Pharmacogenetics of Methylphenidate Response in Preschoolers With ADHD

McGough, James J.; McCracken, James T.; Swanson, James M.; Riddle, Mark A.; Kollins, Scott H.; Greenhill, Laurence L.; Abikoff, Howard; Davies, Mark; Chuang, Shirley; Wigal, Tim; Wigal, Sharon B.; Posner, Kelly; Skrobala, Anne M.; Kastelic, Elizabeth; Ghuman, Jaswinder K.; Cunningham, Charles E.; Shigawa, Sharon; Moyzis, Robert K.; Vitiello, Benedetto

doi:10.1097/01.chi.0000235083.40285.08

Cited by 111 publications

(103 citation statements)

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“…After 15 sessions of NF, patients showed significant improvement of ADHD selfreported symptoms and a tendency for increased CNV amplitude [49]. It would be interesting to test the effects of NF for pre-schoolers because young children are less susceptible to benefit from stimulants [64] and the remission rate with behavioral therapy (as a first-line treatment) is also low [65]. However, pilot work needs to establish whether young children can regularly and for long enough attend and control artifacts to learn self-regulation.…”

Section: Which Adhd Subtypes Benefit From Nf?mentioning

confidence: 99%

Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

et al. 2012

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Summary Neurofeedback (NF) is a training to enhance selfregulatory capacity over brain activity patterns and consequently over brain mental states. Recent findings suggest that NF is a promising alternative for the treatment of attention-deficit/hyperactivity disorder (ADHD). We comprehensively reviewed literature searching for studies on the effectiveness and specificity of NF for the treatment of ADHD. In addition, clinically informative evidence-based data are discussed. We found 3 systematic review on the use of NF for ADHD and 6 randomized controlled trials that have not been included in these reviews. Most nonrandomized controlled trials found positive results with medium-to-large effect sizes, but the evidence for effectiveness are less robust when only randomized controlled studies are considered. The direct comparison of NF and sham-NF in 3 published studies have found no group differences, nevertheless methodological caveats, such as the quality of the training protocol used, sample size, and sample selection may have contributed to the negative results. Further data on specificity comes from electrophysiological studies reporting that NF effectively changes brain activity patterns. No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted. Follow-up studies support long-term effects of NF. Currently there is no available data to guide clinicians on the predictors of response to NF and on optimal treatment protocol. In conclusion, NF is a valid option for the treatment for ADHD, but further evidence is required to guide its use.

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Section: Which Adhd Subtypes Benefit From Nf?mentioning

confidence: 99%

Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

et al. 2012

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“…Conversely, in a separate report on 83 Korean children, subjects who were homozygous for the 4-repeat polymorphism were much more likely to exhibit positive responses on parent and teacher behavioral ratings than those with other genotypes [38]. Other studies have found no relationship between DRD4 genotype and ADHD symptom change [24,30,32,33]. The Preschool ADHD Treatment Study (PATS) was notable in that it focused not only on symptom reduction, but also examined the potential role of genotype in predicting side effects [33].…”

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confidence: 95%

The Pharmacogenomic Era: Promise for Personalizing Attention Deficit Hyperactivity Disorder Therapy

Stein

McGough²

2008

Child and Adolescent Psychiatric Clinics of North America

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SynopsisCurrently, ADHD treatment is often determined empirically through trial and error until an adequate response is obtained or side effects occur. ADHD is highly heritable and there is wide individual variability in response to ADHD medications, suggesting that the mechanism of action of stimulant medications may provide clues for genetic predictors of response. The promise of ADHD pharmacogenetics is far reaching, and includes the potential to develop individualized medication regimens that improve symptom response, decrease risk for side effects, improve long-term tolerability, and thus contribute to long-term treatment compliance and improved general effectiveness. Early ADHD pharmacogenetic studies have focused predominantly on catecholamine pathway genes and response to methylphenidate. Future efforts will also examine a wider range of stimulant and non-stimulant medications on a range of outcome measures and time periods. Based upon these studies, the potential for personalizing ADHD treatment in clinical practice will be determined. IntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) is a common and treatable behavioral syndrome that typically emerges during childhood or adolescence and often persists into adulthood. There are an increasing number of stimulant and non-stimulant medication options for ADHD, with numerous new compounds in development [1]. In acute treatment studies, stimulant medications generally demonstrate large effect sizes on ADHD symptom reduction relative to placebo, with slightly smaller effect sizes in adult studies [2]. Surprisingly, only a minority of children and adolescents with ADHD remain on medication consistently Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. despite persistence of symptoms and impairments. Even among responders, there is marked variability in optimal dosage, duration of effect, and tolerability. Moreover, in spite of acute symptom reduction from ADHD medications, as yet there is little evidence of long-term response and improvement in functioning among those children who received treatment [4,5]. Furthermore, there are few reliable predictors of medication response. In the absence of these data, treatment is often determined "empirically" in clinical practice through a gradual titration of different dosages and trial and error approach to different medications. NIH Public AccessADHD is a highly heritable disorder [6]. The search for candidate genes associated with ADHD has been largely driven by the understanding that medications for the disorder have drug targets in the catecholamine system [7]. Conve...

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“…Une méta-analyse des études pharmacogénéti-ques ayant étudié ce polymorphisme retrouve également l'association du génotype 10-R/10-R et d'une moindre réponse au traitement avec un OR (odds ratio) de 0,46 (IC95 % 0,28-0,76) [26]. Bien que moins étudiés, d'autres polymorphismes tels que le VNTR DRD4*7 (dopamine D4 receptor), seul [27] ou en interaction avec le variant L de la région promotrice du transporteur de la sérotonine (5-HTTLPR) [28], ont été associés à la réponse au méthylphénidate.…”

Section: éTudes Pharmacogénétiquesunclassified