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Nemoda Z, Angyal N, Tarnok Z, Birkas E, Bognar E, Sasvari-Szekely M, Gervai J, Lakatos K. Differential Genetic Effect of the Norepinephrine Transporter Promoter Polymorphisms on Attention Problems in Clinical and Non-clinical Samples. Front Neurosci 2019; 12:1051. [PMID: 30692908 PMCID: PMC6339888 DOI: 10.3389/fnins.2018.01051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 12/27/2018] [Indexed: 11/15/2022] Open
Abstract
Among the monoaminergic modulatory neurotransmitters, norepinephrine is involved in task orienting, hence noradrenergic genetic variants have been studied in connection to attentional processes. The role of this catecholamine system is also highlighted by the selective norepinephrine transporter blocking atomoxetine, which has proved to be effective in the pharmacological treatment of Attention Deficit Hyperactivity Disorder (ADHD). In the present genetic association study three single nucleotide polymorphisms (rs28386840, rs2242446, rs3785143 SNPs) were analyzed from the 5′ region of the norepinephrine transporter (NET, SLC6A2) gene, which have been linked to ADHD previously. Attention problems scores of the mother-rated Child Behavior Checklist (CBCL) were used in separate analyses of 88 preschoolers (59.1% male, 6 years of age) recruited from the general population and 120 child psychiatry patients with ADHD diagnosis (85.8% male, age: 9.8 ± 2.9). The NET SNPs showed associations with attention problems, but the direction was different in the two groups. Regarding the promoter variant rs28386840, which showed the most consistent association, the T-allele-carrier patients with ADHD had lower CBCL attention problems scores compared to patients with AA genotype (p = 0.023), whereas T-allele-carriers in the community sample had more attention problems (p = 0.042). Based on previous reports of lower NE levels in ADHD children and the inverted-U shape effect of NE on cognitive functions, we propose that rs28386840 (-3081) T-allele, which is associated with lower NET expression (and potentially higher synaptic NE level) would support attention processes among ADHD patients (similarly as atomoxetine increases NE levels), whereas it would hinder cortical functions in healthy children.
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Affiliation(s)
- Zsofia Nemoda
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Nora Angyal
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Clinic, Budapest, Hungary
| | - Emma Birkas
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.,Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Emese Bognar
- Vadaskert Child and Adolescent Psychiatric Clinic, Budapest, Hungary
| | - Maria Sasvari-Szekely
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Judit Gervai
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Krisztina Lakatos
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
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Alkam T, Mamiya T, Kimura N, Yoshida A, Kihara D, Tsunoda Y, Aoyama Y, Hiramatsu M, Kim HC, Nabeshima T. Prenatal nicotine exposure decreases the release of dopamine in the medial frontal cortex and induces atomoxetine-responsive neurobehavioral deficits in mice. Psychopharmacology (Berl) 2017; 234:1853-1869. [PMID: 28332006 DOI: 10.1007/s00213-017-4591-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/05/2017] [Indexed: 02/06/2023]
Abstract
Increased risk of attention-deficit/hyperactivity disorder (AD/HD) is partly associated with the early developmental exposure to nicotine in tobacco smoke. Emerging reports link tobacco smoke exposure or prenatal nicotine exposure (PNE) with AD/HD-like behaviors in rodent models. We have previously reported that PNE induces cognitive behavioral deficits in offspring and decreases the contents of dopamine (DA) and its turnover in the prefrontal cortex (PFC) of offspring It is well known that the dysfunction of DAergic system in the brain is one of the core factors in the pathophysiology of AD/HD. Therefore, we examined whether the effects of PNE on the DAergic system underlie the AD/HD-related behavioral changes in mouse offspring. PNE reduced the release of DA in the medial PFC (mPFC) in mouse offspring. PNE reduced the number of tyrosine hydroxylase (TH)-positive varicosities in the mPFC and in the core as well as the shell of nucleus accumbens, but not in the striatum. PNE also induced behavioral deficits in cliff avoidance, object-based attention, and sensorimotor gating in offspring. These behavioral deficits were attenuated by acute treatment with atomoxetine (3 mg/kg, s.c.) or partially attenuated by acute treatment with MPH (1 mg/kg, s.c.). Taken together, our findings support the notion that PNE induces neurobehavioral abnormalities in mouse offspring by disrupting the DAergic system and improve our understanding about the incidence of AD/HD in children whose mothers were exposed to nicotine during their pregnancy.
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Affiliation(s)
- Tursun Alkam
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Takayoshi Mamiya
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan
| | - Nami Kimura
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Aya Yoshida
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Daisuke Kihara
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Yuki Tsunoda
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Yuki Aoyama
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Masayuki Hiramatsu
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan
| | - Hyoung-Chun Kim
- Neuropsychopharmacology and Toxicology Program, College of Pharmacy, Kangwon National University, Chunchon, South Korea
| | - Toshitaka Nabeshima
- Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Nagoya, Japan.
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan.
- Advanced Diagnostic System Research Laboratory, Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, 470-1192, Japan.
- Aino University, Ibaraki, Japan.
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Alkam T, Kim HC, Mamiya T, Yamada K, Hiramatsu M, Nabeshima T. Evaluation of cognitive behaviors in young offspring of C57BL/6J mice after gestational nicotine exposure during different time-windows. Psychopharmacology (Berl) 2013; 230:451-63. [PMID: 23793357 DOI: 10.1007/s00213-013-3175-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 06/03/2013] [Indexed: 12/28/2022]
Abstract
Gestational nicotine exposure is associated with cognitive abnormalities in young offspring. However, practical strategies for prevention or treatment of impaired cognitive behaviors of offspring are not available due to the lack of systematic investigation of underlying mechanism. Therefore, this study aimed at examining the effects of gestational and/or perinatal nicotine exposure (GPNE) on cognitive behaviors in offspring of C57BL/6J mice to provide systematic behavioral data. Pregnant mice were exposed to nicotine via sweetened drinking water during six time-windows, including gestational day 0 to day 13 (G0-G13), G14-postnatal day 0 (P0), G0-P0, G14-P7, G0-P7, and P0-P7. During P42-P56 days, both male and female offspring were given a battery of behavioral tests. Depending on the time of exposure, GPNE impaired working memory, object-based attention, and prepulse inhibition in male and female offspring to different extents. Nicotine exposure during G14-P0 also decreased norepinephrine turnover in the prefrontal cortex on P28 and P56. Overall results indicate that nicotine exposure during any time-windows of development impairs cognitive behaviors in offspring, and suggest that certain time-windows, e.g., G14-P0, should be selected for further studies on the underlying neurochemical or molecular mechanisms.
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Affiliation(s)
- Tursun Alkam
- Research Project on the Risk of Chemical Substances, Food Hygiene Association, The Ministry of Health, Labour and Welfare, Tokyo, 100-8916, Japan
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Caylak E. Biochemical and genetic analyses of childhood attention deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:613-27. [PMID: 22825876 DOI: 10.1002/ajmg.b.32077] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Accepted: 06/26/2012] [Indexed: 02/05/2023]
Abstract
Attention deficit/hyperactivity disorder (ADHD) in children is a neurobehavioral disorder characterized by inattention, hyperactivity, and/or impulsivity. The biochemical abnormalities and genetic factors play significant roles in the etiology of ADHD. These symptoms affect the behavior performance and social relationships of children in school and at home. Recently, many studies about biochemical abnormalities in ADHD have been published. Several research groups have also suggested the genetic contribution to ADHD, and attempted to identify susceptibility and candidate genes for this disorder through the genetic linkage and association studies. To date, these studies have reported substantial evidence implicating several genes (dopaminergic: DRD4, DAT1, DRD5, COMT; noradrenergic: DBH, ADRA2A; serotonergic: 5-HTT, HTR1B, HTR2A; cholinergic: CHRNA4, and central nervous system development pathway: SNAP25, BDNF) in the etiology of ADHD. Understanding the biochemistry and genetics of ADHD will allow us to provide a useful addition with other treatment procedures for ADHD.
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Affiliation(s)
- Emrah Caylak
- Department of Biochemistry, School of Health, Karatekin University, Cankiri, Turkey.
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Evaluation of object-based attention in mice. Behav Brain Res 2011; 220:185-93. [PMID: 21277334 DOI: 10.1016/j.bbr.2011.01.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 01/17/2011] [Accepted: 01/23/2011] [Indexed: 12/26/2022]
Abstract
The deficits of attention result in significant impairment in daily life, and pharmacological intervention to improve attention is the most effective treatment in clinics. However, methods which are suitable for the large scale preclinical screening of attention-improving compounds or drugs are few in the field. In this study, we have developed object-based attention task as a simple and wherever-practical method that suitable for quick drug screening in mice. Treatment with p-chlorophenylalanine (pCPA) (200mg/kg/day, i.p.) for three consecutive days reduced the prefrontal cortical content of serotonin and dopamine, and increased turn-over of dopamine while decreasing turn-over of norepinephrine in the prefrontal cortex on day 7. Auditory attention and working memory, but not long-term object memory after a long (10 min) object (two objects)-exposure period, were impaired on day 7 after the same treatment paradigm with pCPA. Novel object recognition ability immediately (<10s) after a short (3 min) object (on two objects)-exposure period was not impaired after pCPA treatment. However, novel object recognition ability immediately (<10s) after a short (3 min), but not long (6 min), object (five objects)-exposure period was impaired after pCPA treatment. For the verification, the current task, the object-based attention task, was confirmed in an attention deficit model induced by acute phencyclidine (1mg/kg, i.p.) treatment in mice. It was implied that the object-based attention task would assist the behavioral screening process of pharmacological studies on attention-improving drugs.
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Arruda MA, Guidetti V, Galli F, Albuquerque RCAP, Bigal ME. Migraine, tension-type headache, and attention-deficit/hyperactivity disorder in childhood: a population-based study. Postgrad Med 2010; 122:18-26. [PMID: 20861584 DOI: 10.3810/pgm.2010.09.2197] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Primary headache syndromes (eg, migraine and tension-type headache [TTH]) and attention-deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause impairment in social and academic functioning. We tested if ADHD or its symptoms are associated with specific headache syndromes or with headache frequency. STUDY DESIGN Cross-sectional epidemiological study with direct interviews to parents and teachers using validated and standardized questionnaires. SETTING Populational study. PARTICIPANTS Children aged 5 to 11 years (n = 1856). OUTCOME MEASURES Prevalence of ADHD as a function of headache status in crude and adjusted analyses. RESULTS The prevalence of migraine was 3.76%. Infrequent episodic TTH occurred in 2.3% of the sample, and frequent episodic TTH occurred in 1.6%. The prevalence of ADHD was 6.1%. The prevalence of ADHD was not significantly different by headache category. For hyperactivity-impulsivity symptoms, the prevalence was 8.1% in children without headache, 23.7% in children with migraine (relative risk [RR], 2.6; 95% confidence interval [CI], 1.6-4.2), and 18.4% in children with probable migraine (RR, 2.1; 95% CI, 1.4-3.2). For inattention, no significant differences were seen. In multivariate analyses, ADHD or inattention symptoms were not predicted by headache subtypes or headache frequency. Hyperactivity-impulsivity symptoms were significantly associated with any headache (P < 0.01), TTH (P < 0.01), or migraine (P < 0.001). CONCLUSION Migraine and TTH are not comorbid to ADHD overall, but are comorbid to hyperactive-impulsive behavior. Providers and educators should be aware of the association.
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Affiliation(s)
- Marco A Arruda
- Glia Institute, Braz Olaia Acosta, 727, s. 310, Ribeirão Preto, São Paulo, Brazil.
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Riahi F, Tehrani-Doost M, Shahrivar Z, Alaghband-Rad J. Efficacy of reboxetine in adults with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled clinical trial. Hum Psychopharmacol 2010; 25:570-6. [PMID: 21312292 DOI: 10.1002/hup.1158] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The main aim of this study is to evaluate the efficacy of reboxetine, a specific noradrenergic reuptake inhibitor, in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS In a double blind placebo-controlled clinical trial, the efficacy of 8 mg/day of reboxetine (twice daily) was compared with placebo in 40 adults diagnosed with ADHD during 6 weeks. The measures were Conners' Adult ADHD Rating Scale-Self-Report, Screening Version (CAARS-S, SV), Hamilton Anxiety and Depression Rating Scales, Clinical Global Impression - Severity Scale (CGI-S), and Global Assessment of Functioning Scale (GAF). RESULTS There was a main effect of time and significant time X treatment (reboxetine vs. placebo) interaction on CAARS subscales and CGI scores which decreased along the study (p < 0.01). There was also a main effect of time and time X treatment interaction on GAF score which increased at the end point of the study (p < 0.01). In terms of Hamilton Anxiety and Depression Rating Scales there was just a main effect of time on Hamilton Depression Scale (p < 0.01). Irritability, anxiety, sleep disturbance, and dry mouth were the common side effects of reboxetine. CONCLUSION Reboxetine could be used and tolerated as an effective treatment for adults with ADHD.
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Affiliation(s)
- Forough Riahi
- Department of Psychiatry, Jondi Shapour University, Ahvaz, Iran
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Effect of alpha2A-adrenoceptor C-1291G genotype and maltreatment on hyperactivity and inattention in adolescents. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:219-24. [PMID: 19922756 DOI: 10.1016/j.pnpbp.2009.11.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 10/29/2009] [Accepted: 11/10/2009] [Indexed: 11/24/2022]
Abstract
The C-1291G polymorphism (rs1800544) in the promoter region of the alpha(2A)-adrenoceptor gene (ADRA2A) has been associated with attention deficit and hyperactivity in clinical samples. We have examined the effect of ADRA2A C-1291G on inattentive, hyperactive and aggressive behaviour in a population representative cohort of healthy schoolchildren, and possible interaction of genotype with family relations. Ratings on aggressiveness, motor restlessness and concentration difficulties were obtained from the class teachers by using the Hyperactivity Scale of af Klinteberg, and the teacher-report version of SNAP-IV. The relations in the family were reported by children. Symptom scores, self-reports and genotype data of 429 15-years old children (196 boys, 233 girls) were available for analysis. There was a significant interaction effect of maltreatment and the ADRA2A genotype on behavioural functioning in 15years old boys. Boys with CC genotype and higher score of maltreatment demonstrated more overactive behaviour and concentration difficulties than boys with CC genotype and low maltreatment score. They also had more inattentive symptoms measured by SNAP-IV. Among boys with low maltreatment score, subjects with CC genotype demonstrated less overactivity than G allele carriers. In girls, the G allele carriers did not differ from the CC genotype, but in maltreated girls with GG genotype aggression and inattention symptoms were reduced, and the score of aggressive behaviour was also lower compared to maltreated girls with CC genotype. Our data suggest that family environmental factors may act together with the alpha(2A)-adrenoceptor genotype to increase the expression of hyperactive and inattentive symptoms in adolescents.
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New perspectives from microdialysis studies in freely-moving, spontaneously hypertensive rats on the pharmacology of drugs for the treatment of ADHD. Pharmacol Biochem Behav 2008; 90:184-97. [PMID: 18456311 DOI: 10.1016/j.pbb.2008.03.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 03/17/2008] [Accepted: 03/24/2008] [Indexed: 11/23/2022]
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Caylak E. A review of association and linkage studies for genetical analyses of learning disorders. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:923-43. [PMID: 17510947 DOI: 10.1002/ajmg.b.30537] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Learning disorders (LD) commonly comprise of a heterogeneous group of disorders manifested by unexpected problems in some children's experiences in the academic performance arena. These problems especially comprise of a variety of disorders which may be subclassified to attention-deficit hyperactivity disorder (ADHD), reading disability (RD), specific language impairment (SLI), speech-sound disorder (SSD), and dyspraxia. The aim of this review is to summarize the current molecular studies and some of the most exciting recent developments in molecular genetic research on LD. The findings for the association and linkage of LD with candidate genes will help to set the research agendas for future studies to follow.
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Affiliation(s)
- Emrah Caylak
- Department of Biochemistry and Clinical Biochemistry, Firat University, School of Medicine, Elazig, Turkey.
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Comings DE, Chen TJH, Blum K, Mengucci JF, Blum SH, Meshkin B. Neurogenetic interactions and aberrant behavioral co-morbidity of attention deficit hyperactivity disorder (ADHD): dispelling myths. Theor Biol Med Model 2005; 2:50. [PMID: 16375770 PMCID: PMC1352384 DOI: 10.1186/1742-4682-2-50] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Accepted: 12/23/2005] [Indexed: 11/23/2022] Open
Abstract
Background Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, is a common, complex, predominately genetic but highly treatable disorder, which in its more severe form has such a profound effect on brain function that every aspect of the life of an affected individual may be permanently compromised. Despite the broad base of scientific investigation over the past 50 years supporting this statement, there are still many misconceptions about ADHD. These include believing the disorder does not exist, that all children have symptoms of ADHD, that if it does exist it is grossly over-diagnosed and over-treated, and that the treatment is dangerous and leads to a propensity to drug addiction. Since most misconceptions contain elements of truth, where does the reality lie? Results We have reviewed the literature to evaluate some of the claims and counter-claims. The evidence suggests that ADHD is primarily a polygenic disorder involving at least 50 genes, including those encoding enzymes of neurotransmitter metabolism, neurotransmitter transporters and receptors. Because of its polygenic nature, ADHD is often accompanied by other behavioral abnormalities. It is present in adults as well as children, but in itself it does not necessarily impair function in adult life; associated disorders, however, may do so. A range of treatment options is reviewed and the mechanisms responsible for the efficacy of standard drug treatments are considered. Conclusion The genes so far implicated in ADHD account for only part of the total picture. Identification of the remaining genes and characterization of their interactions is likely to establish ADHD firmly as a biological disorder and to lead to better methods of diagnosis and treatment.
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Affiliation(s)
- David E Comings
- Director, Carlsbad Science Foundation, Emeritus Professor City of Hope Medical Center, Duarte, California, USA
| | | | - Kenneth Blum
- Wake Forest University School Of Medicine, Department Physiology & Pharmacology, Medical Center Boulevard, Winston -Salem, North Carolina, Salugen, Inc. San Diego, California, USA
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Collett BR, Ohan JL, Myers KM. Ten-year review of rating scales. V: scales assessing attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2003; 42:1015-37. [PMID: 12960702 DOI: 10.1097/01.chi.0000070245.24125.b6] [Citation(s) in RCA: 207] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHOD The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here. RESULTS Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad. CONCLUSIONS Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.
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Affiliation(s)
- Brent R Collett
- University of Washington School of Medicine at Children's Hospital and Regional Medical Center, Seattle, USA
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Konrad K, Gauggel S, Schurek J. Catecholamine functioning in children with traumatic brain injuries and children with attention-deficit/hyperactivity disorder. BRAIN RESEARCH. COGNITIVE BRAIN RESEARCH 2003; 16:425-33. [PMID: 12706222 DOI: 10.1016/s0926-6410(03)00057-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Recent studies suggest that children with attention-deficit/hyperactivity disorder (ADHD) and children with traumatic brain injuries (TBI) show changes in similar neuronal networks, including the dopaminergic (DA) and norepinephrinergic (NA) systems. Therefore, indirect measures of catecholamine activity were assessed. Twenty-six children with TBI, 31 children with ADHD, and 26 normal controls, 8 to 12 years of age, were investigated with a 90-min cognitive test battery. Before and after the tests, urine samples were collected to measure catecholamine activity in response to cognitive stress. Spontaneous eyeblinking as an indirect measure of DA activity was counted. Children with TBI and ADHD excreted significantly more normetanephrine in resting situations and less epinephrine (EPI) after cognitive stress, and showed a decreased blink rate compared to normal controls. Children with TBI also showed a higher excretion of metanephrine in the resting situation in comparison to children with ADHD and controls. Whereas children with ADHD showed a higher tonic activity of the NA system and a less adaptive EPI excretion in response to cognitive stress, children with TBI seem to be additionally impaired in their tonic EPI excretion. Our study provides further support for similar but also different neurobiochemical characteristics in both groups.
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Affiliation(s)
- Kerstin Konrad
- Department of Child and Adolescent Psychiatry, RWTH Aachen, Neuenhofer Weg 21, D-52074 Aachen, Germany.
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Barr CL, Kroft J, Feng Y, Wigg K, Roberts W, Malone M, Ickowicz A, Schachar R, Tannock R, Kennedy JL. The norepinephrine transporter gene and attention-deficit hyperactivity disorder. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 114:255-9. [PMID: 11920844 DOI: 10.1002/ajmg.10193] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The adrenergic system plays a known role in attentional systems and a suspected causal role in attention-deficit hyperactivity disorder (ADHD), based on evidence from pharmacological interventions and animal models. The efficacy of the highly selective noradrenergic reuptake inhibitor, tomoxetine, in treating ADHD symptoms supports the system's role in ADHD and points to the norephinephrine transporter as a candidate gene. This study tested the gene for the norepinephrine transporter (NET1) as a susceptibility factor in ADHD using three polymorphisms located in exon 9, intron 9, and intron 13. We examined the inheritance of these polymorphisms in a sample of 122 families with a total of 155 children with ADHD identified through an ADHD proband. Use of the transmission disequilibrium test failed to show significant evidence for biased transmission of any of the alleles or the haplotypes of these polymorphisms. We further investigated this gene by screening the probands for five known amino acid variants to determine if they contributed to the ADHD phenotype but observed only one (Thr99Ile) in our sample. Since the frequency of this variant (1.8%) was similar to that previously reported in a control sample (2.2%), it is unlikely that this variant is related to the ADHD phenotype. Our results do not support the NET1 gene as a major genetic susceptibility factor in ADHD.
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Affiliation(s)
- Cathy L Barr
- Department of Psychiatry and Division of Cellular and Molecular Biology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Oades RD. Dopamine may be 'hyper' with respect to noradrenaline metabolism, but 'hypo' with respect to serotonin metabolism in children with attention-deficit hyperactivity disorder. Behav Brain Res 2002; 130:97-102. [PMID: 11864724 DOI: 10.1016/s0166-4328(01)00440-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Noradrenaline: Hechtman (J Psychiat Neurosci 1994;19:193) argued for a role for frontal dopamine (DA) and noradrenaline (NA) in ADHD, where Oades (Prog Neurobiol 1987;29:365) has described lateralised functional impairments. Mechanisms (e.g. via alpha-2 sites) for stimulating low NA activity in ADHD children (J Am Acad Child Adolesc Psychiatry 1997;36:1688) in order to promote interactions with mesocortical DA have been discussed (J Psychopharmacology 1997;11:151; Psychiatr Res 1994;52:305). We described with indicators of overall transmitter metabolism (monoamines, metabolites in 24 h urine samples (Behav Brain Res 1997;88:95)) significantly lower utilisation ratios (MHPG/NA) in ADHD children with respect to healthy controls. Interestingly, a comparison of between catecholamine levels (DA/NA) showed a correlation with the conditioned blocking measure of selective attention recorded at the time of collection. This measure was negatively associated with blocking in controls. These results are consistent with reports of lower DOPEG and increased DOPAC in ADHD urine (J Child Adolesc Psychopharmacol 1996;6:63) and indicate that the relatively hyperactive DA versus NA systems may have functional consequences. Serotonin: the relevance for ADHD of an association of impulsivity with low serotonin (5-HT) metabolism (Behav Brain Sci 1986;9:319) has long been played down. Yet, some symptoms have been related to CSF measures of the metabolite 5-HIAA, and in particular the HVA/5-HIAA ratio has been reported to correlate with ratings of activity (Psychiatr Res 1994;52:305). We find that while urinary measures of 5-HIAA are somewhat higher, the ratio HVA/5-HIAA is markedly lower in ADHD children versus controls. In these ADHD children 5-HIAA levels were negatively related to d-prime measures in a continuous performance task (CPTax), and the HVA/5-HIAA was negatively associated with conditioned blocking. These results suggest a relatively low DA versus 5-HT activity may have functional consequences, albeit in a subgroup of ADHD. This is consistent with drug-induced prolactin changes reported by Verbaten et al. (Eur Child Adolesc Psychiatry 1999;8:30).
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Affiliation(s)
- Robert D Oades
- Biopsychology Group, University Clinic for Child and Adolescent Psychiatry, Virchowstr 174, 45147 Essen, Germany.
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17
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Spivak B, Vered Y, Yoran-Hegesh R, Graff E, Averbuch E, Vinokurow S, Weizman A, Mester R. The influence of three months of methylphenidate treatment on platelet-poor plasma biogenic amine levels in boys with attention deficit hyperactivity disorder. Hum Psychopharmacol 2001; 16:333-337. [PMID: 12404569 DOI: 10.1002/hup.298] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is related to dysregulation in the activity of brain monoamines. The aim of the present study was to assess the impact of three months' methylphenidate (MPH) treatment on platelet-poor plasma (PPP) norepinephrine (NE), dopa and serotonin (5-HT) levels as well as on ADHD symptomatology. Three months of MPH treatment in 16 ADHD boys, aged 11.4 +/- 1.6 years, resulted in a significant reduction in PPP NE levels (p < 0.05). A tendency towards a reduction of PPP 5-HT and dopa levels was detected (p < 0.1 for both). The decrease in PPP biogenic amine levels after three months of MPH treatment was accompanied by a significant reduction in all psychometric characteristics of ADHD. This result indicates the possible role of overactivity of the noradrenergic system in the pathophysiology of ADHD and suggests that the MPH therapeutic action may be related to stimulant-induced inhibitory effect on the noradrenergic system. Copyright 2001 John Wiley & Sons, Ltd.
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Affiliation(s)
- B. Spivak
- Research Unit, Ness Ziona Mental Health Center, Tel. Aviv, Israel
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18
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Comings DE. Clinical and molecular genetics of ADHD and Tourette syndrome. Two related polygenic disorders. Ann N Y Acad Sci 2001; 931:50-83. [PMID: 11462757 DOI: 10.1111/j.1749-6632.2001.tb05773.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ADHD is a polygenic disorder due to the additive effect of genes affecting dopamine, norepinephrine, serotonin, GABA, and other neurotransmitters. Some of the specific loci involved are dopamine genes--DRD2, DRD4, DRD5, and the dopamine transporter; norepinephrine (NE) and epinephrine (EPI) genes--dopamine beta-hydroxylase, ADRA2A, ADRA2C, PNMT, norepinephrine transporter, MAOA, COMT; serotonin genes--TDO2, HTR1A, HTR1DA, serotonin transporter; GABA genes--GABRB3; androgen receptor and other genes. This model is consistent with all of the present knowledge about ADHD including (a) the increased frequency of ADHD in the relatives of ADHD probands, (b) the presence of a wide spectrum of comorbid behaviors (depression, anxiety, learning, conduct, oppositional-defiant, conduct and substance abuse disorders) in ADHD probands and their relatives on both parental sides, (c) the close relationship to Tourette syndrome (TS), (d) the failure to find the genes for TS using linkage analysis, (e) the brain imaging studies showing hypometabolism of the frontal lobes, (f) the relationship between dopamine D2 receptor density and regional blood flow, (g) the correlation between tics and dopamine D2 receptor density in TS, (h) the motor hyperactivity of dopamine transporter and dopamine D3 receptor gene knockout mice, (i) the LeMoal and Shaywitz dopamine deficiency animal models of ADHD, (j) the NE models of ADHD, (k) the failure to explain ADHD on the basis of any single neurotransmitter defect, (l) the response of ADHD to dopamine and alpha 2-adrenergic agonists, (m) the small percentage of the variance of specific behaviors accounted for by each gene, and numerous other aspects of ADHD. The implications of the polygenic model for the understanding, diagnosis and treatment of ADHD and TS, as well as other psychiatric disorders, are reviewed.
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Affiliation(s)
- D E Comings
- Department of Medical Genetics, City of Hope Medical Center, Duarte, California 91010, USA.
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19
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Barr CL, Wigg K, Zai G, Roberts W, Malone M, Schachar R, Tannock R, Kennedy JL. Attention-deficit hyperactivity disorder and the adrenergic receptors alpha 1C and alpha 2C. Mol Psychiatry 2001; 6:334-7. [PMID: 11326305 PMCID: PMC4833494 DOI: 10.1038/sj.mp.4000863] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2000] [Revised: 12/04/2000] [Accepted: 12/04/2000] [Indexed: 11/08/2022]
Abstract
The adrenergic system has been hypothesized to be involved in the etiology of attention-deficit hyperactivity disorder (ADHD) based on pharmacological interventions and animal models. Noradrenergic neurons are implicated in the modulation of vigilance, improvement of visual attention, initiation of adaptive response, learning and memory. In this study we tested the genes for two adrenergic receptors, alpha 1C (ADRA1C) located on chromosome 8p11.2, and alpha 2C (ADRA2C) located on chromosome 4p16, as genetic susceptibility factors in ADHD. For the adrenergic receptor alpha 1C we used a C to T polymorphism that results in a change of Cys to Arg at codon 492 for the linkage study. For the adrenergic receptor alpha 2C gene we examined a dinucleotide repeat polymorphism located approximately 6 kb from the gene. We examined these polymorphisms in a sample of 103 families ascertained through an ADHD proband. Using the transmission disequilibrium test, we did not observe biased transmission of any of the alleles of these polymorphisms. We conclude that the alleles at the polymorphisms tested in these two genes are not linked to the ADHD phenotype in this sample of families.
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Affiliation(s)
- C L Barr
- Department of Psychiatry, The Toronto Western Hospital, Toronto, Ontario, Canada.
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20
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Comings DE, Blum K. Reward deficiency syndrome: genetic aspects of behavioral disorders. PROGRESS IN BRAIN RESEARCH 2001; 126:325-41. [PMID: 11105655 DOI: 10.1016/s0079-6123(00)26022-6] [Citation(s) in RCA: 419] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The dopaminergic and opioidergic reward pathways of the brain are critical for survival since they provide the pleasure drives for eating, love and reproduction; these are called 'natural rewards' and involve the release of dopamine in the nucleus accumbens and frontal lobes. However, the same release of dopamine and production of sensations of pleasure can be produced by 'unnatural rewards' such as alcohol, cocaine, methamphetamine, heroin, nicotine, marijuana, and other drugs, and by compulsive activities such as gambling, eating, and sex, and by risk taking behaviors. Since only a minority of individuals become addicted to these compounds or behaviors, it is reasonable to ask what factors distinguish those who do become addicted from those who do not. It has usually been assumed that these behaviors are entirely voluntary and that environmental factors play the major role; however, since all of these behaviors have a significant genetic component, the presence of one or more variant genes presumably act as risk factors for these behaviors. Since the primary neurotransmitter of the reward pathway is dopamine, genes for dopamine synthesis, degradation, receptors, and transporters are reasonable candidates. However, serotonin, norepinephrine, GABA, opioid, and cannabinoid neurons all modify dopamine metabolism and dopamine neurons. We have proposed that defects in various combinations of the genes for these neurotransmitters result in a Reward Deficiency Syndrome (RDS) and that such individuals are at risk for abuse of the unnatural rewards. Because of its importance, the gene for the [figure: see text] dopamine D2 receptor was a major candidate gene. Studies in the past decade have shown that in various subject groups the Taq I A1 allele of the DRD2 gene is associated with alcoholism, drug abuse, smoking, obesity, compulsive gambling, and several personality traits. A range of other dopamine, opioid, cannabinoid, norepinephrine, and related genes have since been added to the list. Like other behavioral disorders, these are polygenically inherited and each gene accounts for only a small per cent of the variance. Techniques such as the Multivariate Analysis of Associations, which simultaneously examine the contribution of multiple genes, hold promise for understanding the genetic make up of polygenic disorders.
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MESH Headings
- Attention Deficit Disorder with Hyperactivity/genetics
- Behavior, Addictive/genetics
- Carrier Proteins/genetics
- Carrier Proteins/physiology
- Central Nervous System Stimulants/pharmacology
- Compulsive Behavior/genetics
- Dangerous Behavior
- Dopamine beta-Hydroxylase/genetics
- Exploratory Behavior
- Genetic Heterogeneity
- Genetic Predisposition to Disease
- Humans
- Impulsive Behavior/genetics
- Models, Neurological
- Monoamine Oxidase/genetics
- Neurotransmitter Agents/metabolism
- Neurotransmitter Agents/physiology
- Nucleus Accumbens/drug effects
- Nucleus Accumbens/physiology
- Opioid Peptides/genetics
- Opioid Peptides/physiology
- Polymorphism, Restriction Fragment Length
- Prefrontal Cortex/drug effects
- Prefrontal Cortex/physiology
- Receptors, Adrenergic/drug effects
- Receptors, Adrenergic/genetics
- Receptors, Cannabinoid
- Receptors, Dopamine D2/drug effects
- Receptors, Dopamine D2/genetics
- Receptors, Dopamine D2/physiology
- Receptors, Dopamine D4
- Receptors, Drug/drug effects
- Receptors, Drug/genetics
- Receptors, Neurotransmitter/drug effects
- Receptors, Neurotransmitter/genetics
- Receptors, Neurotransmitter/physiology
- Reward
- Satiation/physiology
- Self Stimulation/physiology
- Stress Disorders, Post-Traumatic/genetics
- Stress Disorders, Post-Traumatic/physiopathology
- Substance-Related Disorders/genetics
- Tourette Syndrome/genetics
- Tourette Syndrome/physiopathology
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Affiliation(s)
- D E Comings
- Department of Medical Genetics, City of Hope Medical Center, Duarte, CA 91010, USA.
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21
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Xu C, Schachar R, Tannock R, Roberts W, Malone M, Kennedy JL, Barr CL. Linkage study of the α2A adrenergic receptor in attention-deficit hyperactivity disorder families. ACTA ACUST UNITED AC 2001. [DOI: 10.1002/1096-8628(2001)9999:9999<::aid-ajmg1160>3.0.co;2-b] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Neurobiological models of attention-deficit/hyperactivity disorder: a brief review of the empirical evidence. CNS Spectr 2000; 5:34-44. [PMID: 18268457 DOI: 10.1017/s1092852900007057] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric disorder characterized by inattention, impulsivity, and overactivity that begins in childhood. While considerable research has focused on the neurobiological substrates of this disorder, the specific nature of the brain dysfunction in ADHD has remained elusive. However, early data from pharmacological treatment studies, as well as from basic research in animals and humans, initially led several investigators to develop neurobiological models of ADHD. These models of ADHD and more recent evidence from neuropsychological, neuroimaging, neurochemical, and genetic research are briefly reviewed. While not completely consistent, the empirical data suggest that dysfunction in prefrontal-striatal neural circuits, as well as in brain stem catecholamine systems that innervate these circuits, may underlie the executive function deficits in ADHD.
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23
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Olincy A, Ross RG, Harris JG, Young DA, McAndrews MA, Cawthra E, McRae KA, Sullivan B, Adler LE, Freedman R. The P50 auditory event-evoked potential in adult attention-deficit disorder: comparison with schizophrenia. Biol Psychiatry 2000; 47:969-77. [PMID: 10838065 DOI: 10.1016/s0006-3223(00)00239-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and schizophrenia are both conceptualized as disorders of attention. Failure to inhibit the P50 auditory event-evoked response, extensively studied in schizophrenia, could also occur in ADHD patients, if these two illnesses have common underlying neurobiological substrates. METHODS This study examined the inhibition of the P50 auditory event-evoked potential in 16 unmedicated adults with ADHD, 16 schizophrenic outpatients, and 16 normal control subjects. Auditory stimuli were presented in a paired stimulus, conditioning-testing paradigm. RESULTS The amplitude of initial or conditioning P50 response did not differ between the three groups; however, significant effects of psychiatric diagnosis on the amplitude of the test response and the ratio of the test to the conditioning response amplitudes were observed. Schizophrenic patients' P50 ratios and test amplitudes were higher than both the ADHD and normal groups. CONCLUSIONS Adults with ADHD do not have the inhibitory deficit seen in patients with schizophrenia, suggesting that the mechanism of attentional disturbance in the two illnesses may be fundamentally different.
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Affiliation(s)
- A Olincy
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver 80262, USA
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24
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Bonafina MA, Newcorn JH, McKay KE, Koda VH, Halperin JM. ADHD and reading disabilities: a cluster analytic approach for distinguishing subgroups. JOURNAL OF LEARNING DISABILITIES 2000; 33:297-307. [PMID: 15505967 DOI: 10.1177/002221940003300307] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Data suggest that children with reading disability (RD) and non-RD children with attention-deficit/hyperactivity disorder (ADHD) may comprise distinct subgroups. Research has been hampered by variance in definitional criteria, which results in the study of different subgroups of children. Using cluster analysis, this study empirically divided children with ADHD (N = 54), based on their Full Scale IQ (FSIQ) and reading ability. Four distinct subgroups emerged in which cognitive, behavioral, and neurochemical function was compared. Cluster 1 was of average FSIQ and reading scores; Cluster 2 was of average FSIQ but showed impairment in reading; Cluster 3 had high FSIQ and reading scores; and Cluster 4 had low scores in both domains. The groups had different patterns of cognitive, behavioral, and neurochemical function, as determined by discrepancies in Verbal-Performance IQ, academic achievement scores, parent aggression ratings, and a measure of noradrenergic function. These distinctions are discussed with regard to etiology, treatment, and long-term outcome.
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Affiliation(s)
- M A Bonafina
- The City University of New York, Flushing 11367-1597, USA
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25
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Anderson GM, Dover MA, Yang BP, Holahan JM, Shaywitz SE, Marchione KE, Hall LM, Fletcher JM, Shaywitz BA. Adrenomedullary function during cognitive testing in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2000; 39:635-43. [PMID: 10802982 DOI: 10.1097/00004583-200005000-00018] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Reported correlations between epinephrine (EPI) excretion and classroom performance, the cognition-enhancing effects of EPI infusion, increased EPI excretion with stimulants, and reports of decreased EPI excretion in attention-deficit/hyperactivity disorder (ADHD) suggest that sympathoadrenomedullary function might be altered in ADHD. This hypothesis was tested by examining sympathetic and adrenomedullary functioning during cognitive testing in boys with diagnosed ADHD. METHOD Urinary excretion of EPI and norepinephrine during a 3-hour cognitive test battery was assessed in 7- to 13-year-old boys. Excretion rates (nanograms per hour per square meter of body surface area) were determined in 200 individuals with ADHD (diagnosed according to DSM-IV criteria), with or without co-occurring oppositional defiant/conduct disorder or learning disorder. A non-ADHD contrast group (n = 51) with similar comorbidity was also studied. RESULTS Substantially lower (mean +/- SE) urinary EPI excretion was observed in the ADHD-inattentive subtype (n = 71) compared with the control group (200 +/- 22 versus 278 +/- 24 ng/hr/m2; F = 5.99, p = .015, critical alpha = .017). No diagnostic group differences were seen for norepinephrine excretion. Correlational analysis of both parent- and teacher-rated behaviors revealed that inattention factors consistently negatively predicted urinary EPI excretion. CONCLUSIONS The data extend findings of lower adrenomedullary activity during cognitive challenge in individuals with ADHD and suggest that the alteration is associated with inattentive behavior.
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Affiliation(s)
- G M Anderson
- Child Study Center, Yale University School of Medicine, New Haven, CT 06510, USA.
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26
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Oades RD. Differential measures of 'sustained attention' in children with attention-deficit/hyperactivity or tic disorders: relations to monoamine metabolism. Psychiatry Res 2000; 93:165-78. [PMID: 10725533 DOI: 10.1016/s0165-1781(00)00105-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Controversy exists on whether the constructs tested by paper/pencil and computerized continuous-performance tests (CPT) are similar, and the deficits recorded in children with attention-deficit/hyperactivity symptoms (ADHD) are comparable. Signal-detection measures were recorded on four such tests of 'sustained attention', with increasing working-memory requirements in healthy children (14; mean 10 years), and those with ADHD (14; mean 10 years) or a tic syndrome (TS, 11; mean 11 years). Clinical associations were sought from 24-h urinary measures of monoamine activity. The cancellation paper/pencil test revealed no group differences for errors or signal detection measures. On the CPT, ADHD children made more omission and commission errors than control subjects, but TS children made mostly omissions. This reflected the poor perceptual sensitivity (d-prime, d') for ADHD and conservative response criteria (beta) for TS children. This group difference extended to the CPTax, which was shown on a regression analysis to test for putative working-memory-related abilities as well as concentration. In all children, immediate response-feedback reduced omissions, and modestly improved d'. CPTax performance related negatively to dopamine metabolism in control subjects and to serotonin metabolism in the ADHD group. But comparisons between the metabolites in the ADHD group suggest that increased serotonin and decreased noradrenaline, with respect to dopamine metabolism, may detract from CPT performance in terms of d'. CPT tasks demonstrated a perceptual-based impairment in ADHD and response conservatism in TS patients independent of difficulty. Catecholamine activity was implicated in the promotion of perceptual processing in normal and ADHD children, but serotonin activity may contribute to poor CPTax (working-memory) performance in ADHD patients.
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Affiliation(s)
- R D Oades
- University Clinic for Child and Adolescent Psychiatry, Virchowstr. 174, 45147, Essen, Germany.
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27
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Comings DE, Gade-Andavolu R, Gonzalez N, Wu S, Muhleman D, Blake H, Dietz G, Saucier G, MacMurray JP. Comparison of the role of dopamine, serotonin, and noradrenaline genes in ADHD, ODD and conduct disorder: multivariate regression analysis of 20 genes. Clin Genet 2000; 57:178-96. [PMID: 10782925 DOI: 10.1034/j.1399-0004.2000.570304.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present study is based on the proposal that complex disorders resulting from the effects of multiple genes are best investigated by simultaneously examining multiple candidate genes in the same group of subjects. We have examined the effect of 20 genes for dopamine, serotonin, and noradrenergic metabolism on a quantitative score for attention deficit hyperactivity disorder (ADHD) in 336 unrelated Caucasian subjects. The genotypes of each gene were assigned a score from 0 to 2, based on results from the literature or studies in an independent set of subjects (literature-based scoring), or results based on analysis of variance for the sample (optimized gene scoring). Multivariate linear regression analysis with backward elimination was used to determine which genes contributed most to the phenotype for both coding methods. For optimized gene scoring, three dopamine genes contributed to 2.3% of the variance, p = 0.052; three serotonin genes contributed to 3%, p = 0.015; and six adrenergic genes contributed to 6.9%, p = 0.0006. For all genes combined, 12 genes contributed to 11.6% of the variance, p = 0.0001. These results indicate that the adrenergic genes play a greater role in ADHD than either the dopaminergic or serotonergic genes combined. The results using literature-based gene scoring were similar. An examination of two additional comorbid phenotypes, conduct disorder and oppositional defiant disorder (ODD), indicated they shared genes with ADHD. For ODD different genotypes of the same genes were often used. These results support the value of the simultaneous examination of multiple candidate genes.
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Affiliation(s)
- D E Comings
- Department of Medical Genetics, City of Hope Medical Center, Duarte, CA 91010, USA.
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28
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Bolonna AA, Arranz MJ, Munro J, Osborne S, Petouni M, Martinez M, Kerwin RW. No influence of adrenergic receptor polymorphisms on schizophrenia and antipsychotic response. Neurosci Lett 2000; 280:65-8. [PMID: 10696813 DOI: 10.1016/s0304-3940(99)01000-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The adrenergic system plays an important role in psychiatric disorders such as depression and schizophrenia. Antagonism of the adrenergic receptor subtypes alpha1A and alpha2A has been found to have an antipsychotic effect. Genetic mutations in these receptors could be related to the alterations in the adrenergic system observed in psychiatric patients and to failure to respond to drug antagonism. We have studied one polymorphism in the alpha1A-adrenergic receptor (Arg492Cys) and two polymorphisms in the promoter region of the alpha2A-adrenergic receptor (-1291-C/G and -261-G/A) in a sample of clozapine-treated schizophrenic patients and controls. No clear differences were observed between the different groups suggesting that these polymorphisms did not play an important role in the aetiology of the disorder or in determining antipsychotic response.
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Affiliation(s)
- A A Bolonna
- Department of Psychological Medicine, Institute of Psychiatry, London, UK
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29
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Abstract
ADHD is a highly prevalent condition with the core symptoms of functionally impairing limitations in sustained attention and impulsivity/overactivity. Other frequent symptoms include overemotionality or overreactivity, academic underachievement, low self-esteem, and interpersonal difficulties. The assessment for and diagnosis of ADHD are complicated by the lack of a specific test or marker for the disorder, the occurrence of symptoms along a continuum in the population, and its frequent association with other neurodevelopmental and psychiatric disorders. Due to the often pervasive effects of these symptoms and their chronicity, treatment generally must be multifaceted and prolonged. Neuropsychological studies suggest that individuals with ADHD may have their most salient difficulties in the areas of organizing, preparing, and inhibiting responses. Neurobiologic studies suggest that the circuitry involving frontal cortical-basal ganglia connections may be structurally or functionally different in individuals with ADHD, although the specificity of these findings has not been researched thoroughly. ADHD symptoms are highly, although not entirely, heritable. Many questions remain as to the specifics of etiology and best treatment practices.
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Affiliation(s)
- M Mercugliano
- Division of Developmental/Behavioral Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, USA
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30
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Comings DE, Gade-Andavolu R, Gonzalez N, Blake H, Wu S, MacMurray JP. Additive effect of three noradrenergic genes (ADRA2a, ADRA2C, DBH) on attention-deficit hyperactivity disorder and learning disabilities in Tourette syndrome subjects. Clin Genet 1999; 55:160-72. [PMID: 10334470 DOI: 10.1034/j.1399-0004.1999.550304.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Halperin et al. (Halperin JM. Newcorn JH, Koda VH, Pick L, McKay KE, Knott P. Noradrenergic mechanisms in ADHD children with and without reading disabilities: a replication and extension. J Am Acad Child Adolesc Psychiatry 1997: 36: 1688 1696) reported a significant increase in plasma norepinephrine (NE) in attention-deficit hyperactivity disorder (ADHD) children with reading and other cognitive disabilities compared to ADHD children without learning disabilities (LD). We examined the hypothesis that ADHD + LD was associated with NE dysfunction at a molecular genetic level by testing for associations and additive effects between polymorphisms at three noradrenergic genes the adrenergic alpha2A receptor (ADRA2A), adrenergic alpha2C receptor (ADRA2C), and dopamine beta-hydroxylase (DBH) genes. A total of 336 subjects consisting of 274 individuals with Tourette syndrome (TS) and 62 normal controls were genotyped. Regression analysis showed a significant correlation between scores for ADHD, a history of LD, and poor grade-school academic performance that was greatest for the additive effect of all three genes. Combined, these three genes accounted for 3.5% of the variance of the ADHD score (p = 0.0005). There was a significant increase in the number of variant NE genes progressing from subjects without ADHD (A-) or learning disorders (LD-) to A + LD - to A - LD + to A + LD + (p = 0.0017), but no comparable effect for dopamine genes. These data support an association between NE genes and ADHD, especially in ADHD + LD subjects.
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Affiliation(s)
- D E Comings
- Department of Medical Genetics, City of Hope Medical Center, Duarte, CA 91010, USA
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