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Sif-Eddine W, Ba-M'hamed S, Lefranc B, Leprince J, Boukhzar L, Anouar Y, Bennis M. Selenoprotein T, a potential treatment of attention-deficit/hyperactivity disorder and comorbid pain in neonatal 6-OHDA lesioned mice. Exp Mol Pathol 2024; 137:104905. [PMID: 38797131 DOI: 10.1016/j.yexmp.2024.104905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
pathological pain and Attention-deficit/hyperactivity disorder (ADHD) are two complex multifactorial syndromes. The comorbidity of ADHD and altered pain perception is well documented in children, adolescents, and adults. According to pathophysiological investigations, the dopaminergic system's dysfunction provides a common basis for ADHD and comorbid pain. Growing evidence suggests that oxidative stress may be crucial in both pathologies. Recent studies revealed that a small peptide encompassing the redox-active site of selenoprotein T (PSELT), protects dopaminergic neurons and fibers as well as lesioned nerves in animal models. The current study aims to examine the effects of PSELT treatment on ADHD-like symptoms and pain sensitivity, as well as the role of catecholaminergic systems in these effects. Our results demonstrated that intranasal administration of PSELT reduced the hyperactivity in the open field, decreased the impulsivity displayed by 6-OHDA-lesioned male mice in the 5-choice serial reaction time task test and improved attentional performance. In addition, PSELT treatment significantly increased the nociception threshold in both normal and inflammatory conditions. Furthermore, anti-hyperalgesic activity was antagonized with sulpiride pre-treatment, but not by phentolamine, or propranolol pre-treatments. The present study suggests that PSELT reduces the severity of ADHD symptoms in mice and possesses potent antinociceptive effects which could be related to the involvement of D2/D3 dopaminergic receptors.
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Affiliation(s)
- Wahiba Sif-Eddine
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Marrakesh, Morocco
| | - Saadia Ba-M'hamed
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Marrakesh, Morocco
| | - Benjamin Lefranc
- Univ Rouen Normandie, INSERM, NorDiC, UMR 1239, Rouen, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Jérôme Leprince
- Univ Rouen Normandie, INSERM, NorDiC, UMR 1239, Rouen, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Loubna Boukhzar
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Marrakesh, Morocco; Univ Rouen Normandie, INSERM, NorDiC, UMR 1239, Rouen, France; Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Youssef Anouar
- Univ Rouen Normandie, INSERM, NorDiC, UMR 1239, Rouen, France; Institute for Research and Innovation in Biomedicine, Rouen, France.
| | - Mohamed Bennis
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Marrakesh, Morocco
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Turner D, Gregório Hertz P, Biedermann L, Barra S, Retz W. Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality. Int J Impot Res 2024:10.1038/s41443-024-00891-w. [PMID: 38637719 DOI: 10.1038/s41443-024-00891-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ2 = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ2 = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
| | | | - Laura Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, University Medical Center Homburg, Homburg, Germany
| | - Wolfgang Retz
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Institute for Forensic Psychology and Psychiatry, University Medical Center Homburg, Homburg, Germany
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Tosta A, Fonseca AS, Messeder D, Ferreira ST, Lourenco MV, Pandolfo P. Effects of Gestational Exercise on Nociception, BDNF, and Irisin Levels in an Animal Model of ADHD. Neuroscience 2024; 543:37-48. [PMID: 38401710 DOI: 10.1016/j.neuroscience.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/25/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
Abnormal cognitive and sensorial properties have been reported in patients with psychiatric and neurodevelopmental conditions, such as attention deficit hyperactivity disorder (ADHD). ADHD patients exhibit impaired dopaminergic signaling and plasticity in brain areas related to cognitive and sensory processing. The spontaneous hypertensive rat (SHR), in comparison to the Wistar Kyoto rat (WKY), is the most used genetic animal model to study ADHD. Brain neurotrophic factor (BDNF), critical for midbrain and hippocampal dopaminergic neuron survival and differentiation, is reduced in both ADHD subjects and SHR. Physical exercise (e.g. swimming) promotes neuroplasticity and improves cognition by increasing BDNF and irisin. Here we investigate the effects of gestational swimming on sensorial and behavioral phenotypes, striatal dopaminergic parameters, and hippocampal FNDC5/irisin and BDNF levels observed in WKY and SHR. Gestational swimming improved nociception in SHR rats (p = 0.006) and increased hippocampal BDNF levels (p = 0.02) in a sex-dependent manner in adolescent offspring. Sex differences were observed in hippocampal FNDC5/irisin levels (p = 0.002), with females presenting lower levels than males. Our results contribute to the notion that swimming during pregnancy is a promising alternative to improve ADHD phenotypes in the offspring.
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Affiliation(s)
- Andréa Tosta
- Program of Neurosciences, Federal Fluminense University, Niterói, Brazil
| | - Ariene S Fonseca
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Débora Messeder
- Program of Neurosciences, Federal Fluminense University, Niterói, Brazil
| | - Sérgio T Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mychael V Lourenco
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pablo Pandolfo
- Program of Neurosciences, Federal Fluminense University, Niterói, Brazil; Program of Biomedical Sciences: Physiology and Pharmacology, Federal Fluminense University, Niterói, Brazil.
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Bou Sader Nehme S, Sanchez-Sarasua S, Adel R, Tuifua M, Ali A, Essawy AE, Abdel Salam S, Hleihel W, Boué-Grabot E, Landry M. P2X4 signalling contributes to hyperactivity but not pain sensitization comorbidity in a mouse model of attention deficit/hyperactivity disorder. Front Pharmacol 2024; 14:1288994. [PMID: 38239187 PMCID: PMC10794506 DOI: 10.3389/fphar.2023.1288994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction: Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by hyperactivity, inattention, and impulsivity that often persist until adulthood. Frequent comorbid disorders accompany ADHD and two thirds of children diagnosed with ADHD also suffer from behavioural disorders and from alteration of sensory processing. We recently characterized the comorbidity between ADHD-like symptoms and pain sensitisation in a pharmacological mouse model of ADHD, and we demonstrated the implication of the anterior cingulate cortex and posterior insula. However, few studies have explored the causal mechanisms underlying the interactions between ADHD and pain. The implication of inflammatory mechanisms has been suggested but the signalling pathways involved have not been explored. Methods: We investigated the roles of purinergic signalling, at the crossroad of pain and neuroinflammatory pathways, by using a transgenic mouse line that carries a total deletion of the P2X4 receptor. Results: We demonstrated that P2X4 deletion prevents hyperactivity in the mouse model of ADHD. In contrast, the absence of P2X4 lowered thermal pain thresholds in sham conditions and did not affect pain sensitization in ADHD-like conditions. We further analysed microglia reactivity and the expression of inflammatory markers in wild type and P2X4KO mice. Our results revealed that P2X4 deletion limits microglia reactivity but at the same time exerts proinflammatory effects in the anterior cingulate cortex and posterior insula. Conclusion: This dual role of P2X4 could be responsible for the differential effects noted on ADHD-like symptoms and pain sensitization and calls for further studies to investigate the therapeutic benefit of targeting the P2X4 receptor in ADHD patients.
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Affiliation(s)
- Sarah Bou Sader Nehme
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, IMN, UMR 5293, Bordeaux, France
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sandra Sanchez-Sarasua
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, IMN, UMR 5293, Bordeaux, France
- Faculty of Health Sciences, University of Jaume I, Castellon, Spain
| | - Ramy Adel
- Zoology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Marie Tuifua
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, IMN, UMR 5293, Bordeaux, France
| | - Awatef Ali
- Zoology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Amina E. Essawy
- Zoology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Sherine Abdel Salam
- Zoology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Walid Hleihel
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Eric Boué-Grabot
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, IMN, UMR 5293, Bordeaux, France
| | - Marc Landry
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, IMN, UMR 5293, Bordeaux, France
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Panušková K, Voděrová L, Vaculín Š. Methylphenidate attenuates signs of evoked neuropathic pain in animal model. Physiol Res 2023; 72:S551-S558. [PMID: 38165759 PMCID: PMC10861255 DOI: 10.33549/physiolres.935215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 09/07/2023] [Indexed: 02/01/2024] Open
Abstract
Methylphenidate is a psychostimulant that increases dopamine and noradrenaline levels. Recent studies have shown that methylphenidate potentiates the effect of morphine and together suppress acute and chronic pain. In clinical practice, methylphenidate has been used as a treatment for ADHD and changes of pain threshold have been noted in these patients. The aim of this study was to determine the effect of methylphenidate in an animal model of peripheral neuropathic pain. Neuropathic pain was modeled by the chronic constriction of the sciatic nerve (CCI) in Wistar rats. We evaluated the effect of methylphenidate (1 mg/kg, s.c.) on evoked pain (reflex tests - plantar test, vonFrey test and operant test - thermal place preference) and on spontaneous pain (conditioned place preference). CCI induced thermal, mechanical and cold hyperalgesia/allodynia. Methyphenidate suppressed mechanical and cold hyperalgesia/allodynia, while had no effect on thermal one. Therefore, methylphenidate seems to be a new potential pharmacotherapy for the treatment of neuropathic pain.
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Affiliation(s)
- K Panušková
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
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Rapp L, Mai-Lippold SA, Georgiou E, Pollatos O. Elevated EEG heartbeat-evoked potentials in adolescents with more ADHD symptoms. Biol Psychol 2023; 184:108698. [PMID: 37775030 DOI: 10.1016/j.biopsycho.2023.108698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Symptoms of attention deficit hyperactivity disorder (ADHD) are associated with a variety of mental abnormalities, but little is known about the perception and processing of internal signals, i.e., interoception, in individuals with ADHD symptoms. This study aimed to investigate the association between ADHD symptoms and the heartbeat-evoked potential (HEP), known as a neural correlate of automatic interoceptive processing of cardiac signals, in adolescents. METHODS HEPs of 47 healthy adolescent participants (53.2 % female) with a mean age of 14.29 years were measured during an emotional face recognition task. In addition, participants completed a self-report screening for ADHD symptoms. RESULTS ADHD symptoms were positively related to the HEP activity during the task in three of eight EEG sectors in the left hemisphere, as well as in all sectors in the right hemisphere. DISCUSSION This study is the first to demonstrate preliminary a relationship between the strength of HEP activity and ADHD symptoms in awake subjects. This finding of higher HEP amplitudes in subjects with more ADHD symptoms can be interpreted in terms of (i) increased arousal, (ii) altered neural processing of internal processes in an emotion-relevant task, and (iii) a misaligned precision-weighting process of task-irrelevant stimuli according to the predictive coding framework. These different interpretations could be reflected by previous studies showing heterogeneity of psychological deficits in individuals with ADHD symptoms. However, the generalizability to patients with diagnosed ADHD is limited due to the measurement tool for ADHD symptoms and the sample characteristics.
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Affiliation(s)
- Lorenz Rapp
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany.
| | - Sandra A Mai-Lippold
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | - Eleana Georgiou
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
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Bozkurt A, Balta S. The effect of methylphenidate on pain perception thresholds in children with attention deficit hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2023; 17:118. [PMID: 37833816 PMCID: PMC10576289 DOI: 10.1186/s13034-023-00667-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Pain perception is important in children with attention deficit hyperactivity disorder (ADHD) since they are more likely to experience painful events due to increased accident rates. The aim of this study is to contribute to the literature concerning the relationship between ADHD diagnosis, methylphenidate (MPH) therapy, and pain thresholds, since findings regarding the change in pain perception in children with ADHD are scarce and inconsistent. METHODS Children aged 8-13 years constituted both the ADHD group (n = 82) and the healthy controls (n = 41). The ADHD group was divided into two subgroups, ADHD without MPH (not treated pharmacologically) and ADHD with MPH (treated pharmacologically for at least three-months). The Conners' Parent Rating Scale-Revised: Short Form was employed to assess ADHD, a visual analog scale was applied to evaluate chronic pain severity, and a manual pressure algometer was used to assess pain thresholds. RESULT Children with ADHD had lower pain thresholds than the healthy controls (P < 0.05). However, lower regional pain thresholds were observed in the ADHD group without MPH compared to both the healthy control and ADHD with MPH groups. Although pain thresholds in the ADHD with MPH group were regionally lower than in the healthy controls, low pain thresholds were found in fewer regions compared to the ADHD without MPH group. CONCLUSIONS Children with ADHD are more sensitive to pain sensation, and MPH may help normalize these individuals' pain experiences by raising pain thresholds. Families and clinicians must be aware of situations that may cause pain in children with ADHD. In addition, these children's low threshold for pain may lead them to experience it more intensely.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Turkey.
| | - Selin Balta
- Department of Pain Medicine, University of Health Sciences, Konya, Turkey
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Lockinger K, Gagnon MM. Dysmenorrhea and psychological wellbeing among females with attention deficit hyperactivity disorder. J Health Psychol 2023; 28:1131-1142. [PMID: 37264597 PMCID: PMC10571436 DOI: 10.1177/13591053231177254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Although rarely examined together, ADHD, emotional regulation (ER), and dysmenorrhea may be associated, which could create additive burdens on psychological well-being (PWB). Clinicians working with ADHD populations may need to take these challenges into consideration to maximize treatment outcomes. This study investigated the relationships among ADHD, dysmenorrhea, ER, and PWB within a sample of 266 adult females with a self-reported ADHD diagnosis. ADHD symptom severity was positively correlated with dysmenorrhea severity, but ER skills were not a significant moderator of this relationship. ADHD symptom severity was negatively correlated with PWB; however, this relationship was not moderated by dysmenorrhea severity nor ER ability. Overall, a positive association between ADHD symptom severity and dysmenorrhea severity was found in our sample. Further research is needed to understand the nature of this association, as well as factors that may contribute to PWB among individuals with these comorbid conditions.
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Buchanan DM, Amare S, Gaumond G, D'Angiulli A, Robaey P. Safety and Tolerability of tDCS across Different Ages, Sexes, Diagnoses, and Amperages: A Randomized Double-Blind Controlled Study. J Clin Med 2023; 12:4346. [PMID: 37445385 DOI: 10.3390/jcm12134346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique with substantial evidence for its safety and tolerability in adults. However, less than 5% of published tDCS research is in pediatrics. Our primary objective was to investigate tDCS safety, tolerability, and acceptability in a sample of children and adults. We hypothesized that children and adults would be equal with regard to tDCS safety, tolerability, and acceptability. We tested this hypothesis using a Bayesian approach. Sixty participants aged 6-45 (balanced for sex) participated in a randomized double-blind controlled trial. They were randomly assigned to two ten-minute tDCS sessions with varying amperages and electrode locations. The primary outcome measure of this study was the intensity of 13 potential side effects evaluated at six different time points spanning two weeks. Independent sample Bayes factor tests were conducted between children/adults, males/females, clinical/healthy, and low/high amperage groups. As predicted, there was moderate support for the null hypothesis in all between-group analyses. There were no serious adverse events or dropouts, and the number needed to treat for an additional harmful outcome was 23. This study provided evidence supporting the overall short-term safety, tolerability, and acceptability of tDCS including amperages up to 2 mA and different electrode placements.
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Affiliation(s)
- Derrick M Buchanan
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuroscience of Imagination Cognition Emotion Research Lab, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuropsychiatric Lab, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Sarah Amare
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuroscience of Imagination Cognition Emotion Research Lab, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuropsychiatric Lab, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Genevieve Gaumond
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuroscience of Imagination Cognition Emotion Research Lab, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuropsychiatric Lab, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - Amedeo D'Angiulli
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuroscience of Imagination Cognition Emotion Research Lab, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Philippe Robaey
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- Neuropsychiatric Lab, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Zain E, Sugimoto A, Egawa J, Someya T. Case report: Methylphenidate improved chronic pain in an adult patient with attention deficit hyperactivity disorder. Front Psychiatry 2023; 14:1091399. [PMID: 36970292 PMCID: PMC10038200 DOI: 10.3389/fpsyt.2023.1091399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionChronic pain remains a health problem that is difficult to treat adequately. Its unknown cause and complex comorbidity with other illnesses, including mental disorders, amplify the severity of symptoms, which consequently decreases the quality of life of patients long term. In our clinical practice, we coincidentally found evidence that methylphenidate (MPH) effectively managed chronic pain in an adult patient with attention deficit hyperactivity disorder (ADHD). The effectiveness of MPH in the treatment of ADHD is well-established; however, its utility in treating pain remains unclear.Case presentationWe present a rare case of a 43-year-old male patient with 15 years of chronic idiopathic pain symptoms that did not adequately respond to standard pain management, such as acetaminophen, non-opioid analgesics, and muscle relaxers. Pain also persisted after treatments with antidepressants and an epidural block. Furthermore, symptoms worsened following several sessions of modified electroconvulsive therapy. After a thorough assessment at our child and adolescent psychiatric outpatient clinic, we confirmed a diagnosis of adult ADHD with a predominantly inattentive type. Considering this newly established diagnosis, we prescribed osmotic-release oral system (OROS) methylphenidate. Within 1 month of treatment at a dose of 18 mg/day of OROS-MPH, the patient’s chronic pain unexpectedly improved dramatically, and the patient no longer experienced pain symptoms. The dosage of OROS-MPH was titrated monthly, reaching 72 mg/day as a maintenance dose, and ADHD symptoms improved after 4 months of treatment. The patient was followed up regularly for 7 years during his OROS-MPH treatment. No adverse effects were reported, including stimulant addiction. He was stable overall and functioned well in his daily activities. His pain never recurred.ConclusionThis case report suggests that MPH may be potentially effective in treating chronic pain. Further studies are needed to confirm whether MPH improved chronic pain simultaneously with or separately from the improvement in ADHD. Moreover, elucidating the anatomical sites and molecular pharmacological mechanisms related to the action of MPH in pain modulation and perception is essential. Such sites include the descending dopaminergic pain pathway and higher cortical areas. Furthering our understanding may reinforce the justification for treating chronic pain using MPH.
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Affiliation(s)
- Ekachaeryanti Zain
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Psychiatry, Faculty of Medicine, Mulawarman University, Samarinda, Indonesia
| | - Atsunori Sugimoto
- Department of Community Psychiatric Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan
- *Correspondence: Atsunori Sugimoto,
| | - Jun Egawa
- Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Sifeddine W, Ba-M'hamed S, Landry M, Bennis M. Effect of atomoxetine on ADHD-pain hypersensitization comorbidity in 6-OHDA lesioned mice. Pharmacol Rep 2023; 75:342-357. [PMID: 36787018 DOI: 10.1007/s43440-023-00459-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Methylphenidate and atomoxetine are used for the treatment of attention-deficit/hyperactivity disorder (ADHD). Our previous studies established the validity of the 6-hydroxydopamine (6-OHDA) mouse model of ADHD and demonstrated hypersensitivity to pain, in line with clinical reports in ADHD patients. Acute methylphenidate treatment reduces hyperactivity and increases attention, but does not affect pain behaviors in this mouse model. Whereas atomoxetine has been shown to be effective against some symptoms of ADHD, nothing is known about its possible action on comorbid pain hypersensitivity. The objectives of the present research are (1) to investigate the effects of acute and chronic treatment with atomoxetine on ADHD-like symptoms and nociceptive thresholds, and (2) to explore the catecholaminergic systems underlying these effects. METHODS Sham and 6-OHDA cohorts of male mice were tested for hyperactivity (open field), attention and impulsivity (5-choice serial reaction time task test), and thermal (hot plate test) and mechanical (von Frey test) thresholds after acute or repeated treatment with vehicle or atomoxetine (1, 3 or 10 mg/kg). RESULTS Acute administration of atomoxetine (10 mg/kg) reduced the hyperactivity and impulsivity displayed by 6-OHDA mice, without affecting attention or nociception. However, atomoxetine administered at 3 mg/kg/day for 7 days alleviated the ADHD-like core symptoms and attenuated the hyperalgesic responses. Furthermore, hyperlocomotion and anti-hyperalgesic activity were antagonized with phentolamine, propranolol, and sulpiride pre-treatments. CONCLUSION These findings demonstrated that when administered chronically, atomoxetine has a significant effect on ADHD-associated pain hypersensitization, likely mediated by both α- and β-adrenergic and D2/D3 dopaminergic receptors, and suggest new indications for atomoxetine that will need to be confirmed by well-designed clinical trials.
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Affiliation(s)
- Wahiba Sifeddine
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco
| | - Saadia Ba-M'hamed
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco
| | - Marc Landry
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, UMR 5293, Bordeaux, France.,University of Bordeaux, CNRS, INSERM, Bordeaux Imaging Center, UMS 3420, US 4, Bordeaux, France
| | - Mohamed Bennis
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco.
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12
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Targeting Neuroinflammation with Abscisic Acid Reduces Pain Sensitivity in Females and Hyperactivity in Males of an ADHD Mice Model. Cells 2023; 12:cells12030465. [PMID: 36766806 PMCID: PMC9914171 DOI: 10.3390/cells12030465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome characterized by dopaminergic dysfunction. In this study, we aimed to demonstrate that there is a link between dopaminergic deficit and neuroinflammation that underlies ADHD symptoms. We used a validated ADHD mice model involving perinatal 6-OHDA lesions. The animals received abscisic acid (ABA), an anti-inflammatory phytohormone, at a concentration of 20 mg/L (drinking water) for one month. We tested a battery of behavior tests, learning and memory, anxiety, social interactions, and pain thresholds in female and male mice (control and lesioned, with or without ABA treatment). Postmortem, we analyzed microglia morphology and Ape1 expression in specific brain areas related to the descending pain inhibitory pathway. In females, the dopaminergic deficit increased pain sensitivity but not hyperactivity. In contrast, males displayed hyperactivity but showed no increased pain sensitivity. In females, pain sensitivity was associated with inflammatory microglia and lower Ape1 levels in the anterior cingulate cortex (ACC) and posterior insula cortex (IC). In addition, ABA treatment alleviated pain sensitivity concomitant with reduced inflammation and normalized APE1. In males, ABA reduced hyperactivity but had no significant effect on inflammation in these areas. This is the first study proving a sex-dependent association between dopamine dysfunction and inflammation in specific brain areas, hence leading to different behavioral outcomes in a mouse model of ADHD. These findings provide new clues for potential treatments for ADHD.
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Niburski K, Niburski O. Impact of Elon Musk’s Tweeting about Psychiatric Medication on the Internet, Media, and Purchasing: Observational Study. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2023. [DOI: 10.1080/15398285.2022.2133832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Kacper Niburski
- Faculty of Anesthesia, University of British Columbia, Vancouver, Canada
| | - Oskar Niburski
- Faculty of Computer Science, York University, Toronto, Canada
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14
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Leaver L, Parry A, Read H. Fibromyalgia and attention deficit hyperactivity disorder. Clin Med (Lond) 2023; 23:100. [PMID: 36697007 PMCID: PMC11046556 DOI: 10.7861/clinmed.let.23.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Laurence Leaver
- Jericho Health Centre, Oxford, UK and fellow, Green Templeton College, Oxford University, Oxford, UK
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15
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Grossman A, Avital A. Emotional and sensory dysregulation as a possible missing link in attention deficit hyperactivity disorder: A review. Front Behav Neurosci 2023; 17:1118937. [PMID: 36935890 PMCID: PMC10017514 DOI: 10.3389/fnbeh.2023.1118937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a common developmental disorder affecting 5-7% of adults and children. We surveyed the literature to examine ADHD through three pillars: developmental characteristics, symptomatology, and treatment strategies. Firstly, in terms of developmental characterstics, early life stress may increase the risk of developing ADHD symptoms according to animal models' research. Secondly, the current core symptoms of ADHD are comprised of inattention, hyperactivity, and impulsivity. However, the up-to-date literature indicates individuals with ADHD experience emotional and sensory dysregulation as well, which early-life stress may also increase the risk of. Finally, we discuss the therapeutic benefits of methylphenidate on both the current core ADHD symptoms and the sensory and emotional dysregulation found in those with ADHD. In summation, we surveyed the recent literature to analyze (i) the potential role of early-life stress in ADHD development, (ii) the involvement of emotional and sensory dysregulation in ADHD symptomatology and finally, (iii) the therapeutic intervention with methylphenidate, aiming to reduce the potential effect of early life stress in ADHD, and mainly emotional and sensory dysregulation. The apparent but currently less recognized additional symptoms of emotional and sensory dysregulation in ADHD call for further investigation of these possible causes and thus increasing treatments efficacy in individuals with ADHD.
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16
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Bending and bonding: a randomized controlled trial on the socio-psychobiological effects of spiritual versus secular yoga practice on social bonding. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Kerekes N, Lundqvist S, Schubert Hjalmarsson E, Torinsson Naluai Å, Kantzer AK, Knez R. The associations between ADHD, pain, inflammation, and quality of life in children and adolescents—a clinical study protocol. PLoS One 2022; 17:e0273653. [PMID: 36083951 PMCID: PMC9462574 DOI: 10.1371/journal.pone.0273653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
New research shows that the prevalence of neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD), is increased in children and adolescents as well as in adults with chronic pain, compared to those without chronic pain. Children and adolescents with ADHD also have an increased incidence of various physical conditions associated with pain, and they more frequently suffer from inflammatory diseases. Moreover, parents of children with ADHD can often suffer from pain conditions. These epidemiological and clinical observations form the scientific basis of our study, which aims to map the relationships between ADHD, altered pain experiences/central sensitization, and inflammation in children and adolescents. We will investigate the presence of central sensitization in children and adolescents with newly diagnosed ADHD and compare it with those who have not been diagnosed with ADHD. Participants (and their biological parents) will complete surveys about their somatic health, pain experience, and quality of life. Biological samples (saliva and stool) will be collected, aiming to utilize proteome and metabolome data to discover disease mechanisms and to predict, prevent and treat them. The results from our investigation should enable an expanded understanding of the pathophysiology behind both ADHD and pain/central sensitization. Presently, there are no established protocols for addressing psychiatric symptoms when examining patients with pain conditions in a somatic care setting, nor is there any knowledge of offering patients with ADHD or other neurodevelopmental disorders adapted treatments for pain conditions. Our results, therefore, can contribute to the development of new treatment strategies for pathological pain conditions in children and adolescents with ADHD. They may also increase awareness about and provide opportunities for the treatment of attention and impulse control problems in children and adolescents with pain syndromes.
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Affiliation(s)
- Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Sara Lundqvist
- Child and Adolescent Psychiatry, Queen Silvia Children’s Hospital, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Elke Schubert Hjalmarsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Physiotherapy, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Torinsson Naluai
- Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | | | - Rajna Knez
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
- * E-mail:
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18
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Pain hypersensitivity in a pharmacological mouse model of attention-deficit/hyperactivity disorder. Proc Natl Acad Sci U S A 2022; 119:e2114094119. [PMID: 35858441 PMCID: PMC9335339 DOI: 10.1073/pnas.2114094119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Clinical evidence suggests that pain hypersensitivity develops in patients with attention-deficit/hyperactivity disorder (ADHD). However, the mechanisms and neural circuits involved in these interactions remain unknown because of the paucity of studies in animal models. We previously validated a mouse model of ADHD obtained by neonatal 6-hydroxydopamine (6-OHDA) injection. Here, we have demonstrated that 6-OHDA mice exhibit a marked sensitization to thermal and mechanical stimuli, suggesting that phenotypes associated with ADHD include increased nociception. Moreover, sensitization to pathological inflammatory stimulus is amplified in 6-OHDA mice as compared to shams. In this ADHD model, spinal dorsal horn neuron hyperexcitability was observed. Furthermore, ADHD-related hyperactivity and anxiety, but not inattention and impulsivity, are worsened in persistent inflammatory conditions. By combining in vivo electrophysiology, optogenetics, and behavioral analyses, we demonstrated that anterior cingulate cortex (ACC) hyperactivity alters the ACC-posterior insula circuit and triggers changes in spinal networks that underlie nociceptive sensitization. Altogether, our results point to shared mechanisms underlying the comorbidity between ADHD and nociceptive sensitization. This interaction reinforces nociceptive sensitization and hyperactivity, suggesting that overlapping ACC circuits may be targeted to develop better treatments.
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19
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Tarantino S, Proietti Checchi M, Papetti L, Ursitti F, Sforza G, Ferilli MAN, Moavero R, Monte G, Capitello TG, Vigevano F, Valeriani M. Interictal Cognitive Performance in Children and Adolescents With Primary Headache: A Narrative Review. Front Neurol 2022; 13:898626. [PMID: 35911918 PMCID: PMC9326001 DOI: 10.3389/fneur.2022.898626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Primary headache is a very common and disabling disease. The burden of pain and recurrent attacks may lead to a poor quality of life, anxiety and depression. An increased risk of low functioning and curricular performances in young patients with primary headache has been described. The mechanisms underlying the relationship between migraine and poor school achievement may be various and could be a reflection of weak cognitive skills. Data concerning the cognitive functioning in the free pain interval in pediatric age are under-investigated and results are far from conclusive. The present review article suggests that, though considered a benign disease, pediatric migraine may be associated to altered neuropsychological functioning in the interictal phase. Although children and adolescents with migraine generally have a normal intelligence, they may show a not homogeneous cognitive profile, characterized by possible difficulties in verbal skills, in particular comprehension abilities. Pediatric primary headache may present altered neuropsychological functioning involving attentional resources, processing speed and memory, particularly verbal memory. Given the impact that this disease can have on school performance and the tendency to persist from childhood to adulthood, a cognitive screening in young patients affected by primary headache is pivotal. Additional neuropsychological research using more homogenous methods is needed.
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Affiliation(s)
- Samuela Tarantino
- Unit of Clinical Psychology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- *Correspondence: Samuela Tarantino
| | - Martina Proietti Checchi
- Unit of Clinical Psychology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Laura Papetti
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabiana Ursitti
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giorgia Sforza
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Romina Moavero
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Gabriele Monte
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Teresa Grimaldi Capitello
- Unit of Clinical Psychology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Federico Vigevano
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Massimiliano Valeriani
- Department of Neuroscience, Headache Center, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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20
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Hsu T, Chen M, Chu C, Tsai S, Bai Y, Su T, Chen T, Liang C. Attention deficit hyperactivity disorder and risk of migraine: A nationwide longitudinal study. Headache 2022; 62:634-641. [DOI: 10.1111/head.14306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/06/2022] [Accepted: 03/10/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tien‐Wei Hsu
- Department of Psychiatry Kaohsiung Veterans General Hospital Kaohsiung City Taiwan
| | - Mu‐Hong Chen
- Department of Psychiatry Taipei Veterans General Hospital Taipei Taiwan
- Department of Psychiatry College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Che‐Sheng Chu
- Department of Psychiatry Kaohsiung Veterans General Hospital Kaohsiung City Taiwan
| | - Shih‐Jen Tsai
- Department of Psychiatry Taipei Veterans General Hospital Taipei Taiwan
- Department of Psychiatry College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Ya‐Mei Bai
- Department of Psychiatry Taipei Veterans General Hospital Taipei Taiwan
- Department of Psychiatry College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Tung‐Ping Su
- Department of Psychiatry Taipei Veterans General Hospital Taipei Taiwan
- Department of Psychiatry College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Tzeng‐Ji Chen
- Department of Family Medicine Taipei Veterans General Hospital Taipei Taiwan
- Institute of Hospital and Health Care Administration National Yang Ming Chiao Tung University Taipei Taiwan
| | - Chih‐Sung Liang
- Department of Psychiatry Beitou Branch Tri‐Service General Hospital Taipei Taiwan
- Graduate Institute of Medical Sciences National Defense Medical Center Taipei Taiwan
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21
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Ibrahim ME, Hefny MA. Central sensitization and adult attention deficit hyperactivity disorder in medical students with chronic back pain: a cross-sectional study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [DOI: 10.1186/s43166-022-00124-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Chronic back pain is a common health complaint among university students. A subset of chronic back pain patients suffer from increased pain sensitivity, a process termed central sensitization. Chronic pain is also associated with cognitive dysfunction, involving attention, memory, and learning. Those are key features of adult attention deficit hyperactivity disorder. This study aimed to assess the associations between adult attention deficit hyperactivity disorder and central sensitization in students with chronic back pain.
Results
Two hundred twenty-seven students completed the survey, and 90 (39.6%) had back pain for more than 3 months. Students with back pain had significantly higher central sensitization (P<0.01) and higher attention deficit scores (P=0.05). Significant positive correlations were found between scores of the two questionnaires (r= 0.55, P<0.01). Regression analysis adjusted for age and gender showed that higher attention deficit scores were associated with back pain (odd’s ratio:1.025, P=0.05). The odd’s ratio was attenuated after adding central sensitization to the model (odd’s ratio: 0.99, P=0.70).
Conclusions
The findings of this study suggest that attention deficit hyperactivity disorder is associated with elevated central sensitization in patients with chronic back pain. Our results support the hypothesis that central sensitization mediates the effect of attention deficit on back pain.
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22
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New Insights on Gene by Environmental Effects of Drugs of Abuse in Animal Models Using GeneNetwork. Genes (Basel) 2022; 13:genes13040614. [PMID: 35456420 PMCID: PMC9024903 DOI: 10.3390/genes13040614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Gene-by-environment interactions are important for all facets of biology, especially behaviour. Families of isogenic strains of mice, such as the BXD strains, are excellently placed to study these interactions, as the same genome can be tested in multiple environments. BXD strains are recombinant inbred mouse strains derived from crossing two inbred strains—C57BL/6J and DBA/2J mice. Many reproducible genometypes can be leveraged, and old data can be reanalysed with new tools to produce novel insights. We obtained drug and behavioural phenotypes from Philip et al. Genes, Brain and Behaviour 2010, and reanalysed their data with new genotypes from sequencing, as well as new models (Genome-wide Efficient Mixed Model Association (GEMMA) and R/qtl2). We discovered QTLs on chromosomes 3, 5, 9, 11, and 14, not found in the original study. We reduced the candidate genes based on their ability to alter gene expression or protein function. Candidate genes included Slitrk6 and Cdk14. Slitrk6, in a Chromosome14 QTL for locomotion, was found to be part of a co-expression network involved in voluntary movement and associated with neuropsychiatric phenotypes. Cdk14, one of only three genes in a Chromosome5 QTL, is associated with handling induced convulsions after ethanol treatment, that is regulated by the anticonvulsant drug valproic acid. By using families of isogenic strains, we can reanalyse data to discover novel candidate genes involved in response to drugs of abuse.
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23
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Beliveau CM, McMahan VM, Arenander J, Angst MS, Kushel M, Torres A, Santos GM, Coffin PO. Stimulant use for self-management of pain among safety-net patients with chronic non-cancer pain. Subst Abus 2022; 43:179-186. [PMID: 33798030 PMCID: PMC8791072 DOI: 10.1080/08897077.2021.1903654] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Chronic pain affects one-fifth of US adults. Reductions in opioid prescribing have been associated with increased non-prescription opioid use and, chronologically, increased stimulant (methamphetamine and cocaine) use. While non-prescription opioid use is commonly attributed to pain self-management, the role of stimulants in managing pain is unclear. METHODS We analyzed baseline data from a longitudinal study of patients with chronic non-cancer pain in an urban safety-net healthcare system who had been prescribed an opioid for ≥3 of the last 12 months, and had a history of non-prescription opioid, cocaine, or amphetamine use (N = 300). We estimated the prevalence and identified correlates of stimulant use to treat pain among a subgroup of patients who reported past-year stimulant use (N = 105). Data sources included computer-assisted questionnaire (demographics, substance use, pain), clinical exam and procedures (pain, pain tolerance), and chart abstraction (opioid prescriptions). We conducted bivariate analyses to assess associations between demographics, pain characteristics, non-opioid therapies, substance use, opioid prescriptions, and self-reported symptoms, with reporting using stimulants to treat pain. Demographic variables and those with significant bivariate associations were included in a multivariable logistic regression model. RESULTS Fifty-two percent of participants with past-year stimulant use reported using stimulants in the past year to treat pain. Participants who used stimulants for pain reported slightly higher average pain in the past 3 months (median of 8 (IQR: 6-8) vs 7 (7-9) out of 10, p = 0.049). In the multivariable analysis, female gender (AOR= 3.20, 95% CI: 1.06-9.63, p = 0.039) and higher score on the Douleur Neuropathique 4 neuropathic pain questionnaire (AOR = 1.34, 95% CI: 1.05-1.70, p = 0.017) were associated with past-year stimulant use to treat pain. CONCLUSION Stimulants may be used for pain self-management, particularly for neuropathic pain and among women. Our findings suggest an underexplored motivation for stimulant use in an era of reduced access to prescribed opioids.
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Affiliation(s)
- Cathleen M. Beliveau
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Vanessa M. McMahan
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Justine Arenander
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Martin S. Angst
- Department of Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Margot Kushel
- University of California San Francisco, San Francisco, CA, USA
| | - Andrea Torres
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Glenn-Milo Santos
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
| | - Phillip O. Coffin
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
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24
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Vargas-Schaffer G, Steverman A, Potvin V. Monitoring Pharmacological Treatment in Patients With Chronic Noncancer Pain. Cureus 2021; 13:e20358. [PMID: 34912657 PMCID: PMC8666110 DOI: 10.7759/cureus.20358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/07/2022] Open
Abstract
Chronic pain has been not recognized as a chronic illness, and its far-reaching impacts are often ignored. Chronic noncancer pain (CNCP) is a chronic disease and health care professionals need recommendations on how to monitor treatments, patients and long-term side effects of the different medications used to control CNCP. CNCP patients make up a vulnerable population due to the various associated pathologies and the challenging socio-economic conditions experienced by many of these patients. CNCP is more common among older adults, females, cancer survivors, indigenous peoples, veterans, and populations affected by social inequities and discrimination. These social determinants can lead to a complex interplay between chronic pain, mental illness, and substance use disorders. Given these realities, long-term pharmacological and side effect surveillance is more complex. Follow-up of patients with CNCP is a challenge for physicians, and thus it is important to provide recommendations on how to monitor treatments and long-term side effects of the different medications used to control CNCP.
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Affiliation(s)
- Grisell Vargas-Schaffer
- Anesthesiology and Pain Medicine, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
| | - Allen Steverman
- Family Medicine, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
| | - Veronique Potvin
- Anesthesiology, Pain Center Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, CAN
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25
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Slawek DE, Syed M, Cunningham CO, Zhang C, Ross J, Herman M, Sohler N, Minami H, Levin FR, Arnsten JH, Starrels JL. Pain catastrophizing and mental health phenotypes in adults with refractory chronic pain: A latent class analysis. J Psychiatr Res 2021; 145:102-110. [PMID: 34890916 PMCID: PMC9160202 DOI: 10.1016/j.jpsychires.2021.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 01/12/2023]
Abstract
Chronic pain, pain catastrophizing, and mental health disorders such as anxiety or depression frequently occur together and are challenging to treat. To help understand the relationship between these conditions, we sought to identify distinct phenotypes associated with worse pain and function. In a cohort of people with chronic pain on opioids seeking medical cannabis in New York, we conducted latent class analysis to identify clusters of participants based on pain catastrophizing and mental health symptoms of depression, anxiety, post-traumatic stress disorder (PTSD) and attention deficit/hyperactivity disorder (ADHD). We then compared clusters with respect to sociodemographic and clinical characteristics using descriptive statistics. Among 185 participants, we identified four discrete groups: low pain catastrophizing and low mental health symptoms (49% of participants), low pain catastrophizing and ADHD-predominant mental health symptoms (11%), high pain catastrophizing and anxiety-predominant mental health symptoms (11%), and high pain catastrophizing and high mental health symptoms (30%). The group with high pain catastrophizing and high mental health symptoms had the worst pain intensity and interference, disability, insomnia, and quality of life, compared to the two groups with lower pain catastrophizing, though not all differences were statistically significant. Our findings highlight the importance of identifying and addressing pain catastrophizing in patients with comorbid chronic pain and mental health symptoms.
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Affiliation(s)
- Deepika E Slawek
- Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.
| | - Madiha Syed
- Department of Psychiatry and Behavioral Sciences, Montefiore Health System, Bronx, NY, USA
| | | | - Chenshu Zhang
- Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA
| | - Jonathan Ross
- Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA
| | - Merrill Herman
- Department of Psychiatry and Behavioral Sciences, Montefiore Health System, Bronx, NY, USA
| | - Nancy Sohler
- School of Medicine, City University of New York, New York, NY, USA
| | - Haruka Minami
- Psychology Department, Fordham University, Bronx, NY, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Julia H Arnsten
- Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA
| | - Joanna L Starrels
- Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA
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26
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Kerekes N, Sanchéz-Pérez AM, Landry M. Neuroinflammation as a possible link between attention-deficit/hyperactivity disorder (ADHD) and pain. Med Hypotheses 2021; 157:110717. [PMID: 34717072 DOI: 10.1016/j.mehy.2021.110717] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/01/2021] [Accepted: 10/17/2021] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and pathological pain are two complex syndromes of multifactorial origin. Despite their prevalence and broad impacts, these conditions are seldom recognized and managed simultaneously. The co-existence of neuropsychiatric conditions (such as ADHD) and altered pain perception and chronic pain has been noted in children, and the comorbidity of ADHD and chronic pain is well documented in adults. Pathophysiological studies have suggested dysfunction of the dopaminergic system as a common neurochemical basis for comorbid ADHD and pain. Considerable evidence supports the role of neuroinflammation in the pathophysiology of both. We suggest that central neuroinflammation underlies altered pain perception and pain sensitization in persons with ADHD. Based on our hypothesis, targeting neuroinflammation may serve as a potential new therapeutic intervention to treat ADHD and comorbid pain in children and adolescents and a preventive strategy for the development of chronic pain in adults with ADHD.
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Affiliation(s)
- Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan 461 86, Sweden.
| | - Ana Maria Sanchéz-Pérez
- Neurobiotechnology Laboratory, Faculty of Health Sciences, Institute of Advanced Materials (INAM), University Jaume I, Castellon 120 71, Spain
| | - Marc Landry
- University of Bordeaux, CNRS, Institute for Neurodegenrative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
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de Sousa Lima JL, de Oliveira Cavalcante AM, Chagas AKO, Leite GDO, Campos AR. Audiovisual overstimulation in childhood and adolescence promotes hyperactive behaviour in adult mice. Physiol Behav 2021; 233:113348. [PMID: 33545208 DOI: 10.1016/j.physbeh.2021.113348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/19/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
There is a discussion about the impact of technological development on behavioural aspects, a nuance that the present study aimed to assess. p21, p26 and p36 mice were subjected to audio (70 db) and visual stimulation (flashing lights) for 2 or 6 h per day until p64. Naive animals were included. From p74 onwards, the animals were subjected to tests to assess their locomotion, depression, anxiety, aggressiveness, and nociception behaviours. Weight assessment was also performed. The animals that received stimulation for 2 h a day since p21 showed a decrease in rearing and grooming behaviour in the open field test, as well as in the mechanical orofacial sensitivity. Animals that received stimulation for 6 h daily since p21 showed increased locomotor activity in the open field test. Animals that received stimulation for 2 h a day since p26 showed an increase in locomotor activity and a decrease in grooming behaviour in the open field test, in addition to a reduction in the number of entries in the closed arm of the elevated plus maze. Animals stimulated from p26 for 6 h daily increased the reaction time to the thermal stimulus. Animals that received stimulation for 2 h daily since p36 showed an increase in locomotor activity and a decrease in grooming behaviour in the open field test. Taken together, these findings suggest that audiovisual overstimulation during critical periods of brain development may have adverse effects compatible with hyperactivity in adulthood.
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Primary dysmenorrhea in adolescents: Association with attention deficit hyperactivity disorder and psychological symptoms. Taiwan J Obstet Gynecol 2021; 60:311-317. [PMID: 33678333 DOI: 10.1016/j.tjog.2021.01.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE No prior study has investigated the relation of primary dysmenorrhea (PD) with attention deficit hyperactivity disorder (ADHD) symptoms in adolescent age groups. This study aimed to investigate the relationship of PD with ADHD and psychological symptoms among adolescents. Another objective was to examine the PD related non-psychogenic factors and sleep quality. MATERIALS AND METHODS Two hundred nine adolescent girls who applied to policlinics for various reasons were enrolled. All participants completed self-report questionnaires. Questionnaire for sociodemographic data, menstrual pattern and dysmenorrhea in adolescents, Visual analog scale, Pittsburgh Sleep Quality Index, DSM-5 Level 2 Sleep Disorders Scale, Brief Symptom Inventory, and the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th edition-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale were used to measure outcomes. RESULTS A hundred and four (49.8%) adolescents reported having pain that affects daily activities during menstruation. These adolescents had worse sleep quality, more inattention and hyperactivity-impulsivity problems, and other psychological symptoms of anxiety, depression, somatization, negative self-perception, and hostility in comparison to others (P < 0.05). The menstrual pain severity, measured by VAS, was positively correlated with ADHD symptoms and all other psychological parameters (P < 0.05). CONCLUSION PD affecting daily-activities may be related to ADHD symptoms and psychiatric distress. Future studies are needed to support the association between ADHD and PD. Assessing the psychiatric problems of adolescents with dysmenorrhea is important.
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Santos LM, Silva AFSSE, Brasil ABR, Tolentino ACA, Norberto CA, Paula CBD, Jurno ME. Impulsivity prevalence in migraine patients without and with medication overuse. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:778-782. [PMID: 33263611 DOI: 10.1590/0004-282x20200071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Migraine is one of the most common disorders in neurological clinical practice and is part of the group of primary headaches. It often affects individuals in the age group of 25-55 years, when people are at their peak of economic productivity. Many patients ultimately overuse analgesics. Overuse is defined by the use of analgesics for at least 15 times a month - within a minimal three-month period. Impulsivity and migraine cause losses in the lives of individuals suffering from them, as they can compromise these individuals' social, emotional, and professional spheres. Regarding the professional sphere, it results in economic losses compared with the overall population. OBJECTIVE To investigate the presence of impulsive behavior in patients with migraine and with medication-overuse migraine. METHODS Cross-sectional study on 210 female and male patients; 140 were diagnosed with migraine according to criteria of the International Classification of Headache Disorders and were subdivided into two groups (70 patients each). One of these groups was composed of medication-overuse patients; the control group was composed of non-migraine patients (70 patients). All patients were evaluated with the Barratt Impulsivity Scale (BIS-11). RESULTS The group of migraine patients accounted for the highest impulsivity level, followed by the control group and, finally, by the medication-overuse group. However, these differences did not attain statistical significance. CONCLUSIONS It was not possible to establish a clear connection between migraine and impulsive behavior. Association was higher among migraineurs without medication overuse.
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Affiliation(s)
- Luana Miranda Santos
- Faculdade de Medicina de Barbacena, Departamento de Neurologia, Barbacena MG, Brazil
| | | | | | | | | | - Carla Braun De Paula
- Faculdade de Medicina de Barbacena, Departamento de Neurologia, Barbacena MG, Brazil
| | - Mauro Eduardo Jurno
- Faculdade de Medicina de Barbacena, Departamento de Neurologia, Barbacena MG, Brazil.,Fundação Hospitalar do Estado de Minas Gerais, Barbacena MG, Brazil
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Sakakibara E. The polysemy of psychotropic drugs: continuity and overlap between neuroenhancement, treatment, prevention, pain relief, and pleasure-seeking in a clinical setting. BMC Med Ethics 2020; 21:54. [PMID: 32631307 PMCID: PMC7336425 DOI: 10.1186/s12910-020-00497-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 06/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enhancement involves the use of biomedical technologies to improve human capacities beyond therapeutic purposes. It has been well documented that enhancement is sometimes difficult to distinguish from treatment. As a subtype of enhancement, neuroenhancement aims to improve one's cognitive or emotional capacities. MAIN BODY This article proposes that the notion of neuroenhancement deserves special attention among enhancements in general, because apart from the notion of treatment, it also overlaps with other concepts such as prevention, pain relief, and pleasure seeking. Regarding prevention, patients' mental endurance can be enhanced when a patient is prescribed a selective serotonin reuptake inhibitor for the purpose of preventing the relapse of depression following a stressful situation. As for pain relief, psychiatrists use medication to alleviate distress in patients who experience various types of anxiety; the alleviation of distress is equal to psychological pain relief, but is also an enhancement of the patient's temperamental traits. Regarding pleasure seeking, insidious transition exists between neuroenhancement and pleasure seeking when using psychotropic drugs. It is well known that people use psychostimulants for recreational purposes and to induce overconfidence in one's performance. The polysemy of psychotropics derives from their effects on human sensibility. Therefore, when using psychotropic agents, psychiatrists should pay close attention to what the agent is used for on each patient in each situation, and explicitly share the continuity and overlap in the purpose of prescribing a medication with the patients to make a better clinical decision. CONCLUSIONS The notion of neuroenhancement overlaps not only with the notion of treatment, but also with other concepts of prevention, pain relief, and pleasure seeking. The continuity between those concepts makes the issues concerning the prescription of psychotropic drugs subtler. Psychiatrists should explicitly share the continuity with the patients to make a better clinical decision.
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Affiliation(s)
- Eisuke Sakakibara
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Boehme R, Frost Karlsson M, Heilig M, Olausson H, Capusan AJ. Sharpened self-other distinction in attention deficit hyperactivity disorder. Neuroimage Clin 2020; 27:102317. [PMID: 32599550 PMCID: PMC7327378 DOI: 10.1016/j.nicl.2020.102317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/02/2020] [Accepted: 06/13/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Differentiation between self-produced tactile stimuli and touch by others is necessary for social interactions and for a coherent concept of "self". In attention-deficit-hyperactivity-disorder (ADHD), tactile hypersensitivity and social cognition problems are part of the symptomatology, but pathophysiological mechanisms are largely unknown. Differentiation of self- and non-self- generated sensations might be key to understand and develop novel strategies for managing hypersensitivity. Here, we compared the neural signatures of affective self- and other-touch between adults with ADHD and neurotypical controls (NC). METHODS Twenty-eight adult ADHD participants and 30 age- and gender-matched NC performed a self-other-touch-task during functional magnetic resonance imaging: they stroked their own arm, an object, or were stroked by the experimenter. In addition, tactile detection thresholds and rubber hand illusion (RHI) were measured. RESULTS ADHD participants had more autistic traits than NC and reported to engage less in interpersonal touch. They also reported to be more sensitive to tactile stimuli. Compared to NC, ADHD participants showed enhanced responses to both the self- and other-touch conditions: stronger deactivation during self-touch in the anterior and posterior insula, and increased activation during other-touch in primary somatosensory cortex. ADHD participants had intact tactile detection thresholds, but were less susceptible to the RHI. CONCLUSIONS Unaltered detection thresholds suggest that peripheral processing is intact, and that hypersensitivity might be driven by central mechanisms. This has clinical implications for managing somatosensory hypersensitivity in ADHD. The more pronounced differentiation between self- and other-touch might indicate a clearer self-other-distinction. This is of interest regarding body ownership perception in both NC and ADHD, and possibly other psychiatric conditions with altered self-experiences, like schizophrenia. A sharper boundary of the own body might relate to deficits in social cognition and tactile hypersensitivity.
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Affiliation(s)
- Rebecca Boehme
- Center for Social and Affective Neuroscience, Linköping University, Department of Biomedical and Clinical Sciences, 58185 Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, 58185 Linköping, Sweden.
| | - Morgan Frost Karlsson
- Center for Social and Affective Neuroscience, Linköping University, Department of Biomedical and Clinical Sciences, 58185 Linköping, Sweden
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Linköping University, Department of Biomedical and Clinical Sciences, 58185 Linköping, Sweden; Department of Psychiatry, Linköping University, 58185 Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, 58185 Linköping, Sweden
| | - Håkan Olausson
- Center for Social and Affective Neuroscience, Linköping University, Department of Biomedical and Clinical Sciences, 58185 Linköping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, 58185 Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, 58185 Linköping, Sweden
| | - Andrea Johansson Capusan
- Center for Social and Affective Neuroscience, Linköping University, Department of Biomedical and Clinical Sciences, 58185 Linköping, Sweden; Department of Psychiatry, Linköping University, 58185 Linköping, Sweden
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Deshmukh P, Patel D. Attention Deficit Hyperactivity Disorder and Its Treatment in Geriatrics. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Arruda MA, Arruda R, Guidetti V, Bigal ME. ADHD Is Comorbid to Migraine in Childhood: A Population-Based Study. J Atten Disord 2020; 24:990-1001. [PMID: 28587507 DOI: 10.1177/1087054717710767] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g., migraine), and to headache frequency. Method: Informed consent and analyzable data were obtained for 5,671 children aged 5 to 12 years (65.9% of the target sample). Parents and teachers were interviewed using validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Relative risks were modeled using univariate and multivariate analyses. Results: As contrasted to nonheadache controls, the prevalence of ADHD was significantly higher in children with migraine (p < .001) but not in those with tension-type headaches. In children with migraine, risk of ADHD increased as a function of headache frequency (p < .05). Conclusion: Migraine and frequent migraine are comorbid to ADHD. Future studies should focus on the impact of the association on the burden to the children and their families.
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You Z, Ding W, Doheny JT, Shen S, Yang J, Yang L, Chen L, Zhu S, Mao J. Methylphenidate and Morphine Combination Therapy in a Rat Model of Chronic Pain. Anesth Analg 2020; 130:518-524. [PMID: 31206430 DOI: 10.1213/ane.0000000000004273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The incremental dose of opioids used in chronic pain management often leads to a reduced opioid analgesic effect, opioid misuse, and addiction. Central dopamine (DA) dysfunction contributes to the chronicity of pain and a decreased opioid analgesic effect. Methylphenidate (MPH/Ritalin) enhances central DA function by inhibiting DA reuptake. In this study, we used a rat model of chronic pain to examine whether combination of MPH with morphine (MOR) would improve the MOR analgesic effect under a chronic pain condition. METHODS Tibiotarsal joint Complete Freund's Adjuvant (CFA) injection in rats was utilized to induce chronic nociception. The analgesic effect of low-dose MPH (0.25 mg/kg), low-dose MOR (2.5 mg/kg), and their combination was examined in CFA rats. Nociceptive behavior was assessed by von Frey test. Conditioned place preference (CPP) and open field tests (OFTs) were used to examine the rewarding behavior and locomotor activity in rats, respectively. RESULTS Our findings are as follows: (1) in CFA rats with chronic pain, 2.5 mg/kg of MOR had less analgesic effect than 10 mg/kg of MOR at 28 days after injury (95% confidence intervals [CIs] for difference of means of von Frey threshold in gram: -11.9 [-6.5 to -17.3]); (2) in the 1-hour time window of 30-90 minutes after injection, the combination of MPH (0.25 mg/kg) with MOR (2.5 mg/kg) increased synergistically and prolonged the analgesic effect in CFA rats as compared with MPH or MOR alone (P = .01 for MPH by MOR interaction, and 95% CIs for difference of means of von Frey threshold in gram: 3.3 [1.37-6.12] for the combination versus MPH and 3.2 [1.35-5.74] for the combination versus MOR); (3) at the low dose (0.25 mg/kg), MPH did not increase locomotor activity (MOR + MPH versus MOR, P = .13) nor significantly enhanced MOR reward behavior (MOR + MPH versus MOR, P = .63) in CFA rats. CONCLUSIONS Our data suggest that a combination therapy using low-dose MPH and MOR may produce a MOR-sparing effect in chronic pain management.
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Affiliation(s)
- Zerong You
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Weihua Ding
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Anesthesia, First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Jason T Doheny
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shiqian Shen
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jinsheng Yang
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Liuyue Yang
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lucy Chen
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shengmei Zhu
- Department of Anesthesia, First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Jianren Mao
- From the Department of Anesthesia, Critical Care and Pain Medicine, Center for Translational Pain Research, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Asztély K, Kopp S, Gillberg C, Waern M, Bergman S. Chronic Pain And Health-Related Quality Of Life In Women With Autism And/Or ADHD: A Prospective Longitudinal Study. J Pain Res 2019; 12:2925-2932. [PMID: 31695481 PMCID: PMC6804669 DOI: 10.2147/jpr.s212422] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/30/2019] [Indexed: 01/22/2023] Open
Abstract
Purpose To investigate the prevalence of chronic pain and its association with health-related quality of life (HRQoL) in a group of women, diagnosed with autism spectrum disorder (ASD) and/or attention deficit hyperactive disorder (ADHD) in childhood. Patients and methods Prospective longitudinal 16–19 years follow-up study of 100 Swedish females diagnosed with ASD and/or ADHD in childhood/adolescence. Seventy-seven of the women were included in the current sub-study, using validated measures of pain perception and quality of life. Results A large majority of the women (76.6%) reported chronic pain. HRQoL was low overall and lower still for those reporting chronic pain. Women with ADHD who had ongoing treatment with stimulants reported a significant lower prevalence of chronic widespread pain (CWP) than those not treated. Conclusion Comorbidity with chronic pain is common in women with ASD and/or ADHD and important to address in the clinic since it is associated with an already low HRQoL. Treatment for ADHD might reduce the pain in some cases.
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Affiliation(s)
- Karin Asztély
- Department of Public Health and Community Medicine, Sahlgrenska Academy Institute of Medicine, Göteborg, Sweden
| | - Svenny Kopp
- Gillberg Neuropsychiatric Centre, Sahlgrenska Academy Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatric Centre, Sahlgrenska Academy Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Stefan Bergman
- Department of Public Health and Community Medicine, Sahlgrenska Academy Institute of Medicine, Göteborg, Sweden
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van Rensburg R, Meyer HP, Hitchcock SA, Schuler CE. Screening for Adult ADHD in Patients with Fibromyalgia Syndrome. PAIN MEDICINE 2019; 19:1825-1831. [PMID: 29099955 DOI: 10.1093/pm/pnx275] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective Fibromyalgia syndrome (FMS) is a common chronic pain disorder associated with altered activity of neurotransmitters involved in pain sensitivity such as dopamine, serotonin, and noradrenaline. FMS may significantly impact an individual's functioning due to the presence of chronic pain, fatigue, and cognitive impairment. Dyscognition may be more disabling than the chronic pain but is mostly under-recognized. This study aimed to assess the potential co-occurrence of FMS and adult attention deficit hyperactivity disorder (ADHD), a chronic neurodevelopmental disorder also associated with impaired cognition and dopaminergic function. Methods In a cross-sectional observational study, 123 previously confirmed FMS patients were screened for adult ADHD using the World Health Organization Adult ADHD Self Report scale v1.1. The Revised Fibromyalgia Impact Questionnaire (FIQ-R) was used to assess the impact of FMS. Cognitive assessment was based on self-report in accordance with the 2011 modified American College of Rheumatology criteria and the FIQ-R, respectively. Results Of the 123 participants, 44.72% (N = 55) screened positive for adult ADHD. Participants with both FMS and a positive adult ADHD screening test scored higher on the FIQ-R score (64.74, SD = 17.66, vs 54.10, SD = 17.10). Self-reported cognitive impairment was rated higher in the combined group (odds ratio = 10.61, 95% confidence interval; 3.77-29.86, P < 0.01). Conclusions These results indicate that the co-occurrence of adult ADHD in FMS may be highly prevalent and may also significantly impact the morbidity of FMS. Patients with FMS should be assessed for the presence of adult ADHD.
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Affiliation(s)
- Roland van Rensburg
- Department of Family Medicine, University of Pretoria, Pretoria, South Africa
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Abstract
Pain is a universal, multidimensional experience with sensory, emotional, cognitive, and social components, which is fundamental to our environmental learning when functioning typically. Understanding pain processing in psychiatric conditions could provide unique insight into the underlying pathophysiology or psychiatric disease, especially given the psychobiological overlap with pain processing pathways. Studying pain in psychiatric conditions is likely to provide important insights, yet, there is a limited understanding beyond the work in depression and anxiety. This is a missed opportunity to describe psychiatric conditions in terms of neurobiological alterations. To examine the research into the pain experiences of these groups and the extent to which a-typicality is present, a systematic review was conducted. An electronic search strategy was developed and conducted in several databases. The current systematic review included 46 studies covering five Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) disorders: autism, attention-deficit hyperactivity disorder (ADHD), schizophrenia, personality disorder, and eating disorders, confirming tentative evidence of altered pain and touch processing. Specifically, hyposensitivity is reported in schizophrenia, personality disorder and eating disorder, hypersensitivity in ADHD, and mixed results for autism. Review of the research highlights a degree of methodological inconsistency in the utilization of comprehensive protocols, the lack of which fails to allow us to understand whether a-typicality is systemic or modality specific.
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Bou Khalil R, Khoury E, Richa S. The Comorbidity of Fibromyalgia Syndrome and Attention Deficit and Hyperactivity Disorder from a Pathogenic Perspective. PAIN MEDICINE 2018; 19:1705-1709. [PMID: 30053155 DOI: 10.1093/pm/pny142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Ahnemark E, Di Schiena M, Fredman AC, Medin E, Söderling JK, Ginsberg Y. Health-related quality of life and burden of illness in adults with newly diagnosed attention-deficit/hyperactivity disorder in Sweden. BMC Psychiatry 2018; 18:223. [PMID: 30005675 PMCID: PMC6044069 DOI: 10.1186/s12888-018-1803-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/27/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND This observational, cross-sectional, retrospective chart review aimed to identify factors determining health-related quality of life (HRQoL) in adults with newly diagnosed attention-deficit/hyperactivity disorder (ADHD) in Sweden. METHODS Adult participants with a new clinical diagnosis of ADHD were enrolled from two specialist outpatient clinics in Stockholm, Sweden, from 2013 to 2015. Data extracted from patient records included demographics, clinical characteristics and comorbid psychiatric diagnoses identified using the Mini International Neuropsychiatric Interview (MINI). Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale - Self-reported (MADRS-S). The self-rated five-dimension EuroQol questionnaire (EQ-5D) was used to measure HRQoL. Predictors of EQ-5D index score were identified using multivariate linear regression adjusting for age, sex, education level, and main income source. RESULTS The mean age of the 189 enrolled patients was 35.2 years (standard deviation [SD], 12.3), and 107 (57%) were female. Psychiatric comorbidities were present in 92 patients (49%), with anxiety and depression being the most common diagnoses. The mean EQ-5D index score was 0.63 (SD, 0.28). Low EQ-5D index scores were significantly associated with high MADRS-S scores, multiple comorbid psychiatric disorders, low educational achievement, female sex, and not having a main income derived from employment or self-employment. CONCLUSIONS These findings suggest that adults with newly diagnosed ADHD experience low HRQoL, which may often be exacerbated by psychiatric comorbidities such as anxiety and depression. Patients presenting with ADHD and psychiatric comorbidities in adulthood may require particular care and resources in the management of their ADHD.
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Affiliation(s)
- E. Ahnemark
- Shire, Vasagatan 7, SE-111 20 Stockholm, Sweden
| | - M. Di Schiena
- Prima Child and Adult Psychiatry AB, Stockholm, Sweden
| | - A.-C. Fredman
- Prima Child and Adult Psychiatry AB, Stockholm, Sweden
- Present Address: Psychiatry Centre, Stockholm County Council, Södertälje, Sweden
| | - E. Medin
- PAREXEL International, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | | | - Y. Ginsberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
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Wiwe Lipsker C, von Heijne M, Bölte S, Wicksell RK. A case report and literature review of autism and attention deficit hyperactivity disorder in paediatric chronic pain. Acta Paediatr 2018; 107:753-758. [PMID: 29341240 DOI: 10.1111/apa.14220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
Psychiatric disorders are common in paediatric patients with chronic pain, but the overall prevalence of comorbid neurodevelopmental disorders is unclear. We report on a case of severe chronic pain in a child with undiagnosed comorbid autism spectrum disorder and attention deficit hyperactivity disorder, where significant improvements in pain and function occurred following methylphenidate medication and parental behavioural training. CONCLUSION The inclusion of behavioural assessment and screening for neurodevelopmental comorbidity may be essential in addressing complex paediatric chronic pain.
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Affiliation(s)
- Camilla Wiwe Lipsker
- Functional Area Medical Psychology; Functional Unit Behavioural Medicine; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Margareta von Heijne
- Functional Area Medical Psychology; Functional Unit Behavioural Medicine; Karolinska University Hospital; Stockholm Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND); Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
- Child and Adolescent Psychiatry; Center for Psychiatry Research; Stockholm County Council; Stockholm Sweden
| | - Rikard K. Wicksell
- Functional Area Medical Psychology; Functional Unit Behavioural Medicine; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
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The effects of a dopamine agonist (apomorphine) on experimental and spontaneous pain in patients with chronic radicular pain: A randomized, double-blind, placebo-controlled, cross-over study. PLoS One 2018; 13:e0195287. [PMID: 29621293 PMCID: PMC5886417 DOI: 10.1371/journal.pone.0195287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/15/2018] [Indexed: 11/29/2022] Open
Abstract
Background Although evidence suggests that dopaminergic systems are involved in pain processing, the effects of dopaminergic interventions on pain remains questionable. This randomized, double blinded, placebo-controlled, cross-over study was aimed at exploring the effect of the dopamine agonist apomorphine on experimental pain evoked by cold stimulation and on spontaneous pain in patients with lumbar radicular (neuropathic) pain. Methods Data was collected from 35 patients with chronic lumbar radiculopathy (18 men, mean age 56.2±13 years). The following parameters were evaluated before (baseline) and 30, 75 and 120 minutes subsequent to a subcutaneous injection of 1.5 mg apomorphine or placebo: cold pain threshold and tolerance in the painful site (ice pack, affected leg) and in a remote non-painful site (12°C water bath, hand), and spontaneous (affected leg) pain intensity (NPS, 0–100). Results One-hundred and twenty minutes following apomorphine (but not placebo) injection, cold pain threshold and tolerance in the hand increased significantly compared to baseline (from a median of 8.0 seconds (IQR = 5.0) to 10 seconds (IQR = 9.0), p = 0.001 and from a median of 19.5 seconds (IQR = 30.2) to 27.0 seconds (IQR = 37.5), p<0.001, respectively). In addition, apomorphine prolonged cold pain tolerance but not threshold in the painful site (from a median of 43.0 seconds (IQR = 63.0) at baseline to 51.0 seconds (IQR = 78.0) at 120 min, p = 0.02). Apomorphine demonstrated no superiority over placebo in reducing spontaneous pain intensity. Conclusion These findings are in line with previous results in healthy subjects, showing that apomorphine increases the ability to tolerate cold pain and therefore suggesting that dopaminergic interventions can have potential clinical relevance.
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Methylphenidate attenuates the response to cold pain but not to aversive auditory stimuli in healthy human: a double-blind randomized controlled study. Pain Rep 2017; 2:e593. [PMID: 29392209 PMCID: PMC5741299 DOI: 10.1097/pr9.0000000000000593] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/04/2017] [Accepted: 03/10/2017] [Indexed: 11/26/2022] Open
Abstract
This double-blind, crossover, randomized placebo-controlled study found that methylphenidate has a specific effect on nociceptive pathways rather than a generalized effect on aversive sensory modalities. Introduction: We recently showed that the psycho-stimulant norepinephrine–dopamine reuptake inhibitor methylphenidate (MP) prolonged cold pain threshold and tolerance in adults with attention-deficit hyperactivity disorder (ADHD). Objectives: The objectives of the present study were to: (1) examine whether MP has antinociceptive properties in healthy men; (2) test MP's effects on responses to aversive auditory stimuli. The underlying aim was to determine whether MP exerts antinociceptive properties or more generalized, nonspecific attenuating effects on different aversive sensory modalities. Methods: This double-blind, crossover, randomized placebo-controlled study consisted of 2 sessions one week apart from each other. In each session, pain threshold (seconds) and tolerance (seconds) in response to painful cold stimulation were measured. Additionally, threshold (dB) and tolerance (seconds) to loud aversive auditory stimuli (500 Hz, 2000 Hz and white noise) were also tested prior to and 2 hours following the administration of a single dose of either 20 mg MP or an identical looking placebo. Results: Forty men, 26.1 ± 4.0 (mean ± SD) years were enrolled in the study. Wilcoxon signed-rank test analyses showed that MP, but not the placebo, produced a significant increase in cold pain threshold (from 4.1 ± 2.6 to 5.4 ± 3.1 seconds, P = 0.001 and from 4.5 ± 2.6 to 4.3 ± 2.7 seconds, P = 0.2, respectively) and tolerance (from 57.8 ± 54.0 to 73.8 ± 61.8 seconds, P = 0.001 and from 52.5 ± 53.7 sec to 57.0 ± 52.9 seconds, P = 0.1, respectively). No significant changes were found in any of the auditory parameters. Conclusion: These results suggest that MP has an effect on nociceptive pathways rather than a nonspecific, generalized attenuating effect on aversive sensory stimuli.
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Lazenka MF, Freitas KC, Henck S, Negus SS. Relief of Pain-Depressed Behavior in Rats by Activation of D1-Like Dopamine Receptors. J Pharmacol Exp Ther 2017; 362:14-23. [PMID: 28411257 DOI: 10.1124/jpet.117.240796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/13/2017] [Indexed: 12/11/2022] Open
Abstract
Clinically significant pain often includes a decrease in both behavior and mesolimbic dopamine signaling. Indirect and/or direct dopamine receptor agonists may alleviate pain-related behavioral depression. To test this hypothesis, the present study compared effects of indirect and direct dopamine agonists in a preclinical assay of pain-depressed operant responding. Male Sprague-Dawley rats with chronic indwelling microelectrodes in the medial forebrain bundle were trained in an intracranial self-stimulation (ICSS) procedure to press a lever for pulses of electrical brain stimulation. Intraperitoneal injection of dilute lactic acid served as an acute noxious stimulus to depress ICSS. Intraperitoneal lactic acid-induced depression of ICSS was dose-dependently blocked by the dopamine transporter inhibitor methylphenidate and the D1-selective agonist SKF82958, but not by the D2/3-selective agonists quinpirole, pramipexole, or sumanirole. The antinociceptive effects of methylphenidate and SKF82958 were blocked by the D1-selective antagonist SCH39166. Acid-induced stimulation of a stretching response was evaluated in separate groups of rats, but all agonists decreased acid-stimulated stretching, and antagonism experiments were inconclusive due to direct effects of the antagonists when administered alone. Taken together, these results suggest that D1-receptor stimulation is both sufficient to block acid-induced depression of ICSS and necessary for methylphenidate antinociception in this procedure. Conversely, D2/3-receptor stimulation is not sufficient to relieve pain-depressed behavior. These results support the hypothesis that pain-related depression of dopamine D1 receptor signaling contributes to pain-related depression of behavior in rats. Additionally, these results support further consideration of indirect dopamine agonists and direct D1 receptor agonists as candidate treatments for pain-related behavioral depression.
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Affiliation(s)
- Matthew F Lazenka
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
| | - Kelen C Freitas
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
| | - Sydney Henck
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
| | - S Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
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Fuermaier ABM, Hüpen P, De Vries SM, Müller M, Kok FM, Koerts J, Heutink J, Tucha L, Gerlach M, Tucha O. Perception in attention deficit hyperactivity disorder. ACTA ACUST UNITED AC 2017; 10:21-47. [PMID: 28401487 DOI: 10.1007/s12402-017-0230-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
A large body of research demonstrated that individuals with attention deficit hyperactivity disorder (ADHD) suffer from various neuropsychological deficits. In contrast, less is known and only divergent evidence exists on perceptual functions of individuals with ADHD. This is problematic as neuropsychological and perceptual functions are closely interrelated and are often difficult to disentangle in behavioral assessments. This study presents the conduct and results of a systematic literature review on perceptual functions in children and adults with ADHD. This review considers studies using psychophysical methods (objective measurements) and self- and informant reports (subjective measurements). Results indicate that individuals with ADHD have altered perceptual functions in various domains as compared to typically developing individuals. Increased perceptual functions in individuals with ADHD were found with regard to olfactory detection thresholds, whereas reduced perceptual functions were evident for aspects of visual and speech perception. Moreover, individuals with ADHD were found to experience discomfort to sensory stimuli at a lower level than typically developing individuals. Alterations of perceptual functions in individuals with ADHD were shown to be moderated by various factors, such as pharmacological treatment, cognitive functions, and symptom severity. We conclude by giving implications for daily life functioning and clinical practice.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Philippa Hüpen
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Stefanie M De Vries
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Morgana Müller
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Francien M Kok
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Joost Heutink
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Centre of Expertise for Blind and Partially Sighted People, Royal Dutch Visio, 9752 AC, Haren, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Centre for Mental Health, University Hospital of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Bijlenga D, Tjon-Ka-Jie JYM, Schuijers F, Kooij JJS. Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms. Eur Psychiatry 2017; 43:51-57. [PMID: 28371743 DOI: 10.1016/j.eurpsy.2017.02.481] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Abnormal sensory sensitivity is a feature of autism-spectrum disorder (ASD), but is also reported in attention-deficit/hyperactivity disorder (ADHD). In many cases, ADHD and ASD are comorbid. This study investigated the prevalence of sensory hyper- and hyposensitivity among adults with ADHD, controlling for autistic symptoms. METHOD One hundred and sixteen adults diagnosed with ADHD completed the Adolescent/Adult Sensory Profile-NL (AASP-NL) and the Autism-spectrum Quotient (AQ) questionnaires. Prevalences of hyper- and hyposensitivity and autism-spectrum symptoms were compared to norm values. Multivariate binary logistic regressions were used to determine the association of autistic symptoms, age, gender, ADHD subtype, self-reported severity of ADHD symptoms, comorbid disorders, and use of medication on the sensory hypo- and hypersensitivity in adults with ADHD. RESULTS Adults with ADHD had more autistic symptoms, and they had both more hyper- and hyposensitivity compared to norm groups. This was especially apparent in the Activity level and Auditory sensory modalities. Sensory hypo- and hypersensitivity were both related to an increased ADHD score, even showing a dose-response relationship, but not to any autistic symptom or comorbid disorder. As much as 43% of the females with ADHD reported sensory hypo- and/or hypersensitivity, compared to 22% of the men. CONCLUSIONS Sensory hypo- and hypersensitivity may be viewed as key features of adult ADHD, especially in females, regardless of any autistic symptoms. Future research should be directed at the implications of this sensory dysregulation for the understanding of the pathophysiology of (female) ADHD, and on the usefulness of assessment of atypical sensory profiles in the diagnostic procedure of ADHD in adults.
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Affiliation(s)
- D Bijlenga
- PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands.
| | - J Y M Tjon-Ka-Jie
- PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands
| | - F Schuijers
- PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands
| | - J J S Kooij
- PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands
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Stickley A, Koyanagi A, Takahashi H, Kamio Y. ADHD symptoms and pain among adults in England. Psychiatry Res 2016; 246:326-331. [PMID: 27750114 DOI: 10.1016/j.psychres.2016.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 09/21/2016] [Accepted: 10/02/2016] [Indexed: 12/16/2022]
Abstract
Prior research has produced conflicting findings on the association between attention-deficit/hyperactivity disorder (ADHD) and pain, while studies among community-dwelling adults are lacking. This study examined the association between ADHD symptoms and pain in the general adult population, and the extent to which this association is influenced by comorbid common mental disorders (CMDs). Data came from the 2007 Adult Psychiatric Morbidity Survey which included a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) Screener was used to obtain information on ADHD symptoms, while pain was assessed by the degree to which it interfered with work activity in the previous month. The Clinical Interview Schedule Revised (CIS-R) was used to evaluate six categories of CMDs. In a binary logistic regression analysis adjusted for socio-demographic factors and physical health conditions, an ADHD symptom score ≥14 was strongly associated with extreme pain (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.09-4.74). The OR was attenuated greatly after further adjustment for CMDs (OR: 1.64, 95% CI: 1.05-2.58) but remained statistically significant. Adults with ADHD symptoms have higher odds for experiencing pain. CMDs are influential in this association but do not fully explain it.
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Affiliation(s)
- Andrew Stickley
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Hidetoshi Takahashi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
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YAMAMOTOVÁ A, FRICOVÁ J, ROKYTA R, ŠLAMBEROVÁ R. The Effect of Combined Treatment of Opioids With Methylphenidate on Nociception in Rats and Pain in Human. Physiol Res 2016; 65:S567-S575. [DOI: 10.33549/physiolres.933535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Methylphenidate hydrochloride (MPH/Ritalin) is a stimulant used for off-label management of cancer-related fatigue and sedation; however, its use in pain treatment is still relatively rare. This study 1) compares the antinociceptive effect of MPH and its combination with morphine (MOR) in adult male Wistar rats after a single administration of MPH, MOR or their combination, and 2) compares the analgesic effects of opioids and Ritalin combined therapy with opioid monotherapy in patients with cancer pain. To objectively assess physical activity during a three-week monitoring period, patients were equipped with Actiwatch Score Actigraph. Patients performed daily evaluations of pain intensity and frequency, and the extent to which pain interfered with their daily life. Our research with rats supports the evidence that MPH in lower doses has the ability to enhance the analgesic properties of morphine when the two drugs are used in combination. Results from the patient arm of our study found that short-term treatment had no significant effect on intensity or frequency of pain, however it decreased the overall burden of pain; the combined treatment of opioid and Ritalin also showed anti-sedation effects and resulted in mild improvement in one of our patient’s quality of life.
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Fluegge K. Does environmental exposure to the greenhouse gas, N 2O, contribute to etiological factors in neurodevelopmental disorders? A mini-review of the evidence. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2016; 47:6-18. [PMID: 27566494 DOI: 10.1016/j.etap.2016.08.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Neurodevelopmental disorders are increasing in prevalence worldwide. Previous work suggests that exposure to the environmental air pollutant and greenhouse gas - nitrous oxide (N2O) - may be an etiological factor in neurodevelopmental disorders through the targeting of several neural correlates. METHODOLOGY While a number of recent systematic reviews have addressed the role of general anesthesia in the surgical setting and neurodevelopmental outcomes, a narrative mini-review was conducted to first define and characterize the relevant variables (i.e., N2O, attention-deficit hyperactivity disorder [ADHD] and autism spectrum disorders [ASD]) and their potential interactions into a coherent, hypothesis-generating work. The narrative mini-review merges basic principles in environmental science, anesthesiology, and psychiatry to more fully develop the novel hypotheses that neurodevelopmental impairment found in conditions like ADHD and ASD may be due to exposure to the increasing air pollutant, N2O. RESULTS The results of the present mini-review indicate that exposure to N2O, even at non-toxic doses, may modulate central neurotransmission and target many neural substrates directly implicated in neurodevelopmental disorders, including the glutamatergic, opioidergic, cholinergic, and dopaminergic systems. Epidemiological studies also indicate that early and repeated exposure to general anesthesia, including N2O, may contribute to later adverse neurodevelopmental outcomes in children. CONCLUSIONS The current evidence and subsequent hypotheses suggest that a renewed interest be taken in the toxicological assessment of environmental N2O exposure using validated biomarkers and psychiatric endpoints. Given the relevance of N2O as a greenhouse gas, societies may also wish to engage in a more robust monitoring and reporting of N2O levels in the environment for climactic benefit as well.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
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Wolff N, Rubia K, Knopf H, Hölling H, Martini J, Ehrlich S, Roessner V. Reduced pain perception in children and adolescents with ADHD is normalized by methylphenidate. Child Adolesc Psychiatry Ment Health 2016; 10:24. [PMID: 27453723 PMCID: PMC4957360 DOI: 10.1186/s13034-016-0112-9] [Citation(s) in RCA: 16] [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: 02/15/2016] [Accepted: 06/29/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The present study examined pain perception in children and adolescents with ADHD and the interaction between pain perception and the administration of methylphenidate (MPH) in order to generate hypotheses for further research that will help to clarify the association between ADHD diagnosis, MPH treatment and pain perception. METHODS We included 260 children and adolescents of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) and analyzed parent's assessments of children's pain distribution and pain perception, as well as the influence of MPH administration on pain perception in affected children and adolescents. RESULTS Pain perception was associated with ADHD and MPH administration, indicating that children and adolescents suffering from ADHD without MPH treatment were reported to have lower pain perception compared to both, healthy controls (HC) and ADHD patients medicated with MPH. CONCLUSION We suggest that reduced pain perception in children and adolescents with ADHD not medicated with MPH may lead to higher risk tolerance by misjudgments of dangerous situations, expanding the importance of MPH administration in affected children and adolescents.
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Affiliation(s)
- Nicole Wolff
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Martini
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
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Abstract
BACKGROUND The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. METHOD A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. RESULTS ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70-80 years than the group 50-60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. CONCLUSION It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk-benefit ratio when pharmacotherapy is considered to be a possible treatment.
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Affiliation(s)
- Terje Torgersen
- Department of Østmarka, St Olav’s Hospital, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjorn Gjervan
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, Norway
| | - Michael B Lensing
- NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, Norway
| | - Kirsten Rasmussen
- St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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