The Role of Gene-Gene Interaction Between ADRA2A and SLC6A2 Polymorphisms in Attention System and Treatment Outcomes
Jewook Kang1, Bum-Sung Choi2,3, Bongseog Kim4
1Department of Psychiatry, Inje University Pusan Paik Hospital, Inje University College of Medicine, Pusan 47392, Republic of Korea.
Background And Objectives:
Most genetic studies have focused on catecholamine system genes to identify etiology in attention-deficit/hyperactivity disorder (ADHD), and there is growing evidence that the interaction of several genes may synergistically or antagonistically affect disease outcomes. We investigated the interaction between the alpha-2 adrenergic receptor (ADRA2A) and its transporter (SLC6A2) to determine the etiology and treatment outcomes for ADHD.
Materials And Methods:
Children with ADHD (age 8.3 ± 2.0 y, 72 boys and 11 girls) were assessed using the Kiddie Schedule for Affective Disorders-Present and Lifetime (K-SASD-PL), ADHD rating scale-IV (ARS), Clinical Global Impressions-Improvement (CGI-I), and Clinical Global Impressions-Severity (CGI-S) scales. Neuropsychological assessments were performed using a continuous performance test (CPT). Methylphenidate was titrated based on the CGI-I and CGI-S scales for 8 weeks. We assessed two polymorphisms, ADRA2A rs553668 and SLC6A2 rs998424, for their association with disease outcomes.
Results:
The ADRA2A polymorphism had a significant effect on visual/auditory commission errors in the CPT. The CC genotype for ADRA2A combined with the GG genotype for SLC6A2 showed more commission errors than the other combinations of genotypes. Treatment outcome assessment using the CGI-S showed that the SLC6A2 GG genotype had more favorable treatment outcome (p < 0.05) and significant gene × dose interaction on ARS score across 8 weeks (p < 0.01).
Conclusions:
Our findings provide preliminary evidence for the effect of ADR2A and SLC6A2 gene-gene interactions on the attention system and treatment response in children with ADHD. Although these findings require future replication, our study contributes to the understanding of the genetic basis of ADHD.
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