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Karatayev O, Collier AD, Targoff SR, Leibowitz SF. Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment. Int J Mol Sci 2024; 25:8341. [PMID: 39125913 PMCID: PMC11313660 DOI: 10.3390/ijms25158341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/10/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
Clinical studies demonstrate that the risk of developing neurological disorders is increased by overconsumption of the commonly used drugs, alcohol, nicotine and cannabis. These drug-induced neurological disorders, which include substance use disorder (SUD) and its co-occurring emotional conditions such as anxiety and depression, are observed not only in adults but also with drug use during adolescence and after prenatal exposure to these drugs, and they are accompanied by long-lasting disturbances in brain development. This report provides overviews of clinical and preclinical studies, which confirm these adverse effects in adolescents and the offspring prenatally exposed to the drugs and include a more in-depth description of specific neuronal systems, their neurocircuitry and molecular mechanisms, affected by drug exposure and of specific techniques used to determine if these effects in the brain are causally related to the behavioral disturbances. With analysis of further studies, this review then addresses four specific questions that are important for fully understanding the impact that drug use in young individuals can have on future pregnancies and their offspring. Evidence demonstrates that the adverse effects on their brain and behavior can occur: (1) at low doses with short periods of drug exposure during pregnancy; (2) after pre-conception drug use by both females and males; (3) in subsequent generations following the initial drug exposure; and (4) in a sex-dependent manner, with drug use producing a greater risk in females than males of developing SUDs with emotional conditions and female offspring after prenatal drug exposure responding more adversely than male offspring. With the recent rise in drug use by adolescents and pregnant women that has occurred in association with the legalization of cannabis and increased availability of vaping tools, these conclusions from the clinical and preclinical literature are particularly alarming and underscore the urgent need to educate young women and men about the possible harmful effects of early drug use and to seek novel therapeutic strategies that might help to limit drug use in young individuals.
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Affiliation(s)
| | | | | | - Sarah F. Leibowitz
- Laboratory of Behavioral Neurobiology, The Rockefeller University, New York, NY 10065, USA; (O.K.); (S.R.T.)
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Huang M, Wang J, Liu W, Zhou H. Advances in the role of the GADD45 family in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Front Neurosci 2024; 18:1349409. [PMID: 38332860 PMCID: PMC10850240 DOI: 10.3389/fnins.2024.1349409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Abstract
The growth arrest and DNA damage inducible protein 45 (GADD45) family comprises stress-induced nuclear proteins that interact with DNA demethylases to facilitate DNA demethylation, thereby regulating diverse cellular processes including oxidative stress, DNA damage repair, apoptosis, proliferation, differentiation, inflammation, and neuroplasticity by modulating the expression patterns of specific genes. Widely expressed in the central nervous system, the GADD45 family plays a pivotal role in various neurological disorders, rendering it a potential therapeutic target for central nervous system diseases. This review presented a comprehensive overview of the expression patterns and potential mechanisms of action associated with each member of GADD45 family (GADD45α, GADD45β, and GADD45γ) in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders, while also explored strategies to harness these mechanisms for intervention and treatment. Future research should prioritize the development of effective modulators targeting the GADD45 family for clinical trials aimed at treating central nervous system diseases.
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Affiliation(s)
| | | | | | - Hongyan Zhou
- Hubei Key Laboratory of Cognitive and Affective Disorders, Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
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Leconte CE, Ng JW, Manzardo AM, Douglass MM. A Pediatric Patient with Severe Obstructive Sleep Apnea and Comorbid Depression and Substance Abuse. Case Rep Psychiatry 2023; 2023:9985503. [PMID: 38028754 PMCID: PMC10656197 DOI: 10.1155/2023/9985503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Obstructive sleep apnea (OSA), depression, and substance abuse problems share similar symptomatology and have significant interplay. An underlying diagnosis of OSA can often be overlooked in patients with significant psychiatric illness and polysubstance use. Pediatric OSA is often associated with adenotonsillar hypertrophy and frequently requires surgical intervention for resolution of symptoms. Untreated OSA can worsen mental status and encourage polysubstance abuse as a form of self-medication. Proper identification and management of OSA plays an important role in treating psychiatric conditions. We report a 16-year-old with major depressive disorder (MDD), suicide attempts, polysubstance use disorder, and severe OSA admitted to an inpatient psychiatric facility. History included sleep and mood disturbances started at age 12. Patient presented with apnea-hypopnea index greater than 50 and started on bilevel-positive airway pressure (BiPAP) prior to admission. Management of OSA led to significant improvement of MDD, insomnia, and polysubstance abuse. OSA can often be overlooked in patients with MDD or substance abuse. Among adolescent patients with poorly managed psychiatric conditions, significant sleep disturbances, and polysubstance abuse, providers should maintain a high degree of suspicion for OSA, as its proper management will aid in the management of the other conditions.
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Affiliation(s)
- Caitlin E. Leconte
- University of Kansas School of Medicine, 2060 W 39th Avenue, Kansas City, KS 66103, USA
| | - Joshua W. Ng
- University of Kansas School of Medicine-Wichita, 1010 N Kansas Street, Wichita, KS 67214, USA
| | - Ann M. Manzardo
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
| | - Mitchell M. Douglass
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
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Ahlberg R, Du Rietz E, Ahnemark E, Andersson LM, Werner-Kiechle T, Lichtenstein P, Larsson H, Garcia-Argibay M. Real-life instability in ADHD from young to middle adulthood: a nationwide register-based study of social and occupational problems. BMC Psychiatry 2023; 23:336. [PMID: 37173664 PMCID: PMC10176742 DOI: 10.1186/s12888-023-04713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/23/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Studies using self-reports indicate that individuals with ADHD are at increased risk for functional impairments in social and occupational settings, but evidence around real-life instability remains limited. It is furthermore unclear if these functional impairments in ADHD differ across sex and across the adult lifespan. METHOD A longitudinal observational cohort design of 3,448,440 individuals was used to study the associations between ADHD and residential moves, relational instability and job shifting using data from Swedish national registers. Data were stratified on sex and age (18-29 years, 30-39 years, and 40-52 years at start of follow up). RESULTS 31,081 individuals (17,088 males; 13,993 females) in the total cohort had an ADHD-diagnosis. Individuals with ADHD had an increased incidence rate ratio (IRR) of residential moves (IRR 2.35 [95% CI, 2.32-2.37]), relational instability (IRR = 1.07 [95% CI, 1.06-1.08]) and job shifting (IRR = 1.03 [95% CI, 1.02-1.04]). These associations tended to increase with increasing age. The strongest associations were found in the oldest group (40-52 years at start of follow). Women with ADHD in all three age groups had a higher rate of relational instability compared to men with ADHD. CONCLUSION Both men and women with a diagnosis of ADHD present with an increased risk of real-life instability in different domains and this behavioral pattern was not limited to young adulthood but also existed well into older adulthood. It is therefore important to have a lifespan perspective on ADHD for individuals, relatives, and the health care sector.
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Affiliation(s)
- Rickard Ahlberg
- School of Medical Sciences, Örebro University, Örebro, 701 82, Sweden.
| | - E Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - E Ahnemark
- Department of Neuropsychiatry, Region Stockholm, Stockholm, Sweden
| | | | - T Werner-Kiechle
- Global Medical Affairs, Shire International GmbH, Zug, Switzerland
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - H Larsson
- School of Medical Sciences, Örebro University, Örebro, 701 82, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M Garcia-Argibay
- School of Medical Sciences, Örebro University, Örebro, 701 82, Sweden
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Schepis TS, Werner KS, Figueroa O, McCabe VV, Schulenberg JE, Veliz PT, Wilens TE, McCabe SE. Type of medication therapy for ADHD and stimulant misuse during adolescence: a cross-sectional multi-cohort national study. EClinicalMedicine 2023; 58:101902. [PMID: 36969344 PMCID: PMC10036501 DOI: 10.1016/j.eclinm.2023.101902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is associated with higher substance use rates. Stimulant and non-stimulant pharmacotherapy improve adolescent ADHD, but their associations with prescription stimulant misuse (PSM), cocaine, and methamphetamine use are unclear. Using 2005-2020 US Monitoring the Future data, we investigated relationships between ADHD pharmacotherapy history and PSM, cocaine, or methamphetamine use. Methods Secondary students (13-19 years) provided data on pharmacotherapy history (N = 199,560; 86.3% of total sample) between January 1, 2005 and May 31, 2020 in a cross-sectional multi-cohort study; weights assured a nationally representative sample. Participants were grouped by ADHD pharmacotherapy history: none (88.7%; principally non-ADHD controls); stimulant-only (5.8%); non-stimulant-only (3.3%); both stimulant and non-stimulant (2.1%). Outcomes were past-year PSM, cocaine, and methamphetamine use. Logistic regressions examined relationships between pharmacotherapy history and outcomes, controlling for sociodemographics, recent substance use, and stimulant treatment cessation. Findings Past-year outcome rates were lowest in adolescents with no pharmacotherapy history: 4.7% for PSM [8310/174,561], 1.6% for cocaine [2858/174,688], and 0.7% for methamphetamine [1036/148,378]. A history of both stimulant and non-stimulant treatment was associated with the highest rates: 22.3% for PSM [940/4098], 10.4% for cocaine [450/4110], and 7.8% for methamphetamine [275/3427]. Adolescents who received monotherapy (stimulant- or non-stimulant-only) had intermediate rates, with no differences between monotherapy groups. Interpretation While elevated PSM and illicit stimulant use rates are likely influenced by ADHD, our findings suggested adolescents with a history of both stimulant and non-stimulant pharmacotherapy are at highest risk for these stimulant outcomes. Adolescents receiving ADHD pharmacotherapy should be monitored for PSM and illicit stimulant use. Funding National Institute on Drug Abuse/National Institutes of Health (USA) and Food and Drug Administration (USA).
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Affiliation(s)
- Ty S. Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Kennedy S. Werner
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Olivia Figueroa
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Vita V. McCabe
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - John E. Schulenberg
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Phil T. Veliz
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Timothy E. Wilens
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Sean Esteban McCabe
- Department of Health Behavior and Biological Sciences, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Kim SC, Lee H, Lee HS, Kim G, Song JH. Adjuvant Therapy for Attention in Children with ADHD Using Game-Type Digital Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14982. [PMID: 36429699 PMCID: PMC9690113 DOI: 10.3390/ijerph192214982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Children diagnosed with attention deficit hyperactivity disorder (ADHD) require early intervention and sustained treatment. This study used a game-based digital treatment planning NeuroWorld DTx to analyze the impact on attention and cognitive function in children with ADHD. Thirty children diagnosed with ADHD were recruited and subjected to a four-week NeuroWorld DTx digital treatment. To assess the impact of the digital therapeutic therapy on children's attention, we used the comprehension attention test (CAT) and Korean ADHD Rating Scale (K-ARS). Clinical global impression (CGI) and the Korean-child behavior checklist (K-CBCL 6-18) were used to examine the degree of improvement in ADHD. After four weeks, significant differences in the sensitivity and response style indices were noted, as compared with the baseline in the CAT test; in the case of K-ARS and CGI, a moderate decrease in ADHD was confirmed. The study achieved better results for the "total behavior problems" belonging to the K-CBCL assessment. Game-based digital therapy intervention can be a treatment method that elicits interest and satisfaction in children with ADHD and can be used as an adjunct to drug therapy to improve the quality of life and strengthen attention in children with symptoms of ADHD.
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Affiliation(s)
- Seon-Chil Kim
- Department of Biomedical Engineering, School of Medicine, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea
| | - Hojun Lee
- Department of Psychiatry, Keimyung University Dongsan Medical Center, Daegu 42601, Republic of Korea
- Department of Psychiatry, School of Medicine, Keimyung University, Daegu 42601, Republic of Korea
| | - Hyun-Suk Lee
- Woori Children’s Development Clinic, Affiliated with Woori Soft, 175, Wolbae-ro, Dalseo-gu, Daegu 42781, Republic of Korea
| | - Gaeun Kim
- College of Nursing, Keimyung University, Daegu 42601, Republic of Korea
| | - Jeong-Heon Song
- Woorisoft Inc., 175, Wolbae-ro, Dalseo-gu, Daegu 42781, Republic of Korea
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