Helen Costello

Delineating ADHD and bipolar disorder: A comparison of clinical profiles in adult women.

OBJECTIVE Overlapping symptoms can make the diagnostic differentiation of attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) challenging in adults using current clinical assessments. This study sought to determine if current clinical measures delineate ADHD from BD in adults, comparing relative levels of ADHD, BD and emotional lability (EL) symptoms. METHODS Sixty adult women with ADHD, BD or controls were compared on self-report and interview measures for ADHD symptoms, mania, depression, EL, and impairment. RESULTS ADHD interview measures and self-ratings of ADHD symptoms best discriminated between ADHD and BD. Self-report measures of EL and depression showed non-specific enhancement in both clinical groups. BD-specific items may distinguish BD from ADHD if a retrospective time-frame is adopted. CONCLUSIONS Using measures which capture specific symptoms of ADHD and chronicity/episodicity of symptoms facilitates the delineation of ADHD from BD in adult women.

Immune signatures and disorder-specific patterns in a cross-disorder gene expression analysis

Background Recent studies point to overlap between neuropsychiatric disorders in symptomatology and genetic aetiology. Aims To systematically investigate genomics overlap between childhood and adult attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD). Method Analysis of whole-genome blood gene expression and genetic risk scores of 318 individuals. Participants included individuals affected with adult ADHD (n = 93), childhood ADHD (n = 17), MDD (n = 63), ASD (n = 51), childhood dual diagnosis of ADHD–ASD (n = 16) and healthy controls (n = 78). Results Weighted gene co-expression analysis results reveal disorder-specific signatures for childhood ADHD and MDD, and also highlight two immune-related gene co-expression modules correlating inversely with MDD and adult ADHD disease status. We find no significant relationship between polygenic risk scores and gene expression signatures. Conclusions Our results reveal disorder overlap and specificity at the genetic and gene expression level. They suggest new pathways contributing to distinct pathophysiology in psychiatric disorders and shed light on potential shared genomic risk factors.

A pilot study of potential brain donor satisfaction and attitudes towards telephone assessment

Test the feasibility of assessing cognition, psychiatric symptoms and daily living skills of potential brain donors by telephone and compare satisfaction and attitudes across telephone and face‐to‐face assessment.

Factors affecting withdrawal and donation attrition in the brains for dementia research cohort

To measure two forms of attrition in a cohort of volunteer brain donors: Withdrawal during life and non‐donation at death. To test whether cognitive impairment independently predicts attrition.

AN INTEGRATED APPROACH TO U.K. BRAIN BANKING ALLOWING RESEARCHERS TO SELECT TISSUE WITH PRECISION: MRC U.K. BRAIN BANK NETWORK, CSOLS TRACKING SYSTEM AND BRAINS FOR DEMENTIA RESEARCH

Results: The longitudinal and transitional nature of a readiness cohort creates the risk of the cohort and its concatenated trials becoming a ‘fish trap’ for its participants. With every step further into such a research project, it becomes more difficult for a participant to go back or retract from participation. Therefore, we recommend an adapted stagedconsent model for concatenated projects like EPAD, which are extended over time and multi-staged, and in which participants and data move from one stage to the next. This consent model feeds relevant information, bit by bit, along research participants’ journey, and asks informed consent at every moment in which important decisions need to be made by participants. Although informed consent is always given for a specific stage of the research project, information about the ‘totality of the project’ must always and explicitly be part of the informed consent process. Conclusions: It is critical to the success of readiness cohorts to carefully align ethical guidance for recruitment and informed consent. The ELSIwork package of EPAD recommends an adapted staged-consent model. This model may also be of value to other research collaborations in the process of developing and using readiness cohorts in Alzheimer’s disease research.

ANALYSIS OF PARTICIPANTS WITHDRAWING FROM A COHORT CONSENTING TO BRAIN DONATION AT DEATH AND DETAILED PSYCHOMETRIC ASSESSMENTS DURING LIFE

Despite no statistical significance, patients atMCI stagewithLODpresented a higher percentage of AD pathology in comparison with those having EOD. A relevant issue regards whether patients with AD pathologyatMCI stage, in the co-occurrenceofdepression, couldpresent a more aggressive course of the disease than thosewithout depression. Another important point regards if depression constitutes a predictor of clinical deterioration, including dementia, independently of the occurrence of AD pathology. To increase the sample number and to explain the aforementioned issues are the next steps of the present investigation. (1) Forlenza et al., AlzheimersDement, 2015;1:455-463. Laboratory of Neuroscience (LIM-27), IPq-FM-USP, Brazil.