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Dombi ZB, Szendi I, Burnet PWJ. Brain Derived Neurotrophic Factor and Cognitive Dysfunction in the Schizophrenia-Bipolar Spectrum: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:827322. [PMID: 35686181 PMCID: PMC9170985 DOI: 10.3389/fpsyt.2022.827322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/27/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Cognitive impairment is a core feature of disorders on the schizophrenia-bipolar spectrum, i.e., schizophrenia, bipolar disorder, and schizoaffective disorder. Brain-derived neurotrophic factor (BDNF) has been proposed to be a biomarker of cognitive impairment in these disorders as it plays a critical role in neuroplasticity and proposed to mediate some of the psychotropic effects of medication. However, despite numerous studies investigating the association between circulating BDNF and these disorders, no solid conclusions have been drawn regarding its involvement in cognitive impairment. OBJECTIVES The current systematic review and meta-analysis aims to examine blood BDNF levels and cognitive dysfunction in patients on the schizophrenia-bipolar spectrum as well as to evaluate whether circulating BDNF measurements can act as a biomarker for cognitive dysfunction. METHODS Studies were identified by searching Embase and Medline databases for English language articles published in peer-reviewed journals between 2000 January and 2021 June according to the PRISMA guidelines. A total of 815 articles were identified of which 32 met the inclusion criteria for the systematic review - reporting on comparisons between blood BDNF levels and cognitive functions of schizophrenia or bipolar disorder patients versus healthy controls (no studies involving schizoaffective patients were specifically obtained for the time being). Twenty-four of these studies (19 with schizophrenia and 5 with bipolar disorder patients) were eligible to be included in the meta-analysis. RESULTS Our findings indicated that circulating BDNF levels were significantly reduced in patients experiencing an acute episode of schizophrenia or bipolar disorder compared to healthy controls. Cognitive function was also found to be significantly worse in patients, however, correlations between BDNF levels and cognitive impairment were not always detected. Interventions, especially pharmacotherapy seemed to improve certain aspects of cognition and increase circulating BDNF levels. CONCLUSION Circulating BDNF alone does not seem to be a valid biomarker of cognitive dysfunction in patients with disorders on the schizophrenia-bipolar spectrum, owing to several confounding factors. Changes of the circulating levels of BDNF should be evaluated in a wider context of other stress-, immune-, and inflammatory-related factors.
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Affiliation(s)
- Zsófia B Dombi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Medical Division, Gedeon Richter Plc., Budapest, Hungary
| | - István Szendi
- Department of Psychiatry, Kiskunhalas Semmelweis Hospital, Kiskunhalas, Hungary.,Department of Software Engineering, University of Szeged, Szeged, Hungary
| | - Philip W J Burnet
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Abstract
OBJECTIVE Despite effective pharmacological treatments for bipolar disorder, we still lack a comprehensive pathophysiological model of the illness. Recent neurobiological research has implicated a number of key brain regions and neuronal components in the behavioural and cognitive manifestations of bipolar disorder. Dopamine has previously been investigated in some depth in bipolar disorder, but of late has not been a primary focus of attention. This article examines the role of dopamine in bipolar disorder, incorporating recent advances into established models where possible. METHODS A critical evaluation of the literature was undertaken, including a review of behavioural, neurochemical, receptor, and imaging studies, as well as genetic studies focusing on dopamine receptors and related metabolic pathways. In addition, pharmacologic manipulation of the central dopaminergic pathways and comparisons with other disease states such as schizophrenia were considered, principally as a means of exploring the hypothesised models. RESULTS Multiple lines of evidence, including data from pharmacological interventions and structural and functional magnetic resonance imaging studies, suggest that the dopaminergic system may play a central role in bipolar disorder. CONCLUSION Future research into the pathophysiological mechanisms of bipolar disorder and the development of new treatments for bipolar disorder should focus on the dopaminergic system.
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Affiliation(s)
- David A Cousins
- Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
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Gershon AA, Vishne T, Grunhaus L. Dopamine D2-like receptors and the antidepressant response. Biol Psychiatry 2007; 61:145-53. [PMID: 16934770 DOI: 10.1016/j.biopsych.2006.05.031] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 05/12/2006] [Accepted: 05/16/2006] [Indexed: 01/11/2023]
Abstract
Converging lines of evidence suggest a role for the mesolimbic dopamine system in the response to somatic antidepressant therapies. Here, we review evidence suggesting that antidepressant treatments of different types share the effect of increasing the sensitivity of dopamine D2-like receptors in the nucleus accumbens, clinical studies suggesting that activation of these receptors has antidepressant efficacy, as well as relevant imaging and genetic data on the role of this system in the antidepressant response. We then attempt to reconcile this data with evidence of a common target of antidepressant drugs in the cyclic adenosine monophosphate (cAMP) response element binding protein-brain-derived neurotrophic factor (CREB-BDNF) pathway in a model that suggests potential directions for future inquiry.
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Affiliation(s)
- Ari A Gershon
- Division of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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Abstract
Australian research in psychiatric genetics covers molecular genetic studies of depression, anxiety, alcohol dependence, Alzheimer's disease, bipolar disorder, schizophrenia, autism, and attention deficit hyperactivity disorder. For each disorder, a variety of clinical cohorts have been recruited including affected sib pair families, trios, case/controls, and twins from a large population-based twin registry. These studies are taking place both independently and in collaboration with international groups. Microarray studies now complement DNA investigations, while animal models are in development. An Australian government genome facility provides a high throughput genotyping and mutation detection service to the Australian scientific community, enhancing the contribution of Australian psychiatric genetics groups to gene discovery.
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Affiliation(s)
- Bryan J Mowry
- Department of Psychiatry, Queensland Centre for Schizophrenia Research, University of Queensland, The Park, Centre for Mental Health, Wacol, Queensland 4076, Australia. ,edu.au
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Massat I, Souery D, Del-Favero J, Van Gestel S, Serretti A, Macciardi F, Smeraldi E, Kaneva R, Adolfsson R, Nylander PO, Blackwood D, Muir W, Papadimitriou GN, Dikeos D, Oru? L, Segman RH, Ivezi? S, Aschauer H, Ackenheil M, Fuchshuber S, Dam H, Jakovljevi? M, Peltonen L, Hilger C, Hentges F, Staner L, Milanova V, Jazin E, Lerer B, Van Broeckhoven C, Mendlewicz J. Positive association of dopamine D2 receptor polymorphism with bipolar affective disorder in a European multicenter association study of affective disorders. ACTA ACUST UNITED AC 2002. [DOI: 10.1002/ajmg.10118] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Elvidge G, Jones I, McCandless F, Asherson P, Owen MJ, Craddock N. Allelic variation of a BalI polymorphism in the DRD3 gene does not influence susceptibility to bipolar disorder: results of analysis and meta-analysis. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 105:307-11. [PMID: 11378841 DOI: 10.1002/ajmg.1353] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bipolar disorder is a major psychiatric illness that has evidence for a significant genetic contribution toward its development. In recent years, the BalI RFLP (restriction fragment length polymorphism) in the dopamine D3 receptor gene has been examined as a possible susceptibility factor for both schizophrenia and bipolar disorder. While analysis in schizophrenia has produced examples of increased homozygosity in patients, less encouraging results have been found for bipolar disorder. Recently, however, a family-based association study has found a significant excess of allele 1 and allele 1-containing genotypes in transmitted alleles to bipolar probands over nontransmitted controls. In a large bipolar case control sample (n = 454), we have been unable to replicate the family-based association study (chi-square = 0.137, P = 0.71, 1 df) or detect an effect similar to the positive homozygosity findings in schizophrenia (chi-square = 0.463, P = 0.50, 1 df). A meta-analysis of previous association studies also revealed no difference in allele distributions between bipolar patients and controls for this polymorphism in ethnically homogeneous samples (odds ratio, OR, = 1.04; P = 0.60; 95% confidence interval, CI, = 0.89-1.20). In view of this evidence, we conclude that variation at the BalI RFLP is not an important factor influencing the susceptibility to bipolar disorder. It remains possible, however, that other sequence variations within the DRD3 gene could play a role.
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Affiliation(s)
- G Elvidge
- Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham, England
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Serretti A, Macciardi F, Cusin C, Lattuada E, Souery D, Lipp O, Mahieu B, Van Broeckhoven C, Blackwood D, Muir W, Aschauer HN, Heiden AM, Ackenheil M, Fuchshuber S, Raeymaekers P, Verheyen G, Kaneva R, Jablensky A, Papadimitriou GN, Dikeos DG, Stefanis CN, Smeraldi E, Mendlewicz J. Linkage of mood disorders with D2, D3 and TH genes: a multicenter study. J Affect Disord 2000; 58:51-61. [PMID: 10760558 DOI: 10.1016/s0165-0327(99)00112-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND It has been suggested that the dopaminergic system is involved in the pathophysiology of mood disorders. We conducted a multicenter study of families with mood disorders, to investigate a possible linkage with genes coding for dopamine receptor D2, dopamine receptor D3 and tyrosine hydroxylase (TH). METHODS Twenty three mood disorder pedigrees collected within the framework of the European Collaborative Project on Affective Disorders were analyzed with parametric and non-parametric linkage methods. Various potential phenotypes were considered, from a narrow (only bipolar as affected) to a broad (bipolar+major depressive+schizoaffective disorders) definition of affection status. RESULTS Parametric analyses excluded linkage for all the candidate genes, even though small positive LOD (Limit of Detection) scores were observed for TH in three families. Non-parametric analyses yielded negative results for all markers. CONCLUSION The D2 and D3 dopamine receptors were, therefore, not a major liability factor for mood disorders in our sample, whereas TH may play a role in a subgroup of patients.
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Affiliation(s)
- A Serretti
- Istituto Scientifico Ospedale San Raffaele, Department of Neuropsychiatric Sciences, University of Milan School of Medicine, Via Luigi Prinetti 29, 20127, Milan, Italy.
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Henderson AS, Korten AE, Jorm AF, Jacomb PA, Christensen H, Rodgers B, Tan X, Easteal S. COMT and DRD3 polymorphisms, environmental exposures, and personality traits related to common mental disorders. AMERICAN JOURNAL OF MEDICAL GENETICS 2000; 96:102-7. [PMID: 10686561 DOI: 10.1002/(sici)1096-8628(20000207)96:1<102::aid-ajmg20>3.0.co;2-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In a community sample of 2,327 Caucasians, we tested the hypotheses that polymorphisms in the COMT and DRD3 genes are associated with personality traits conferring vulnerability to anxiety, depression, or alcohol misuse, or with current symptoms of these; and that the association is stronger in persons who also have been exposed to stressor experiences. To conserve resources and to allow replication, the genetic analysis was undertaken in two stages. For the COMT polymorphism, no statistically significant associations were found in the first sample of 862 persons. The remainder of the sample was therefore not analysed for that gene. For the DRD3 polymorphism, those in the first sample with at least one of the Ser(9) alleles had significantly higher scores in neuroticism (p=0.006) and behavioral inhibition (p=0.003). There was a trend, failing to meet the 1% significance criterion, for those with this genotype also to have higher depression and anxiety. The groups did not differ in alcohol use. In persons with the Ser(9) allele who were also exposed to stressors, there was a higher level of depression at the 5% level; and the depression level was higher in homozygotes. But when the remainder of the sample (1,465) was analysed, none of the associations reached statistical significance. We conclude that neither the COMT nor DRD3 polymorphisms are associated with anxiety, depression, or alcohol abuse. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:102-107, 2000
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Affiliation(s)
- A S Henderson
- NHMRC Psychiatric Epidemiology Research Centre, The Australian National University, Canberra, Australia.
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Henderson A, Korten A, Jorm A, Jacomb P, Christensen H, Rodgers B, Tan X, Easteal S. COMT andDRD3 polymorphisms, environmental exposures, and personality traits related to common mental disorders. ACTA ACUST UNITED AC 2000. [DOI: 10.1002/(sici)1096-8628(20000207)96:1%3c102::aid-ajmg20%3e3.0.co;2-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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Serretti A, Lattuada E, Cusin C, Lilli R, Lorenzi C, Smeraldi E. Dopamine D3 receptor gene not associated with symptomatology of major psychoses. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/(sici)1096-8628(19991015)88:5<476::aid-ajmg8>3.0.co;2-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Piccardi MP, Severino G, Bocchetta A, Palmas MA, Ruiu S, Del Zompo M. No evidence of association between dopamine D3 receptor gene and bipolar affective disorder. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/(sici)1096-8628(19970418)74:2<137::aid-ajmg4>3.0.co;2-r] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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12
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Souery D, Lipp O, Mahieu B, Mendelbaum K, De Martelaer V, Van Broeckhoven C, Mendlewicz J. Association study of bipolar disorder with candidate genes involved in catecholamine neurotransmission: DRD2, DRD3, DAT1, and TH genes. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 67:551-5. [PMID: 8950413 DOI: 10.1002/(sici)1096-8628(19961122)67:6<551::aid-ajmg7>3.0.co;2-k] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Despite strong evidence for genetic involvement in the etiology of affective disorders (from twin adoption and family studies), linkage and association methodologies are still exploring the nature of genetic factors in these diseases. Interesting testable hypotheses have been described, including candidate genes involved in catecholamine neurotransmission. We studied 69 bipolar patients and 69 matched controls (for age, sex, and geographical origin) for association and linkage disequilibrium with DNA markers at the following genes: the tyrosine hydroxylase gene, dopamine transporter gene, and dopamine D2 and D3 receptor genes. Association and linkage disequilibrium were excluded between bipolar affective disorder and these four candidate genes in our sample.
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Affiliation(s)
- D Souery
- Department of Psychiatry, University Clinics of Brussels, Erasme Hospital, Free University of Brussels, Belgium
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Abstract
Genetic factors have long been implicated in the aetiology of bipolar disorder (BD). During the past two decades several linkage studies have been carried out with the aim of identifying major genes. However, remarkable discrepancies in results both between and within studies have constituted a major problem. In order to elucidate some of these conflicts, we assessed the published literature on linkage studies of bipolar disorder, focusing on methodological issues. Studies published between January 1980 and December 1994 were identified by computerized literature searches and subsequent scanning of review articles, and the reference lists of the articles primarily identified. A set of defined inclusion and exclusion criteria was used to select studies for assessment. A total of 31 variables were determined, and pre-defined codes were assigned in a structured manner. More than 200 citations were reviewed, and 60 articles were included in this study. Descriptive statistical analyses of the variables, as well as associations between variables, are presented. The findings are discussed with regard to the possibility that, beyond the genetic complexity of the disorder itself, there are several other similarly complicated study design issues which should be more carefully observed. Moreover, the need for standardization of basic criteria to use and report clinical and analytical parameters employed in linkage studies is strongly suggested.
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Affiliation(s)
- G Turecki
- Centre for Research in Neuroscience, McGill University, Montreal, Canada
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Rothschild LG, Badner J, Cravchik A, Gershon ES, Gejman PV. No association detected between a D3 receptor gene-expressed variant and schizophrenia. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 67:232-4. [PMID: 8723055 DOI: 10.1002/(sici)1096-8628(19960409)67:2<232::aid-ajmg18>3.0.co;2-k] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A missense polymorphism (glycine to serine) in the first exon of the dopamine D3 (DRD3) gene was examined in the sib-pairs schizophrenia collection by the transmission test for linkage disequilibrium (TDT). No association due to linkage disequilibrium was detected using TDT. Additionally, no evidence for excess homozygosity was found.
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Affiliation(s)
- L G Rothschild
- Clinical Neurogenetics Branch, National Institute of Mental Health, Bethesda, Maryland 20892-1274, USA
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Le F, Mitchell P, Vivero C, Waters B, Donald J, Selbie LA, Shine J, Schofield P. Exclusion of close linkage of bipolar disorder to the Gs-alpha subunit gene in nine Australian pedigrees. J Affect Disord 1994; 32:187-95. [PMID: 7531727 DOI: 10.1016/0165-0327(94)90017-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Growing evidence suggests that guanine nucleotide binding proteins (G proteins) may be involved in both the pathogenesis and treatment of bipolar affective disorder. Both overactive G proteins and increased levels of the alpha subunit of the stimulatory form (Gs-alpha) have been demonstrated in peripheral leucocytes of manic patients while an increase of Gs-alpha subunit levels has also been found in a postmortem study of bipolar disorder. The function of Gs and Gi alpha subunits has now been shown to be affected by lithium. The present study aimed to determine whether bipolar affective disorder was linked to the Gs-alpha subunit gene which has been mapped to chromosomal region 20q13.2. Linkage analysis utilized the PCR amplification of a portion of the Gs-alpha gene that contains a dinucleotide repeat (CA repeat) polymorphism. Linkage of bipolar disorder and recurrent depression to the Gs-alpha subunit gene was tested using a series of autosomal dominant and recessive models with varying penetrance levels. Additionally, linkage was examined using a series of levels of definitions of affective illness. Close linkage to the Gs-alpha subunit gene was strongly excluded using each model and definition. Thus, our study indicates that a genetic defect in the Gs-alpha subunit gene is unlikely to be the cause of bipolar disorder.
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Affiliation(s)
- F Le
- Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, N.S.W., Australia
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Lim LC, Nöthen MM, Körner J, Rietschel M, Castle D, Hunt N, Propping P, Murray R, Gill M. No evidence of association between dopamine D4 receptor variants and bipolar affective disorder. AMERICAN JOURNAL OF MEDICAL GENETICS 1994; 54:259-63. [PMID: 7810585 DOI: 10.1002/ajmg.1320540314] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Disturbance in the dopamine neurotransmitter system has been implicated in the pathogenesis of affective disorder. In this study, we examine the possibility that functional variants of the recently cloned dopamine D4 receptor gene contribute to the genetic component of manic depression. The polymorphism, a 48 bp tandem repeat coding for part of the third cytoplasmic loop, was detected using a PCR based method. In a first sample of 57 patients and 59 controls, we found allele 7 to be in excess in the patients. In contrast, allele 3 was less frequent in patients. A second, larger sample of 90 patients and 91 controls was utilized to test these hypotheses. Data from the two samples were then pooled together for further analyses. We calculated the power of our samples, and if the frequency of 7 repeat allele obtained from sample 1 is true, i.e., 25% (28/114) for patients and 14% (16/118) for controls, then the power of the combined sample is 62% at 5% (two-tailed) significance level. However, both observations were not replicated; we therefore conclude that variations in this repeat at the DRD4 gene do not contribute to the genetic component of manic depression.
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Affiliation(s)
- L C Lim
- Genetics Section, Institute of Psychiatry, De Crespigny Park, London, England
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