10 research outputs found
Updated European Consensus Statement on diagnosis and treatment of adult ADHD
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD. (c) 2018 The Author(s). Published by Elsevier Masson SAS.Peer reviewe
GABAB receptor deficiency causes failure of neuronal homeostasis in hippocampal networks
Stabilization of neuronal activity by homeostatic control systems is fundamental for proper functioning of neural circuits. Failure in neuronal homeostasis has been hypothesized to underlie common pathophysiological mechanisms in a variety of brain disorders. However, the key molecules regulating homeostasis in central mammalian neural circuits remain obscure. Here, we show that selective inactivation of GABAB, but not GABA(A), receptors impairs firing rate homeostasis by disrupting synaptic homeostatic plasticity in hippocampal networks. Pharmacological GABA(B) receptor (GABA(B)R) blockade or genetic deletion of the GB(1a) receptor subunit disrupts homeostatic regulation of synaptic vesicle release. GABA(B)Rs mediate adaptive presynaptic enhancement to neuronal inactivity by two principle mechanisms: First, neuronal silencing promotes syntaxin-1 switch from a closed to an open conformation to accelerate soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) complex assembly, and second, it boosts spike-evoked presynaptic calcium flux. In both cases, neuronal inactivity removes tonic block imposed by the presynaptic, GB(1a)-containing receptors on syntaxin-1 opening and calcium entry to enhance probability of vesicle fusion. We identified the GB(1a) intracellular domain essential for the presynaptic homeostatic response by tuning intermolecular interactions among the receptor, syntaxin-1, and the Ca(V)2.2 channel. The presynaptic adaptations were accompanied by scaling of excitatory quantal amplitude via the postsynaptic, GB(1b)-containing receptors. Thus, GABA(B)Rs sense chronic perturbations in GABA levels and transduce it to homeostatic changes in synaptic strength. Our results reveal a novel role for GABA(B)R as a key regulator of population firing stability and propose that disruption of homeostatic synaptic plasticity may underlie seizure's persistence in the absence of functional GABA(B)Rs
The Study of Genetic Susceptibility and Mitochondrial Dysfunction in Mesial Temporal Lobe Epilepsy
Updated European Consensus Statement on diagnosis and treatment of adult ADHD
Background Attention-deficit/hyperactivity disorder (ADHD) is among the
most common psychiatric disorders of childhood that often persists into
adulthood and old age. Yet ADHD is currently underdiagnosed and
undertreated in many European countries, leading to chronicity of
symptoms and impairment, due to lack of, or ineffective treatment, and
higher costs of illness.
Methods The European Network Adult ADHD and the Section for
Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European
Psychiatric Association (EPA), aim to increase awareness and knowledge
of adult ADHD in and outside Europe. This Updated European Consensus
Statement aims to support clinicians with research evidence and clinical
experience from 63 experts of European and other countries in which ADHD
in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence,
persistence, genetics and neurobiology of ADHD, three major questions
are addressed: (1) What is the clinical picture of ADHD in adults? (2)
How should ADHD be properly diagnosed in adults? (3) How should adult
ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The
stigma surrounding ADHD, mainly due to lack of knowledge, increases the
suffering of patients. Education on the lifespan perspective, diagnostic
assessment, and treatment of ADHD must increase for students of general
and mental health, and for psychiatry professionals. Instruments for
screening and diagnosis of ADHD in adults are available, as are
effective evidence-based treatments for ADHD and its negative outcomes.
More research is needed on gender differences, and in older adults with
ADHD. (c) 2018 The Author(s). Published by Elsevier Masson SAS