We discussed the cross section studies and the meta-analysis of published data in children and adolescents with ADHD (both drug naive and receiving stimulant medications), in comparison with healthy children and adolescents of the same age. In children and adolescents with ADHD the deceleration of the maturation dynamics of discrete CNS structures is found, volume reduction and decreased grey matter in prefrontal and occipital regions, which is accompanied by reverse asymmetry of the basal ganglia volume (putamen, nucleus caudate). The above mentioned developmental characteristics are valid only for the ADHD children, who have not been treated by stimulant medications. The stimulant treatment eliminates the mentioned changes into various extend. These developmental changes of CNS structures volume are missing in girls.
- MeSH
- bazální ganglia * abnormality patologie účinky léků MeSH
- dítě MeSH
- hyperkinetická porucha * farmakoterapie patologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- mozek * abnormality patologie účinky léků MeSH
- průřezové studie MeSH
- stimulanty centrálního nervového systému * terapeutické užití MeSH
- velikost orgánu účinky léků MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
OBJECTIVES: ADHD is one of the most significant diagnostic units in child and adolescent psychiatry. The occurrence in children is 5-6% and 50-80% continued to adult age. The presence of individual genes (polymorphism) on particular symptoms and processes in ADHD are not known. It is estimated that ADHD symptoms are up to 80% to genetic. The higher density of resultant DAT 1 protein was observed in ADHD patients in comparison with controls. The question was if DAT 1 10/10 predicted bad prognoses in long term therapy. METHODS: We compared 30 ADHD DAT 1 10/10 adolescents treated for 5-6 years. Patients with 30 control adolescents. They were the same age of probands and controls. All these subjects were examined by child psychiatry scales (Conners, Achenbach…). Biological changes were tested by MRI specific CNS volumometry. RESULTS: We didn't confirm bad prognoses in long term therapy with methylphenidate or atomoxetine in ADHD children DAT 1 10/10 in long term therapy. In MRI specific CNS volumometry were not identify any differences in controls and ADHD probands. Gray matter thickness was significantly higher in prefrontal and occipital areas in patients compared to control in prefrontal and occipital areas with cluster-wise p-value<0.05. By this method were not identify any cerebrum damage in long term therapy by methylphenidate and atomoxetine.
- MeSH
- atomoxetin terapeutické užití MeSH
- hyperkinetická porucha diagnostické zobrazování farmakoterapie genetika MeSH
- inhibitory vychytávání adrenergních neurotransmiterů terapeutické užití MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- methylfenidát terapeutické užití MeSH
- mladiství MeSH
- mozek diagnostické zobrazování patologie MeSH
- polymorfismus genetický MeSH
- prefrontální mozková kůra diagnostické zobrazování patologie MeSH
- prognóza MeSH
- proteiny přenášející dopamin přes plazmatickou membránu genetika MeSH
- šedá hmota diagnostické zobrazování patologie MeSH
- stimulanty centrálního nervového systému terapeutické užití MeSH
- týlní lalok diagnostické zobrazování patologie MeSH
- velikost orgánu MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The clinical course of chronic renal diseases and their progression to ESRD is highly variable. The strongest predictors of poor outcome of IgAN involve hypertension, severe proteinuria and elevated serum creatinine level. Different candidate gene polymorphisms have been advocated as possible modulators of the progression of IgAN. Megsin belongs to the serpin superfamily and was mapped to chromosome 18q21.3. Megsin plays a role in the regulation of a wide variety of processes in mesangial cells, such as matrix metabolism, cell proliferation, and apoptosis. Overexpression of Megsin might lead to mesangial dysfunction, and impair degradation of the mesangial matrix and disposal of immune complexes. The expression of Megsin is upregulated in a variety of glomerular diseases with mesangial injury in humans and in animal models. We investigated a possible association of two C2093T, C2180T polymorphisms of the megsin gene with the progression of IgAN towards ESRD, as well as the haplotype reconstruction of megsin gene polymorphisms and clinical manifestation of IgAN. We examined a group of 197 pts with histologically proven IGAN (84 pts with normal renal function, 113 pts with progressive renal insufficiency); as a control group we used 61 genetically unrelated healthy subjects. DNA samples from collected blood were genotyped for two singlenucleotide polymorphisms of megsin C2093T, C2180T by means of PCR with defined primers, electrophoresis on 2% agarose gel, UV light visualization and direct sequencing. The megsin genotype distribution showed no differences among the groups of IgAN with normal renal function, progressive renal insufficiency and the control group. According to haplotype analysis, the TT haplotype (defined as T-2093, T-2180 alleles) was substantially more frequent in pts with IgAN and normal renal function (Table 1, P = 0.025; Table 3, P = 0.062). Pts in the progressive group showed significantly higher levels of 24-h UP (3.53 +/- 2.80 vs 2.06 +/- 2.06, P = 0.042; Table 10), diastolic blood pressure (92.89 +/- 15.66 vs 84.93 +/- 10.43, P = 0.047; Table 10) and almost significantly systolic blood pressure (150.79 +/- 32.88 vs 135.21 +/- 14.88, P = 0.058; Table 10). We confirmed the negative prognostic influence of hypertension and proteinuria on the progression of IgAN in Czech pts. We found out that the TT haplotype (defined as T-2093, T-2180 alleles) could play a protective role in the progression of IgAN. In our Czech population, we excluded the negative influence of the 2093C-2180T haplotype, which was proposed by Chinese studies.
