Elham Shirazi

Attention-deficit/hyperactivity disorder (ADHD) association with the DAT1 core promoter -67 T allele.

Association between attention deficit hyperactivity disorder (ADHD) and the 10-repeat allele of a polymorphism (a 40 bp variable number of tandem repeats) in the dopamine transporter gene (DAT1) has been reported by several groups. In this study, we examined whether either allele of the DAT1 core promoter -67 functional polymorphism is associated with ADHD in a case/control study. The allele and genotype frequencies of the polymorphism were studied in 110 patients and 120 controls, which were matched on the basis of sex, age and ethnicity. The genotype frequencies in the patients group were as follows: AA 19.2%; AT 65.2%; TT 15.4% vs. the genotype frequencies in the control group: AA 47.5%; AT 43.3%; TT 9.2% [chi2=20.73, df=2, P<or=0.0001]. The T allele of the -67A/T polymorphism revealed an approximately 1.56-fold excess in the patients group comparing with the controls [chi2=14.50, df=1 (P<or=0.001). For the first time, these findings provide tentative evidence of the contribution of the DAT1 gene core promoter polymorphism to the etiopathophysiology of ADHD at least in the Iranian population that we have studied. Further work is warranted to confirm this finding and to assess its generalization to other ethnic groups.

No association between the DAT1 10-repeat allele and ADHD in the Iranian population†

Association studies between attention‐deficit hyperactivity disorder (ADHD) and the 10‐repeat allele of a polymorphism (a 40 bp variable number of tandem repeats) in the dopamine transporter gene (DAT1) have resulted in mixed findings in different populations. We performed a case/control study to clarify the contribution of this allele with ADHD in the Iranian population. No association was observed between the 10‐allele and disease (χ2 = 0.081, P < 0.9). Furthermore, no significant difference was observed in the homozygosity of this allele between the case and control groups (χ2 = 0.022, P < 0.9). Implication of the dopamine transporter gene in the pathophysiology of ADHD warrants investigation of other functional polymorphisms within this gene in the Iranian ADHD patients.

Profile of Major Depressive Disorder Symptoms Among Patients in Tehran

Introduction and purpose: The aim of this research was to predict depression and general health based on health locus of control in older adults with chronic diseases. Materials and Methods: This correlation study used convenience sampling method to collect 100 older adults living in Shiraz city. Research instruments included General Health Questionnaire, Geriatric Depression Scale and Health Locus of Control Questionnaire. To analyze the data, multiple regression methods were applied using SPPS (version 17). Findings: Regression analysis showed that internal control (β= 0.41, p< 0.000) and believe in God (β= 0.20, p< 0.03) significantly predicted general health. Additionally, our findings showed that depression can be significantly predicted by internal control (β= 0.37, p< 0.000) and believe in God (β= -0.20, p< 0.04). Conclusion: According to our findings, the two components of Internal control and believe in God, in health locus of control variable’s, play an important role in predicting general health status and depressive symptoms among older adults.

Palmitoylethanolamide as adjunctive therapy for autism: Efficacy and safety results from a randomized controlled trial

Inflammation as well as glutamate excitotoxicity have been proposed to participate in the propagation of autism. Palmitoylethanolamide (PEA) is an endocannabinoid proven to prevent glutamatergic toxicity and inhibit inflammatory responses simultaneously. The present randomized, parallel group, double-blind placebo-controlled trial is the first study depicted to probe the efficacy of co-treatment with risperidone and PEA over 10 weeks in children with autism. Seventy children (aged 4-12 years) with autism and moderate to severe symptoms of irritability were randomly assigned to two treatment regimens. The study outcomes were measured using the Aberrant Behavior Checklist-Community Edition (ABC-C). At trial endpoint (week 10), combination of PEA and risperidone had superior efficacy in ameliorating the ABC-irritability and hyperactivity/noncompliance symptoms (Cohens d, 95% confidence interval (CI) = 0.94, 0.41 to 1.46, p = 0.001) compared with a risperidone plus placebo regimen. Interestingly, effect of combination treatment on hyperactivity symptoms was also observed at trial midpoint (week 5) but with a smaller effect size (d = 0.53, p = 0.04) than that at the endpoint (d = 0.94, p = 0.001). Meanwhile, there was a trend toward significance for superior effect of risperidone plus PEA over risperidone plus placebo on inappropriate speech at trial endpoint (d = 0.51, p = 0.051). No significant differences existed between the two treatment groups for the other two ABC-C subscales (lethargy/social withdrawal and stereotypic behavior). The findings suggest that PEA may augment therapeutic effects of risperidone on autism-related irritability and hyperactivity. Future studies are warranted to investigate whether PEA can serve as a stand-alone treatment for autism.

Childhood disintegrative disorder with seasonal total mutism: A rare clinical presentation.

Childhood disintegrative disorder (CDD) is a rare autistic-like clinical condition with unknown etiology, in that previously acquired age-appropriate language, social and adaptive abilities deteriorate significantly in 2-10-year-old healthy children, although physical and neurological evaluations display no observable abnormality. Our case is a 22-year-old female born of a consanguineous marriage, with the appearance of CDD symptoms in her fifth year of age following normal mental and physical development during her initial four years of life. Without any precipitating factor, she gradually lost her language abilities, social relational skills, affectionate behavior, adaptive capacities, peer play and meaningful interest in her surrounding, friends and family members over a period of 4 years, reaching a plateau in her ninth year of age. The unique special clinical symptom in this case is a seasonal total mutism, which after the beginning of her CDD symptoms is revealing every year covering the spring. As no additional physical or psychological change accompanies her total seasonal speech loss, it cannot be attributed to any mental condition known as having a seasonal pattern. Because in the literature CDD is presented mostly as case reports with lacking of advanced research data, describing any new case is recommended to improve the knowledge about this rare condition, especially if it displays some new unusual signs, not reported till now.