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Mamiya PC, Arnett AB, Stein MA. Precision Medicine Care in ADHD: The Case for Neural Excitation and Inhibition. Brain Sci 2021; 11:brainsci11010091. [PMID: 33450814 PMCID: PMC7828220 DOI: 10.3390/brainsci11010091] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/15/2020] [Accepted: 01/11/2021] [Indexed: 12/14/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.
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Affiliation(s)
- Ping C. Mamiya
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA 98195, USA
- Correspondence:
| | - Anne B. Arnett
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; (A.B.A.); (M.A.S.)
| | - Mark A. Stein
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; (A.B.A.); (M.A.S.)
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Szopinska-Tokov J, Dam S, Naaijen J, Konstanti P, Rommelse N, Belzer C, Buitelaar J, Franke B, Aarts E, Arias Vasquez A. Investigating the Gut Microbiota Composition of Individuals with Attention-Deficit/Hyperactivity Disorder and Association with Symptoms. Microorganisms 2020; 8:microorganisms8030406. [PMID: 32183143 PMCID: PMC7143990 DOI: 10.3390/microorganisms8030406] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 12/16/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Given the growing evidence of gut microbiota being involved in psychiatric (including neurodevelopmental) disorders, we aimed to identify differences in gut microbiota composition between participants with ADHD and controls and to investigate the role of the microbiota in inattention and hyperactivity/impulsivity. Fecal samples were collected from 107 participants (NADHD = 42; Ncontrols = 50; NsubthreholdADHD = 15; range age: 13-29 years). The relative quantification of bacterial taxa was done using 16S ribosomal RNA gene amplicon sequencing. Beta-diversity revealed significant differences in bacterial composition between participants with ADHD and healthy controls, which was also significant for inattention, but showing a trend in case of hyperactivity/impulsivity only. Ten genera showed nominal differences (p < 0.05) between both groups, of which seven genera were tested for their association with ADHD symptom scores (adjusting for age, sex, body mass index, time delay between feces collection and symptoms assessment, medication use, and family relatedness). Our results show that variation of a genus from the Ruminococcaceae family (Ruminococcaceae_UCG_004) is associated (after multiple testing correction) with inattention symptoms and support the potential role of gut microbiota in ADHD pathophysiology.
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Affiliation(s)
- Joanna Szopinska-Tokov
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands; (J.S.-T.); (N.R.); (B.F.)
| | - Sarita Dam
- Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 EN Nijmegen, The Netherlands; (S.D.); (J.N.); (J.B.)
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 EN Nijmegen, The Netherlands; (S.D.); (J.N.); (J.B.)
| | - Prokopis Konstanti
- Laboratory of Microbiology, Wageningen University, 6708 WE Wageningen, The Netherlands; (P.K.); (C.B.)
| | - Nanda Rommelse
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands; (J.S.-T.); (N.R.); (B.F.)
- Karakter Child and Adolescent Psychiatry University Center, 6525 GC Nijmegen, The Netherlands
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University, 6708 WE Wageningen, The Netherlands; (P.K.); (C.B.)
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 EN Nijmegen, The Netherlands; (S.D.); (J.N.); (J.B.)
- Karakter Child and Adolescent Psychiatry University Center, 6525 GC Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands; (J.S.-T.); (N.R.); (B.F.)
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands
| | - Esther Aarts
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands;
| | - Alejandro Arias Vasquez
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands; (J.S.-T.); (N.R.); (B.F.)
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, 6525 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-(0)-24-3613970
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