Dikkat eksikliği hiperaktivite bozukluğu tanılı çocuk ve ergenlerde ADRA 2A-rs1800544, slc6a4-5HTTLPR ve SLC6A2-rs28386840 gen polimorfizmlerinin tedavi yanıtı ve yan etki profili ile ilişkisinin araştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda ADRA-2A rs1800544, SLC6A2 rs28386840 ve SLC6A4 5-HTTLPR polimorfizm genotiplerinin sağlıklı toplum popülasyonu ile DEHB grubu arasında dağılımları ve kliniğimize başvuran DEHB'li olguların tedavi öncesi değerlendirmeleri, tedavi yanıtları ve yan etkileri ile arasındaki ilişki araştırılmıştır. Araştırmamıza; DEHB grubu olarak, polikliniğimizde 6-18 yaş aralığında yeni DEHB tanısı almış ve tedavisi düzenlenmiş olan 98 olgu ile kronik tıbbi ve psikiyatrik hastalığı olmayan, yaş ve cinsiyet açısından benzer olan 96 sağlıklı toplum popülasyonu dahil edildi. Olgular tedavi öncesi ve sonrasında sosyodemografik veri formu, Hollingshead-Redich Ölçeği (HRÖ), ÇDŞG–ŞY–DSM–5–T, Çocuklarda Anksiyete ve Depresyon Ölçeği- Çocuk ve Ebeveyn Formu (ÇADÖ), Klinik Global İzlenim Ölçeği (KGİ), Global Değerlendirme Ölçeği (GDÖ), Barkley Psikostimülan Yan Etki Formu (BSYEF) ve nöropsikolojik testlerden Stroop TBAG Formu, İz Sürme Testi A ve B (İST A, İST B) ile değerlendirilmiştir. ADRA 2A rs1800544 polimorfizmine göre C allelinin hastalık şiddeti açısından riskli allel olduğu, G allelinin ise tedaviye dirençten sorumlu allel olduğu bulundu. GC genotipinde iştahsızlık yan etkisi diğer genotiplere oranla daha hafif şiddette görüldü. SLC6A2 rs28386840 polimorfizmine göre T allelinin yüksek hastalık şiddetinden sorumlu olduğu bulundu. A allelinin ise baş ağrısı ve baş dönmesi yan etkisi açısından riskli allel olduğu görüldü. SLC6A4 5-HTTLPR polimorfizmine göre s allelinin hastalık şiddeti ve tedaviye dirençten sorumlu olduğu bulundu. Aynı zamanda s allelinin tik yan etkisi açısından riskli allel olduğu görüldü. Çalışmamızda ADRA-2A rs1800544, SLC6A2 rs28386840 ve SLC6A4 5-HTTLPR polimorfizmlerinin DEHB belirtileri, tedavi yanıtları ve yan etkileri ile ilişkisinin olduğu bulundu. Literatürde bulgularımız ile uyumlu sonuçların yanında bulgularımızı desteklemeyen sonuçlar da bulunmaktadır. Literatürdeki bu çeşitliliğin çalışmalarda kullanılan metodolojik farklılıklar, örneklemin seçildiği etnik köken farklılıkları ve farklı DEHB tedavi planları nedeniyle olabileceği düşünülmektedir. Birden fazla bölgeden alınacak olgular ile örneklem boyutu büyütülerek, genetik analiz yanında nörogörüntüleme araçları ile çalışmamızın sonuçlarının desteklenebileceği düşünülmektedir.
In our study, we investigated the distribution of ADRA-2A rs1800544, SLC6A2 rs28386840, and SLC6A4 5-HTTLPR polymorphism genotypes between the healthy population and the ADHD group and the relationship between pretreatment evaluations, treatment responses, and side effects of ADHD patients admitted to our clinic. In our study, 98 cases aged 6-18 years with newly diagnosed ADHD whose treatment was organized in our outpatient clinic were included as the ADHD group and 96 healthy population without chronic medical and psychiatric diseases and similar in age and sex were included in the study. Before and after treatment, sociodemographic data form, Hollingshead-Redich Scale (HRS), ÇDŞG–ŞY–DSM–5-T, Anxiety and Depression Scale in Children - Child and Parent Form, Clinical Global Impression Scale (CGI), Global Assessment Scale (GAS), Barkley Psychostimulant Side Effect Form (BSSERS) and neuropsychological tests Stroop TBAG Form, Trail Making Test A and B (TMT A, TMT B) were evaluated. According to the ADRA 2A rs1800544 polymorphism, the C allele was found to be the risk allele for disease severity and the G allele was found to be the treatment resistance allele. In the GC genotype, the side effect of anorexia was milder compared to other genotypes. According to the SLC6A2 rs28386840 polymorphism, the T allele was found to be responsible for high disease severity. The A allele was found to be the risk allele for headache and dizziness side effects. In the SLC6A4 5-HTTLPR polymorphism, the 's' allele was found to be responsible for disease severity and treatment resistance. At the same time, the 's' allele was found to be a risk allele for tic side effects. In our study, ADRA-2A rs1800544, SLC6A2 rs28386840 and SLC6A4 5-HTTLPR polymorphisms were found to be associated with ADHD symptoms, treatment response and side effects. There are results in the literature that are consistent with our findings as well as results that do not support our findings. It is thought that this diversity in the literature may be due to methodological differences used in the studies, differences in the ethnicity of the sample, and different ADHD treatment plans. It is believed that the results of our study can be supported with neuroimaging tools as well as genetic analysis by increasing the sample size with cases from more than one region.
In our study, we investigated the distribution of ADRA-2A rs1800544, SLC6A2 rs28386840, and SLC6A4 5-HTTLPR polymorphism genotypes between the healthy population and the ADHD group and the relationship between pretreatment evaluations, treatment responses, and side effects of ADHD patients admitted to our clinic. In our study, 98 cases aged 6-18 years with newly diagnosed ADHD whose treatment was organized in our outpatient clinic were included as the ADHD group and 96 healthy population without chronic medical and psychiatric diseases and similar in age and sex were included in the study. Before and after treatment, sociodemographic data form, Hollingshead-Redich Scale (HRS), ÇDŞG–ŞY–DSM–5-T, Anxiety and Depression Scale in Children - Child and Parent Form, Clinical Global Impression Scale (CGI), Global Assessment Scale (GAS), Barkley Psychostimulant Side Effect Form (BSSERS) and neuropsychological tests Stroop TBAG Form, Trail Making Test A and B (TMT A, TMT B) were evaluated. According to the ADRA 2A rs1800544 polymorphism, the C allele was found to be the risk allele for disease severity and the G allele was found to be the treatment resistance allele. In the GC genotype, the side effect of anorexia was milder compared to other genotypes. According to the SLC6A2 rs28386840 polymorphism, the T allele was found to be responsible for high disease severity. The A allele was found to be the risk allele for headache and dizziness side effects. In the SLC6A4 5-HTTLPR polymorphism, the 's' allele was found to be responsible for disease severity and treatment resistance. At the same time, the 's' allele was found to be a risk allele for tic side effects. In our study, ADRA-2A rs1800544, SLC6A2 rs28386840 and SLC6A4 5-HTTLPR polymorphisms were found to be associated with ADHD symptoms, treatment response and side effects. There are results in the literature that are consistent with our findings as well as results that do not support our findings. It is thought that this diversity in the literature may be due to methodological differences used in the studies, differences in the ethnicity of the sample, and different ADHD treatment plans. It is believed that the results of our study can be supported with neuroimaging tools as well as genetic analysis by increasing the sample size with cases from more than one region.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Psikiyatri, Psychiatry
