Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Mol Psychiatry. 2012 Oct;17(10):960-87. doi: 10.1038/mp.2011.138. Epub 2011 Nov 22.
The adult form of attention deficit/hyperactivity disorder (aADHD) has a prevalence of up to 5% and is the most severe long-term outcome of this common neurodevelopmental disorder. Family studies in clinical samples suggest an increased familial liability for aADHD compared with childhood ADHD (cADHD), whereas twin studies based on self-rated symptoms in adult population samples show moderate heritability estimates of 30-40%. However, using multiple sources of information, the heritability of clinically diagnosed aADHD and cADHD is very similar. Results of candidate gene as well as genome-wide molecular genetic studies in aADHD samples implicate some of the same genes involved in ADHD in children, although in some cases different alleles and different genes may be responsible for adult versus childhood ADHD. Linkage studies have been successful in identifying loci for aADHD and led to the identification of LPHN3 and CDH13 as novel genes associated with ADHD across the lifespan. In addition, studies of rare genetic variants have identified probable causative mutations for aADHD. Use of endophenotypes based on neuropsychology and neuroimaging, as well as next-generation genome analysis and improved statistical and bioinformatic analysis methods hold the promise of identifying additional genetic variants involved in disease etiology. Large, international collaborations have paved the way for well-powered studies. Progress in identifying aADHD risk genes may provide us with tools for the prediction of disease progression in the clinic and better treatment, and ultimately may help to prevent persistence of ADHD into adulthood.
成人注意力缺陷/多动障碍(aADHD)的患病率高达 5%,是这种常见神经发育障碍的最严重的长期后果。临床样本中的家族研究表明,与儿童多动症(cADHD)相比,aADHD 的家族易感性增加,而基于成人人群样本中自我报告症状的双胞胎研究表明,其遗传度估计为 30-40%。然而,使用多种信息来源,临床诊断的 aADHD 和 cADHD 的遗传度非常相似。aADHD 样本中的候选基因和全基因组分子遗传学研究结果表明,一些与儿童多动症相关的相同基因也涉及其中,尽管在某些情况下,不同的等位基因和不同的基因可能与成人多动症和儿童多动症有关。连锁研究成功地确定了 aADHD 的基因座,并导致了 LPHN3 和 CDH13 作为与整个生命过程中的 ADHD 相关的新基因的鉴定。此外,对罕见遗传变异的研究确定了 aADHD 的可能致病突变。基于神经心理学和神经影像学的表型、下一代基因组分析以及改进的统计和生物信息分析方法的使用有望确定与疾病病因学相关的其他遗传变异。大型国际合作已经为有力的研究铺平了道路。识别 aADHD 风险基因的进展可能为我们提供预测疾病在临床上进展的工具,并提供更好的治疗方法,最终可能有助于预防 ADHD 持续到成年。