Pillidge Katharine, Porter Ashley J, Young Jared W, Stanford S Clare
Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
J Psychopharmacol. 2016 Sep;30(9):837-47. doi: 10.1177/0269881116642541. Epub 2016 Apr 19.
The underlying cause(s) of abnormalities expressed by patients with attention deficit hyperactivity disorder (ADHD) have yet to be delineated. One factor that has been associated with increased vulnerability to ADHD is polymorphism(s) of TACR1, which is the human equivalent of the rodent NK1 (substance P-preferring) receptor gene (Nk1r). We have reported previously that genetically altered mice, lacking functional NK1R (NK1R-/-), express locomotor hyperactivity, which was blunted by the first-line treatment for ADHD, methylphenidate. Here, we compared the effects of this psychostimulant (3, 10 and 30 mg/kg, intraperitoneally) on the behaviour of NK1R-/- mice and their wild types in the 5-Choice Continuous Performance Test, which emulates procedures used to study attention and response control in ADHD patients. Methylphenidate increased total trials (a measure of 'productivity') completed by wild types, but not by NK1R-/- mice. Conversely, this drug reduced perseveration by NK1R-/- mice, but not by wild types. Other drug-induced changes in key behaviours were not genotype dependent, especially at the highest dose: for example, % omissions (an index of inattentiveness) was increased, whereas % false alarms and % premature responses (measures of impulsivity) declined in both genotypes, indicating reduced overall response. These findings are discussed in the context of the efficacy of methylphenidate in the treatment of ADHD. Moreover, they lead to several testable proposals. First, methylphenidate does not improve attention in a subgroup of ADHD patients with a functional deficit of TACR1. Second, these patients do not express excessive false alarms when compared with other groups of subjects, but they do express excessive perseveration, which would be ameliorated by methylphenidate.
注意力缺陷多动障碍(ADHD)患者所表现出的异常潜在病因尚未明确。与ADHD易感性增加相关的一个因素是TACR1的多态性,它相当于啮齿动物的NK1(偏好P物质)受体基因(Nk1r)的人类基因。我们之前报道过,缺乏功能性NK1R(NK1R-/-)的基因改造小鼠表现出运动性多动,而ADHD的一线治疗药物哌甲酯可使其减弱。在此,我们在5-选择连续作业测试中比较了这种精神兴奋剂(3、10和30mg/kg,腹腔注射)对NK1R-/-小鼠及其野生型小鼠行为的影响,该测试模拟了用于研究ADHD患者注意力和反应控制的程序。哌甲酯增加了野生型小鼠完成的总试验次数(一种“生产力”指标),但对NK1R-/-小鼠没有作用。相反,这种药物减少了NK1R-/-小鼠的持续性错误,但对野生型小鼠没有作用。其他药物诱导的关键行为变化不依赖于基因型,尤其是在最高剂量时:例如,遗漏百分比(注意力不集中的指标)增加,而两种基因型的错误警报百分比和过早反应百分比(冲动性指标)均下降,表明总体反应减少。这些发现结合哌甲酯治疗ADHD的疗效进行了讨论。此外,它们还引出了几个可测试的提议。第一,哌甲酯对TACR1功能缺陷的ADHD患者亚组的注意力没有改善作用。第二,与其他受试者组相比,这些患者没有表现出过多的错误警报,但他们确实表现出过多的持续性错误,而哌甲酯可以改善这种情况。