Flera kandidatgener har föreslagits spela en roll i utvecklingen av antisociala beteenden i samband med miljöfaktorer. Syftet med den föreliggande studien var därmed att undersöka sambandet mellan genen Katekol-O-Metyltransferas (COMT) och våld; och om det fanns interaktioner mellan exponering för tidigare övergrepp och COMT i samband med senare våld. Data hämtades från en Svensk populationsbaserad studie baserad på 2500 20-24 åringar. Den aktuella studien fann att beroende på vilken variant av genen man besitter, kommer man att påverkas i olika grad av negativa miljöfaktorer såsom försummelse och sexuella övergrepp i samband med våld. / Several candidate genes have been suggested to play a role in the development of antisocial behavior in association with social and environmental factors. Therefore, the purpose of the present study was to investigate the relationship between the gene Catechol-O-Methyltransferase (COMT) and violence; and to examine whether there were interactions between earlier abuse and COMT in the association of violence. Data were drawn from a Swedish population-based study including 2,500 20-24 year olds. The present study found that depending on which variant of the gene one possess, one will be affected to different degree of adverse environmental factors in association with violence.

In the present set of experiments, we investigated the effects of age and COMT genotypes on traditional measures of executive functions, e.g., Wisconsin Card Sorting Test (WCST; Hart et al., 1988), a battery of executive functions based on the 3 factor model (shifting, updating, inhibition) described by Miyake et al. (2000) and developed at the University of Arizona (Alexander et al., 2012), and two fMRI tasks of executive functions (shifting, updating). The results of experiment 1 showed that COMT influenced performance on several traditional measures of executive functions, with Met homozygotes outperforming Val homozygotes. However, on the WCST we did not observe less perseverative errors in Met carriers as reported previously (Barnett, Jones, Robbins, & Muller, 2007; Bruder et al., 2005; Malhotra et al., 2002; Nagel et al., 2008). According to Miyake et al. (2000), however, such tasks as the WCST may actually involve multiple executive processes, making it difficult to tease apart the different types of executive functions being measured. Furthermore, COMT may be sensitive to some aspects of executive functions and not others. To this end, in experiment 2 we investigated associations between COMT and measures of executive functions from each of the 3 domains described in Miyake et al. (2000). According to the models proposed by Bilder et al. (2004) and Cools and D’Esposito (2011), the Val allele promotes cognitive flexibility, while the Met allele promotes cognitive stability. Contrary to what we expected, Met homozygotes actually performed better than Met/Val heterozygotes but no better than Val homozygotes on one measure of updating (flexibility). Upon closer examination of the processes involved in the updating task, however, the results may not necessarily be contradictory as the task may have required greater stability than previously thought. In the fMRI experiment, although behavioral performance was largely similar between age groups and COMT genotypes on the fMRI tasks, we observed differences in activation such that younger adults and Met homozygotes showed higher levels of activation relative to older adults and Val carriers, respectively. Our results suggest that these higher levels of activation may have been relied upon to maintain similar levels of performance. Additionally, across the 3 experiments the effects of COMT indicate that an overall Met advantage cannot be assumed. Rather, the benefits of one allele compared to the other should be investigated in terms of the specific cognitive processes involved in the task at hand. Thus, it is important for future studies to continue characterizing the unity and diversity of executive functions and investigate factors that may influence these patterns behaviorally and neurally, such as age and genetics.

Wesentlicher Inhalt der vorliegenden Dissertation war die EEG-Ableitung und EKP-Messung zur Untersuchung des sensorischen Gatings anhand des P50-Paarstimulus-Paradigmas bei einer Gruppe von ADHS-Patienten (n=23) sowie einer vergleichbaren Gruppe gesunder Erwachsener (n=25). Die Ableitung des EEGs erfolgte nach dem allgemein anerkannten internationalen 10/20-System, die Auswertung mit der Software Brain-Vision-Analyzer®. Bislang beschränkten sich viele Studien zur ADHS allein auf Untersuchungen im Kindesalter, da es sich bei der Aufmerksamkeits-Defizit-Hyperaktivitätsstörung (ADHS) um eine der häufigsten psychiatrischen Störungen des Kindes- und Jugendalters überhaupt handelt. Da diese bei Betroffenen meist aber bis in das Erwachsenenalter fortbesteht, lag der Schwerpunkt dieser Arbeit speziell auf der Untersuchung erwachsener ADHS-Patienten. In der ADHS-Gruppe konnte ein beeinträchtigtes Sensorisches Gating mit höheren Gatingquotienten im Vergleich zur gesunden Kontrollgruppe gezeigt werden. Des Weiteren galt es, mögliche Einflüsse des COMT-Val/Met-Polymorphismus auf die P50 herauszuarbeiten. Hypothetisch sollten Probanden mit dem katalytisch aktiveren Val/Val-Allel und dem dadurch resultierenden relativen Dopaminmangel ein schlechteres Sensorisches Gating aufweisen, als Probanden mit den Allelausprägungen Val/Met oder Met/Met. In der Patientengruppe fanden sich diesbezüglich keine signifikanten Unterscheidungen. Hingegen wiesen Träger des Val-Allels in der gesunden Normgruppe eine Beeinträchtigung des Gatings mit dem Nachweis der größten Gatingquotienten auf. Weitere signifikante Unterschiede zwischen den Allelen Val/Met und Met/Met wurden nicht gezeigt. Auch die bildschematische Darstellung der EEG-Datensätze mittels LORETA kam zu dem Ergebnis einer verstärkten frontalen Hirnaktivierung zum Zeitpunkt des Teststimulus (tS) im superioren frontalen Cortex in der gesunden Kontrollgruppe und gilt als Ausdruck normal funktionierender (inhibitorischer) Gating-Regelkreise. Diese verstärkte Aktivierung des frontalen Cortex fand sich bei ADHS-Patienten nicht und stützt somit die Hypothese eines Gating-Defizits bei ADHS-Patienten bedingt durch ein präfrontales Defizit. Ein positiver Einfluss von Nikotin auf die P50 konnte nicht gezeigt werden, wobei aufgrund der kleinen Studiengröße keine abschließende Beurteilung möglich scheint. Ob die Messung der P50 nach Beobachtung eines einschränkten Gatings bei ADHS-Patienten künftig als Endophänotyp der adulten ADHS-Erkrankung herangezogen werden kann, bleibt weiteren Untersuchungen vorbehalten. Basierend auf den vorliegenden Ergebnissen scheinen weitere Studien an größeren Kollektiven sinnvoll. Neben dem COMT-Polymorphismus ist ggf. die Untersuchung von Polymorphismen weiterer Dopamin relevanter Enzyme und deren Einfluss auf das sensorische Gating zu diskutieren. / OBJECTIVE: Sensory Gating deficits are a common and well described endophenotype in schizophrenia patients. Abnormalities of prefrontal cortical function are discussed in line with deficits in attentional control associated with genetic risk. Multiple susceptibility genes which may impact on molecular mechanisms of prefrontal function have been examined, such like COMT-Val158Met-polymorphism in the catechol-O-methyltransferase (COMT) gene, which accounts for a 4-fold variation in enzyme activity and dopamine catabolism. Homozygous Val-allel-carriers seem to have the lowest dopamine levels. METHOD: Main issue of this study was to examine the electrophysiological phenomenon of sensory gating in a group of adult ADHD-patients (n = 23) and a similar group of normal healthy controls (n = 25) with a combined 21-channel-EEG-ERP-recording and the measure of the P50-double-click-paradigm. A second part of the study was to reveal the impact of COMT-Val158Met-polymorphism on sensory gating with hypothetical highest gating-quotients in homozygous val-allel-carriers with the (relative) lowest dopamine levels. RESULTS: In ADHD-patients a deficit in P50-sensory gating with higher gating-quotients was described. Healthy controls showed a normal P50-suppression confirming normal capacity of inhibitory prefrontal networks, underlined in the LORETA-analysis as well. In ADHD-patients no impact of COMT-polymorphism on sensory gating was seen though in healthy controls. Homozygous healthy Val-allel-carriers showed the highest gating quotients compared to Val/Met- or Met/Met-allel-carriers. Nicotine had no effects on sensory gating in this study. CONCLUSIONS: Sensory Gating deficits in ADHD-patients have to be taken into account as a possible endophenotype in the attention-deficit-hyperactive-disorder. If there is a strong impact of COMT-Val158Met-polymorphism on sensory gating even in ADHD affected persons, has to be evaluated in future studies. More research in major groups is needed to proof these findings.

La Esquizofrenia es una enfermedad mental crónica y compleja que afecta al 1% de la población. El gen que codifica a la enzima catecol o-metil transferasa (COMT) es candidato de riesgo porque participa en el catabolismo de la dopamina. El polimorfismo funcional Val/Met (rs4680) en el gen COMT genera actividad enzimática diferencial, es variable en las poblaciones y ha sido asociado a la esquizofrenia. En el Perú, no existen estudios de asociación genética y es necesario implementarlas para la prevención, diagnóstico, pronóstico y farmacogenética de la enfermedad. El objetivo fue establecer la asociación entre el polimorfismo Val/Met en el gen COMT y la esquizofrenia en una muestra peruana. Se ha realizado un estudio tipo casos-controles, previo consentimiento informado, con una muestra de 50 pacientes esquizofrénicos del hospital nacional Hermilio Valdizán y 150 personas saludables, sin diagnóstico de la enfermedad, residentes en la ciudad de Lima. El análisis molecular del polimorfismo Val/Met se realizó mediante la técnica PCR-RFLP y confirmado por secuenciamiento automático. En los controles y los pacientes las frecuencias genotípicas fueron similares (Val/Val=40-44%, Val/Met=46-52%, Met/Met=8-10%), y evaluados según el modelo de herencia codominante, no se han encontrado diferencias significativas [p>0.05; Val/Met: OR=0.80 (IC 95%: 0.41-1.58) y Met/Met: OR=1.14 (IC 95%: 0.36-3.64)]; la tendencia es similar bajo los modelos de herencia dominante, recesivo, sobredominante y aditivo. Asimismo, las frecuencias alélicas en ambos grupos (Val=66-67%, Met=33-34%), no muestran diferencias (p>0.05). Además, el género no interactúa en la asociación con la enfermedad según genotipos Val/Met (p>0.05). Los resultados nos indican que no existe asociación entre el polimorfismo Val/Met en el gen COMT y la susceptibilidad a la esquizofrenia en esta muestra peruana evaluada. En perspectiva, es necesario estudiar un mayor número de muestra, incluir otras subpoblaciones peruanas según ancestralidad, evaluar en conjunto con otros genes y epigenes, considerar los endofenotipos clínicos y utilizar tecnologías de secuenciamiento de ADN de alto rendimiento.

Purpose: Familial aggregation and sibling pair studies suggest there is a genetic contribution to the development of irritable bowel syndrome (IBS). The aim of this study was to review the evidence of genetics in IBS based on genetic epidemiology, studies of association with intermediate phenotypes and pharmacogenetics. Results: Genetic association studies with IBS symptom phenotype have generally provided inconsistent results for many candidate genes investigated, such as SLC6A4, GNB3, and IL-10. There have been no genome-wide association studies in IBS to date. Studies of associations of candidate genes with intermediate phenotypes suggest associations with pathophysiological mechanisms of motor and sensory functions; however, these results also require replication. Pharmacogenetics studies illustrate the potential of genetics to impact on response to therapy, as observed with SLC6A4 and responses to the 5-HT3 antagonist alosetron and the 5-HT4 agonist, tegaserod. Conclusions: While the heritable component and genetics in the complex disorder of IBS are still poorly understood, studies of the associations of spontaneous genetic variations and altered functions may provide novel insights of the mechanisms contributing to the disease.

In dieser Studie führten 37 adulte Patienten mit einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) ein Delay Discounting (DD) - Paradigma aus, während gleichzeitig mittels Funktioneller-Nahinfrarotspektroskopie (fNIRS) die Gehirnaktivität der „Regions of Interest“ (ROIs) des Orbitofrontalen-Kortex (OFC) und des Dorsolateralen-Präfrontalen-Kortex (dlPFC) gemessen wurde. Mittels Fragebögen und eines Delay Discounting Tasks (DDT) wurden zusätzlich Verhaltensparameter erhoben und flossen in den Auswertungsprozess mit ein. Vorausgegangene Untersuchungen weisen auf ein hypofunktionel-les dopaminerges System bei ADHS-Patienten hin, welches mit der ADHS-Pathogenese in Zusammenhang gebracht wird. Vor allem im Präfrontalen-Kortex (PFC), bestehend unter anderem aus OFC und dlPFC, erfolgt die Metabolisierung von Dopamin durch die Catechol-O-Methyltransferase (COMT). Hierbei hängt die Metabolisierungsgeschwindigkeit vom genetischen COMT-Val158Met- Polymorphismus ab. Die Einflussnahme dieses COMT-Val158Met-Polymorphismus auf die kortikale Aktivität der ROIs und Impulsivität ist ebenfalls Gegenstand dieser Dissertation („Imaging Genetics“). Adulte ADHS Patienten zeigten eine verstärkte Aktivität des OFC der Entscheidungskategorie „verzögert“ im Verhältnis zu der Entscheidungskategorie „sofort“. Die gemessene Impulsivität korrelierte mit der kortikalen Gehirnaktivität „DD-Kontrast“. Es konnte kein Zusammenhang zwischen Verhaltensparameter und Gehirnaktivität mit dem COMT-Polymorphismus gezeigt werden. Die erhöhte Aktivität des OFC bei der Entscheidungskategorie verzögert unterstützt die These der „Delay Aversion“ des „Dual Pathway Model“. Eine enge Konnektivität der stark dopaminerg innervierten kortiko-striataler Strukturen in Form des OFC und der Amygdala, welche Einfluss auf die ADHS-Pathogenese nehmen, erscheint somit plausibel. / In this study 37 adult subjects with ADHD (Attention Deficit Hyperactivity Disorder) performed a validated Delay Discounting (DD) paradigm. By using near-infrared-spectroskopy (NIRS) functional brain activation in the regions of interest (ROIs) was measured. The ROIs are represented by the Orbito-Frontal-Cortex (OFC) and the Dorsolateral Prefrontal Cortex (dlPFC). Additionally questionnaires with relation to behaviour and a Delay Discounting Task (DDT) were interpreted. Former studies indicate a hypo-functional dopaminergic system in ADHD pathology. Mainly the Prefrontal Cortex (PFC), including the OFC and the dlPFC, metabolizes dopamine with the Catechol-O-Methyltransferase (COMT). Velocity of this metabolism depends on the COMT-Val158Met-polymorphism. This effect is generally known by the term “imaging genetics”. Adult ADHD subjects showed a stronger activation in the OFC in the DD category “delayed” than in the category “now”. Measured impulsivity correlated with the cortical brain activity “DD-Kontrast”. No significant relation between the COMT polymorphism an the cortical brain activity or behaviour could be shown. The stronger activation of the OFC in the category “delayed” underlines the thesis of “Delay Aversion” from the “Dual Pathway Model”. A close connectivity between the dopaminergic corticostriatal brain regions of the amygdala and the OFC, which have an influence to the ADHD pathology, seem to be a plausible approach.

The mechanisms underlying caffeine’s acute effects and withdrawal symptoms are not entirely understood. The purpose was to determine whether the clusters of acute effects or withdrawal symptoms are associated with genetic polymorphisms in DARPP-32 and COMT, which mediate some of caffeine’s physiological effects. Subjects (n=1135) were from the Toronto Nutrigenomics and Healthy Study. Fourteen well-described acute effects of caffeine co-exist in six groups, while fourteen well-characterized withdrawal symptoms co-exist in three groups. Neither the rs907094 C>T polymorphism in the PPP1R1B gene encoding DARPP-32, nor the COMT Val158Met affected the odds of reporting any acute effects or withdrawal symptoms cluster. Among individuals consuming ≥ 200 mg/d of caffeine, Met/Met homozygotes were more likely to report the “increased heart rate” acute effects cluster. These results suggest that ‘slow’ COMT activity, conferred by the Met allele, may explain part of the inter-individual variability in the risk for increased heart rate among heavy caffeine consumers.

The mechanisms underlying caffeine’s acute effects and withdrawal symptoms are not entirely understood. The purpose was to determine whether the clusters of acute effects or withdrawal symptoms are associated with genetic polymorphisms in DARPP-32 and COMT, which mediate some of caffeine’s physiological effects. Subjects (n=1135) were from the Toronto Nutrigenomics and Healthy Study. Fourteen well-described acute effects of caffeine co-exist in six groups, while fourteen well-characterized withdrawal symptoms co-exist in three groups. Neither the rs907094 C>T polymorphism in the PPP1R1B gene encoding DARPP-32, nor the COMT Val158Met affected the odds of reporting any acute effects or withdrawal symptoms cluster. Among individuals consuming ≥ 200 mg/d of caffeine, Met/Met homozygotes were more likely to report the “increased heart rate” acute effects cluster. These results suggest that ‘slow’ COMT activity, conferred by the Met allele, may explain part of the inter-individual variability in the risk for increased heart rate among heavy caffeine consumers.

3,4-(±)-Methylenedioxymethamphetamine (MDMA, ecstasy) is a widely abused amphetamine derivative. The metabolism of MDMA is thought to be a necessary component of MDMA-induced neurotoxicity, as direct administration of MDMA into the central nervous system of rats failed to reproduce the hallmark serotonin deficits seen following systemic administration of MDMA. Mechanistic questions remain regarding how MDMA elicits this neurotoxicity. Work of this thesis was undertaken to examine how MDMA-induced neurotoxicity is affected by the activity of two polymorphic enzymes involved in the metabolism of MDMA, namely cytochrome P450 family member 2D6 (CYP2D6) and catechol-O-methyltransferase (COMT), as well as the potential role microglia play in the facilitation of this neurotoxicity. Inhibition of CYP2D1, the homolog of human CYP2D6 in the rat, resulted in an attenuation of serotonergic neurotoxicity following MDMA-administration. In both a pharmacological model and a genetic model of CYP2D1 inhibition, serotonin deficits were alleviated when compared to normal-activity CYP2D1 counterparts. Inhibition of COMT, the primary detoxication enzyme in the MDMA pathway, resulted in potentiation of MDMA-induced neurotoxicity. In a pharmacological model of COMT inhibition, rats displayed greater long-term serotonin deficits after COMT inhibition. Mice devoid of COMT proved sensitive to the lethal hyperthermic effects of MDMA, illustrating the importance of this enzyme in preventing the acute toxicity of MDMA. Brain lesions often elicit a microglial response. Microglia have the potential of both beneficial and deleterious actions in the brain. Whether microglia are activated by nerve terminal degeneration produced by MDMA is an area of ongoing debate. Systemically delivered MDMA produces a modest increase in the amount of microglial cells present in the parietal cortex of rats over a one-week period. MDMA also increased the phagocytic activity of microglia in the cortex. The studies described herein support the hypothesis that metabolism is critical in MDMA-induced neurotoxicity. Furthermore, as both CYP2D6 and COMT are polymorphic in the human population, certain individuals are more at risk for severe serotonergic toxicity following MDMA administration. Finally, while microglia are likely not the cause of MDMA-induced neurotoxicity, contributions of these cells cannot be dismissed.

The frontostriatal dopamine system modulates brain function and is affected by both genetic and environmental factors. Dysfunction of this system is associated with many pathological states, including schizophrenia. The enzyme catechol-O- methyltransferase (COMT) metabolises dopamine and its gene contains a polymorphism (Val¹⁵⁸Met) that affects enzyme activity. Delta-9- tetrahydrocannabinol (THC), the main psychoactive component of cannabis, has been suggested to interact with this polymorphism to increase the risk for psychosis and cognitive impairments. Dopaminergic mechanisms are a plausible candidate for mediating this interaction. I used microdialysis coupled with high performance liquid chromatography (HPLC) to examine the effects of THC on extracellular dopamine and its metabolites in the nucleus accumbens, dorsal striatum and medial prefrontal cortex (mPFC) in freely moving mice. Following acute COMT inhibition with tolcapone, THC increased extracellular dopamine levels in the nucleus accumbens in tolcapone-, but not in vehicle-, treated mice. The introduction of the low activity Met allele into the COMT gene produced a highly specific, novel mouse model of the Val158Met polymorphism. In contrast to the effects of acute COMT inhibition, the Met allele protected against THC-induced changes in accumbal dopamine. No interactive neurochemical effects were observed in the dorsal striatum (pharmacological and genetic study) or in a preliminary study of the mPFC (genetic study only). On a progressive ratio task measuring motivational salience, the direction of the interactive effect between COMT genotype and THC differed between 2 independent cohorts and provided tentative leads that stress/arousal-dependent effects on COMT may have a confounding effect. My data provide evidence that COMT activity modulates the effect of THC on accumbal dopamine function, and suggest the mechanism through which this interaction is mediated differs between acute and lifelong reduction in COMT activity. Through the interactive effect on the dopaminergic system, the data provide a potential mechanism for the reported interaction between COMT and cannabis/THC in determining psychosis risk and cognitive impairments.