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Bellia F, Vismara M, Annunzi E, Cifani C, Benatti B, Dell'Osso B, D'Addario C. Genetic and epigenetic architecture of Obsessive-Compulsive Disorder: In search of possible diagnostic and prognostic biomarkers. J Psychiatr Res 2021; 137:554-571. [PMID: 33213890 DOI: 10.1016/j.jpsychires.2020.10.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023]
Abstract
Obsessive-Compulsive Disorder (OCD) is a prevalent and severe clinical condition whose hallmarks are excessive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). The onset of symptoms generally occurs during pre-adult life and typically affects subjects in different aspects of their life's, compromising social and professional relationships. Although robust evidence suggests a genetic component in the etiopathogenesis of OCD, the causes of the disorder are still not completely understood. It is thus of relevance to take into account how genes interact with environmental risk factors, thought to be mediated by epigenetic mechanisms. We here provide an overview of genetic and epigenetic mechanisms of OCD, focusing on the modulation of key central nervous system genes, in the attempt to suggest possible disease biomarkers.
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Affiliation(s)
- Fabio Bellia
- Faculty of Bioscience, University of Teramo, Teramo, Italy
| | - Matteo Vismara
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milano, Italy
| | - Eugenia Annunzi
- Faculty of Bioscience, University of Teramo, Teramo, Italy; Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Carlo Cifani
- School of Pharmacy, University of Camerino, Camerino, Italy
| | - Beatrice Benatti
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milano, Italy; CRC "Aldo Ravelli", University of Milan, Milano, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milano, Italy; CRC "Aldo Ravelli", University of Milan, Milano, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, CA, USA.
| | - Claudio D'Addario
- Faculty of Bioscience, University of Teramo, Teramo, Italy; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Maurex L, Zaboli G, Öhman A, Åsberg M, Leopardi R. The serotonin transporter gene polymorphism (5-HTTLPR) and affective symptoms among women diagnosed with borderline personality disorder. Eur Psychiatry 2020; 25:19-25. [DOI: 10.1016/j.eurpsy.2009.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Revised: 04/27/2009] [Accepted: 05/02/2009] [Indexed: 10/20/2022] Open
Abstract
AbstractGene variants of the serotonin transporter have been associated with vulnerability to affective disorders. In particular, the presence of one or two copies of the short (s) allele of the 5-HTTLPR polymorphism has been associated with reduced serotonin transporter expression and function, and vulnerability to affective disorders. To test for an association between variants of the serotonin transporter gene polymorphism (5-HTTLPR) and relevant clinical features of borderline personality disorder (BPD), a psychiatric disorder with symptoms characteristic for serotonin dysfunction, 77 women with BPD were genotyped in the 5-HTTLPR polymorphism. They rated their subjective experience of borderline-specific, depressive, anxious and obsessive-compulsive symptoms, and were interviewed about lifetime incidence of suicide attempts and self-harming acts. Carriers of two s alleles of the 5-HTTLPR reported more symptoms of borderline, depression, anxiety and obsessive-compulsive behaviours, but not of suicidal and self-injury behaviour, compared to carriers of a long (l) allele. This indicates that the 5-HTTLPR ss homozygous genotype might influence serotonin function affecting susceptibility to both borderline-specific, depressive, anxious and obsessive-compulsive symptoms in BPD, and leading to a more severe symptomatology related to these clinical features. Further, this suggests that 5-HTT gene variants may not be as influential on suicidal and self-injury behaviour in BPD.
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Derksen M, Feenstra M, Willuhn I, Denys D. The serotonergic system in obsessive-compulsive disorder. HANDBOOK OF BEHAVIORAL NEUROSCIENCE 2020. [DOI: 10.1016/b978-0-444-64125-0.00044-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Zhang K, Fan X, Yuan J, Yin J, Su H, Hashimoto K, Wang G. Impact of serotonin transporter gene on rTMS augmentation of SSRIs for obsessive compulsive disorder. Neuropsychiatr Dis Treat 2019; 15:1771-1779. [PMID: 31308670 PMCID: PMC6612955 DOI: 10.2147/ndt.s209319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/17/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) is beneficial for treatment-resistant patients with obsessive-compulsive disorder (OCD). The serotonin transporter gene (SLC6A4) may be associated with OCD. We aimed to determine whether SLC6A4 impacts the beneficial effects of rTMS in patients with OCD treated with selective serotonin reuptake inhibitors (SSRIs). METHODS Fifty-seven untreated patients with OCD were randomly assigned to receive active or sham rTMS in a 4-week double-blind study. The participants received 1-Hz rTMS over the supplementary motor area once per day, for 5 days a week, for 4 weeks. One of the widely employed SSRIs was utilized at the initiation of active or sham rTMS. Yale-Brown obsessive-compulsive scale (Y-BOCS) scores were used for assessing the symptoms. The most-researched polymorphism of SLC6A4, 5-HTTLPR (L/S), was also examined. RESULTS Y-BOCS scores in the active group at the completion of the treatment were significantly lower than those in the sham group. Interestingly, the improvement in Y-BOCS scores in patients with the LL genotype treated with active rTMS was significantly (p<0.05) greater than in those treated with sham rTMS. Conversely, rTMS did not produce significant improvements in S allele carriers. CONCLUSIONS The findings of this study suggest that rTMS can augment the beneficial effects of SSRIs in OCD patients with the LL genotype of 5-HTTLPR. Therefore, the presence of 5-HTTLPR (L/S) in SLC6A4 may be a predictable biomarker for the beneficial effects of rTMS, although more studies using larger sample sizes are warranted for confirming the results.
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Affiliation(s)
- Kai Zhang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, People's Republic of China.,Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Xiwang Fan
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, People's Republic of China
| | - Jianmin Yuan
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, People's Republic of China
| | - Jiajun Yin
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, People's Republic of China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Guoqiang Wang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, People's Republic of China
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Rashidi FS, Ahmadipour E, Shiravand S, Ahmadiani A, Asadi S, Shams J. Association of the functional serotonin transporter haplotype with familial form of obsessive compulsive disorder in Iranian patients. Int J Psychiatry Clin Pract 2018; 22:47-53. [PMID: 28691545 DOI: 10.1080/13651501.2017.1353634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Several polymorphisms have been reported in the 5-HTTLPR of the serotonin transporter gene (SLC6A4). Family-based evidences for the association of 5-HTTLPR polymorphisms with OCD were previously reported but results were controversial. The present study investigated the possible correlation of SLC6A4 polymorphisms (5-HTTLPR, rs25532, rs25531) in Iranian OCD patients considering gender, age of onset, family history of psychiatric disorders, obsessive and compulsive subtypes and severities. METHODS The included OCD patients fulfilled the criteria for DSM-IV-TR whom Y-BOCS score was more than 9. Blood samples (184 cases and 192 controls) were genotyped by means of PCR-RFLP. RESULTS Mean of Y-BOCS scores of included patients was 20.1 ± 0.69. Rs25532 CC genotype showed significant association with OCD in men and were detected more in the patients reported positive family history of psychiatric disorders but the other single loci (5-HTTLPR and rs25531) did not associate with OCD. Haplotype analysis showed significant association of 14-A variant with OCD and revealed the association of 14-A/14-A genotype with familial form of OCD. CONCLUSIONS The findings of this study showed the association of SLC6A4 variants with familial form of OCD and proposed stratified analyses in the genetic studies facilitate identification of genetic risk factors for this heterogeneous disorder.
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Affiliation(s)
- Fatemeh Sadat Rashidi
- a Neuroscience Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Ehsan Ahmadipour
- a Neuroscience Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sepideh Shiravand
- a Neuroscience Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Abolhassan Ahmadiani
- a Neuroscience Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sareh Asadi
- b NeuroBiology Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Jamal Shams
- c Behavioral Sciences Research Center , Shahid Beheshti University of Medical Science , Tehran , Iran
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Grünblatt E, Marinova Z, Roth A, Gardini E, Ball J, Geissler J, Wojdacz TK, Romanos M, Walitza S. Combining genetic and epigenetic parameters of the serotonin transporter gene in obsessive-compulsive disorder. J Psychiatr Res 2018; 96:209-217. [PMID: 29102815 DOI: 10.1016/j.jpsychires.2017.10.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 02/07/2023]
Abstract
While genetic variants have been reported to be associated with obsessive-compulsive disorder (OCD), the small effect sizes suggest that epigenetic mechanisms such as DNA methylation may also be relevant. The serotonin transporter (SLC6A4) gene has been extensively investigated in relation to OCD, since serotonin reuptake inhibitors are the pharmacological treatment of choice for the disorder. The current study set three questions: Firstly, whether the high expressing loci of the SLC6A4 polymorphisms, 5-HTTLPR + rs25531, rs25532 and rs16965628 are associated with family-based (n = 164 trios) and case-control OCD (n = 186, 152, respectively). This was also examined by a meta-analysis. Secondly, whether DNA methylation and RNA levels of the SLC6A4 differ in saliva and blood of a subset of samples from pediatric and adult OCD patients and matched controls. And lastly, whether morning awakening cortisol levels correlate with the above. A meta-analysis confirmed the association of the LA-allele with OCD (OR = 1.21, p = 0.00018), maintaining significance in the early-onset OCD subgroup (OR = 1.21, p = 0.022). There was no association between rs25532 or rs16965628 and OCD. Our preliminary data showed that SLC6A4 DNA methylation levels in an amplicon located at the beginning of the first intron were significantly higher in the saliva of pediatric OCD patients compared to controls and adult patients with OCD, but no alterations in RNA levels or in polymorphism interactions were observed. Morning awakening salivary cortisol levels positively correlated with methylation levels, and negatively correlated with RNA levels. This study further supports the involvement of the SLC6A4 gene in OCD through both genetic and epigenetic mechanisms. This finding needs to be explored further in an independent large sample.
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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, Switzerland.
| | - Zoya Marinova
- 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
| | - Elena Gardini
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Juliane Ball
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Julia Geissler
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Tomasz K Wojdacz
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, Build. 1230, DK-8000 Aarhus, Denmark; Aarhus Institute of Advanced Studies, Høegh-Guldbergs Gade 6B, DK-8000 Aarhus C, Denmark
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, 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, Switzerland
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Methylation Status of the Serotonin Transporter Promoter CpG Island Is Associated With Major Depressive Disorder in Chinese Han Population: A Case-Control Study. J Nerv Ment Dis 2017; 205:641-646. [PMID: 27668354 DOI: 10.1097/nmd.0000000000000600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was aimed to investigate the relationship between the methylation status of serotonin transporter (5-HTT) and major depressive disorder (MDD) in Chinese Han population. A total of 96 patients with MDD and 55 healthy volunteers were recruited, and the methylation index (MtI) at six positions in the cytosine-phosphate-guanosine island of 5-HTT gene was measured for each subject using bisulfite pyrosequencing. MtIs at positions 5 and 6 were higher in patients with MDD than those in controls. According to the multivariable logistic regression analysis, MtIs at positions 4 and 5 were significantly associated with MDD. Besides, depression education was an independent risk factor, whereas higher educational levels were protective factors for MDD. In addition, positions 1 and 4 were negatively correlated with weight and diurnal variation. Therefore, 5-HTT methylation might be closely related with MDD in Chinese Han population because of the correlation with diurnal variation and weight.
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Peripheral SLC6A4 Gene Expression in Obsessive-Compulsive Disorder in the Han Chinese Population. SHANGHAI ARCHIVES OF PSYCHIATRY 2017; 29:146-153. [PMID: 28904509 PMCID: PMC5579458 DOI: 10.11919/j.issn.1002-0829.216105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Serotonergic system dysfunction has been implicated in obsessive-compulsive disorder (OCD). This study examined peripheral SLC6A4 gene expression in OCD patients and healthy controls to explore the relationship between SLC6A4 and OCD. METHODS Participants included 50 first episode OCD patients and 60 age and gender-matched healthy controls. Relative SLC6A4 gene expression were examined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in peripheral leukocytes of all the subjects. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess the severity and subtype of OCD. RESULTS SLC6A4 gene expression, normalized by glyceraldehyde-3-phosphate dehydrogenase (GAPDH), were not significantly different between the OCD patients and healthy controls(z=-0.79, p=0.428). Male OCD patients showed a tendency of low gene expression of SLC6A4 in peripheral blood (z=-1.66, p=0.096). We did not find a significant correlation between SLC6A4 expression and the severity and subtype of OCD. CONCLUSION There is no correlation between SLC6A4 expression levels and the severity and subtype of OCD, but male OCD patients showed a tendency of low gene expression of SLC6A4 in peripheral blood. These results suggest that gene expression of SLC6A4 in peripheral blood may not be a useful biomarker of OCD in the Han Chinese population.
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Sinopoli VM, Burton CL, Kronenberg S, Arnold PD. A review of the role of serotonin system genes in obsessive-compulsive disorder. Neurosci Biobehav Rev 2017; 80:372-381. [PMID: 28576508 DOI: 10.1016/j.neubiorev.2017.05.029] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/20/2017] [Accepted: 05/29/2017] [Indexed: 12/16/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric disorder that causes the patient to experience intrusive thoughts and/or to carry out repetitive, ritualized behaviors that are time consuming and impairing. OCD is familial and heritable. The genetic factors responsible for pathogenesis, however, remain largely unknown despite the numerous candidate gene studies conducted. Based on efficacy of serotonin reuptake inhibitors (SRIs) in treating OCD, serotonin system genes have been a dominant focus in OCD candidate gene studies. We review the most commonly studied candidate serotonin system gene variants (specifically in SLC6A4, HTR2A, HTR1B, and HTR2C) and their association with OCD. Although findings to date are mixed, serotonin transporter polymorphism 5-HTTLPR and HTR2A polymorphism rs6311 (or rs6313) are most consistently associated with OCD. Mixed findings may be the result of genetic complexity and phenotypic heterogeneity that future studies should account for. Homogenous patient subgroups reflecting OCD symptom dimensions, OCD subtypes, and sex should be used for gene discovery.
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Affiliation(s)
- Vanessa M Sinopoli
- Institute of Medical Science, University of Toronto, Canada; Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Christie L Burton
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Sefi Kronenberg
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Paul D Arnold
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Canada; Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Canada.
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He A, Song D, Zhang L, Li C. Unveiling the relative efficacy, safety and tolerability of prophylactic medications for migraine: pairwise and network-meta analysis. J Headache Pain 2017; 18:26. [PMID: 28220376 PMCID: PMC5318356 DOI: 10.1186/s10194-017-0720-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A large number patients struggle with migraine which is classified as a chronic disorder. The relative efficacy, safety and tolerability of prophylactic medications for migraine play a key role in managing this disease. METHODS We conducted an extensive literature search for popular prophylactic medications that are used for migraine patients. Pairwise meta-analysis and network meta-analysis (NMA) were carried out sequentially for determining the relative efficacy, safety and tolerability of prophylactic medications. Summary effect for migraine headache days, headache frequency, at least 50% reduction in headache attacks, all-adverse events, nausea, somnolence, dizziness, withdrawal and withdrawal due to adverse events were produced by synthesizing both direct and indirect evidence. RESULTS Patients with three interventions exhibited significantly less average migraine headache days compared with those treated by placebo (topiramate, propranolol, divalproex). Moreover, topiramate and valproate exhibited a significantly increased likelihood of at least 50% reduction in migraine headache attacks compared to placebo. Patients with topiramate and propranolol also exhibited significantly reduced headache frequency compared to those with placebo. On the other hand, patients with divalproex exhibited significantly higher risk of nausea compared to those with placebo, topiramate, propranolol, gabapentin and amitriptyline. Finally, divalproex was associated with an increased risk of withdrawal compared to placebo and propranolol. CONCLUSIONS Topiramate, propranolol and divalproex may be more efficacious than other prophylactic medications. Besides, the safety and tolerability of divalproex should be further verified by future studies.
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Affiliation(s)
- Aijie He
- Department of Neurosurgery, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000, Yantai, Shandong, China
| | - Dehua Song
- Department of Radiotherapy, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000, Yantai, Shandong, China
| | - Lei Zhang
- Department of Pharmacy, Yantai Hospital of Traditional Chinese Medicine, 264000, Yantai, Shandong, China
| | - Chen Li
- Department of Anesthesia, Yantai Hospital of Traditional Chinese Medicine, No. 39 Xingfu Road, Zhifu Disctrict, 264000, Yantai, Shandong, China.
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Honda S, Nakao T, Mitsuyasu H, Okada K, Gotoh L, Tomita M, Sanematsu H, Murayama K, Ikari K, Kuwano M, Yoshiura T, Kawasaki H, Kanba S. A pilot study exploring the association of morphological changes with 5-HTTLPR polymorphism in OCD patients. Ann Gen Psychiatry 2017; 16:2. [PMID: 28203264 PMCID: PMC5303222 DOI: 10.1186/s12991-017-0126-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 01/05/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Clinical and pharmacological studies of obsessive-compulsive disorder (OCD) have suggested that the serotonergic systems are involved in the pathogenesis, while structural imaging studies have found some neuroanatomical abnormalities in OCD patients. In the etiopathogenesis of OCD, few studies have performed concurrent assessment of genetic and neuroanatomical variables. METHODS We carried out a two-way ANOVA between a variable number of tandem repeat polymorphisms (5-HTTLPR) in the serotonin transporter gene and gray matter (GM) volumes in 40 OCD patients and 40 healthy controls (HCs). RESULTS We found that relative to the HCs, the OCD patients showed significant decreased GM volume in the right hippocampus, and increased GM volume in the left precentral gyrus. 5-HTTLPR polymorphism in OCD patients had a statistical tendency of stronger effects on the right frontal pole than those in HCs. CONCLUSIONS Our results showed that the neuroanatomical changes of specific GM regions could be endophenotypes of 5-HTTLPR polymorphism in OCD.
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Affiliation(s)
- Shinichi Honda
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Hiroshi Mitsuyasu
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Kayo Okada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Leo Gotoh
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mayumi Tomita
- Kurume University Graduate School of Psychology, Fukuoka, Japan
| | - Hirokuni Sanematsu
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Masumi Kuwano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Takashi Yoshiura
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiroaki Kawasaki
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan.,Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
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Smoller JW, Gardner-Schuster E, Misiaszek M. Genetics of anxiety: would the genome recognize the DSM? Depress Anxiety 2016; 25:368-77. [PMID: 18412063 DOI: 10.1002/da.20492] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The nosology of anxiety disorders has undergone substantial evolution over the past several decades. The modern classification of these disorders dates to the publication of Diagnostic and Statistical Manual-III (DSM-III) in 1980, but the validity of the current diagnostic categories has been the subject of controversy. Genetic research can help clarify the boundaries of diagnostic categories by examining the etiologic relationships among them. The question posed in the title of this article asks to what degree the DSM-IV definitions of the anxiety disorders are supported by the evolving body of research on the genetic basis of pathologic anxiety. With DSM-V on the horizon, there is a renewed imperative to examine the structure of these disorders. In this article, we address this issue by, first, providing a brief update about the current status of genetic research on anxiety disorders and then considering whether the evidence suggests that genetic influences conform to or transcend DSM definitions. Finally, we discuss future directions for the genetic dissection of anxiety disorders.
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Affiliation(s)
- Jordan W Smoller
- Department of Psychiatry, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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Tükel R, Alkaş E, Gürvit H, Aslantaş Ertekin B, Ertekin E, Baran B, Akça Kalem Ş, Saruhan Direskeneli G. Serotonin transporter promoter polymorphism is associated with executive function impairments in patients with obsessive compulsive disorder. Clin Neuropsychol 2016; 30:536-46. [PMID: 26986829 DOI: 10.1080/13854046.2016.1162329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In the present study, we investigate the association between the 5-HTTLPR polymorphism and executive functions in a sample of patients with obsessive compulsive disorder (OCD). METHOD A total of 98 unmedicated patients diagnosed with OCD according to DSM-IV criteria and 80 healthy controls were included in this study. The genotype frequencies of 5-HTTLPR polymorphism were compared in OCD and healthy control groups. The four subgroups of OCD and healthy control participants, determined according to having LaLa genotype (high expressing) or S- and/or Lg alleles (low expressing), were also compared using neuropsychological tests of executive functions. RESULTS The frequency of SLa genotype of 5-HTTLPR polymorphism was found to be higher in patients with OCD compared with healthy controls. The mean scores of conceptual level responses of the Wisconsin Card Sorting Test (WCST) were significantly lower in the OCD-high-expressing subgroup compared with the low-expressing control group. The mean scores of the number of moves of the Tower of London were found to be significantly higher in the OCD-high-expressing subgroup, compared with the high-expressing subgroup of healthy controls. CONCLUSION Our findings suggest that the high-expressing variant may be associated with lower performance on some abstraction and planning measures in OCD patients.
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Affiliation(s)
- Raşit Tükel
- a Department of Psychiatry , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Elif Alkaş
- b Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Hakan Gürvit
- c Department of Neurology, Behavioral Neurology and Movement Disorders Unit , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Banu Aslantaş Ertekin
- a Department of Psychiatry , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Erhan Ertekin
- a Department of Psychiatry , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Bengi Baran
- c Department of Neurology, Behavioral Neurology and Movement Disorders Unit , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
| | - Şükriye Akça Kalem
- c Department of Neurology, Behavioral Neurology and Movement Disorders Unit , Istanbul University Istanbul Faculty of Medicine , Istanbul , Turkey
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van Velzen LS, de Wit SJ, Ćurĉić-Blake B, Cath DC, de Vries FE, Veltman DJ, van der Werf YD, van den Heuvel OA. Altered inhibition-related frontolimbic connectivity in obsessive-compulsive disorder. Hum Brain Mapp 2015; 36:4064-75. [PMID: 26183689 DOI: 10.1002/hbm.22898] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 06/09/2015] [Accepted: 06/24/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Recent studies have shown that response inhibition is impaired in patients with obsessive-compulsive disorder and their unaffected siblings, suggesting that these deficits may be considered a cognitive endophenotype of obsessive-compulsive disorder. Structural and functional neural correlates of altered response inhibition have been identified in patients and siblings. This study aims to examine the functional integrity of the response inhibition network in patients with obsessive-compulsive disorder and their unaffected siblings. METHODS Forty-one unmedicated patients with obsessive-compulsive disorder, 17 of their unaffected siblings and 37 healthy controls performed a stop signal task during functional magnetic resonance imaging. Psycho-physiological interaction analysis was used to examine functional connectivity between the following regions of interest: the bilateral inferior frontal gyri, presupplementary motor area, subthalamic nuclei, inferior parietal lobes, anterior cingulate cortex, and amygdala. We then used dynamic causal modeling to investigate the directionality of the networks involved. RESULTS Patients, and to a lesser extent also their unaffected siblings, show altered connectivity between the inferior frontal gyrus and the amygdala during response inhibition. The follow-up dynamic causal modeling suggests a bottom-up influence of the amygdala on the inferior frontal gyrus in healthy controls, whereas processing occurs top-down in patients with obsessive-compulsive, and in both directions in siblings. CONCLUSIONS Our findings suggest that amygdala activation in obsessive-compulsive disorder interferes differently with the task-related recruitment of the inhibition network, underscoring the role of limbic disturbances in cognitive dysfunctions in obsessive-compulsive disorder.
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Affiliation(s)
- Laura S van Velzen
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
| | - Stella J de Wit
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
| | - Branislava Ćurĉić-Blake
- Department of Neuroscience, Neuroimaging Center, University Medical Centre Groningen, Groningen, the Netherlands
| | - Daniëlle C Cath
- Altrecht Academic Anxiety Center, Utrecht, the Netherlands
- Division of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands
| | - Froukje E de Vries
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
- Netherlands Institute for Neuroscience, Netherlands Academy of Sciences, Amsterdam, the Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam (NCA), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
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15
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Mak L, Streiner DL, Steiner M. Is serotonin transporter polymorphism (5-HTTLPR) allele status a predictor for obsessive-compulsive disorder? A meta-analysis. Arch Womens Ment Health 2015; 18:435-45. [PMID: 25896187 DOI: 10.1007/s00737-015-0526-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/17/2015] [Indexed: 12/16/2022]
Abstract
The serotonin transporter polymorphism has been implicated in obsessive-compulsive disorder (OCD). However, molecular genetic association studies have yielded inconsistent results. Variation may be due to lack of OCD subtype classification. The goal of this systematic review is to investigate the association of the S-allele of the serotonin transporter polymorphism with OCD and OCD subtypes. A total of 69 studies were initially found through a systematic search of the literature but only 13 with sufficient information to compute odds ratios were suitable for review. A total of 1991 participants with OCD and their 5-HTTLPR allele status were examined. The primary outcome measures were allele frequency and OCD diagnosis. A full meta-analysis was completed comparing the L- and S-alleles using a random effects model in RevMan 5.2.1. Further, a secondary meta-analysis stratified by sex and late-onset was conducted for S- versus L-allele frequency. In the primary meta-analysis, OCD was not associated with the S-allele of the 5-HTTLPR polymorphism (Z = 0.07, p = 0.94). Moreover, late-onset OCD was not associated with the S-allele (Z = 1.45, p = 0.15). However, when stratified by sex, there is an emerging sex-specific relationship. There was a trending association between the S-allele and OCD status in females (Z = 1.62, p = 0.10) but not in males (Z = 0.69, p = 0.49). The findings provide further support for the need of subtype classification of this heterogeneous disorder. Future studies should clearly examine sex differences and OCD age-of-onset. In particular, emphasis should be placed on the effect of female reproductive milestones on OCD onset and symptom exacerbation.
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Affiliation(s)
- Lauren Mak
- MiNDS Neuroscience, McMaster University, Hamilton, ON, Canada
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16
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Godar SC, Bortolato M, Castelli MP, Casti A, Casu A, Chen K, Ennas MG, Tambaro S, Shih JC. The aggression and behavioral abnormalities associated with monoamine oxidase A deficiency are rescued by acute inhibition of serotonin reuptake. J Psychiatr Res 2014; 56:1-9. [PMID: 24882701 PMCID: PMC4114985 DOI: 10.1016/j.jpsychires.2014.04.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/20/2014] [Accepted: 04/21/2014] [Indexed: 11/25/2022]
Abstract
The termination of serotonin (5-hydroxytryptamine, 5-HT) neurotransmission is regulated by its uptake by the 5-HT transporter (5-HTT), as well as its degradation by monoamine oxidase (MAO)-A. MAO-A deficiency results in a wide set of behavioral alterations, including perseverative behaviors and social deficits. These anomalies are likely related to 5-HTergic homeostatic imbalances; however, the role of 5-HTT in these abnormalities remains unclear. To ascertain the role of 5-HTT in the behavioral anomalies associated to MAO-A deficiency, we tested the behavioral effects of its blocker fluoxetine on perseverative, social and aggressive behaviors in transgenic animals with hypomorphic or null-allele MAO-A mutations. Acute treatment with the 5-HTT blocker fluoxetine (10 mg/kg, i.p.) reduced aggressive behavior in MAO-A knockout (KO) mice and social deficits in hypomorphic MAO-A(Neo) mice. Furthermore, this treatment also reduced perseverative responses (including marble burying and water mist-induced grooming) in both MAO-A mutant genotypes. Both MAO-A mutant lines displayed significant reductions in 5-HTT expression across the prefrontal cortex, amygdala and striatum, as quantified by immunohistochemical detection; however, the down-regulation of 5-HTT in MAO-A(Neo) mice was more pervasive and widespread than in their KO counterparts, possibly indicating a greater ability of the hypomorphic line to enact compensatory mechanisms with respect to 5-HT homeostasis. Collectively, these findings suggest that the behavioral deficits associated with low MAO-A activity may reflect developmental alterations of 5-HTT within 5-HTergic neurons. Furthermore, the translational implications of our results highlight 5-HT reuptake inhibition as an interesting approach for the control of aggressive outbursts in MAO-A deficient individuals.
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Affiliation(s)
- Sean C Godar
- Dept. of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA; Dept. of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Marco Bortolato
- Dept. of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA.
| | - M Paola Castelli
- Department of Biomedical Sciences, University of Cagliari, CA, Italy
| | - Alberto Casti
- Department of Biomedical Sciences, University of Cagliari, CA, Italy
| | - Angelo Casu
- Department of Biomedical Sciences, University of Cagliari, CA, Italy
| | - Kevin Chen
- Dept. of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA
| | - M Grazia Ennas
- Department of Biomedical Sciences, University of Cagliari, CA, Italy
| | - Simone Tambaro
- Dept. of Cell and Neurobiology, University of Southern California, Los Angeles, CA, USA
| | - Jean C Shih
- Dept. of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA; Dept. of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
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17
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Grünblatt E, Hauser TU, Walitza S. Imaging genetics in obsessive-compulsive disorder: linking genetic variations to alterations in neuroimaging. Prog Neurobiol 2014; 121:114-24. [PMID: 25046835 DOI: 10.1016/j.pneurobio.2014.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/10/2014] [Accepted: 07/10/2014] [Indexed: 12/11/2022]
Abstract
Obsessive-compulsive disorder (OCD) occurs in ∼1-3% of the general population, and its often rather early onset causes major disabilities in the everyday lives of patients. Although the heritability of OCD is between 35 and 65%, many linkage, association, and genome-wide association studies have failed to identify single genes that exhibit high effect sizes. Several neuroimaging studies have revealed structural and functional alterations mainly in cortico-striato-thalamic loops. However, there is also marked heterogeneity across studies. These inconsistencies in genetic and neuroimaging studies may be due to the heterogeneous and complex phenotypes of OCD. Under the consideration that genetic variants may also influence neuroimaging in OCD, researchers have started to combine both domains in the field of imaging genetics. Here, we conducted a systematic search of PubMed and Google Scholar literature for articles that address genetic imaging in OCD and related disorders (published through March 2014). We selected 8 publications that describe the combination of imaging genetics with OCD, and extended it with 43 publications of comorbid psychiatric disorders. The most promising findings of this systematic review point to the involvement of variants in genes involved in the serotonergic (5-HTTLPR, HTR2A), dopaminergic (COMT, DAT), and glutamatergic (SLC1A1, SAPAP) systems. However, the field of imaging genetics must be further explored, best through investigations that combine multimodal imaging techniques with genetic profiling, particularly profiling techniques that employ polygenetic approaches, with much larger sample sizes than have been used up to now.
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Affiliation(s)
- Edna Grünblatt
- University Clinics for Child and Adolescent Psychiatry (UCCAP), University of Zurich, Neumuensterallee 9, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland.
| | - Tobias U Hauser
- University Clinics for Child and Adolescent Psychiatry (UCCAP), University of Zurich, Neumuensterallee 9, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom
| | - Susanne Walitza
- University Clinics for Child and Adolescent Psychiatry (UCCAP), University of Zurich, Neumuensterallee 9, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland
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18
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Sauer-Zavala S, Barlow DH. The case for borderline personality disorder as an emotional disorder: Implications for treatment. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/cpsp.12063] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The genetic study of obsessive-compulsive disorder (OCD) has made significant gains in the past decade. However, etiological gene findings are still elusive. Epidemiological studies, including family and twin studies, strongly support a genetic component for OCD. In addition, complex segregation analyses suggest the presence of at least one major gene. The neurobiology of OCD also lends support to the notion that programmed CNS-based biological processes underlie OCD symptom expression, with mapping of brain circuits to fronto-subcortical circuits in a consistent manner. Genetic linkage studies of OCD, using families with multiple affected relatives, have generated several suggestive linkage peaks, regions that may harbor a gene or genes for OCD. However, the presence of multiple linkage peaks has added to the complexity of OCD genetics, suggesting that the exploration of gene-gene interactions and gene-environment interactions, in addition to the exploration of alternate phenotypes based on symptom expression, age at onset or comorbid conditions, may be key in locating etiologic genes. Finally, candidate gene studies, while promising, are not yet associated with linkage regions, except in the case of the glutamate transporter gene SLC1A1 in 9p24. While OCD appears to have a genetic component, additional innovative research is needed to unravel the genetic influences in the disorder.
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Affiliation(s)
- Marco Grados
- The Johns Hopkins University, CMSC 346, Baltimore, MD 21287-3325, USA.
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20
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How specific are inhibitory deficits to obsessive-compulsive disorder? A neurophysiological comparison with panic disorder. Clin Neurophysiol 2013; 125:463-75. [PMID: 24079948 DOI: 10.1016/j.clinph.2013.08.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 08/05/2013] [Accepted: 08/17/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Impaired inhibition may perpetuate repetitive symptoms in obsessive-compulsive disorder (OCD), however OCD-specific deficits have yet to be established. We investigated neural correlates of inhibition in OCD vs. healthy and anxious controls. METHODS ERPs and reaction times (RTs) were compared between participants with OCD (n=20), panic disorder (PD; n=20) and healthy controls (HCs; n=20) during an adapted Go/NoGo task, which manipulated inhibitory difficulty. RESULTS A classic P3 NoGo anteriorisation effect occurred across groups. Both clinical groups showed RT impairment, and similar topographical anomalies of several (P2, N2 and P3) ERP components. Notably, both clinical groups lacked the strong frontally maximal N2 component topography seen in the HCs, across stimuli. Additionally, with increasing inhibitory difficulty, N2 latency increased in HCs but not in the clinical groups. CONCLUSIONS Unexpectedly, ERP and behavioural anomalies during inhibition in OCD were not qualitatively different to those in PD, but were generally more severe. Common general and inhibitory deficits may underlie intrusive mental phenomena in both conditions. SIGNIFICANCE This first ERP response inhibition study in OCD to include anxious controls disconfirmed hypotheses regarding OCD-specific inhibitory deficits, indicating the importance of comparing OCD to other conditions, to evaluate neurobiological models.
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21
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Taylor S. Molecular genetics of obsessive-compulsive disorder: a comprehensive meta-analysis of genetic association studies. Mol Psychiatry 2013; 18:799-805. [PMID: 22665263 DOI: 10.1038/mp.2012.76] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Twin studies indicate that obsessive-compulsive disorder (OCD) is strongly influenced by additive genetic factors. Yet, molecular genetic association studies have yielded inconsistent results, possibly because of differences across studies in statistical power. Meta-analysis can yield greater power. This study reports the first comprehensive meta-analysis of the relationship between OCD and all previously examined polymorphisms for which there was sufficient information in the source studies to compute odds ratios (ORs). A total of 230 polymorphisms from 113 genetic association studies were identified. A full meta-analysis was conducted for 20 polymorphisms that were examined in 5 or more data sets, and a secondary meta-analysis (limited to the computation of mean effect sizes) was conducted for 210 polymorphisms that were examined in fewer than 5 data sets. In the main meta-analysis, OCD was associated with serotonin-related polymorphisms (5-HTTLPR and HTR2A) and, in males only, with polymorphisms involved in catecholamine modulation (COMT and MAOA). Nonsignificant trends were identified for two dopamine-related polymorphisms (DAT1 and DRD3) and a glutamate-related polymorphism (rs3087879). The secondary meta-analysis identified another 18 polymorphisms with significant ORs that merit further investigation. This study demonstrates that OCD is associated with multiple genes, with most having a modest association with OCD. This suggests a polygenic model of OCD, consistent with twin studies, in which multiple genes make small, incremental contributions to the risk of developing the disorder. Future studies, with sufficient power to detect small effects, are needed to investigate the genetic basis of OCD subtypes, such as early vs late onset OCD.
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Affiliation(s)
- S Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
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22
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Abstract
OBJECTIVE Menopause symptoms result from the interaction of estrogen deprivation, psychosocial influences, and genetic factors. We examined the influence of stress and of estrogen receptor-α (ER-α; PvuII and XbaI) and serotonin transporter (5-HTT) polymorphisms on symptoms at postmenopause. METHODS We studied 290 urban women from three cities in Mexico. General characteristics, menopause symptoms, and scores of perceived stress, effort-reward imbalance, dominance, and submission were collected. A fasting blood sample was obtained for hormone measurements and genotypification. RESULTS Women had a mean ± SD age of 54.4 ± 4.5 years and BMI of 29.5 ± 4.9 kg/m. The frequency of hot flashes was 75.5%; vaginal dryness, 57.8%; and diminished sexual interest, 78.7%. Follicle-stimulating hormone and estradiol levels were 59 ± 27 mIU/mL and 22 ± 29 pg/mL, respectively. Women from Torreón had higher schooling and less parity but higher scores for depression and lower submission. Hot flashes were more frequent in women from León. Genotype distribution was similar among cities. Lower scores for dominance were found in women with the pp and xx ER-α genotypes. Increased smoking habit was found for the SS genotype of 5-HTT. Factors significantly associated with symptoms were years since menopause, with hot flashes (negative), and with diminished sexual interest (positive); dominance was negatively associated with depression, perceived stress, and vaginal dryness; submission was positively associated with depression, perceived stress, anxiety, and hot flashes; and effort-reward imbalance was positively associated with anxiety, hot flashes, and perceived stress. CONCLUSIONS Symptoms at postmenopause were associated mainly with dominance, submission, and effort-reward imbalance. The pp genotype of ER-α showed lower scores of dominance.
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Baganz NL, Blakely RD. A dialogue between the immune system and brain, spoken in the language of serotonin. ACS Chem Neurosci 2013; 4:48-63. [PMID: 23336044 DOI: 10.1021/cn300186b] [Citation(s) in RCA: 213] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 12/07/2012] [Indexed: 12/20/2022] Open
Abstract
Neuropsychiatric disorders have long been linked to both immune system activation and alterations in serotonin (5-HT) signaling. In the CNS, the contributions of 5-HT modulate a broad range of targets, most notably, hypothalamic, limbic and cortical circuits linked to the control of mood and mood disorders. In the periphery, many are aware of the production and actions of 5-HT in the gut but are unaware that the molecule and its receptors are also present in the immune system where evidence suggests they contribute to the both innate and adaptive responses. In addition, there is clear evidence that the immune system communicates to the brain via both humoral and neuronal mechanisms, and that CNS 5-HT neurons are a direct or indirect target for these actions. Following a brief primer on the immune system, we describe our current understanding of the synthesis, release, and actions of 5-HT in modulating immune function, including the expression of 5-HT biosynthetic enzymes, receptors, and transporters that are typically studied with respect to the roles in the CNS. We then orient our presentation to recent findings that pro-inflammatory cytokines can modulate CNS 5-HT signaling, leading to a conceptualization that among the many roles of 5-HT in the body is an integrated physiological and behavioral response to inflammatory events and pathogens. From this perspective, altered 5-HT/immune conversations are likely to contribute to risk for neurobehavioral disorders historically linked to compromised 5-HT function or ameliorated by 5-HT targeted medications, including depression and anxiety disorders, obsessive-compulsive disorder (OCD), and autism. Our review raises the question as to whether genetic variation impacting 5-HT signaling genes may contribute to maladaptive behavior as much through perturbed immune system modulation as through altered brain mechanisms. Conversely, targeting the immune system for therapeutic development may provide an important opportunity to treat mental illness.
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Affiliation(s)
- Nicole L. Baganz
- Department of Pharmacology and ‡Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8548, United States
| | - Randy D. Blakely
- Department of Pharmacology and ‡Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8548, United States
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Lei X, Chen C, He Q, Chen C, Moyzis RK, Xue G, Chen X, Cao Z, Li J, Li H, Zhu B, Chun Hsu AS, Li S, Li J, Dong Q. Sex determines which section of the SLC6A4 gene is linked to obsessive-compulsive symptoms in normal Chinese college students. J Psychiatr Res 2012; 46:1153-60. [PMID: 22727904 DOI: 10.1016/j.jpsychires.2012.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 04/17/2012] [Accepted: 05/03/2012] [Indexed: 12/16/2022]
Abstract
Previous case-control and family-based association studies have implicated the SLC6A4 gene in obsessive-compulsive disorder (OCD). Little research, however, has examined this gene's role in obsessive-compulsive symptoms (OCS) in community samples. The present study genotyped seven tag SNPs and two common functional tandem repeat polymorphisms (5-HTTLPR and STin2), which together cover the whole SLC6A4 gene, and investigated their associations with OCS in normal Chinese college students (N = 572). The results revealed a significant gender main effect and gender-specific genetic effects of the SLC6A4 gene on OCS. Males scored significantly higher on total OCS and its three dimensions than did females (ps < .01). The 5-HTTLPR in the promoter region showed a female-specific genetic effect, with the l/l and l/s genotypes linked to higher OCS scores than the s/s genotype (ps < .05). In contrast, a conserved haplotype polymorphism (rs1042173| rs4325622| rs3794808| rs140701| rs4583306| rs2020942) covering from intron 3 to the 3' UTR of the SLC6A4 gene showed male-specific genetic effects, with the CGAAGG/CGAAGG genotype associated with lower OCS scores than the other genotypes (ps < .05). These effects remained significant after controlling for OCS-related factors including participants' depressive and anxiety symptoms as well as stressful life events, and correction for multiple tests. These results are discussed in terms of their implications for our understanding of the sex-specific role of the different sections of the SLC6A4 gene in OCD.
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Affiliation(s)
- Xuemei Lei
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.
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Liu SG, Zhang XH, Yin YY, Wang MJ, Che FY, Ma X. An association analysis between 5-HTTLPR polymorphism and obsessive-compulsive disorder, Tourette syndrome in a Chinese Han population. CNS Neurosci Ther 2012; 17:793-5. [PMID: 22117805 DOI: 10.1111/j.1755-5949.2011.00274.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Margoob MA, Mushtaq D. Serotonin transporter gene polymorphism and psychiatric disorders: is there a link? Indian J Psychiatry 2011; 53:289-99. [PMID: 22303036 PMCID: PMC3267339 DOI: 10.4103/0019-5545.91901] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders.
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Affiliation(s)
- Mushtaq A Margoob
- Department of Psychiatry, Institute of Mental Health and Neurosciences-Kashmir, Kashmir, India.
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27
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Drago A, De Ronchi D, Serretti A. Incomplete coverage of candidate genes: a poorly considered bias. Curr Genomics 2011; 8:476-83. [PMID: 19412419 PMCID: PMC2647155 DOI: 10.2174/138920207783591681] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2007] [Revised: 10/22/2007] [Accepted: 11/01/2007] [Indexed: 12/31/2022] Open
Abstract
Current genetic investigations are performed both on the basis of a rational and biologically based choice of candidate genes and through genome wide scans. Nonetheless, lack of replication is a common problem in psychiatric genetics as well as in other genetic fields. There are a number of reasons for this inconsistency, among them a well known but poorly considered issue is gene coverage. The aim of the present paper is to focus on this well known and defectively deemed bias, especially when a candidate gene approach is chosen. The rational and the technical feasibility of this proposal are discussed as well as a survey of current investigations. The known consistent methodology to fix this bias is also discussed.
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Affiliation(s)
- Antonio Drago
- Institute of Psychiatry, University of Bologna, Italy
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Kristensen AS, Andersen J, Jørgensen TN, Sørensen L, Eriksen J, Loland CJ, Strømgaard K, Gether U. SLC6 neurotransmitter transporters: structure, function, and regulation. Pharmacol Rev 2011; 63:585-640. [PMID: 21752877 DOI: 10.1124/pr.108.000869] [Citation(s) in RCA: 601] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The neurotransmitter transporters (NTTs) belonging to the solute carrier 6 (SLC6) gene family (also referred to as the neurotransmitter-sodium-symporter family or Na(+)/Cl(-)-dependent transporters) comprise a group of nine sodium- and chloride-dependent plasma membrane transporters for the monoamine neurotransmitters serotonin (5-hydroxytryptamine), dopamine, and norepinephrine, and the amino acid neurotransmitters GABA and glycine. The SLC6 NTTs are widely expressed in the mammalian brain and play an essential role in regulating neurotransmitter signaling and homeostasis by mediating uptake of released neurotransmitters from the extracellular space into neurons and glial cells. The transporters are targets for a wide range of therapeutic drugs used in treatment of psychiatric diseases, including major depression, anxiety disorders, attention deficit hyperactivity disorder and epilepsy. Furthermore, psychostimulants such as cocaine and amphetamines have the SLC6 NTTs as primary targets. Beginning with the determination of a high-resolution structure of a prokaryotic homolog of the mammalian SLC6 transporters in 2005, the understanding of the molecular structure, function, and pharmacology of these proteins has advanced rapidly. Furthermore, intensive efforts have been directed toward understanding the molecular and cellular mechanisms involved in regulation of the activity of this important class of transporters, leading to new methodological developments and important insights. This review provides an update of these advances and their implications for the current understanding of the SLC6 NTTs.
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Affiliation(s)
- Anders S Kristensen
- Department of Medicinal Chemistry, Faculty of Pharmaceutical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Atmaca M, Onalan E, Yildirim H, Yuce H, Koc M, Korkmaz S, Mermi O. Serotonin transporter gene polymorphism implicates reduced orbito-frontal cortex in obsessive-compulsive disorder. J Anxiety Disord 2011; 25:680-5. [PMID: 21441009 DOI: 10.1016/j.janxdis.2011.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 02/26/2011] [Accepted: 03/01/2011] [Indexed: 12/16/2022]
Abstract
Although a number of magnetic resonance imaging (MRI) and genetic studies have been performed on obsessive-compulsive disorder (OCD), only limited studies in which genetic and neuroanatomical variables are evaluated concurrently have been performed. Therefore, the aim of our present study is (to understand) better understanding how genetic variation in the promoter region of the 5-HTT gene (5-HTTLPR) is associated with key brain structures in OCD, orbito-frontal cortex (OFC), thalamus and anterior cingulate. 5-HTT genotypes (SS, SL, LL) were determined for 40 patients with OCD and the same number of healthy controls. MRI-derived volumes of the OFC, thalamus, and anterior cingulate were determined by reliable tracing techniques. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5T, and were done blindly. In comparison with controls, OCD patients demonstrated volumes reduction in OFC, increased volumes of thalamus and total white matter volumes, but no difference in total brain volume, total gray matter volumes and anterior cingulate volumes. No significant difference was observed in allelic frequencies between the patients and controls. The stronger effects of 5-HTT polymorphism on brain morphology in OCD than those in controls were determined in the both OFC and thalamus. On the other hand, for the OCD patients, ANCOVA revealed a significant main effect of genotype for both the OFC and thalamus and a significant genotype-by-side interaction for the OFC, demonstrating that the short variants had a smaller right OFC than the long variants. In conclusion, we found a significant genotype-diagnosis interaction effects on key brain structures, with a stronger effects of 5-HTT polymorphism in OFC and thalamus of OCD patients, whereas no morphological changes related to the polymorphism were found in normal individuals.
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Affiliation(s)
- Murad Atmaca
- Firat University School of Medicine Department of Psychiatry, Elazig, Turkey.
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The serotonin transporter availability in untreated early-onset and late-onset patients with obsessive-compulsive disorder. Int J Neuropsychopharmacol 2011; 14:606-17. [PMID: 21232166 DOI: 10.1017/s1461145710001604] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The pathogenetic role of central serotonin transporters (SERT) in obsessive-compulsive disorder (OCD) has been investigated in vivo by positron emission tomography (PET) or single-photon emission computed tomography (SPECT) studies with inconsistent results. This might reflect methodological differences but possibly also the pathophysiological heterogeneity of the disorder, i.e. the age at onset of OCD. The aim of our study was to compare SERT availability in patients with OCD to healthy controls (HC) taking into account the onset type, other factors and covariates (e.g. SERT genotype, age, depression level, gender). We studied 19 drug-naive OCD patients (36±13 yr, eight females) with early onset (EO-OCD, n=6) or with late onset (LO-OCD, n=13), and 21 HC (38±8 yr, nine females) with PET and the SERT-selective radiotracer [11C]DASB. Statistical models indicated that a variety of covariates and their interaction influenced SERT availability measured by distribution volume ratios (DVR). These models revealed significant effects of onset type on DVR with lower values in LO-OCD (starting at age 18 yr) compared to EO-OCD and HC in limbic (e.g. the amygdala), paralimbic brain areas (the anterior cingulate cortex), the nucleus accumbens and striatal regions, as well as borderline significance in the thalamus and the hypothalamus. The putamen, nucleus accumbens and hypothalamus were found with significant interaction between two SERT gene polymorphisms (SERT-LPR and VNTR). These findings suggest that late but not early onset of OCD is associated with abnormally low SERT availability. In part, functional polymorphisms of the SERT gene might determine the differences.
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Park BY, Lee BC, Jung KH, Jung MH, Park BL, Chai YG, Choi IG. Epigenetic changes of serotonin transporter in the patients with alcohol dependence: methylation of an serotonin transporter promoter CpG island. Psychiatry Investig 2011; 8:130-3. [PMID: 21852989 PMCID: PMC3149107 DOI: 10.4306/pi.2011.8.2.130] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Revised: 09/24/2010] [Accepted: 09/25/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Psychiatric disorders such as depression, anxiety and alcohol dependence are associated with serotonin metabolism. We assessed the methylation level of the serotonin transporter (5-HTT) promoter region in control and alcohol dependent patients. METHODS Twenty seven male patients who met the Diagnostic and Statistical Manual of Mental Disorder IV (DSM-IV) criteria for alcohol dependence were compared with fifteen controls. Polymerase chain reaction (PCR) assays of bisulfate-modified DNA were designed to amplify a part of the CpG island in the 5HTT gene. Pyrosequencing was performed and the methylation level at seven CpG island sites was measured. RESULTS We found no differences in the methylation patterns of the serotonin transporter linked promoter region (5-HTTLPR) between alcohol-dependent and control subjects. CONCLUSION Our negative finding may be because 5-HTT epigenetic variation may not affect the expression for 5-HTT or there may be other methylation site critical for its expression. To find out more conclusive result, repeating the study in more methylation sites with a larger number of samples in a well-controlled setting is needed.
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Affiliation(s)
- Byung-Yang Park
- Department of Neuropsychiatry, Hallym University, Chuncheon, Korea
| | - Boung-Chul Lee
- Department of Neuropsychiatry, Hangang Sacred Heart Hospital, Seoul, Korea
| | - Kyoung Hwa Jung
- Division of Molecular & Life Science, Hanyang University, Ansan, Korea
| | - Myung Hun Jung
- Department of Neuropsychiatry, Hangang Sacred Heart Hospital, Seoul, Korea
| | - Byung Lae Park
- Department of Genetic Epidemiology, SNP Genetics, Inc., Seoul, Korea
| | - Young Gyu Chai
- Division of Molecular & Life Science, Hanyang University, Ansan, Korea
| | - Ihn-Geun Choi
- Department of Neuropsychiatry, Hangang Sacred Heart Hospital, Seoul, Korea
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Merenäkk L, Mäestu J, Nordquist N, Parik J, Oreland L, Loit HM, Harro J. Effects of the serotonin transporter (5-HTTLPR) and α2A-adrenoceptor (C-1291G) genotypes on substance use in children and adolescents: a longitudinal study. Psychopharmacology (Berl) 2011; 215:13-22. [PMID: 21140256 DOI: 10.1007/s00213-010-2109-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
Abstract
RATIONALE AND OBJECTIVE Twin studies suggest that substance use initiation in children and adolescents is determined primarily by environmental influences, whereas the establishment of use patterns is strongly controlled by genetic factors. The present study analysed the effects of the serotonin transporter promoter polymorphism [5-HT transporter gene-linked polymorphic region (5-HTTLPR)] and the α(2A)-adrenoceptor C-1291G genotype (ADRA2A C-1291G) as well as their interaction effects on alcohol, tobacco and drug use from preadolescence to the late adolescence. METHODS Initial sample of 9-year-old children of Estonian Children Personality Behaviour and Health Study (n = 583) was recalled at ages 15 and 18. Participants reported in all waves how frequently they smoked and used alcohol and illicit drugs. RESULTS 5-HTTLPR had age-dependent effects on alcohol, tobacco and drug use: substance use did not differ by genotype at age 9, but at age 15, the participants with the short (s)/s genotype had higher tobacco use, and at age 18, they were more active alcohol, drug and tobacco users. Effects of ADRA2A C-1291G on drug use were dependent on gender, age and 5-HTTLPR. Males (age 18) with ADRA2A CG genotype, when compared to other participants, tended to have higher drug use especially when they had s/s genotype of 5-HTTLPR. CONCLUSIONS Our results reveal that expression of genetic vulnerability for substance use in children and adolescents may depend on age, gender, interaction of genes, and type of substance.
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Affiliation(s)
- Liis Merenäkk
- Department of Public Health, Estonian Centre of Behavioural and Health Sciences, University of Tartu, Tartu, Estonia
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Holmboe K, Nemoda Z, Fearon RMP, Sasvari-Szekely M, Johnson MH. Dopamine D4 receptor and serotonin transporter gene effects on the longitudinal development of infant temperament. GENES BRAIN AND BEHAVIOR 2011; 10:513-22. [PMID: 21166770 DOI: 10.1111/j.1601-183x.2010.00669.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Existing studies of the effect on infant temperament of the 48 base pair variable number of tandem repeats polymorphism in exon 3 of the dopamine D4 receptor gene, DRD4 VNTR, and the serotonin transporter-linked polymorphic region, 5-HTTLPR, have provided contradictory results, and age seems to be an important factor. The present study investigated the effect of these two polymorphisms on the stability of infant temperament between 4 and 9 months of age. Furthermore, the effect of a recently discovered single nucleotide polymorphism which modulates the 5-HTTLPR (rs25531) was investigated in relation to infant temperament. The study sample consisted of 90 infants, who were assessed by parental report at the two ages under consideration using the Revised Infant Behavior Questionnaire. It was found that infants carrying the 7-repeat allele of the DRD4 VNTR had higher levels of Negative Affect. Furthermore, there was an interaction between DRD4 VNTR and 5-HTTLPR genotype such that infants with the DRD4 VNTR 7-repeat allele and the highest expressing 5-HTTLPR genotype (L(A) L(A) ) had the highest level of Negative Affect. These effects were largely driven by scores on the Falling Reactivity scale. Genetic effects were stable across age. The results emphasize the need for developmental studies of genetic effects on temperament.
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Affiliation(s)
- K Holmboe
- Centre for Brain and Cognitive Development, King's College London, Birkbeck, London, UK.
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Abstract
Genetic association studies of SLC6A4 (SERT) and obsessive-compulsive disorder (OCD) have been equivocal. We genotyped 1241 individuals in 278 pedigrees from the OCD Collaborative Genetics Study for 13 single-nucleotide polymorphisms, for the linked polymorphic region (LPR) indel with molecular haplotypes at rs25531, for VNTR polymorphisms in introns 2 and 7 and for a 381-bp deletion 3' to the LPR. We analyzed using the Family-Based Association Test (FBAT) under additive, dominant, recessive and genotypic models, using both OCD and sex-stratified OCD as phenotypes. Two-point FBAT analysis detected association between Int2 (P = 0.0089) and Int7 (P = 0.0187) (genotypic model). Sex-stratified two-point analysis showed strong association in females with Int2 (P<0.0002), significant after correction for linkage disequilibrium, and multiple marker and model testing (P(Adj) = 0.0069). The SLC6A4 gene is composed of two haplotype blocks (our data and the HapMap); FBAT whole-marker analysis conducted using this structure was not significant. Several noteworthy nonsignificant results have emerged. Unlike Hu et al., we found no evidence for overtransmission of the LPR L(A) allele (genotype relative risk = 1.11, 95% confidence interval: 0.77-1.60); however, rare individual haplotypes containing L(A) with P<0.05 were observed. Similarly, three individuals (two with OCD/OCPD) carried the rare I425V SLC6A4 variant, but none of them passed it on to their six OCD-affected offspring, suggesting that it is unlikely to be solely responsible for the 'OCD plus syndrome', as reported by Ozaki et al. In conclusion, we found evidence of genetic association at the SLC6A4 locus with OCD. A noteworthy lack of association at the LPR, LPR-rs25531 and rare 425V variants suggests that hypotheses about OCD risk need revision to accommodate these new findings, including a possible gender effect.
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Kang EH, Shim HB, Kim KJ, Park JE, Lee IS, Yu BH. Platelet serotonin transporter function after short-term paroxetine treatment in patients with panic disorder. Psychiatry Res 2010; 176:250-3. [PMID: 20207008 DOI: 10.1016/j.psychres.2008.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Revised: 09/23/2008] [Accepted: 12/22/2008] [Indexed: 10/19/2022]
Abstract
Dysfunctions in serotonin neurotransmission have been implicated in some psychiatric disorders, and in particular, altered serotonin transporter function has been noted in panic disorder. In this study, the authors compared platelet [(3)H]serotonin uptake parameters, including maximum velocities (V(max)) and affinity constants (K(m)), in patients with panic disorder not undergoing treatment (n=21) and in healthy subjects (n=20). V(max) and K(m) values were re-examined after 12 weeks of paroxetine treatment. Values of V(max) and K(m) were lower in panic disorder patients at baseline than in healthy subjects. After treatment, K(m) normalized in panic patients, whereas V(max) did not change. A significant inverse correlation was found between increased K(m) and changes in anxiety levels. These results support a hypothesis of serotonergic transporter abnormalities in panic disorder, and suggest that increased K(m) values of platelet serotonin transporters parallel clinical improvement after short-term pharmacotherapy in panic disorder.
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Affiliation(s)
- Eun-Ho Kang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea
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Kang EH, Lee IS, Park JE, Kim KJ, Yu BH. Platelet serotonin transporter function and heart rate variability in patients with panic disorder. J Korean Med Sci 2010; 25:613-8. [PMID: 20358007 PMCID: PMC2844607 DOI: 10.3346/jkms.2010.25.4.613] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 08/18/2009] [Indexed: 11/20/2022] Open
Abstract
Many studies showed abnormal serotonin transporter (5-HTT) function and heart rate variability (HRV) in panic disorder patients. The present study investigated the relationship between HRV power spectral analysis findings and platelet serotonin uptake in panic disorder patients. Short-term HRV over 5 min and platelet serotonin transporter uptake parameters (V(max) and K(m)) were measured both in 45 patients with panic disorder and in 30 age-matched normal healthy control subjects. Low frequency power (LF) normalized unit (nu) and LF/high frequency power (HF) were significantly higher, whereas HF and HF nu were lower in the patient group than in the control group. V(max) and K(m) were all significantly lower (i.e., reflects decreased 5-HTT function) in patients with panic disorder than in normal controls. In the patient group, K(m) was negatively correlated with LF/HF and LF nu whereas no such correlations between them were found in the control group. By multivariate analysis based on multiple hierarchical linear regression, a low K(m) independently predicted an increased LF nu even after controlling for age, sex, and body mass index in the patient group. These results suggest that impaired 5-HTT function is closely related to dysregulation of autonomic nervous system in panic disorder.
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Affiliation(s)
- Eun-Ho Kang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In-Soo Lee
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Joo-Eon Park
- Department of Psychiatry, Keyo Hospital, Uiwang, Korea
| | | | - Bum-Hee Yu
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Smoller JW, Block SR, Young MM. Genetics of anxiety disorders: the complex road from DSM to DNA. Depress Anxiety 2010; 26:965-75. [PMID: 19885930 DOI: 10.1002/da.20623] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Anxiety disorders are among the most common psychiatric disorders, affecting one in four individuals over a lifetime. Although our understanding of the etiology of these disorders is incomplete, familial and genetic factors are established risk factors. However, identifying the specific casual genes has been difficult. Within the past several years, advances in molecular and statistical genetic methods have made the genetic dissection of complex disorders a feasible project. Here we provide an overview of these developments, with a focus on their implications for genetic studies of anxiety disorders. Although the genetic and phenotypic complexity of the anxiety disorders present formidable challenges, advances in neuroimaging and experimental animal models of anxiety and fear offer important opportunities for discovery. Real progress in identifying the genetic basis of anxiety disorders will require integrative approaches that make use of these biologic tools as well as larger-scale genomic studies. If successful, such efforts may yield novel and more effective approaches for the prevention and treatment of these common and costly disorders.
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Affiliation(s)
- Jordan W Smoller
- Psychiatric Genetics Program in Mood and Anxiety Disorders, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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38
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Affiliation(s)
- Steven P Hamilton
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, California 94143-0984, USA.
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39
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Wray NR, James MR, Gordon SD, Dumenil T, Ryan L, Coventry WL, Statham DJ, Pergadia ML, Madden PAF, Heath AC, Montgomery GW, Martin NG. Accurate, Large-Scale Genotyping of 5HTTLPR and Flanking Single Nucleotide Polymorphisms in an Association Study of Depression, Anxiety, and Personality Measures. Biol Psychiatry 2009; 66:468-76. [PMID: 19541292 PMCID: PMC3060567 DOI: 10.1016/j.biopsych.2009.04.030] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/23/2009] [Accepted: 04/15/2009] [Indexed: 12/16/2022]
Abstract
BACKGROUND The length polymorphism repeat in the promoter region of the serotonin transporter gene (5HTTLPR) is one of the most studied polymorphisms for association with a range of psychiatric and personality phenotypes. However, the original 5HTTLPR assay is prone to bias toward short allele calling. METHODS We designed new assays for the 5HTTLPR suitable for large-scale genotyping projects and we genotyped 13 single nucleotide polymorphisms (SNPs) in a 38-kilobase region around the 5HTTLPR, including SNP rs25531, a polymorphism of the 5HTTLPR long allele. Association analysis was conducted for major depression and/or anxiety disorder in unrelated cases (n = 1161) and control subjects (n = 1051) identified through psychiatric interviews administered to a large population sample of Australian twin families. Participants had been scored for personality traits several years earlier (n > or = 2643 unrelated individuals). RESULTS We identified a two-SNP haplotype proxy for 5HTTLPR; the CA haplotype of SNPs rs4251417 and rs2020934 is coupled with the short allele of 5HTTLPR (r(2) = .72). We found evidence for association (p = .0062, after accounting for multiple testing) for SLC6A4 SNPs rs6354 and rs2020936 (positioned in a different linkage disequilibrium [LD] block about 15.5 kb from 5HTTLPR) with anxiety and/or depression and neuroticism, with the strongest association for recurrent depression with onset in young adulthood (odds ratio = 1.55, 95% confidence interval = 1.16-2.06). CONCLUSIONS The associated SNPs are in the same LD block as the variable number of tandem repeats serotonin transporter intron 2 marker, for which association has previously been reported.
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Affiliation(s)
- Naomi R Wray
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, 300 Herston Road, Brisbane 4006, Australia.
| | - Michael R James
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Scott D Gordon
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Troy Dumenil
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Leanne Ryan
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - William L Coventry
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia,School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, New South Wales 2350, Australia
| | - Dixie J Statham
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia,Faculty of Arts & Social Sciences, University of the Sunshine Coast, Maroochydore, Queensland 4558, Australia
| | - Michele L Pergadia
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Pamela AF Madden
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Andrew C Heath
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Grant W Montgomery
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Nicholas G Martin
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
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Matsumoto R, Ichise M, Ito H, Ando T, Takahashi H, Ikoma Y, Kosaka J, Arakawa R, Fujimura Y, Ota M, Takano A, Fukui K, Nakayama K, Suhara T. Reduced serotonin transporter binding in the insular cortex in patients with obsessive-compulsive disorder: a [11C]DASB PET study. Neuroimage 2009; 49:121-6. [PMID: 19660554 DOI: 10.1016/j.neuroimage.2009.07.069] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 07/25/2009] [Accepted: 07/29/2009] [Indexed: 11/26/2022] Open
Abstract
The serotonin transporter (5-HTT) and other markers of the serotonergic system have been of interest in the pathophysiology of obsessive-compulsive disorder (OCD). Previous studies using single photon emission computed tomography (SPECT) with [(123)I]beta-CIT or positron emission tomography (PET) with [(11)C]McN5652 have not shown consistent findings about 5-HTT in OCD patients. The aim of the present study was to investigate 5-HTT binding using [(11)C]DASB, which has higher selectivity or specific binding-to-nonspecific binding ratios for 5-HTT compared to the aforementioned radioligands. Four drug-naive and 6 drug-free patients with OCD who were free of comorbid depression and 18 gender and age-matched healthy subjects underwent PET scans with [(11)C]DASB. The severity of OCD was assessed by Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) (mean+/-SD: 22+/-7.6, range: 7-32). The binding potential (BP(ND)) of [(11)C]DASB was calculated using a two-parameter multilinear reference tissue model (MRTM2). The parametric images of BP(ND) were analyzed using a statistical parametric mapping system. Significant reductions of BP(ND) were observed in the right posterior and left anterior insular cortices in patients with OCD compared to controls. Region-of-interest analysis has also confirmed significant reduction of BP(ND) in the insular cortex. Although significantly reduced BP(ND) in the orbitofrontal cortex was also observed in patients with OCD compared to controls, this finding should be considered with caution because of the very low 5-HTT binding in the region. On the other hand, no significant correlation was observed between the Y-BOCS score and BP(ND). The change in [(11)C]DASB binding in the insular cortex suggests that dysfunction of the serotonergic system in the limbic area might be involved in the pathophysiology of OCD.
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Affiliation(s)
- Ryohei Matsumoto
- Molecular Neuroimaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, Japan.
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Abstract
This article reviews recent developments in understanding the genetic etiology of obsessive-compulsive disorder (OCD). Family studies provide further support for the familial aggregation of OCD. Genome-wide linkage studies indicate that specific chromosomal regions are linked to OCD. Moreover, results from recent molecular genetic studies suggest that several candidate genes are associated with OCD. However, specific genes causing OCD have not been conclusively identified, and the molecular pathogenesis of the disorder has not been elucidated. The search for genes is complicated by the clinical and etiologic heterogeneity of OCD, as well as the possibility of gene-gene and gene-environment interactions. Despite this complexity, further refinement of the phenotype and developments in molecular and statistical genetics hold promise for further deepening our genetic understanding of OCD in the future.
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Affiliation(s)
- Jack F Samuels
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 1629 Thames Street, Suite 401, Baltimore, MD 21231, USA.
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Matsushima Y, Eguchi F, Kikukawa T, Matsuda T. Historical overview of psychoactive mushrooms. Inflamm Regen 2009. [DOI: 10.2492/inflammregen.29.47] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Association of the serotonin transporter polymorphism and obsessive-compulsive disorder: systematic review. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:850-8. [PMID: 18186076 DOI: 10.1002/ajmg.b.30699] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We investigated the association between the long (l) and short (s) alleles of the serotonin transporter polymorphism (5-HTTLPR) in the promoter region of the SLC6A4 gene and obsessive-compulsive disorder (OCD) using meta-analysis to combine all published data from case-control and family based association studies (2,283 cases). In stratified meta-analysis we investigated whether age of sample (child and adult), ethnicity (Caucasian and Asian) and study design (case-control and family-based association studies) moderated any association. In the overall meta-analysis we found no evidence of association between genetic variation at the 5-HTTLPR locus and OCD. We did find significant heterogeneity between studies. In the stratified meta-analyses, we demonstrated a significant association between the l-allele and OCD in family-based association studies and in studies involving children and Caucasians. Our meta-analysis suggests the possibility that the l-allele may be associated with OCD in specific OCD subgroups such as childhood-onset OCD and in Caucasians. Further meta-analyses based on individual patient data would be helpful in determining whether age of OCD onset, gender and the presence of comorbid illness (e.g., tics) moderates the relationship between 5-HTTLPR and OCD.
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Abstract
Obsessive–compulsive disorder (OCD) is a psychiatric disorder consisting of obsessions and compulsions. Over the past two decades, it has been suggested that OCD might be related to the functioning of brain serotonin systems, mainly because of the antiobsessional efficacy of selective serotonin-reuptake inhibitors (SSRIs). Although the efficacy of SSRIs suggests a role of the serotonergic system in OCD, the exact function of serotonin is still unclear. Is the serotonergic system implicated in the pathophysiology of OCD, or is it implicated in the treatment effect in OCD? Do SSRIs compensate for a fundamental abnormality of the serotonergic system, or do SSRIs modulate an intact serotonergic system to compensate for another neurotransmitter mechanism? This review summarizes evidence supporting a role for the serotonin transporter and serotonin receptor subtypes in the pathophysiology and treatment of OCD.
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Affiliation(s)
- Addy van Dijk
- University of Amsterdam, Department of Psychiatry, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Andre Klompmakers
- University of Amsterdam, Department of Psychiatry, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Damiaan Denys
- University of Amsterdam, PA.2–179, PO Box 75867, 1070 AW Amsterdam, The Netherlands
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Eaton WW, Shao H, Nestadt G, Lee HB, Lee BH, Bienvenu OJ, Zandi P. Population-based study of first onset and chronicity in major depressive disorder. ACTA ACUST UNITED AC 2008; 65:513-20. [PMID: 18458203 DOI: 10.1001/archpsyc.65.5.513] [Citation(s) in RCA: 386] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT There are no studies of the natural history of major depressive disorder that lack prevalence and clinic biases. OBJECTIVES To estimate risk factors for first lifetime onset and parameters of chronicity following the first episode, including duration, recovery, and recurrence, and to search for predictors of each parameter. DESIGN Prospective population-based cohort study with 23 years of follow-up. SETTING East Baltimore, Maryland, an urban setting. PARTICIPANTS Probability sample of 3481 adult household residents in 1981, including 92 with first lifetime onset of major depressive disorder during the course of the follow-up, and 1739 other participants followed up for at least 13 years. OUTCOME MEASURES Diagnostic Interview Schedule and Life Chart Interview. RESULTS Female participants showed higher risk of onset of disorder, longer duration of episodes, and a nonsignificant tendency for higher risk of recurrence. Sex was not related to recovery. The median episode length was 12 weeks. About 15% of 92 individuals with first episodes did not have a year free of episodes, even after 23 years. About 50% of first episode participants recovered and had no future episodes. The evolution of the course was relatively stable from first to later episodes. Individuals with 1 or 2 short alleles of the serotonin transporter gene were at higher risk for an initial episode, but experienced episodes of shorter duration. There were few strong predictors of recovery or recurrence. CONCLUSIONS Major depressive disorder is unremitting in 15% of cases and recurrent in 35%. About half of those with a first-onset episode recover and have no further episodes.
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Affiliation(s)
- William W Eaton
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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da Rocha FF, Malloy-Diniz L, Lage NV, Romano-Silva MA, de Marco LA, Correa H. Decision-making impairment is related to serotonin transporter promoter polymorphism in a sample of patients with obsessive-compulsive disorder. Behav Brain Res 2008; 195:159-63. [PMID: 18603313 DOI: 10.1016/j.bbr.2008.05.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 05/22/2008] [Accepted: 05/22/2008] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Decision-making impairment is an important feature of some psychiatric disorders, such as attention-deficit/hyperactivity disorder and substance-use disorders, and is associated with dysfunction of the fronto-subcortical circuit, mainly the orbitofrontal cortex (OFC). Several data reports support significant correlations between decision-making impairment and the serotonin system. Thus, this neurotransmission system may be a major step in some cognitive features, particularly in OCD because serotonin is associated with this disorder. Therefore, the serotonin transporter promoter polymorphism (5-HTTLPR) may be related to the modulation of these cognitive characteristics. In a sample of Caucasian OCD patients, we explored the link between decision-making and the 5-HTTLPR. METHOD We used the Iowa Gambling Task (IGT) to measure decision-making in 49 OCD patients, according to the DSM-IV criteria. All patients were submitted to Y-BOCS, BDI, BAI, the Raven Progressive Matrices, the Continuous Performance Task, and the Trail Making Test. We grouped S- and/or Lg-carriers in view of the fact that these act in a nearly dominant way. RESULTS On IGT, S- and/or Lg-carriers had significantly lower scores on the third, fourth, and fifth blocks. These findings were confirmed after adjusting for clinical and cognitive variables. DISCUSSION Inconclusive findings about the link between OCD and 5-HTTLPR may be better elucidated by studying OCD subgroups that could be more related in some genetic characteristics. Based on our study, low performance on IGT is associated with S- and/or Lg-carriers. CONCLUSION Our results corroborate the hypothesis that the pattern of neuropsychological functioning observed in previous studies may constitute a biological marker or heritable endophenotype of OCD.
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Saiz PA, Garcia-Portilla MP, Arango C, Morales B, Bascaran MT, Martinez-Barrondo S, Florez G, Sotomayor E, Paredes B, Alvarez C, San Narciso G, Carreño E, Bombin I, Alvarez V, Coto E, Fernandez JM, Bousoño M, Bobes J. Association study between obsessive-compulsive disorder and serotonergic candidate genes. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:765-70. [PMID: 18191318 DOI: 10.1016/j.pnpbp.2007.12.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 11/16/2007] [Accepted: 12/06/2007] [Indexed: 12/16/2022]
Abstract
BACKGROUND To date, research examining the relationship between serotonergic genes and obsessive-compulsive disorder (OCD) has yielded conflicting results. The purpose of this study is to investigate the association between four serotonergic polymorphisms (STin2 VNTR and 5-HTTLPR of the SLC6A4 gene, and A-1438G (rs6311) and T102C (rs6313) of the HTR2A gene) and OCD. METHODS 99 OCD patients, 456 non-OCD psychiatric patients, and 420 healthy controls from a homogeneous Spanish Caucasian population were genotyped using standard methods. RESULTS All groups showed Hardy-Weinberg equilibrium for the analyzed genetic variability. A-1438G and T102C polymorphisms were in complete linkage disequilibrium. OCD patients showed an excess of STin2.12 carriers (12/12, 12/10, and 12/9 genotypes) compared with healthy controls (chi(2) (1)=7.21, corrected p=0.021; OR=3.38, 95% CI=1.32-8.62) and non-OCD psychiatric patients (chi(2) (1)=6.70, corrected p=0.030; OR=3.24, 95% CI=1.27-8.26). However, no differences were found between non-OCD patients and healthy controls (chi(2) (1)=0.05, corrected p>1; OR=1.04, 95% CI=0.72-1.51). No significant differences were found with respect to A-1438G and 5-HTTLPR polymorphisms. CONCLUSIONS Our data provide supporting evidence of an association between the STin2 VNTR polymorphism of the SLC6A4 gene and OCD.
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Affiliation(s)
- Pilar A Saiz
- Department of Psychiatry, School of Medicine, University of Oviedo, Julian Claveria 6-3, 33006 Oviedo, Spain.
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Walitza S, Zellmann H, Irblich B, Lange KW, Tucha O, Hemminger U, Wucherer K, Rost V, Reinecker H, Wewetzer C, Warnke A. Children and adolescents with obsessive-compulsive disorder and comorbid attention-deficit/hyperactivity disorder: preliminary results of a prospective follow-up study. J Neural Transm (Vienna) 2008; 115:187-90. [PMID: 18200431 DOI: 10.1007/s00702-007-0841-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2007] [Accepted: 10/01/2007] [Indexed: 01/12/2023]
Abstract
In the present study, we have investigated the influence of comorbid attention deficit hyperactivity disorder (ADHD) on early onset obsessive compulsive disorder (OCD). For that purpose, we compared 20 patients with "OCD with ADHD" and 20 randomly selected patients with "OCD without ADHD". "OCD with ADHD" patients tended to show an earlier age of OCD onset, a higher severity of symptoms and a higher persistence rate than OCD patients without ADHD. Both groups appear to develop different patterns of comorbid disorders.
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Affiliation(s)
- S Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany.
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Walitza S, J. Renner T, Wewetzer C, Warnke A. Genetische Befunde bei Zwangsstörungen im Kindes- und Jugendalter und bei Erwachsenen. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2008; 36:45-52. [DOI: 10.1024/1422-4917.36.1.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Im Kindes- und Jugendalter sind Zwangsstörungen bei einer Inzidenz von ein bis zwei Prozent keine Seltenheit und können die Betroffenen in ihrer Entwicklung deutlich beeinträchtigen. Die Erkrankung ist durch wiederkehrende und anhaltende Verhaltensweisen, Gedanken und Impulse gekennzeichnet, die als quälend erlebt werden und sich je nach Entwicklungstand gegen inneren Widerstand aufdrängen und vom Patienten als unsinnig und übertrieben wahrgenommen werden. Die Entstehung von Zwangsstörungen hängt sowohl von Umweltfaktoren, nicht genetischen hirnpathologischen als auch von genetischen Einflussfaktoren ab. Die Mehrheit der bisherigen Ergebnisse bezieht sich dabei auf Untersuchungen im Erwachsenenalter. Es wird eine aktuelle Übersicht über genetische Befunde bei Zwangsstörungen unter besonderer Berücksichtigung des Kindes- und Jugendalters gegeben. Bei jung erkrankten Patienten findet sich eine deutlichere familiäre Belastung. Befunde aus Kopplungs- und Assoziationsstudien sowie Tiermodellen werden vorgestellt und diskutiert. Die phänotypische und genetische Heterogenität von Zwangsstörungen trägt zu den unterschiedlichen Studienergebnissen bei und erfordert für künftige Untersuchungen die Differenzierung von Subtypen, z.B. die Einbeziehung des Alters bei Erkrankungsbeginn, von Symptomdimensionen, geschlechtlichen Besonderheiten und komorbider Störungen.
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Affiliation(s)
- Susanne Walitza
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Würzburg (Ärztlicher Direktor: Prof. Dr. A. Warnke)
| | - Tobias J. Renner
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Würzburg (Ärztlicher Direktor: Prof. Dr. A. Warnke)
| | - Christoph Wewetzer
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Städtischen Kliniken Köln GmbH
| | - Andreas Warnke
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Würzburg (Ärztlicher Direktor: Prof. Dr. A. Warnke)
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