
- Zsolt Demetrovics
- Institutional Group on Addiction Research, Eötvös Loránd University, Budapest H-1064, Hungary
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