title: Role of ADHD symptoms as a contributing factor to obesity in patients with MC4R mutations.
abstract: Besides the crucial role of genetic susceptibility in the development of early-onset obesity, it has been shown that feeding behavior could contribute to increased body weight. A significant association between obesity/overweight and ADHD has been reported, suggesting that these two conditions, despite their heterogeneity, might share common molecular pathways. Although the co-occurrence of obesity and ADHD is increasingly supported by empirical evidence, the complex pathogenetic link between these two conditions is still unclear. Here, we focus on the relationship between MC4R gene mutations and ADHD in children with early-onset obesity. Mutations in the gene MC4R lead to the most common form of monogenic obesity. We hypothesize that dysregulated eating behavior in a subset of patients with MC4R mutation might be due to comorbid ADHD symptoms, underpinned by abnormal reward mechanisms. Therefore, we speculate that it is possible to prevent obesity in a subset of patients with MC4R mutation, even if these patients are genetically programmed to "be fat", via an appropriate treatment of ADHD symptoms. We hope that our paper will stimulate further studies testing if the early screening for ADHD symptoms and their appropriate treatment may be an effective way to prevent obesity in a subset of children with MC4R mutation.
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata" University of Rome, Italy.
authors.forename: Maria-Cristina
authors.initials: MC
authors.lastname: Porfirio
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata" University of Rome, Italy. Electronic address: silviagiovinazzo@yahoo.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Giovinazzo
authors.affiliation: Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; School of Medicine, University of Nottingham, UK; The Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK; New York University Child Study Center, NY, USA.
authors.forename: Samuele
authors.initials: S
authors.lastname: Cortese
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata" University of Rome, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Giana
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata" University of Rome, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Lo-Castro
authors.affiliation: Child and Adolescent Psychopathology Unit, Robert Debré Hospital, Paris, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mouren
authors.affiliation: Unit of Child Neurology and Psychiatry of "Tor Vergata" University of Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Curatolo
authors.affiliation: CHRU Montpellier - St Eloi Hospital, Unit of Child and Adolescent Psychiatry (MPEA) Montpellier, France; INSERM U894 Team 1, Centre de Psychiatrie et de Neurosciences (CPN), Paris.
authors.forename: Diane
authors.initials: D
authors.lastname: Purper-Ouakil
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D005247:Feeding Behavior / Q000502:physiology*; D006801:Humans; D008954:Models, Biological; D009154:Mutation / Q000235:genetics; D009765:Obesity / Q000209:etiology*; D044105:Receptor, Melanocortin, Type 4 / Q000235:genetics*; D012201:Reward
chemical_list: C470072:MC4R protein, human; D044105:Receptor, Melanocortin, Type 4