title: Association and linkage of the dopamine transporter gene and attention-deficit hyperactivity disorder in children: heterogeneity owing to diagnostic subtype and severity.
abstract: Attention-deficit hyperactivity disorder (ADHD) affects approximately 3%-5% of children in the United States. In the current psychiatric nomenclature, ADHD comprises three subtypes: inattentive, hyperactive-impulsive, and combined. In this study, we used four analytic strategies to examine the association and linkage of the dopamine transporter gene (DAT1) and ADHD. Our sample included 122 children referred to psychiatric clinics for behavioral and learning problems that included but were not limited to ADHD, as well as their parents and siblings. Within-family analyses of linkage disequilibrium, using the transmission disequilibrium test (TDT), confirmed the 480-bp allele as the high-risk allele. In between-family association analyses, levels of hyperactive-impulsive symptoms but not inattentive symptoms were related to the number of DAT1 high-risk alleles. Siblings discordant for the number of DAT1 high-risk alleles differed markedly in their levels of both hyperactive-impulsive and inattentive symptoms, such that the sibling with the higher number of high-risk alleles had much higher symptom levels. Within-family analyses of linkage disequilibrium, using the TDT, suggested association and linkage of ADHD with DAT1 and that this relation was especially strong with the combined but not the inattentive subtype. The relation of DAT1 to ADHD increased monotonically, from low to medium to high levels of symptom severity. Our results replicate and extend previous findings of the association between the DAT1 gene and childhood ADHD. This represents one of the first replicated relations of a candidate gene and a psychiatric disorder in children.
authors.affiliation: Department of Psychology, Emory University, Atlanta, Georgia, USA. waldman@ss.emory.edu
authors.forename: I D
authors.initials: ID
authors.lastname: Waldman
authors.forename: D C
authors.initials: DC
authors.lastname: Rowe
authors.forename: A
authors.initials: A
authors.lastname: Abramowitz
authors.forename: S T
authors.initials: ST
authors.lastname: Kozel
authors.forename: J H
authors.initials: JH
authors.lastname: Mohr
authors.forename: S L
authors.initials: SL
authors.lastname: Sherman
authors.forename: H H
authors.initials: HH
authors.lastname: Cleveland
authors.forename: M L
authors.initials: ML
authors.lastname: Sanders
authors.forename: J M
authors.initials: JM
authors.lastname: Gard
authors.forename: C
authors.initials: C
authors.lastname: Stever
mesh_terms: D000483:Alleles; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D001526:Behavioral Symptoms; D002352:Carrier Proteins / Q000235:genetics*; D002648:Child; D004200:Diseases in Twins / Q000235:genetics; D050483:Dopamine Plasma Membrane Transport Proteins; D005006:Ethnicity / Q000235:genetics; D005260:Female; D005799:Genes, Dominant; D005808:Genes, Recessive; D008040:Genetic Linkage; D006801:Humans; D007859:Learning Disabilities; D016014:Linear Models; D015810:Linkage Disequilibrium; D008297:Male; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D008957:Models, Genetic; D009419:Nerve Tissue Proteins; D009679:Nuclear Family; D010641:Phenotype; D011569:Psychiatric Status Rating Scales
chemical_list: D002352:Carrier Proteins; D050483:Dopamine Plasma Membrane Transport Proteins; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; C493214:SLC6A3 protein, human