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Zhu W, Bu Y, Wu L, Li J, Song C, Hao Y. Association between 5-HT1A receptor C-1019G, 5-HTTLPR polymorphisms and panic disorder: a meta-analysis. Aging (Albany NY) 2024; 16:12293-12311. [PMID: 39207450 DOI: 10.18632/aging.206087] [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: 02/19/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024]
Abstract
HTR1A C-1019G polymorphism (rs6295) and serotonin transporter promoter polymorphism (5-HTTLPR) have been linked with panic disorder (PD) in different ethnic backgrounds. Both these polymorphisms are in the promoter regions. However, results are inconsistent and contrasting evidence makes reliable conclusions even more challenging. A meta-analysis was conducted to test whether C-1019G polymorphism and 5-HTTLPR were involved in the etiology of PD. Articles researching the link between C-1019G, 5-HTTLPR polymorphisms, and PD were retrieved by database searching and systematically selected on the basis of selected inclusion parameters. 21 studies were included that examined the relationship of rs6295,5-HTTLPR polymorphisms with PD risk susceptibility (rs62957 polymorphism - 7 articles, and 5-HTTLPR polymorphism - 14 articles). A significant association was seen between the rs6295 polymorphism and PD pathogenesis, especially in Caucasian PD patients. No significant genetic linkage was found between the 5-HTTLPR polymorphism and PD. C-1019G polymorphism was involved in the etiology of PD in Caucasian patients. The 5-HTTLPR polymorphism was not a susceptibility factor of PD.
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Affiliation(s)
- Wenli Zhu
- Department of Psychiatry, Fourth Hospital of Wuhu City, Wuhu, Anhui, China
| | - Yangying Bu
- Department of Psychiatry, Fourth Hospital of Wuhu City, Wuhu, Anhui, China
| | - Lijuan Wu
- Department of Psychiatry, Shenyang Mental Health Center, Shenyang, Liaoning, China
| | - Junwei Li
- Department of Psychiatry, Fourth Hospital of Wuhu City, Wuhu, Anhui, China
| | - Chuanfu Song
- Department of Psychiatry, Fourth Hospital of Wuhu City, Wuhu, Anhui, China
| | - Yihui Hao
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Tomasi J, Zai CC, Zai G, Kennedy JL, Tiwari AK. Genetics of human startle reactivity: A systematic review to acquire targets for an anxiety endophenotype. World J Biol Psychiatry 2021; 22:399-427. [PMID: 33040669 DOI: 10.1080/15622975.2020.1834619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Startle response is an objective physiological measure integral to the human defense system and a promising target for endophenotype investigations of anxiety. Given the alterations in startle reactivity observed among anxiety and related disorders, we searched for genetic variants associated with startle reactivity as they may be further involved in pathological anxiety risk. METHODS A systematic literature review was performed to identify genetic variants associated with startle reactivity in humans, specifically baseline and fear- or anxiety-potentiated startle. RESULTS The polymorphisms Val66Met (rs6265) from brain-derived neurotrophic factor (BDNF), Val158Met (rs4680) from catechol-O-methyltransferase (COMT), and the serotonin transporter-linked polymorphic region (5-HTTLPR) from the serotonin transporter gene (SLC6A4) were most commonly studied in human startle. In addition, several other genetic variants have also been identified as potential candidates that warrant further research, especially given their novelty in in the context of anxiety. CONCLUSIONS Similar to psychiatric genetic studies, the studies on startle reactivity primarily focus on candidate genes and are plagued by non-replication. Startle reactivity is a promising endophenotype that requires concerted efforts to collect uniformly assessed, large, well-powered samples and hypothesis-free genome-wide strategies. To further support startle as an endophenotype for anxiety, this review suggests advanced genetic strategies for startle research.
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Affiliation(s)
- Julia Tomasi
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Clement C Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Gwyneth Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,General Adult Psychiatry and Health Systems Division, CAMH, Toronto, Canada
| | - James L Kennedy
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Arun K Tiwari
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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Hande SH, Krishna SM, Sahote KK, Dev N, Erl TP, Ramakrishna K, Ravidhran R, Das R. Population genetic variation of SLC6A4 gene, associated with neurophysiological development. J Genet 2021. [DOI: 10.1007/s12041-021-01266-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Schiele MA, Reif A, Lin J, Alpers GW, Andersson E, Andersson G, Arolt V, Bergström J, Carlbring P, Eley TC, Esquivel G, Furmark T, Gerlach AL, Hamm A, Helbig-Lang S, Hudson JL, Lang T, Lester KJ, Lindefors N, Lonsdorf TB, Pauli P, Richter J, Rief W, Roberts S, Rück C, Schruers KRJ, Thiel C, Wittchen HU, Domschke K, Weber H, Lueken U. Therapygenetic effects of 5-HTTLPR on cognitive-behavioral therapy in anxiety disorders: A meta-analysis. Eur Neuropsychopharmacol 2021; 44:105-120. [PMID: 33483252 DOI: 10.1016/j.euroneuro.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/12/2020] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
There is a recurring debate on the role of the serotonin transporter gene linked polymorphic region (5-HTTLPR) in the moderation of response to cognitive behavioral therapy (CBT) in anxiety disorders. Results, however, are still inconclusive. We here aim to perform a meta-analysis on the role of 5-HTTLPR in the moderation of CBT outcome in anxiety disorders. We investigated both categorical (symptom reduction of at least 50%) and dimensional outcomes from baseline to post-treatment and follow-up. Original data were obtained from ten independent samples (including three unpublished samples) with a total of 2,195 patients with primary anxiety disorder. No significant effects of 5-HTTLPR genotype on categorical or dimensional outcomes at post and follow-up were detected. We conclude that current evidence does not support the hypothesis of 5-HTTLPR as a moderator of treatment outcome for CBT in anxiety disorders. Future research should address whether other factors such as long-term changes or epigenetic processes may explain further variance in these complex gene-environment interactions and molecular-genetic pathways that may confer behavioral change following psychotherapy.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jiaxi Lin
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Evelyn Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Division of Psychology, Linköping University, Linköping, Sweden
| | - Volker Arolt
- Institute of Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Jan Bergström
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Thalia C Eley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - Gabriel Esquivel
- School for Mental Health and Neuroscience, Maastricht University, The Netherlands and Mondriaan Mental Health Center, Maastricht, The Netherlands
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Alexander L Gerlach
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Alfons Hamm
- Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Sylvia Helbig-Lang
- Department of Clinical Psychology and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Jennifer L Hudson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Thomas Lang
- Christoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany; Department of Psychology and Methods, Jacobs University Bremen, Germany
| | - Kathryn J Lester
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Nils Lindefors
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Sweden
| | - Tina B Lonsdorf
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Jan Richter
- Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Susanna Roberts
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Sweden
| | - Koen R J Schruers
- School for Mental Health and Neuroscience, Maastricht University, The Netherlands and Mondriaan Mental Health Center, Maastricht, The Netherlands
| | - Christiane Thiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany; Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Germany
| | - Ulrike Lueken
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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5
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Schiele MA, Herzog K, Kollert L, Böhnlein J, Repple J, Rosenkranz K, Leehr EJ, Ziegler C, Lueken U, Dannlowski U, Pauli P, Arolt V, Zwanzger P, Deckert J, Erfurth A, Domschke K. Affective temperaments (TEMPS-A) in panic disorder and healthy probands: Genetic modulation by 5-HTT variation. World J Biol Psychiatry 2020; 21:790-796. [PMID: 31852378 DOI: 10.1080/15622975.2019.1705999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Temperamental traits as ascertained by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-Questionnaire (TEMPS-A) have been suggested as promising intermediate phenotypes of mental disorders. In anxiety disorders, however, TEMPS scales and their genetic underpinnings are still understudied. METHODS TEMPS-A scores in 109 patients with panic disorder (PD) were compared to a sample of 536 healthy probands. All participants were genotyped for serotonin transporter gene variation (5-HTTLPR/rs25531). RESULTS PD patients displayed significantly increased scores on the dysthymic, cyclothymic, irritable and anxious subscales, and lower scores on the hyperthymic subscale, respectively (all ps < 0.001) compared to healthy probands. In the total sample, the less active 5-HTTLPR/rs25531 S/LG alleles were associated with higher scores on the dysthymic, cyclothymic, irritable and anxious temperaments (all ps < 0.01), but not the hyperthymic subscale. Mediation analyses revealed anxious temperament in particular to mediate the relationship between 5-HTT genotype and PD. CONCLUSIONS Dysthymic, cyclothymic, irritable and notably anxious temperament could serve as valuable intermediate phenotypes in efforts to unravel neurobiological, particularly serotonin system related genetic pathomechanisms associated with PD and potentially contribute to a panel of vulnerability markers guiding early targeted preventive interventions.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Herzog
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Leonie Kollert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Joscha Böhnlein
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Jonathan Repple
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Karoline Rosenkranz
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elisabeth J Leehr
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Wasserburg, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas Erfurth
- 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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6
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Zou Z, Huang Y, Wang J, Min W, Zhou B. The association between serotonin-related gene polymorphisms and susceptibility and early sertraline response in patients with panic disorder. BMC Psychiatry 2020; 20:388. [PMID: 32723321 PMCID: PMC7388522 DOI: 10.1186/s12888-020-02790-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A number of studies have shown that genetic factor plays an important role in etiology of panic disorder (PD). The aim of the present study was to examine the association of serotonin-related gene polymorphisms with PD risk. Then, we analyzed the correlation between these gene polymorphisms and response to sertraline drug. METHODS Two hundred thirty-three patients with PD and 231 healthy controls were enrolled in the study. Panic Disorder Severity Scale (PDSS) were administered to all subjects, and all patients in the study were also assessed after 4 weeks of treatment. The SLC6A4(rs140701, rs3813034, 5-HTTLPR and STin2), 5-HTR1A rs6295, 5-HTR2A rs6313 and COMT rs4680 gene polymorphisms were genotyped and assessed for the potential association. RESULTS The allelic model showed that the SLC6A4 rs140701 polymorphism variant was significantly associated with increased risk of PD (OR = 0.624, 95% CI 0.450-0.864, p < 0.05), and a significant result was found in the dominant model (OR = 0.546; 95% CI, 0.371-0.804, p < 0.05). There was a significant difference in allele and genotype frequency between responders and nonresponders in the 5-HTTLPR polymorphism (OR = 0.205, 95% CI 0.128-0.328; OR = 0.249, 95% CI 0.155-0.401, both p < 0.001), indicating the PD patients with S-allele had a poorer response to sertraline than L-allele carriers. CONCLUSIONS The present study suggests that the SLC6A4 rs140701 polymorphism variant may be associated with susceptibility to PD, and 5-HTTLPR polymorphism may be a predictor of response to sertraline in the treatment of PD.
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Affiliation(s)
- Zhili Zou
- grid.410646.10000 0004 1808 0950Psychosomatic Department, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, No. 32 West Second Section First Ring Road, Chengdu, Sichuan 610072 P.R. China
| | - Yulan Huang
- grid.410646.10000 0004 1808 0950Psychosomatic Department, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, No. 32 West Second Section First Ring Road, Chengdu, Sichuan 610072 P.R. China
| | - Jinyu Wang
- grid.410646.10000 0004 1808 0950Psychosomatic Department, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, No. 32 West Second Section First Ring Road, Chengdu, Sichuan 610072 P.R. China
| | - Wenjiao Min
- grid.410646.10000 0004 1808 0950Psychosomatic Department, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, No. 32 West Second Section First Ring Road, Chengdu, Sichuan 610072 P.R. China
| | - Bo Zhou
- Psychosomatic Department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, No. 32 West Second Section First Ring Road, Chengdu, Sichuan, 610072, P.R. China.
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7
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Schiele MA, Kollert L, Lesch KP, Arolt V, Zwanzger P, Deckert J, Ziegler C, Domschke K. Hypermethylation of the serotonin transporter gene promoter in panic disorder-Epigenetic imprint of comorbid depression? Eur Neuropsychopharmacol 2019; 29:1161-1167. [PMID: 31353282 DOI: 10.1016/j.euroneuro.2019.07.131] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/24/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
Panic disorder (PD) is frequently comorbid with major depressive disorder (MDD), which has been associated with impaired treatment response and recovery rates. Alterations in the serotonergic system may play a crucial role in the pathogenesis of PD and MDD and might constitute a shared biological trunk of both disorders. Epigenetic patterns such as hypermethylation of the serotonin transporter gene (SLC6A4) have been associated with various mental disorders including MDD, but, to date, no association with PD has been reported. In the present study, SLC6A4 promoter methylation was investigated in two independent samples of PD patients in a case-control design (sample 1: N = 120; sample 2: N = 118), while - given the reported high comorbidity of both disorders - taking into account the effect of comorbid MDD. The functional relevance of altered SLC6A4 promoter methylation was investigated by means of luciferase-based reporter gene assays. SLC6A4 promoter hypermethylation in PD patients relative to healthy controls was driven by comorbid diagnosis of MDD (p = 9 × 10-6), whereas no altered methylation levels were observed in patients without comorbid MDD. This held true not only in comparison to healthy controls, but also in direct comparison between PD patients with and without comorbid MDD (p = .009). Functional analyses revealed increased methylation of the investigated region to confer decreased reporter gene activity. The present results suggest functionally relevant SLC6A4 promoter hypermethylation as a possibly specific epigenetic marker of MDD, but not of PD itself, and thus might constitute a selective biomarker informing differential diagnosis based on individual epigenetic profiles.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Leonie Kollert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Peter Zwanzger
- kbo Inn-Salzach-Hospital, Wasserburg am Inn, Germany; Department of Psychiatry und Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany.
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Assessment of fear and anxiety associated behaviors, physiology and neural circuits in rats with reduced serotonin transporter (SERT) levels. Transl Psychiatry 2019; 9:33. [PMID: 30670681 PMCID: PMC6343029 DOI: 10.1038/s41398-019-0368-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 08/15/2018] [Accepted: 10/05/2018] [Indexed: 01/11/2023] Open
Abstract
Genetic variation in serotonin transporter (SERT) that reduces transcriptional efficiency is associated with higher anxiety and fear traits and a greater incidence of post traumatic stress disorder (PTSD). Although previous studies have shown that rats with no expression of SERT (SERT-/-) have increased baseline anxiety behaviors, SERT+/- rats with low SERT expression (and more relevant to the clinical condition with low SERT expression) do not. Yet, no systematic studies of fear acquisition/extinction or their underlying neural mechanisms have been conducted in this preclinical genetic SERT+/- model. Here we sought to determine if SERT+/- or SERT-/-, compared to wildtype, rats would show exacerbated panic responses and/or persistent conditioned fear responses that may be associated with PTSD or phobia vulnerability. Results: Only SERT-/- rats showed increased baseline anxiety-like behaviors with heightened panic respiratory responses. However SERT+/- (also SERT-/-) rats showed enhanced acquisition of fear and delayed extinction of fear that was associated with changes in serotonergic-related genes (e.g., reduced 5-HT1A receptor) and disrupted inhibition within the basolateral amygdala (BLA). Furthermore, the disrupted fear responses in SERT+/- rats were normalized with 5HT1A antagonist infusions into the BLA. Enhanced acquisition and failure to extinguish fear memories displayed by both SERT-/- and SERT+/- rats are cardinal symptoms of disabling anxiety disorders such as phobias and PTSD. The data here support the hypothesis that reduced SERT function is a genetic risk that disrupts select gene expression and network properties in the amygdala that could result in vulnerability to these syndromes.
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Leibold NK, Schruers KR. Assessing Panic: Bridging the Gap Between Fundamental Mechanisms and Daily Life Experience. Front Neurosci 2018; 12:785. [PMID: 30459546 PMCID: PMC6232935 DOI: 10.3389/fnins.2018.00785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/10/2018] [Indexed: 12/16/2022] Open
Abstract
Panic disorder (PD) is one of the most common psychiatric disorders. Recurrent, unexpected panic attacks (PAs) are the primary symptom and strongly impact patients’ quality of life. Clinical manifestations are very heterogeneous between patients, emphasizing the need for a dimensional classification integrating various aspects of neurobiological and psychological circuits in line with the Research Domain Criteria (RDoC) proposed by the US National Institute of Mental Health. To go beyond data that can be collected in the daily clinical situation, experimental panic provocation is widely used, which has led to important insights into involved brain regions and systems. Genetic variants can determine the sensitivity to experimental models such as carbon dioxide (CO2) exposure and can increase the risk to develop PD. Recent developments now allow to better assess the dynamic course of PAs outside the laboratory in patients’ natural environment. This can provide novel insights into the underlying mechanisms and the influence of environmental factors that can alter gene regulation by changing DNA methylation. In this mini review, we discuss assessment of PAs in the clinic, in the laboratory using CO2 exposure, genetic associations, and the benefits of real-life assessment and epigenetic research.
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Affiliation(s)
- Nicole K Leibold
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, European Graduate School of Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Koen R Schruers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, European Graduate School of Neuroscience, Maastricht University, Maastricht, Netherlands.,Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
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10
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Watanabe T, Ueda M, Ishiguro S, Hayashi Y, Aoki A, Shinozaki M, Kato K, Akiyama K, Shimoda K. Early Improvement and Marriage Are Determinants of the 12-Month Treatment Outcome of Paroxetine in Outpatients with Panic Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:382-390. [PMID: 29073750 PMCID: PMC5678480 DOI: 10.9758/cpn.2017.15.4.382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/22/2017] [Accepted: 03/18/2017] [Indexed: 01/06/2023]
Abstract
Objective In this study, we investigated the determinants of remission and discontinuation of paroxetine pharmacotherapy in outpatients with panic disorder (PD). Methods Subjects were 79 outpatients diagnosed with PD who took 10-40 mg/day of paroxetine for 12 months. The candidate therapeutic determinants included the serotonin transporter gene-linked polymorphic region and the -1019C/G promoter polymorphism of the serotonin receptor 1A as genetic factors, educational background and marital status as environmental factors, and early improvement (EI) at 2 weeks as a clinical factor were assessed. The Clinical Global Impression scale was used to assess the therapeutic effects of the pharmacotherapy. Results Cox proportional hazards regression was performed to investigate the significant predictive factors of remission and discontinuation. EI was only a significant predictive factor of remission. EI was a significant predictive factor of remission (hazard ratio [HR], 2.709; 95% confidence interval [CI], 1.177-6.235). Otherwise, EI and marital status were significant predictive factors of the discontinuation. EI (HR, 0.266; 95% CI, 0.115-0.617) and being married (HR, 0.437; 95% CI, 0.204-0.939) were considered to reduce the risk of treatment discontinuation. In married subjects, EI was a significant predictive factor of the discontinuation (HR, 0.160; 95% CI, 0.045-0.565). However, in unmarried subjects, EI was not a significantly predictive factor for the discontinuation. Conclusion EI achievement appears to be a determinant of PD remission in paroxetine treatment. In married PD patients, EI achievement also appears to reduce a risk of discontinuation of paroxetine treatment.
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Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Masataka Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazuko Kato
- Mental Health Clinic SAKURA-RA, Utsunomiya, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
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11
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Jabłoński M, Mazur JK, Tarnowski M, Dołęgowska B, Pędziwiatr D, Kubiś E, Budkowska M, Sałata D, Wysiecka JP, Kazimierczak A, Reginia A, Ratajczak MZ, Samochowiec J. Mobilization of Peripheral Blood Stem Cells and Changes in the Concentration of Plasma Factors Influencing their Movement in Patients with Panic Disorder. Stem Cell Rev Rep 2017; 13:217-225. [PMID: 27914035 PMCID: PMC5380702 DOI: 10.1007/s12015-016-9700-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this paper we examined whether stem cells and factors responsible for their movement may serve as new biological markers of anxiety disorders. The study was carried out on a group of 30 patients diagnosed with panic disorder (examined before and after treatment), compared to 30 healthy individuals forming the control group. We examined the number of circulating HSCs (hematopoetic stem cells) (Lin−/CD45 +/CD34 +) and HSCs (Lin−/CD45 +/AC133 +), the number of circulating VSELs (very small embryonic-like stem cells) (Lin−/CD45−/CD34 +) and VSELs (Lin−/CD45−/AC133 +), as well as the concentration of complement components: C3a, C5a and C5b-9, SDF-1 (stromal derived factor) and S1P (sphingosine-1-phosphate). Significantly lower levels of HSCs (Lin−/CD45 +/AC133 +) have been demonstrated in the patient group compared to the control group both before and after treatment. The level of VSELs (Lin−/CD45−/CD133 +) was significantly lower in the patient group before treatment as compared to the patient group after treatment. The levels of factors responsible for stem cell movement were significantly lower in the patient group compared to the control group before and after treatment. It was concluded that the study of stem cells and factors associated with their movement can be useful in the diagnostics of panic disorder, as well as differentiating between psychotic and anxiety disorders.
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Affiliation(s)
- Marcin Jabłoński
- Department of Psychiatry, Pomeranian University of Medicine, Broniewskiego 26, 71-460, Szczecin, Poland
| | - Jolanta Kucharska Mazur
- Department of Psychiatry, Pomeranian University of Medicine, Broniewskiego 26, 71-460, Szczecin, Poland.
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Medical Analytics, Pomeranian University of Medicine, Szczecin, Poland
| | - Daniel Pędziwiatr
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Ewa Kubiś
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Marta Budkowska
- Department of Medical Analytics, Pomeranian University of Medicine, Szczecin, Poland
| | - Daria Sałata
- Department of Medical Analytics, Pomeranian University of Medicine, Szczecin, Poland
| | - Justyna Pełka Wysiecka
- Department of Psychiatry, Pomeranian University of Medicine, Broniewskiego 26, 71-460, Szczecin, Poland
| | | | - Artur Reginia
- Department of Psychiatry, Pomeranian University of Medicine, Broniewskiego 26, 71-460, Szczecin, Poland
| | - Mariusz Z Ratajczak
- Stem Cell Biology Program at the James Graham Brown Cancer Center, University of Louisville, Louisville, KY, 40202, USA
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian University of Medicine, Broniewskiego 26, 71-460, Szczecin, Poland
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12
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Watanabe T, Ishiguro S, Aoki A, Ueda M, Hayashi Y, Akiyama K, Kato K, Shimoda K. Genetic Polymorphism of 1019C/G (rs6295) Promoter of Serotonin 1A Receptor and Catechol-O-Methyltransferase in Panic Disorder. Psychiatry Investig 2017; 14:86-92. [PMID: 28096880 PMCID: PMC5240452 DOI: 10.4306/pi.2017.14.1.86] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Family and twin studies have suggested genetic liability for panic disorder (PD) and therefore we sought to determine the role of noradrenergic and serotonergic candidate genes for susceptibility for PD in a Japanese population. METHODS In this age- and gender-matched case-control study involving 119 PD patients and 119 healthy controls, we examined the genotype distributions and allele frequencies of the serotonin transporter gene linked polymorphic region (5-HTTLPR), -1019C/G (rs6295) promoter polymorphism of the serotonin receptor 1A (5-HT1A), and catechol-O-methyltransferase (COMT) gene polymorphism (rs4680) and their association with PD. RESULTS No significant differences were evident in the allele frequencies or genotype distributions of the COMT (rs4680), 5-HTTLPR polymorphisms or the -1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients and controls. Although there were no significant associations of these polymorphisms with in subgroups of PD patients differentiated by gender or in subgroup comorbid with agoraphobia (AP), significant difference was observed in genotype distributions of the -1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients without AP and controls (p=0.047). CONCLUSION In this association study, the 1019C/G (rs6295) promoter polymorphism of the 5-HT1A receptor G/G genotype was associated with PD without AP in a Japanese population.
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Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Kazufumi Akiyama
- Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
| | - Kazuko Kato
- Sakura La Mental Clinic, Utsunomiya, Tochigi, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan
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13
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Khdour HY, Abushalbaq OM, Mughrabi IT, Imam AF, Gluck MA, Herzallah MM, Moustafa AA. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation. Front Integr Neurosci 2016; 10:20. [PMID: 27445719 PMCID: PMC4925696 DOI: 10.3389/fnint.2016.00020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 05/26/2016] [Indexed: 11/29/2022] Open
Abstract
Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits.
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Affiliation(s)
- Hussain Y Khdour
- Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds UniversityJerusalem, State of Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers UniversityNewark, NJ, USA
| | - Oday M Abushalbaq
- Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine
| | - Ibrahim T Mughrabi
- Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine
| | - Aya F Imam
- Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds University Jerusalem, State of Palestine
| | - Mark A Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers University Newark, NJ, USA
| | - Mohammad M Herzallah
- Palestinian Neuroscience Initiative, Faculty of Medicine, Al-Quds UniversityJerusalem, State of Palestine; Center for Molecular and Behavioral Neuroscience, Rutgers UniversityNewark, NJ, USA
| | - Ahmed A Moustafa
- Marcs Institute for Brain and Behavior and School of Social Sciences and Psychology, Western Sydney University Sydney, NSW, Australia
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14
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Schiele MA, Ziegler C, Holitschke K, Schartner C, Schmidt B, Weber H, Reif A, Romanos M, Pauli P, Zwanzger P, Deckert J, Domschke K. Influence of 5-HTT variation, childhood trauma and self-efficacy on anxiety traits: a gene-environment-coping interaction study. J Neural Transm (Vienna) 2016; 123:895-904. [PMID: 27145764 DOI: 10.1007/s00702-016-1564-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/27/2016] [Indexed: 11/29/2022]
Abstract
Environmental vulnerability factors such as adverse childhood experiences in interaction with genetic risk variants, e.g., the serotonin transporter gene linked polymorphic region (5-HTTLPR), are assumed to play a role in the development of anxiety and affective disorders. However, positive influences such as general self-efficacy (GSE) may exert a compensatory effect on genetic disposition, environmental adversity, and anxiety traits. We, thus, assessed childhood trauma (Childhood Trauma Questionnaire, CTQ) and GSE in 678 adults genotyped for 5-HTTLPR/rs25531 and their interaction on agoraphobic cognitions (Agoraphobic Cognitions Questionnaire, ACQ), social anxiety (Liebowitz Social Anxiety Scale, LSAS), and trait anxiety (State-Trait Anxiety Inventory, STAI-T). The relationship between anxiety traits and childhood trauma was moderated by self-efficacy in 5-HTTLPR/rs25531 LALA genotype carriers: LALA probands maltreated as children showed high anxiety scores when self-efficacy was low, but low anxiety scores in the presence of high self-efficacy despite childhood maltreatment. Our results extend previous findings regarding anxiety-related traits showing an interactive relationship between 5-HTT genotype and adverse childhood experiences by suggesting coping-related measures to function as an additional dimension buffering the effects of a gene-environment risk constellation. Given that anxiety disorders manifest already early in childhood, this insight could contribute to the improvement of psychotherapeutic interventions by including measures strengthening self-efficacy and inform early targeted preventive interventions in at-risk populations, particularly within the crucial time window of childhood and adolescence.
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Affiliation(s)
- Miriam A Schiele
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.,Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Christiane Ziegler
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Karoline Holitschke
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Christoph Schartner
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Brigitte Schmidt
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Heike Weber
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany.,Department of Psychiatry und Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Katharina Domschke
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.
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15
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Kang E, Choe AY, Kim B, Lee JY, Choi TK, Na HR, Lee SH. Serotonin Transporter and COMT Polymorphisms as Independent Predictors of Health-related Quality of Life in Patients with Panic Disorder. J Korean Med Sci 2016; 31:757-63. [PMID: 27134498 PMCID: PMC4835602 DOI: 10.3346/jkms.2016.31.5.757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/15/2016] [Indexed: 12/13/2022] Open
Abstract
There is growing evidence of poor health-related quality of life (HRQOL) in patients with panic disorder (PD). However, little is known about the factors affecting HRQOL in patients with PD. The authors examined whether 5-HTTLPR tri-allelic approach and Cathechol-O-methyltransferase (COMT) Val(158)Met polymorphism can predict HRQOL in patients with PD controlling for sociodemographic factors and disorder-related symptom levels. The sample consisted of 179 patients with PD consecutively recruited from an outpatient clinic and age- and gender ratio-matched 110 healthy controls. The SF-36 was used to assess multiple domains of HRQOL. Hierarchical multiple regression analysis was performed to determine the independent effect of the 5-HTTLPR and COMT Val(158)Met on the SF-36 in panic patients. Patients with PD showed lowered HRQOL in all sub-domains of the SF-36 compared to healthy controls. The 5-HTTLPR independently and additively accounted for 2.2% of variation (6.7% of inherited variance) of perceived general health and the COMT Val(158)Met independently and additively accounted for 1.5% of variation (5.0% of inherited variance) of role limitation due to emotional problems in patient group. The present study suggests that specific genetic polymorphisms are associated with certain domains of HRQOL and provides a new insight on exploring the factors that predict HRQOL in patients with PD.
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Affiliation(s)
- Eunho Kang
- Department of Psychiatry, Inwha Hospital, Pocheon, Korea
| | | | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jun-Yeob Lee
- Department of Psychiatry, CHA Gumi Medical Center, CHA University, Gumi, Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hae-Ran Na
- Department of Psychiatry, the Catholic University of Korea, Seoul, Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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16
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Howe GW, Beach SRH, Brody GH, Wyman PA. Translating Genetic Research into Preventive Intervention: The Baseline Target Moderated Mediator Design. Front Psychol 2016; 6:1911. [PMID: 26779062 PMCID: PMC4703788 DOI: 10.3389/fpsyg.2015.01911] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 11/26/2015] [Indexed: 11/22/2022] Open
Abstract
In this paper we present and discuss a novel research approach, the baseline target moderated mediation (BTMM) design, that holds substantial promise for advancing our understanding of how genetic research can inform prevention research. We first discuss how genetically informed research on developmental psychopathology can be used to identify potential intervention targets. We then describe the BTMM design, which employs moderated mediation within a longitudinal study to test whether baseline levels of intervention targets moderate the impact of the intervention on change in that target, and whether change in those targets mediates causal impact of preventive or treatment interventions on distal health outcomes. We next discuss how genetically informed BTMM designs can be applied to both microtrials and full-scale prevention trials. We use simulated data to illustrate a BTMM, and end with a discussion of some of the advantages and limitations of this approach.
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Affiliation(s)
- George W Howe
- Department of Psychology, George Washington University Washington, DC, USA
| | - Steven R H Beach
- Center for Family Research, University of Georgia Athens, GA, USA
| | - Gene H Brody
- Center for Family Research, University of Georgia Athens, GA, USA
| | - Peter A Wyman
- Department of Psychiatry, University of Rochester Medical Center Rochester Rochester, NY, USA
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17
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Sharma S, Powers A, Bradley B, Ressler KJ. Gene × Environment Determinants of Stress- and Anxiety-Related Disorders. Annu Rev Psychol 2015; 67:239-61. [PMID: 26442668 DOI: 10.1146/annurev-psych-122414-033408] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The burgeoning field of gene-by-environment (G×E) interactions has revealed fascinating biological insights, particularly in the realm of stress-, anxiety-, and depression-related disorders. In this review we present an integrated view of the study of G×E interactions in stress and anxiety disorders, including the evolution of genetic association studies from genetic epidemiology to contemporary large-scale genome-wide association studies and G×E studies. We convey the importance of consortia efforts and collaboration to gain the large sample sizes needed to move the field forward. Finally, we discuss several robust and well-reproduced G×E interactions and demonstrate how epidemiological identification of G×E interactions has naturally led to a plethora of basic research elucidating the mechanisms of high-impact genetic variants.
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Affiliation(s)
- Sumeet Sharma
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts 02478,
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322.,Atlanta VA Medical Center, US Department of Veterans Affairs, Decatur, Georgia 30033
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts 02478,
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18
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Park MH, Sanders E, Howe M, Singh M, Hallmayer J, Kim E, Chang K. Association of Anxiety Symptoms in Offspring of Bipolar Parents with Serotonin Transporter-Linked Polymorphic Region (5-HTTLPR) Genotype. J Child Adolesc Psychopharmacol 2015; 25. [PMID: 26218602 PMCID: PMC4545526 DOI: 10.1089/cap.2014.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Offspring of parents with bipolar disorder (BD) have been shown to be at high risk for BD. Anxiety symptoms, even at subclinical levels, have been associated with increased risk for BD in these youth. The s-allele of the serotonin transporter-linked polymorphic region (5-HTTLPR) has been implicated in the pathophysiology of both BD and anxiety disorders and has been associated with pharmacological treatment response and increased risk for antidepressant side effects. Therefore, we aimed to explore 1) whether anxiety symptoms in offspring of BD parents were associated with presence of the 5-HTTLPR s-allele and 2) whether anxiety symptoms in the offspring of BD parents according to the 5-HTTLPR genotypes are related to antianxiety medication status. METHODS A total of 64 offspring of BD parents (mean age: 13.7 years) and 51 healthy controls (HC) (mean age: 13.7 years) were compared genetically and on the Multidimensional Anxiety Scale for Children (MASC). RESULTS Offspring of BD parents showed higher levels of overall anxiety than did the HC group. Only antianxiety medication naïve offspring of BD parents were found to have an association between 5-HTTLPR genotypes and anxiety symptoms. The antianxiety medication naïve offspring of BD parents with the s-allele showed higher level of overall anxiety than offspring of BD parents with the l/l genotype. No significant differences in anxiety symptoms or their association with the 5-HTTLPR genotype were found in the HC group. CONCLUSIONS This study indicated that there may be an association between 5-HTTLPR genotypes and anxiety symptoms in offspring of BD parents, and that antianxiety medication status may affect anxiety symptoms in the offspring of BD patients according to genotype.
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Affiliation(s)
- Min-Hyeon Park
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, St. Mary's Hospital, Korea
| | - Erica Sanders
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Meghan Howe
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Manpreet Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Eunjoo Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kiki Chang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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19
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Anxiety disorders and anxiety-related traits and serotonin transporter gene-linked polymorphic region (5-HTTLPR) in adolescents: case-control and trio studies. Psychiatr Genet 2015; 24:176-80. [PMID: 24842237 DOI: 10.1097/ypg.0000000000000035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The role of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in anxiety disorder and anxiety-related traits is controversial. Besides this study, few studies have evaluated the triallelic genotype in adolescents. The aim of this study was to investigate whether anxiety disorders and anxiety-related traits are associated with 5-HTTLPR (biallelic and triallelic) in adolescents, integrating both case-control-based and family-based designs in a community sample. This is a cross-sectional community study of 504 individuals and their families: 225 adolescents (129 adolescents with anxiety disorder and 96 controls) and their biological families. We assessed psychiatric diagnosis using the Kiddie Schedule for Affective Disorders and Schizophrenia. The Temperament and Character Inventory and the Resnick Behavioral Inhibition Scale were used to evaluate harm avoidance and behavioral inhibition. DNA was extracted from saliva and genotyped, including biallelic and triallelic 5-HTTLPR classification, by PCR-RFLP followed by agarose gel electrophoresis. We were not able to find any associations between 5-HTTLPR and anxiety-related phenotypes in both case-control and trio analyses. Further investigation and meta-analytic studies are needed to better clarify the inconsistent results with regard to the association between 5-HTTLPR and anxiety-related phenotypes in adolescents.
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20
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Therapygenetics: anterior cingulate cortex–amygdala coupling is associated with 5-HTTLPR and treatment response in panic disorder with agoraphobia. J Neural Transm (Vienna) 2014; 122:135-44. [DOI: 10.1007/s00702-014-1311-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/06/2014] [Indexed: 12/16/2022]
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21
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Knuts I, Esquivel G, Kenis G, Overbeek T, Leibold N, Goossens L, Schruers K. Therapygenetics: 5-HTTLPR genotype predicts the response to exposure therapy for agoraphobia. Eur Neuropsychopharmacol 2014; 24:1222-8. [PMID: 24906789 DOI: 10.1016/j.euroneuro.2014.05.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/27/2014] [Accepted: 05/09/2014] [Indexed: 01/09/2023]
Abstract
This study was intended to assess the extent to which the low-expression allele of the serotonin transporter gene promoter predicts better response to exposure-based behavior therapy in patients with panic disorder with agoraphobia (PDA). Ninety-nine patients with PDA underwent a 1-week in vivo exposure-based behavior therapy program and provided saliva samples to extract genomic DNA and classify individuals according to four allelic forms (SA, SG, LA, LG) of the 5-HTT-linked polymorphic region (5-HTTLPR). We determined whether the 5-HTTLPR genotype predicted change in avoidance behavior in PDA following treatment. After controlling for pre-treatment avoidance behavior, the 5-HTTLPR low-expression genotypes showed a more favorable response to exposure therapy two weeks following treatment, compared to the other patients. This study suggests a genetic contribution to treatment outcome following behavior therapy and implicates the serotonergic system in response to exposure-based treatments in PDA.
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Affiliation(s)
- Inge Knuts
- School for Mental Health en Neuroscience, Maastricht University and Mondriaan, Vijverdalseweg 1, gebouw Concorde, 6226 NB Maastricht, The Netherlands.
| | - Gabriel Esquivel
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
| | - Gunter Kenis
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
| | - Thea Overbeek
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
| | - Nicole Leibold
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
| | - Lies Goossens
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
| | - Koen Schruers
- School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands
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Choe AY, Kim B, Lee KS, Lee JE, Lee JY, Choi TK, Lee SH. Serotonergic genes (5-HTT and HTR1A) and separation life events: gene-by-environment interaction for panic disorder. Neuropsychobiology 2014; 67:192-200. [PMID: 23635830 DOI: 10.1159/000347084] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 01/02/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The polymorphisms of serotonergic genes (5-HTTLPR and HTR1A rs6295) and separation life events have been studied to find an association with panic disorder, respectively. However, there are no studies that have yet evaluated the interaction effect between serotonergic genes and separation life events for panic disorder. METHODS For this study, 194 panic disorder patients and 172 healthy controls were included for genotyping and environmental factor analysis. Separation life events were assessed using the Stressful Life Events Scale and clinical interviews. To evaluate the potential endophenotypes of panic disorder, the Anxiety Sensitivity Index-revised (ASI-R), harm avoidance in the Temperament and Character Inventory (HA), and neuroticism in the Eysenck Personality Questionnaire (neuroticism) scales were administered. RESULTS For 5-HTTLPR and HTR1A rs6295, there was no significant main effect of each genotype on panic disorder alone. However, the number of separation life events and their interaction with 5-HTTLPR showed a statistically significant effect on panic disorder. In addition, the interaction between 5-HTTLPR and the number of separation life events significantly affected the HA for potential endophenotypes. CONCLUSION This study could suggest the effect of the interaction between 5-HTTLPR and separation life events on panic disorder and its potential endophenotype.
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Affiliation(s)
- Ah Young Choe
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Smitherman TA, Kolivas ED, Bailey JR. Panic disorder and migraine: comorbidity, mechanisms, and clinical implications. Headache 2012; 53:23-45. [PMID: 23278473 DOI: 10.1111/head.12004] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 12/17/2022]
Abstract
A growing body of literature suggests that comorbid anxiety disorders are more common and more prognostically relevant among migraine sufferers than comorbid depression. Panic disorder (PD) appears to be more strongly associated with migraine than most other anxiety disorders. PD and migraine are both chronic diseases with episodic manifestations, involving significant functional impairment and shared symptoms during attacks, interictal anxiety concerning future attacks, and an absence of identifiable secondary pathology. A meta-analysis of high-quality epidemiologic study data from 1990 to 2012 indicates that the odds of PD are 3.76 times greater among individuals with migraine than those without. This association remains significant even after controlling for demographic variables and comorbid depression. Other less-rigorous community and clinical studies confirm these findings. The highest rates of PD are found among migraine with aura patients and those presenting to specialty clinics. Presence of PD is associated with greater negative impact of migraine, including more frequent attacks, increased disability, and risk for chronification and medication overuse. The mechanisms underlying this common comorbidity are poorly understood, but both pathophysiological (eg, serotonergic dysfunction, hormonal influences, dysregulation of the hypothalamic-pituitary-adrenal axis) and psychological (eg, interoceptive conditioning, fear of pain, anxiety sensitivity, avoidance behavior) factors are implicated. Means of assessing comorbid PD among treatment-seeking migraineurs are reviewed, including verbal screening for core PD symptoms, ruling out medical conditions with panic-like features, and administering validated self-report measures. Finally, evidence-based strategies for both pharmacologic and behavioral management are outlined. The first-line migraine prophylactics are not indicated for PD, and the selective serotonin re-uptake inhibitors used to treat PD are not efficacious for migraine; thus, separate agents are often required to address each condition. Core components of behavioral treatments for PD are reviewed, and their integration into clinical headache practice is discussed.
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Affiliation(s)
- Todd A Smitherman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | | | - Jennifer R Bailey
- Department of Psychology, University of Mississippi, Oxford, MS, USA
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McGrath LM, Weill S, Robinson EB, Macrae R, Smoller JW. Bringing a developmental perspective to anxiety genetics. Dev Psychopathol 2012; 24:1179-93. [PMID: 23062290 PMCID: PMC3721501 DOI: 10.1017/s0954579412000636] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Despite substantial recent advancements in psychiatric genetic research, progress in identifying the genetic basis of anxiety disorders has been limited. We review the candidate gene and genome-wide literatures in anxiety, which have made limited progress to date. We discuss several reasons for this hindered progress, including small samples sizes, heterogeneity, complicated comorbidity profiles, and blurred lines between normative and pathological anxiety. To address many of these challenges, we suggest a developmental, multivariate framework that can inform and enhance anxiety phenotypes for genetic research. We review the psychiatric and genetic epidemiological evidence that supports such a framework, including the early onset and chronic course of anxiety disorders, shared genetic risk factors among disorders both within and across time, and developmentally dynamic genetic influences. We propose three strategies for developmentally sensitive phenotyping: examination of early temperamental risk factors, use of latent factors to model underlying anxiety liability, and use of developmental trajectories as phenotypes. Expanding the range of phenotypic approaches will be important for advancing studies of the genetic architecture of anxiety disorders.
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Sayyah M, Sayyah M, Boostani H, Ghaffari SM, Hoseini A. Effects of aripiprazole augmentation in treatment-resistant obsessive-compulsive disorder (a double blind clinical trial). Depress Anxiety 2012; 29:850-4. [PMID: 22933237 DOI: 10.1002/da.21996] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 07/31/2012] [Accepted: 08/09/2012] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a chronic disorder with unknown etiology. Failure in OCD treatmentcompulsive is common and finding effective augmentations in treatment of OCD will benefit patients. Antipsychotic augmentation is a common strategy for treatment resistant OCD. This trial evaluated the efficacy of adding aripiprazole in patients whose OCD was insufficiently responsive to an adequate SSRI treatment. METHODS Thirty-nine adult outpatients, who met the DSM-IV-TR criteria for OCD and had treatment resistant OCD were evaluated in a double-blind randomized clinical trial. The patients received either aripiprazole 10 mg/day or placebo, for 12 weeks. Data were analyzed using intention-to-treat analysis with last observation carried forward. All statistical tests were two-sided, and were considered statistically significant at P < 0.05. RESULTS A significant reduction in total scores of Y-BOCS (P < 0.0001) was found in the aripiprazole group. Aripiprazole was generally well tolerated. There was no significant difference between the two groups in terms of observed side effects. CONCLUSION Results of the present study indicate that aripiprazole could be an effective augmentation medicine in treatment resistant OCD.
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Affiliation(s)
- Mehdi Sayyah
- Education Development Center, Jundishapur University of Medical Sciences, Ahwaz, Iran.
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Donner NC, Johnson PL, Fitz SD, Kellen KE, Shekhar A, Lowry CA. Elevated tph2 mRNA expression in a rat model of chronic anxiety. Depress Anxiety 2012; 29:307-19. [PMID: 22511363 PMCID: PMC4414333 DOI: 10.1002/da.21925] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Allelic variations in TPH2, the gene encoding tryptophan hydroxylase 2, the rate-limiting enzyme for brain serotonin (5-HT) biosynthesis, may be genetic predictors of panic disorder and panic responses to panicogenic challenges in healthy volunteers. To test the hypothesis that tph2 mRNA is altered in chronic anxiety states, we measured tph2 expression in an established rat model of panic disorder. METHODS We implanted 16 adult, male rats with bilateral guide cannulae and then primed them with daily injections of the corticotropin-releasing factor (CRF) receptor agonist, urocortin 1 (UCN1, 6 fmoles/100 nl per side, n = 8) or vehicle (n = 8) into the basolateral amygdaloid complex (BL) for 5 consecutive days. Anxiety-like behavior was assessed, 24 hr prior to and 48 hr following priming, in the social interaction (SI) test. A third group (n = 7) served as undisturbed home cage controls. All rats were killed 3 days after the last intra-BL injection to analyze tph2 and slc6a4 (gene encoding the serotonin transporter, SERT) mRNA expression in the dorsal raphe nucleus (DR), the main source of serotonergic projections to anxiety-related brain regions, using in situ hybridization histochemistry. RESULTS UCN1 priming increased anxiety-related behavior in the SI test compared to vehicle-injected controls and elevated tph2, but not slc6a4, mRNA expression in DR subregions, including the ventrolateral DR/ventrolateral periaqueductal gray (DRVL/VLPAG), a subregion previously implicated in control of panic-related physiologic responses. Tph2 mRNA expression in the DRVL/VLPAG was correlated with increased anxiety-related behavior. CONCLUSION Our data support the hypothesis that chronic anxiety states are associated with dysregulated tph2 expression.
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Affiliation(s)
- Nina C. Donner
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado,Correspondence to: Nina C. Donner, Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, 1725 Pleasant St, 114 Clare Small, Boulder, CO 80309–0354,
| | - Philip L. Johnson
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephanie D. Fitz
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Karen E. Kellen
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
| | - Anantha Shekhar
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Christopher A. Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado
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Abstract
As shown by clinical genetic studies, affective and anxiety disorders are complex genetic disorders with genetic and environmental factors interactively determining their respective pathomechanism. Advances in molecular genetic techniques including linkage studies, association studies, and genome-wide association studies allow for the detailed dissection of the genetic influence on the development of these disorders. Besides the molecular genetic investigation of categorical entities according to standardized diagnostic criteria, intermediate phenotypes comprising neurobiological or neuropsychological traits (e.g., neuronal correlates of emotional processing) that are linked to the disease of interest and that are heritable, have been proposed to be closer to the underlying genotype than the overall disease phenotype. These intermediate phenotypes are dimensional and more precisely defined than the categorical disease phenotype, and therefore have attracted much interest in the genetic investigation of affective and anxiety disorders. Given the complex genetic nature of affective and anxiety disorders with an interaction of multiple risk genes and environmental influences, the interplay of genetic factors with environmental factors is investigated by means of gene-environment interaction (GxE) studies. Pharmacogenetic studies aid in the dissection of the genetically influenced heterogeneity of psychotropic drug response and may contribute to the development of a more individualized treatment of affective and anxiety disorders. Finally, there is some evidence for genetic factors potentially shared between affective and anxiety disorders pointing to a possible overlapping phenotype between anxiety disorders and depression.
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Affiliation(s)
- Katharina Domschke
- Department of Psychiatry, University of Würzburg, Füchsleinstrasse 15, D-97080, Würzburg, Germany,
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Klauke B, Deckert J, Reif A, Pauli P, Zwanzger P, Baumann C, Arolt V, Glöckner-Rist A, Domschke K. Serotonin transporter gene and childhood trauma--a G × E effect on anxiety sensitivity. Depress Anxiety 2011; 28:1048-57. [PMID: 21681867 DOI: 10.1002/da.20840] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 04/27/2011] [Accepted: 04/27/2011] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Genetic factors and environmental factors are assumed to interactively influence the pathogenesis of anxiety disorders. Thus, a gene-environment interaction (G × E) study was conducted with respect to anxiety sensitivity (AS) as a promising intermediate phenotype of anxiety disorders. METHOD Healthy subjects (N = 363) were assessed for AS, childhood maltreatment (Childhood Trauma Questionnaire), and genotyped for functional serotonin transporter gene variants (5-HTTLPR/5-HTT rs25531). The influence of genetic and environmental variables on AS and its subdimensions was determined by a step-wise hierarchical regression and a multiple indicator multiple cause (MIMIC) model. RESULTS A significant G × E effect of the more active 5-HTT genotypes and childhood maltreatment on AS was observed. Furthermore, genotype (LL)-childhood trauma interaction particularly influenced somatic AS subdimensions, whereas cognitive subdimensions were affected by childhood maltreatment only. CONCLUSIONS Results indicate a G × E effect of the more active 5-HTT genotypes and childhood maltreatment on AS, with particular impact on its somatic subcomponent.
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Affiliation(s)
- Benedikt Klauke
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
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29
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Determinants of pharmacodynamic trajectory of the therapeutic response to paroxetine in Japanese patients with panic disorder. Eur J Clin Pharmacol 2011; 67:1213-21. [DOI: 10.1007/s00228-011-1073-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 05/25/2011] [Indexed: 01/20/2023]
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Abstract
Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed.
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Affiliation(s)
- Hae-Ran Na
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Ho Kang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hon Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bum-Hee Yu
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Schruers K, Esquivel G, van Duinen M, Wichers M, Kenis G, Colasanti A, Knuts I, Goossens L, Jacobs N, van Rozendaal J, Smeets H, van Os J, Griez E. Genetic moderation of CO2-induced fear by 5-HTTLPR genotype. J Psychopharmacol 2011; 25:37-42. [PMID: 20584994 DOI: 10.1177/0269881110372543] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Inhalation of an increased concentration of carbon dioxide (CO(2)) has been shown to induce a state of negative affect in healthy subjects that is closely related to the clinical phenomenon of panic. It has been suggested that the vulnerability to CO(2) is moderated by differences in serotonin (5-HT) activity, caused by a functional polymorphism in the promoter region of the 5-HT transporter (5-HTTLPR) gene. Our aim was to examine the relationship between bi- and tri-allelic 5-HTTLPR genotype and the affective response to different dosages of inhaled CO(2) in healthy volunteers. Ninety-six subjects performed a double inhalation of four mixtures containing, respectively, 0%, 9%, 17.5% and 35% CO(2), following a double-blind, cross-over, randomized design. Affective responses were measured with a visual analogue scale for fear and the Panic Symptom List. 5-HTTLPR genotype was expressed as LL, SL and SS. Subjects with the SL and SS genotype reported less fear than LL subjects. A significant interaction effect was found between genotype and CO(2) dosage: the SS genotype showed lower fear scores than the LL genotype, particularly in the 17.5% CO(2) dose condition. The present study suggests that the dose-dependent fear reaction to CO(2) is moderated by a polymorphism in the 5-HT transporter gene, particularly at intermediate CO(2) dosages. It also underscores the usefulness of the introduction of an intermediate phenotype related to panic to reveal an underlying genetic vulnerability otherwise staying elusive. These results are in line with current theories on the role of 5-HT in both panic and respiration.
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Affiliation(s)
- Koen Schruers
- Academic Anxiety Center, Maastricht University, Maastricht, The Netherlands.
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Jacob C, Domschke K, Gajewska A, Warrings B, Deckert J. Genetics of panic disorder: focus on association studies and therapeutic perspectives. Expert Rev Neurother 2010; 10:1273-84. [PMID: 20662753 DOI: 10.1586/ern.10.76] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is evidence for either genetic heterogeneity or complex inheritance with an interaction of environmental factors and multiple single genes in the etiology of panic disorder. Although linkage analyses of panic disorder have implicated several chromosomal regions including 1q, 2q, 4q, 7p, 9q, 12q, 13q, 15q and 22q, they so far have not been able to identify a major gene responsible for panic disorder. Several genes of classical candidate neurotransmitter systems have been reported to be associated with panic disorder. Genetic variation in genes of monoamine oxidase A, catechol-O-methyltransferase, adenosine receptor (ADORA2A) and cholecystokinin B receptor have been inconsistently replicated. There are multiple lines of evidence for highly relevant effects of gender and ethnicity. Future research strategies might focus on broad phenotypes defined by comorbidity or intermediate phenotypes and include the use of animal models for identifying candidate genes, such as the regulator of G-protein signaling (RGS2) gene, genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions and pharmacogenetic studies. The identification of novel pathophysiological pathways may provide the basis for the development of novel therapeutic interventions.
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Affiliation(s)
- C Jacob
- University of Wuerzburg, Wuerzburg, Germany
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Blaya C, Salum GA, Moorjani P, Seganfredo AC, Heldt E, Leistner-Segal S, Smoller JW, Manfro GG. Panic disorder and serotonergic genes (SLC6A4, HTR1A and HTR2A): Association and interaction with childhood trauma and parenting. Neurosci Lett 2010; 485:11-5. [PMID: 20817074 DOI: 10.1016/j.neulet.2010.08.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 07/29/2010] [Accepted: 08/13/2010] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the association between HTR1A, HTR2A and the 5-HTTLPR in panic disorder (PD) patients and controls. In addition, this study also aims to evaluate the interaction between these genes and two environmental factors previously associated with PD: childhood trauma and parental bonding. METHODS This is a case-control candidate gene association study (107 PD patients and 125 controls). Genes were analyzed using a gene-based test in PLINK followed by single marker association tests and haplotype test only for genes that reached experiment-wide significance in the gene-based test in order to minimize multiple testing. Logistic regression was used to test the relationships between genotype in the additive model, trauma, optimal paternal parenting and optimal maternal parenting and their interactions. RESULTS Only HTR1A was associated with PD in gene-based test after correction for multiple tests (p(corrected)=0.027) and one HTR1A haplotype comprising four SNPs was associated with PD (p(corrected)=0.032). In the interaction analysis, no significant gene-environment interaction was found with the genes evaluated. CONCLUSION This study reinforces the association between HTR1A and PD. No major evidence of gene-environment interaction in PD with parenting or trauma was found. Further studies are necessary in order to confirm these findings.
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Affiliation(s)
- Carolina Blaya
- Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Post-Graduate Program in Medical Sciences: Psychiatry, Federal University of Rio Grande do Sul, Luiz Manoel Gonzaga, 630/11, 90470-280 Porto Alegre, RS, Brazil
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Abstract
The molecular genetic research on panic disorder (PD) has grown tremendously in the past decade. Although the data from twin and family studies suggest an involvement of genetic factors in the familial transmission of PD with the heritability estimate near 40%, the genetic substrate underlying panicogenesis is not yet understood. The linkage studies so far have suggested that chromosomal regions 13q, 14q, 22q, 4q31-q34, and probably 9q31 are associated with the transmission of PD phenotypes. To date, more than 350 candidate genes have been examined in association studies of PD, but most of these results remain inconsistent, negative, or not clearly replicated. Only Val158Met polymorphism of the catechol-O-methyltransferase gene has been implicated in susceptibility to PD by several studies in independent samples and confirmed in a recent meta-analysis. However, the specific role of this genetic variation in PD requires additional analysis considering its gender- and ethnicity-dependent effect and putative impact on cognitive functions. The recent advantages in bioinformatics and genotyping technologies, including genome-wide association and gene expression methods, provide the means for far more comprehensive discovery in PD. The progress in clinical and neurobiological concepts of PD may further guide genetic research through the current controversies to more definitive findings.
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Affiliation(s)
- E Maron
- Department of Psychiatry, University of Tartu, Tartu, Estonia.
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35
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Abstract
Panic disorder (PD) is the most common anxiety disorder. Although PD seems to occur unprovoked and the underlying etiology is not well understood, studies have consistently shown that genetic factors explain approximately 48% of the variance. Moreover, family and twin studies support the view that the majority of PD cases have a complex genetic basis. Promising findings have most recently implicated the polymorphisms at the 3' end of the serotonin transporter gene SLC6A4 as PD risk variants. If independent studies can replicate the observed association with the SLC6A4 variants and their functional effects on gene expression, this would have a great impact on our understanding of the disease pathophysiology and would provide opportunities to investigate genotype-phenotype correlations.
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Affiliation(s)
- Johannes Schumacher
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Str, 25, 53127 Bonn, Germany.
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Yevtushenko OO, Oros MM, Reynolds GP. Early response to selective serotonin reuptake inhibitors in panic disorder is associated with a functional 5-HT1A receptor gene polymorphism. J Affect Disord 2010; 123:308-11. [PMID: 19800133 DOI: 10.1016/j.jad.2009.09.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 09/09/2009] [Accepted: 09/09/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Panic disorder is a common and disabling condition which can be treated with selective serotonin reuptake inhibitors (SSRIs). Although many subjects respond well to such treatment, there is substantial inter-individual variation implicating genetic factors. METHODS 102 patients with a diagnosis of panic disorder receiving sertraline or paroxetine took part in study. Hospital Anxiety and Depression Scale score, CGI and panic attack frequency (per month) were assessed before and after 6 weeks of SSRI treatment with 1 week of titration period. All patients were genotyped for the -1019C/G 5-HT1A receptor and ins/del 5-HT transporter polymorphisms. RESULTS The 5-HT1A receptor -1019C/G polymorphism was strongly associated with response to treatment, in which 20 subjects with the GG genotype showed minimal changes in panic attack frequency with a relative risk of no response of 4.73. This association was also found with each drug independently. However, no association of the ins/del 5-HT transporter polymorphism with treatment response was observed. LIMITATIONS Larger numbers of subjects and longer period of SSRI treatment would confirm and strengthen these preliminary findings. CONCLUSION These results indicate the importance of a 5-HT1A receptor gene polymorphism in the response to SSRI treatment of panic disorder.
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Affiliation(s)
- Olga O Yevtushenko
- Department of Neuropharmacology, Institute of Pharmacology and Toxicology AMS Ukraine, Eugene Potie str., 14, Kyiv, 03057, Ukraine.
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Kang EH, Shim HB, Kim KJ, Park JE, Lee IS, Yu BH. Platelet serotonin transporter function after short-term paroxetine treatment in patients with panic disorder. Psychiatry Res 2010; 176:250-3. [PMID: 20207008 DOI: 10.1016/j.psychres.2008.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Revised: 09/23/2008] [Accepted: 12/22/2008] [Indexed: 10/19/2022]
Abstract
Dysfunctions in serotonin neurotransmission have been implicated in some psychiatric disorders, and in particular, altered serotonin transporter function has been noted in panic disorder. In this study, the authors compared platelet [(3)H]serotonin uptake parameters, including maximum velocities (V(max)) and affinity constants (K(m)), in patients with panic disorder not undergoing treatment (n=21) and in healthy subjects (n=20). V(max) and K(m) values were re-examined after 12 weeks of paroxetine treatment. Values of V(max) and K(m) were lower in panic disorder patients at baseline than in healthy subjects. After treatment, K(m) normalized in panic patients, whereas V(max) did not change. A significant inverse correlation was found between increased K(m) and changes in anxiety levels. These results support a hypothesis of serotonergic transporter abnormalities in panic disorder, and suggest that increased K(m) values of platelet serotonin transporters parallel clinical improvement after short-term pharmacotherapy in panic disorder.
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Affiliation(s)
- Eun-Ho Kang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea
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Gyawali S, Subaran R, Weissman MM, Hershkowitz D, McKenna MC, Talari A, Fyer AJ, Wickramaratne P, Adams PB, Hodge SE, Schmidt CJ, Bannon MJ, Glatt CE. Association of a polyadenylation polymorphism in the serotonin transporter and panic disorder. Biol Psychiatry 2010; 67:331-8. [PMID: 19969287 PMCID: PMC2980348 DOI: 10.1016/j.biopsych.2009.10.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 09/17/2009] [Accepted: 10/11/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Genetic markers in the serotonin transporter are associated with panic disorder (PD). The associated polymorphisms do not include the serotonin transporter-linked polymorphic region and display no obvious functional attributes. A common polymorphism (rs3813034) occurs in one of the two reported polyadenylation signals for the serotonin transporter and is in linkage disequilibrium with the PD-associated markers. If functional, rs3813034 might be the risk factor that explains the association of the serotonin transporter and PD. METHODS Quantitative polymerase chain reaction on human brain samples (n = 65) and lymphoblast cultures (n = 71) was used to test rs3813034 for effects on expression of the polyadenylation forms of the serotonin transporter. rs3813034 was also tested for association in a sample of PD cases (n = 307) and a control sample (n = 542) that has similar population structure. RESULTS The balance of the two polyadenylation forms of the serotonin transporter is associated with rs3813034 in brain (p < .001) and lymphoblasts (p < .001). The balance of the polyadenylation forms is also associated with gender in brain only (p < .05). Association testing of rs3813034 in PD identified a significant association (p = .0068) with a relative risk of 1.56 and 1.81 for the heterozygous and homozygous variant genotypes, respectively. CONCLUSIONS rs3813034 is a functional polymorphism in the serotonin transporter that alters the balance of the two polyadenylation forms of the serotonin transporter. rs3813034 is a putative risk factor for PD and other behavioral disorders that involve dysregulation of serotonergic neurotransmission.
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Affiliation(s)
- Sandeep Gyawali
- Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Ryan Subaran
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Myrna M. Weissman
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, Division of Epidemiology, New York State Psychiatric Institute, New York, New York, Mailman School of Public Health, Columbia University, New York, New York
| | - Dylan Hershkowitz
- Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Morgan C. McKenna
- Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
| | - Ardesheer Talari
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, Division of Epidemiology, New York State Psychiatric Institute, New York, New York
| | - Abby J. Fyer
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York
| | - Priya Wickramaratne
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, Mailman School of Public Health, Columbia University, New York, New York
| | - Phillip B. Adams
- Division of Epidemiology, New York State Psychiatric Institute, New York, New York, Division of Statistical Genetics, Department of Biostatistics, Columbia University, New York, NY, USA
| | - Susan E. Hodge
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, Division of Epidemiology, New York State Psychiatric Institute, New York, New York, Division of Statistical Genetics, Department of Biostatistics, Columbia University, New York, NY, USA
| | - Carl J. Schmidt
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan
| | - Michael J. Bannon
- Department of Pharmacology, and The Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan
| | - Charles E. Glatt
- Department of Psychiatry, Weill Medical College of Cornell University, New York, New York
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Strug LJ, Suresh R, Fyer A, Talati A, Adams PB, Li W, Hodge SE, Gilliam TC, Weissman MM. Panic disorder is associated with the serotonin transporter gene (SLC6A4) but not the promoter region (5-HTTLPR). Mol Psychiatry 2010; 15:166-76. [PMID: 18663369 PMCID: PMC2811233 DOI: 10.1038/mp.2008.79] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Panic disorder (PD) and social anxiety disorder (SAD) are moderately heritable anxiety disorders. We analyzed five genes, derived from pharmacological or translational mouse models, in a new case-control study of PD and SAD in European Americans: (1) the serotonin transporter (SLC6A4), (2) the serotonin receptor 1A, (3) catechol-O-methyltransferase, (4) a regulator of g-protein signaling and (5) the gastrin-releasing peptide receptor. Cases were interviewed using the schedule for affective disorders and schizophrenia and were required to have a probable or definite lifetime diagnosis of PD (N=179), SAD (161) or both (140), with first onset by age 31 and a family history of anxiety. Final diagnoses were determined using the best estimate procedure, blind to genotyping data. Controls were obtained from the National Institute of Mental Health Human Genetics Initiative; only subjects above 25 years of age who screened negative for all psychiatric symptoms were included (N=470). A total of 45 single nucleotide polymorphisms were successfully genotyped over the five selected genes using Applied Biosystems SNPlex protocol. SLC6A4 provided strong and consistent evidence of association with the PD and PD+SAD groups, with the most significant association in both groups being at rs140701 (chi(2)=10.72, P=0.001 with PD and chi(2)=8.59, P=0.003 in the PD+SAD group). This association remained significant after multiple test correction. Those carrying at least one copy of the haplotype A-A-G constructed from rs3794808, rs140701 and rs4583306 have 1.7 times the odds of PD than those without the haplotype (95% confidence interval: 1.2-2.3). The SAD only group did not provide evidence of association, suggesting a PD-driven association. The findings remained after adjustment for age and sex, and there was no evidence that the association was due to population stratification. The promoter region of the gene, 5-HTTLPR, did not provide any evidence of association, regardless of whether analyzed as a triallelic or biallelic locus, nor did any of the other four candidate genes tested. Our findings suggest that the serotonin transporter gene may play a role in PD; however, the findings require replication. Future studies should attend to the entire genetic region rather than the promoter.
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Affiliation(s)
- Lisa J. Strug
- Child Health Evaluative Sciences, The Hospital For Sick Children Toronto, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rathi Suresh
- Department of Genetics and Development, Columbia University
| | - Abby Fyer
- Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, NY 10032
| | - Ardesheer Talati
- Division of Statistical Genetics, Department of Biostatistics, Columbia University,Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032
| | - Philip B. Adams
- Division of Statistical Genetics, Department of Biostatistics, Columbia University,Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032
| | - Weili Li
- Child Health Evaluative Sciences, The Hospital For Sick Children Toronto, Canada
| | - Susan E. Hodge
- Division of Statistical Genetics, Department of Biostatistics, Columbia University,Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032,Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032
| | - T. Conrad Gilliam
- Department of Human Genetics, The University of Chicago, Chicago Ill., 60637
| | - Myrna M. Weissman
- Department of Epidemiology, Mailman School of Public Health, Columbia University,Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032,Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032
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Guimarães FS, Zangrossi H, Del Ben CM, Graeff FG. Serotonin in Panic and Anxiety Disorders. HANDBOOK OF BEHAVIORAL NEUROSCIENCE 2010. [DOI: 10.1016/s1569-7339(10)70105-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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41
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Lonsdorf TB, Rück C, Bergström J, Andersson G, Ohman A, Schalling M, Lindefors N. The symptomatic profile of panic disorder is shaped by the 5-HTTLPR polymorphism. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:1479-83. [PMID: 19683026 DOI: 10.1016/j.pnpbp.2009.08.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 07/16/2009] [Accepted: 08/05/2009] [Indexed: 11/16/2022]
Abstract
The short allele of a functional polymorphism (5-HTTLPR) in the serotonin transporter (5-HTT) promoter is associated with reduced serotonin transporter expression, lower in vivo 5-HTT binding, higher neuroticism and amygdala reactivity as well as facilitated fear conditioning and is a candidate variant for panic disorder. However, case-control studies have consistently failed to show an association between 5-HTTLPR and panic disorder. As psychiatric disorders are broadly defined phenotypes merging different symptoms to syndromes, they may not be very well suited for genetic association studies. An alternative approach is to measure symptoms along continuous symptom dimensions which may more appropriately reflect their biological underpinnings and may reveal subpopulations within clinical diagnostic groups. We recorded the symptomatic profile in 73 in panic disorder patients using observer-rated instruments (Panic Disorder Severity Scale, PDSS; Montgomery-Asberg Depression Rating Scale, MADRS) and hypothesized more severe symptoms in patients carrying the 5-HTTLPR s-allele. We observed a strong association between bi- and triallelic 5-HTTLPR polymorphisms and the symptomatic profile. Carriers of the 5-HTTLPR s-allele suffered from most severe panic and depressive symptoms. Our data highlight the importance of defining appropriate phenotypes for psychiatric genetic studies and demonstrate that the 5-HTTLPR genotype may be related to the symptomatic profiles rather than to the vulnerability to develop panic disorder.
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Affiliation(s)
- Tina B Lonsdorf
- Department of Clinical Neuroscience, Psychology section, Karolinska Institutet, Stockholm, Sweden
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Wray NR, James MR, Gordon SD, Dumenil T, Ryan L, Coventry WL, Statham DJ, Pergadia ML, Madden PAF, Heath AC, Montgomery GW, Martin NG. Accurate, Large-Scale Genotyping of 5HTTLPR and Flanking Single Nucleotide Polymorphisms in an Association Study of Depression, Anxiety, and Personality Measures. Biol Psychiatry 2009; 66:468-76. [PMID: 19541292 PMCID: PMC3060567 DOI: 10.1016/j.biopsych.2009.04.030] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/23/2009] [Accepted: 04/15/2009] [Indexed: 12/16/2022]
Abstract
BACKGROUND The length polymorphism repeat in the promoter region of the serotonin transporter gene (5HTTLPR) is one of the most studied polymorphisms for association with a range of psychiatric and personality phenotypes. However, the original 5HTTLPR assay is prone to bias toward short allele calling. METHODS We designed new assays for the 5HTTLPR suitable for large-scale genotyping projects and we genotyped 13 single nucleotide polymorphisms (SNPs) in a 38-kilobase region around the 5HTTLPR, including SNP rs25531, a polymorphism of the 5HTTLPR long allele. Association analysis was conducted for major depression and/or anxiety disorder in unrelated cases (n = 1161) and control subjects (n = 1051) identified through psychiatric interviews administered to a large population sample of Australian twin families. Participants had been scored for personality traits several years earlier (n > or = 2643 unrelated individuals). RESULTS We identified a two-SNP haplotype proxy for 5HTTLPR; the CA haplotype of SNPs rs4251417 and rs2020934 is coupled with the short allele of 5HTTLPR (r(2) = .72). We found evidence for association (p = .0062, after accounting for multiple testing) for SLC6A4 SNPs rs6354 and rs2020936 (positioned in a different linkage disequilibrium [LD] block about 15.5 kb from 5HTTLPR) with anxiety and/or depression and neuroticism, with the strongest association for recurrent depression with onset in young adulthood (odds ratio = 1.55, 95% confidence interval = 1.16-2.06). CONCLUSIONS The associated SNPs are in the same LD block as the variable number of tandem repeats serotonin transporter intron 2 marker, for which association has previously been reported.
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Affiliation(s)
- Naomi R Wray
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, 300 Herston Road, Brisbane 4006, Australia.
| | - Michael R James
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Scott D Gordon
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Troy Dumenil
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Leanne Ryan
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - William L Coventry
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia,School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, New South Wales 2350, Australia
| | - Dixie J Statham
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia,Faculty of Arts & Social Sciences, University of the Sunshine Coast, Maroochydore, Queensland 4558, Australia
| | - Michele L Pergadia
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Pamela AF Madden
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Andrew C Heath
- Washington University School of Medicine, Department of Psychiatry, St Louis, Missouri, USA
| | - Grant W Montgomery
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
| | - Nicholas G Martin
- Genetic and Molecular Epidemiology Laboratories, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia
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Genetic and pharmacokinetic factors affecting the initial pharmacotherapeutic effect of paroxetine in Japanese patients with panic disorder. Eur J Clin Pharmacol 2009; 65:685-91. [DOI: 10.1007/s00228-009-0633-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2008] [Accepted: 02/06/2009] [Indexed: 11/25/2022]
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Kellner M, Muhtz C, Demiralay C, Husemann J, Koelsch W, Yassouridis A, Wiedemann K. The selective serotonin re-uptake inhibitor escitalopram modulates the panic response to cholecystokinin tetrapeptide in healthy men depending on 5-HTTLPR genotype. J Psychiatr Res 2009; 43:642-8. [PMID: 18930474 DOI: 10.1016/j.jpsychires.2008.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 08/11/2008] [Accepted: 09/03/2008] [Indexed: 11/27/2022]
Abstract
Selective serotonin re-uptake inhibitors, such as escitalopram, are currently the treatment of choice for patients with panic disorder. The panic response to intravenous cholecystokinin tetrapeptide, a potentially useful paradigm for volunteer translational studies, has so far not been investigated in healthy man after respective pre-treatment. In a double-blind, placebo-controlled, randomized, within subject cross-over design 30 healthy young men, 15 each with the long/long or short/short genotype for the serotonin transporter linked polymorphic region, were pre-treated with 10mg/d of escitalopram orally for six weeks and then challenged with 50 microg of cholecystokinin tetrapeptide. The primary outcome measure was the increase of Acute Panic Inventory ratings by cholecystokinin tetrapeptide. The increase of anxiety, tension and stress hormone secretion were secondary outcome measures. A significant treatment by genotype effect on the increases of Acute Panic Inventory ratings emerged. Panic induced by cholecystokinin tetrapeptide was significantly more pronounced in the short/short genotype subjects under escitalopram vs. placebo pre-treatment. With the exception of significantly elevated serum prolactin after escitalopram, no effects in the secondary outcome measures were detected. Contrary to our expectation, no inhibitory effect of escitalopram upon panic symptoms elicited by choleystokinin tetrapeptide could be demonstrated in healthy men. These findings do not support the potential usefulness of this panic model for proof-of-concept studies. The biological underpinnings of the increased panic symptoms after escitalopram in our volunteers with short/short genotype need further research.
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Affiliation(s)
- Michael Kellner
- University Hospital Hamburg-Eppendorf, Department of Psychiatry, Martinistrasse 52, D-20246 Hamburg, Germany.
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Saiz PA, Martínez-Barrondo S, García-Portilla MP, Corcoran P, Morales B, Bascaran MT, Paredes B, Álvarez V, Coto E, Fernández JM, Bousoño M, Bobes J. Implicación de polimorfismos serotoninérgicos en la gravedad clínica del trastorno de pánico. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2009; 2:35-41. [DOI: 10.1016/s1888-9891(09)70712-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 12/29/2008] [Indexed: 10/20/2022]
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46
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Hettema JM. What is the genetic relationship between anxiety and depression? AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2008; 148C:140-6. [DOI: 10.1002/ajmg.c.30171] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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47
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Wachleski C, Blaya C, Salum GA, Vargas V, Leistner-Segal S, Manfro GG. Lack of association between the serotonin transporter promoter polymorphism (5-HTTLPR) and personality traits in asymptomatic patients with panic disorder. Neurosci Lett 2008; 431:173-8. [DOI: 10.1016/j.neulet.2007.11.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 11/05/2007] [Accepted: 11/29/2007] [Indexed: 12/16/2022]
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