An exploratory study of candidate gene(s) for Delirium Tremens: Adding the new cholinergic dimension to the conundrum

Malhotra, Savita; Basu, Debasish; Ghosh, Abhishek; Khullar, Madhu; Chugh, Neera; Kakkar, Neeraj

doi:10.1016/j.ajp.2018.02.003

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…So far, no explicit connection with the development of delirium could be shown. Only in an Asian candidate gene study an association between the CHRM2 gene (rs1824024) and the development of delirium tremens, which is the severe form of alcohol withdrawal, was also shown [ 37 ]. Of particular interest was the finding that the genetic variant was not associated with alcohol dependence per se.…”

Section: Discussionmentioning

confidence: 99%

Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients

et al. 2021

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Background Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are frequent and serious complications after surgery. We aim to investigate the association between genetic variants in cholinergic candidate genes according to the Kyoto encyclopedia of genes and genomes - pathway: cholinergic neurotransmission with the development of POD or POCD in elderly patients. Methods This analysis is part of the European BioCog project (www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini-Mental-State-Examination score ≤ 23 points were excluded. POD was assessed up to seven days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method and a patient chart review. POCD was assessed three months after surgery with a neuropsychological test battery. Genotyping was performed on the Illumina Infinium Global Screening Array. Associations with POD and POCD were analyzed using logistic regression analysis, adjusted for age, comorbidities and duration of anesthesia (for POCD analysis additionally for education). Odds ratios (OR) refer to minor allele counts (0, 1, 2). Results 745 patients could be included in the POD analysis, and 452 in the POCD analysis. The rate of POD within this group was 20.8% (155 patients), and the rate of POCD was 10.2% (46 patients). In a candidate gene approach three genetic variants of the cholinergic genes CHRM2 and CHRM4 were associated with POD (OR [95% confidence interval], rs8191992: 0.61[0.46; 0.80]; rs8191992: 1.60[1.22; 2.09]; rs2067482: 1.64[1.10; 2.44]). No associations were found for POCD. Conclusions We found an association between genetic variants of CHRM2 and CHRM4 and POD. Further studies are needed to investigate whether disturbances in acetylcholine release and synaptic plasticity are involved in the development of POD. Trial registration: ClinicalTrials.gov: NCT02265263.

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Section: Discussionmentioning

confidence: 99%

Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients

et al. 2021

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“…The role of cholinergic genes (CHRM2) in patients with a risk of delirium tremens was studied. [ 46 ]…”

Section: Factors Associated With Alcohol Usementioning

confidence: 99%

Alcohol use disorder research in India: An update

Narasimha,

Mukherjee,

Arya

et al. 2024

Indian Journal of Psychiatry

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Background: Despite alcohol use being a risk factor for numerous health-related conditions and alcohol use disorder (AUD) recognized as a disease, there was limited research in India until 2010. This narrative review aims to evaluate AUD-related research in India from 2010 to July 2023. Methods: A PubMed search used key terms for AUD in India after 2010. Indian and international journals with regional significance that publish alcohol-related research were searched by each author individually. These were then collated, and duplicates were removed. In addition, we also conducted a gray literature search on focused areas related to AUD. Results: The alcohol-related research in India after 2010 focused on diverse areas associated with alcohol use. Some areas of research have received more attention than others. Two major epidemiological surveys conducted in the past decade reveal that around 5% have a problematic alcohol use pattern. Factors associated with alcohol use, like genetic, neurobiological, psychological, and sociocultural, were studied. The studies focused on the clinical profile of AUD, including their correlates, such as craving, withdrawal, alcohol-related harm, and comorbid psychiatric and medical illnesses. During this period, minimal research was conducted to understand AUD’s laboratory biomarkers, course, and prognosis. While there was a focus on generating evidence for different psychological interventions for alcohol dependence in management-related research, pharmacological studies centered on anticraving agents like baclofen. Research on noninvasive brain stimulation, such as rTMS, has shown preliminary usefulness in treating alcohol dependence. Very little research has been conducted regarding alcohol policy. Conclusion: In the past decade, Indian research on alcohol has focused on diverse areas. Epidemiological and psychological management-related research received maximum attention. Considering the magnitude of the alcohol-related burden, it is essential to prioritize research to other less studied areas like pharmacological management of alcohol dependence and alcohol policy.

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“…31 One study evaluated the genetic variations associated with the development of delirium tremens and reported that delirium tremens was significantly associated with presence of T allele (GT and TT; [rs1824024]) of muscarinic cholinergic receptor 2 (CHRM2). 60…”

Section: Studies Focusing On Patients With Alcohol-withdrawal Deliriummentioning

confidence: 99%

“…Five studies have primarily focused on patients with AWD (►Table 5). 30,31,[58][59][60] One study evaluated the service model for patients with AWD and reported that compared with Delirium Research in India Grover et al…”

Section: Studies Focusing On Patients With Alcohol-withdrawal Deliriummentioning

confidence: 99%

Delirium Research in India: A Systematic Review

Grover

Kathiravan

Dua

2021

JNRP

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Delirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were “delirium,” “delirious,” “delirium tremens” AND “India.” No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms “delirium,” “delirious,” “delirium tremens” in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles (n = 81), and these were followed by, case reports (n = 58), review articles (n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials (n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context.

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An exploratory study of candidate gene(s) for Delirium Tremens: Adding the new cholinergic dimension to the conundrum

Cited by 4 publications

References 22 publications

Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients

Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients

Alcohol use disorder research in India: An update

Delirium Research in India: A Systematic Review

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