VU University Amsterdam, the Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam.
VU University Amsterdam, the Netherlands; Neuroscience Campus Amsterdam, VU University Amsterdam; GGZinGeest/ VU University Medical Center.
J Am Acad Child Adolesc Psychiatry. 2014 Oct;53(10):1123-9.e6. doi: 10.1016/j.jaac.2014.06.014. Epub 2014 Aug 19.
Clinically, attention-deficit/hyperactivity disorder (ADHD) is characterized by hyperactivity, impulsivity, and inattention and is among the most common childhood disorders. These same traits that define ADHD are variable in the general population, and the clinical diagnosis may represent the extreme end of a continuous distribution of inattentive and hyperactive behaviors. This hypothesis can be tested by assessing the predictive value of polygenic risk scores derived from a discovery sample of ADHD patients in a target sample from the general population with continuous scores of inattention and hyperactivity. In addition, the genetic overlap between ADHD and continuous ADHD scores can be tested across rater and age.
The Psychiatric Genomics Consortium has performed the largest genome-wide analysis (GWA) study of ADHD so far, including 5,621 clinical patients and 13,589 controls. The effects sizes of single nucleotide polymorphisms (SNPs) estimated in this meta-analysis were used to obtain individual polygenic risk scores in an independent population-based cohort of 2,437 children from the Netherlands Twin Register. The variance explained in Attention Problems (AP) scale scores by the polygenic risk scores was estimated by linear mixed modeling.
The ADHD polygenic risk scores significantly predicted both parent and teacher ratings of AP in preschool- and school-aged children.
These results indicate genetic overlap between a diagnosis of ADHD and AP scale scores across raters and age groups and provides evidence for a dimensional model of ADHD. Future GWA studies on ADHD can likely benefit from the inclusion of population-based cohorts and the analysis of continuous scores.
临床上,注意力缺陷多动障碍(ADHD)的特征是多动、冲动和注意力不集中,是最常见的儿童疾病之一。这些定义 ADHD 的相同特征在普通人群中是可变的,临床诊断可能代表注意力不集中和多动行为连续分布的极端。通过评估从 ADHD 患者发现样本中得出的多基因风险评分在注意力不集中和多动连续评分的普通人群目标样本中的预测值,可以检验这一假设。此外,可以在评分者和年龄上测试 ADHD 与连续 ADHD 评分之间的遗传重叠。
精神疾病基因组学联合会 (Psychiatric Genomics Consortium) 迄今为止对 ADHD 进行了最大规模的全基因组分析 (GWA) 研究,包括 5621 名临床患者和 13589 名对照。在这个荟萃分析中估计的单核苷酸多态性 (SNP) 的效应大小用于在荷兰双胞胎登记处的一个独立的基于人群的 2437 名儿童队列中获得个体多基因风险评分。通过线性混合模型估计多基因风险评分对注意力问题 (AP) 量表评分的方差解释。
ADHD 多基因风险评分显著预测了父母和教师对学龄前和学龄儿童 AP 的评分。
这些结果表明,ADHD 的诊断与 AP 量表评分在评分者和年龄组之间存在遗传重叠,并为 ADHD 的维度模型提供了证据。未来的 ADHD GWA 研究可能受益于纳入基于人群的队列和分析连续评分。