成人注意力缺陷多动障碍患者中SNAP-25基因与哌甲酯对前扣带回皮质影响的关系：一项磁共振波谱研究
Relationship between the SNAP-25 gene and the effects of methylphenidate on the anterior cingulate cortex of patients with adult attention deficit hyperactivity disorder: a magnetic resonance spectroscopy study.
作者信息
Ünal G A, İnci Kenar A N, Tepeli E, Kıroğlu Y, Herken H
机构信息
Psychiatry Clinic, Kozan State Hospital, Adana, Turkey.
出版信息
Eur Rev Med Pharmacol Sci. 2016 Jun;20(11):2443-9.
OBJECTIVE
The effects of certain genetic alterations in the brain function of patients with attention deficit hyperactivity disorder (ADHD) remain unclear and, in fact, there is a limited amount of data in this field. For example, the relationship between the SNAP-25 polymorphism and brain metabolites in response to methylphenidate (MPH) has yet to be investigated. Thus, the present study aimed to determine the relationship between changes in creatine (Cr), choline (Cho), and N-acetyl aspartate (NAA) levels in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) of adults with ADHD and the SNAP-25 gene polymorphism following the use of MPH.
PATIENTS AND METHODS
The present study assessed 60 patients between 18 and 60 years of age who were diagnosed with ADHD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Genetic analyses were carried out using blood samples obtained from the ADHD patients and included a detailed clinical evaluation for the SNAP-25 gene polymorphism. The NAA, Cr, and Cho levels in the ACC and PFC were measured using magnetic resonance spectroscopy (MRS). Following the evaluation, 10 mg of oral MPH was given to the patients, and the same metabolite levels were measured after 30 minutes.
RESULTS
The levels of NAA, Cr, and Cho in the PFC and ACC of patients with the SNAP-25 Ddel and Mnll polymorphism genotypes did not significantly differ before and after the administration of MPH. However, in patients with the SNAP-25 Ddel polymorphism T/T genotype and the Mnll polymorphism G/G genotype, there was a significant increase in NAA levels in the ACC after MPH treatment compared with before MPH treatment.
CONCLUSION
The present results suggest that the SNAP-25 Ddel and Mnll polymorphisms might be associated with MPH-related changes in NAA levels in the ACC.
目的
注意缺陷多动障碍（ADHD）患者某些基因改变对脑功能的影响仍不明确，实际上该领域的数据有限。例如，SNAP - 25基因多态性与哌甲酯（MPH）反应后脑代谢物之间的关系尚未得到研究。因此，本研究旨在确定ADHD成年患者前额叶皮质（PFC）和前扣带回皮质（ACC）中肌酸（Cr）、胆碱（Cho）和N - 乙酰天门冬氨酸（NAA）水平的变化与使用MPH后SNAP - 25基因多态性之间的关系。
患者与方法
本研究评估了60名年龄在18至60岁之间、根据《精神障碍诊断与统计手册》第4版（DSM - IV）标准被诊断为ADHD的患者。使用从ADHD患者采集的血样进行基因分析，包括对SNAP - 25基因多态性的详细临床评估。使用磁共振波谱（MRS）测量ACC和PFC中的NAA、Cr和Cho水平。评估后，给患者口服10 mg MPH，并在30分钟后测量相同的代谢物水平。
结果
具有SNAP - 25 Ddel和Mnll多态性基因型的患者，在服用MPH前后，PFC和ACC中NAA、Cr和Cho的水平没有显著差异。然而，具有SNAP - 25 Ddel多态性T/T基因型和Mnll多态性G/G基因型的患者，与MPH治疗前相比，MPH治疗后ACC中NAA水平显著升高。
结论
目前的结果表明，SNAP - 25 Ddel和Mnll多态性可能与ACC中NAA水平与MPH相关的变化有关。
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