title: Combined analysis of 635 patients confirms an age-related association of the serotonin 2A receptor gene with tardive dyskinesia and specificity for the non-orofacial subtype.
abstract: Tardive dyskinesia (TD) is an important limiting factor in the use of typical antipsychotic drugs. Genetic variability in the serotonin 2A (5-HT(2A)) receptor may influence risk for TD but the results of prior studies are not confirmatory. The objective of this study was to determine association of T102C and His452Tyr polymorphisms in the 5-HT(2A) receptor gene (HTR(2A)) with TD in a large, multicentre patient sample. The design employed case-control analysis controlling for possible confounders using pooled, original data from published and available unpublished samples and employing logistic regression, analysis of variance and meta-analysis. The study sample consisted of 635 patients with schizophrenia or schizoaffective disorder (256 with TD and 379 without TD) drawn from five research centres, divided into six groups based on population origin. The main outcome measure was association of a categorical diagnosis of TD based on the Research Diagnostic Criteria for TD with HTR(2A) T102C and His452Tyr genotypes and haplotypes. The findings indicate significant association of TD with HTR(2A) T102C genotype (p=0.002) over and above the effect of population group, also when controlling for age and gender (p=0.0008), but not with His452Tyr genotype. The T102C genotype was significantly associated with TD in older (>median age 47 yr, p=0.002) but not younger patients and in patients with non-orofacial (limb-truncal) (p=0.001) but not orofacial TD. By meta-analysis the Mantel-Haenszel (M-H) pooled odds ratio (OR) across all the available data was 1.64. A T102C-His452Tyr haplotype was significantly associated with TD (p=0.0008). These findings confirm that genetic variability in HTR(2A) contributes a small but significant degree of risk for the expression of TD, particularly in older patients and specifically for the non-orofacial (limb-truncal) type. Together with other genetic variants associated with TD the findings could be used to assess risk in patients who are candidates for treatment with typical antipsychotic medications.
authors.affiliation: Biological Psychiatry Laboratory, Department of Psychiatry, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. lerer@cc.huji.ac.il
authors.forename: Bernard
authors.initials: B
authors.lastname: Lerer
authors.forename: Ronnen H
authors.initials: RH
authors.lastname: Segman
authors.forename: Ene-Choo
authors.initials: EC
authors.lastname: Tan
authors.forename: Vincenzo S
authors.initials: VS
authors.lastname: Basile
authors.forename: Roberto
authors.initials: R
authors.lastname: Cavallaro
authors.forename: Harald N
authors.initials: HN
authors.lastname: Aschauer
authors.forename: Rael
authors.initials: R
authors.lastname: Strous
authors.forename: Siow-Ann
authors.initials: SA
authors.lastname: Chong
authors.forename: Uriel
authors.initials: U
authors.lastname: Heresco-Levy
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Verga
authors.forename: Joachim
authors.initials: J
authors.lastname: Scharfetter
authors.forename: Herbert Y
authors.initials: HY
authors.lastname: Meltzer
authors.forename: James L
authors.initials: JL
authors.lastname: Kennedy
authors.forename: Fabio
authors.initials: F
authors.lastname: Macciardi
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000235:genetics*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004409:Dyskinesia, Drug-Induced / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006639:Histidine / Q000235:genetics; D006801:Humans; D007391:International Cooperation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D011110:Polymorphism, Genetic; D044402:Receptor, Serotonin, 5-HT2A / Q000235:genetics*; D014364:Tryptophan / Q000235:genetics
chemical_list: D044402:Receptor, Serotonin, 5-HT2A; D006639:Histidine; D014364:Tryptophan