Abstract
Attention-deficit hyperactivity disorder (ADHD) has been shown to be familial and heritable, in previous studies. As with most psychiatric disorders, examination of pedigrees has not revealed a consistent Mendelian mode of transmission. The response of ADHD patients to medications that inhibit the dopamine transporter, including methylphenidate, amphetamine, pemoline, and bupropion, led us to consider the dopamine transporter as a primary candidate gene for ADHD. To avoid effects of population stratification and to avoid the problem of classification of relatives with other psychiatric disorders as affected or unaffected, we used the haplotype-based haplotype relative risk (HHRR) method to test for association between a VNTR polymorphism at the dopamine transporter locus (DAT1) and DSM-III-R-diagnosed ADHD (N = 49) and undifferentiated attention-deficit disorder (UADD) (N = 8) in trios composed of father, mother, and affected offspring. HHRR analysis revealed significant association between ADHD/UADD and the 480-bp DAT1 allele (chi 2 7.51, 1 df, P = .006). When cases of UADD were dropped from the analysis, similar results were found (Chi 2 7.29, 1 df, P = .007). If these findings are replicated, molecular analysis of the dopamine transporter gene may identify mutations that increase susceptibility to ADHD/UADD. Biochemical analysis of such mutations may lead to development of more effective therapeutic interventions.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Askew G. R., Doetschman T., Lingrel J. B. Site-directed point mutations in embryonic stem cells: a gene-targeting tag-and-exchange strategy. Mol Cell Biol. 1993 Jul;13(7):4115–4124. doi: 10.1128/mcb.13.7.4115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Biederman J., Faraone S. V., Keenan K., Benjamin J., Krifcher B., Moore C., Sprich-Buckminster S., Ugaglia K., Jellinek M. S., Steingard R. Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives psychiatrically and pediatrically referred samples. Arch Gen Psychiatry. 1992 Sep;49(9):728–738. doi: 10.1001/archpsyc.1992.01820090056010. [DOI] [PubMed] [Google Scholar]
- Biederman J., Faraone S. V., Keenan K., Knee D., Tsuang M. T. Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. J Am Acad Child Adolesc Psychiatry. 1990 Jul;29(4):526–533. doi: 10.1097/00004583-199007000-00004. [DOI] [PubMed] [Google Scholar]
- Blum K., Noble E. P., Sheridan P. J., Montgomery A., Ritchie T., Jagadeeswaran P., Nogami H., Briggs A. H., Cohn J. B. Allelic association of human dopamine D2 receptor gene in alcoholism. JAMA. 1990 Apr 18;263(15):2055–2060. [PubMed] [Google Scholar]
- Byerley W., Coon H., Hoff M., Holik J., Waldo M., Freedman R., Caron M. G., Giros B. Human dopamine transporter gene not linked to schizophrenia in multigenerational pedigrees. Hum Hered. 1993 Sep-Oct;43(5):319–322. doi: 10.1159/000154151. [DOI] [PubMed] [Google Scholar]
- Cantwell D. P. Psychiatric illness in the families of hyperactive children. Arch Gen Psychiatry. 1972 Sep;27(3):414–417. doi: 10.1001/archpsyc.1972.01750270114018. [DOI] [PubMed] [Google Scholar]
- Casat C. D., Pleasants D. Z., Van Wyck Fleet J. A double-blind trial of bupropion in children with attention deficit disorder. Psychopharmacol Bull. 1987;23(1):120–122. [PubMed] [Google Scholar]
- Comings D. E., Comings B. G., Muhleman D., Dietz G., Shahbahrami B., Tast D., Knell E., Kocsis P., Baumgarten R., Kovacs B. W. The dopamine D2 receptor locus as a modifying gene in neuropsychiatric disorders. JAMA. 1991 Oct 2;266(13):1793–1800. [PubMed] [Google Scholar]
- Gejman P. V., Ram A., Gelernter J., Friedman E., Cao Q., Pickar D., Blum K., Noble E. P., Kranzler H. R., O'Malley S. No structural mutation in the dopamine D2 receptor gene in alcoholism or schizophrenia. Analysis using denaturing gradient gel electrophoresis. JAMA. 1994 Jan 19;271(3):204–208. [PubMed] [Google Scholar]
- Gelernter J., Goldman D., Risch N. The A1 allele at the D2 dopamine receptor gene and alcoholism. A reappraisal. JAMA. 1993 Apr 7;269(13):1673–1677. [PubMed] [Google Scholar]
- Gelernter J., O'Malley S., Risch N., Kranzler H. R., Krystal J., Merikangas K., Kennedy J. L., Kidd K. K. No association between an allele at the D2 dopamine receptor gene (DRD2) and alcoholism. JAMA. 1991 Oct 2;266(13):1801–1807. [PubMed] [Google Scholar]
- Goyette C. H., Conners C. K., Ulrich R. F. Normative data on revised Conners Parent and Teacher Rating Scales. J Abnorm Child Psychol. 1978 Jun;6(2):221–236. doi: 10.1007/BF00919127. [DOI] [PubMed] [Google Scholar]
- Greenhill L. L. Pharmacologic treatment of attention deficit hyperactivity disorder. Psychiatr Clin North Am. 1992 Mar;15(1):1–27. [PubMed] [Google Scholar]
- Hauser P., Zametkin A. J., Martinez P., Vitiello B., Matochik J. A., Mixson A. J., Weintraub B. D. Attention deficit-hyperactivity disorder in people with generalized resistance to thyroid hormone. N Engl J Med. 1993 Apr 8;328(14):997–1001. doi: 10.1056/NEJM199304083281403. [DOI] [PubMed] [Google Scholar]
- Hechtman L. Aims and methodological problems in multimodal treatment studies. Can J Psychiatry. 1993 Aug;38(6):458–464. doi: 10.1177/070674379303800614. [DOI] [PubMed] [Google Scholar]
- Ialongo N. S., Horn W. F., Pascoe J. M., Greenberg G., Packard T., Lopez M., Wagner A., Puttler L. The effects of a multimodal intervention with attention-deficit hyperactivity disorder children: a 9-month follow-up. J Am Acad Child Adolesc Psychiatry. 1993 Jan;32(1):182–189. doi: 10.1097/00004583-199301000-00026. [DOI] [PubMed] [Google Scholar]
- Kelsoe J. R., Ginns E. I., Egeland J. A., Gerhard D. S., Goldstein A. M., Bale S. J., Pauls D. L., Long R. T., Kidd K. K., Conte G. Re-evaluation of the linkage relationship between chromosome 11p loci and the gene for bipolar affective disorder in the Old Order Amish. Nature. 1989 Nov 16;342(6247):238–243. doi: 10.1038/342238a0. [DOI] [PubMed] [Google Scholar]
- Mannuzza S., Klein R. G., Bessler A., Malloy P., LaPadula M. Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry. 1993 Jul;50(7):565–576. doi: 10.1001/archpsyc.1993.01820190067007. [DOI] [PubMed] [Google Scholar]
- Orita M., Suzuki Y., Sekiya T., Hayashi K. Rapid and sensitive detection of point mutations and DNA polymorphisms using the polymerase chain reaction. Genomics. 1989 Nov;5(4):874–879. doi: 10.1016/0888-7543(89)90129-8. [DOI] [PubMed] [Google Scholar]
- Ott J. Statistical properties of the haplotype relative risk. Genet Epidemiol. 1989;6(1):127–130. doi: 10.1002/gepi.1370060124. [DOI] [PubMed] [Google Scholar]
- Rapport M. D., Denney C., DuPaul G. J., Gardner M. J. Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children. J Am Acad Child Adolesc Psychiatry. 1994 Jul-Aug;33(6):882–893. doi: 10.1097/00004583-199407000-00015. [DOI] [PubMed] [Google Scholar]
- Stevenson J. Evidence for a genetic etiology in hyperactivity in children. Behav Genet. 1992 May;22(3):337–344. doi: 10.1007/BF01066665. [DOI] [PubMed] [Google Scholar]
- Ullmann R. K., Sleator E. K., Sprague R. L. A new rating scale for diagnosis and monitoring of ADD children. Psychopharmacol Bull. 1984 Winter;20(1):160–164. [PubMed] [Google Scholar]
- Vandenbergh D. J., Persico A. M., Hawkins A. L., Griffin C. A., Li X., Jabs E. W., Uhl G. R. Human dopamine transporter gene (DAT1) maps to chromosome 5p15.3 and displays a VNTR. Genomics. 1992 Dec;14(4):1104–1106. doi: 10.1016/s0888-7543(05)80138-7. [DOI] [PubMed] [Google Scholar]
- Weiss R. E., Stein M. A., Duck S. C., Chyna B., Phillips W., O'Brien T., Gutermuth L., Refetoff S. Low intelligence but not attention deficit hyperactivity disorder is associated with resistance to thyroid hormone caused by mutation R316H in the thyroid hormone receptor beta gene. J Clin Endocrinol Metab. 1994 Jun;78(6):1525–1528. doi: 10.1210/jcem.78.6.8200958. [DOI] [PubMed] [Google Scholar]
- Weiss R. E., Stein M. A., Trommer B., Refetoff S. Attention-deficit hyperactivity disorder and thyroid function. J Pediatr. 1993 Oct;123(4):539–545. doi: 10.1016/s0022-3476(05)80947-3. [DOI] [PubMed] [Google Scholar]
- Zametkin A. J., Rapoport J. L. Neurobiology of attention deficit disorder with hyperactivity: where have we come in 50 years? J Am Acad Child Adolesc Psychiatry. 1987 Sep;26(5):676–686. doi: 10.1097/00004583-198709000-00011. [DOI] [PubMed] [Google Scholar]