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Lefrere A, Godin O, Jamain S, Dansou Y, Samalin L, Alda M, Aouizerate B, Aubin V, Rey R, Contu M, Courtet P, Dubertret C, Haffen E, Januel D, Leboyer M, Llorca PM, Marlinge E, Manchia M, Neilson S, Olié E, Paribello P, Pinna M, Polosan M, Roux P, Schwan R, Tondo L, Walter M, Tzavara E, Auzias G, Deruelle C, Etain B, Belzeaux R. Refining Criteria for a Neurodevelopmental Subphenotype of Bipolar Disorders: A FondaMental Advanced Centers of Expertise for Bipolar Disorders Study. Biol Psychiatry 2025; 97:806-815. [PMID: 39395474 DOI: 10.1016/j.biopsych.2024.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 09/03/2024] [Accepted: 09/25/2024] [Indexed: 10/14/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a complex and heterogeneous psychiatric disorder. It has been suggested that neurodevelopmental factors contribute to the etiology of BD, but a specific neurodevelopmental phenotype (NDP) of the disorder has not been identified. Our objective was to define and characterize an NDP in BD and validate its associations with clinical outcomes, polygenic risk scores, and treatment responses. METHODS We analyzed the FondaMental Advanced Centers of Expertise for Bipolar Disorders cohort of 4468 patients with BD, a validation cohort of 101 patients with BD, and 2 independent replication datasets of 274 and 89 patients with BD. Using factor analyses, we identified a set of criteria for defining NDP. Next, we developed a scoring system for NDP load and assessed its association with prognosis, neurological soft signs, polygenic risk scores for neurodevelopmental disorders, and responses to treatment using multiple regressions, adjusted for age and gender with bootstrap replications. RESULTS Our study established an NDP in BD consisting of 9 clinical features: advanced paternal age, advanced maternal age, childhood maltreatment, attention-deficit/hyperactivity disorder, early onset of BD, early onset of substance use disorders, early onset of anxiety disorders, early onset of eating disorders, and specific learning disorders. Patients with higher NDP load showed a worse prognosis and increased neurological soft signs. Notably, these individuals exhibited a poorer response to lithium treatment. Furthermore, a significant positive correlation was observed between NDP load and polygenic risk score for attention-deficit/hyperactivity disorder, suggesting potential overlapping genetic factors or pathophysiological mechanisms between BD and attention-deficit/hyperactivity disorder. CONCLUSIONS The proposed NDP constitutes a promising clinical tool for patient stratification in BD.
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Affiliation(s)
- Antoine Lefrere
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; Institut de Neurosciences de la Timone, Aix-Marseille University, Unité mixte de recherche (UMR) Centre National de la Recherche Scientifique, Marseille, France; Fondation Fondamental, Créteil, France
| | - Ophélia Godin
- Fondation Fondamental, Créteil, France; University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Translational Neuro-Psychiatry, Assistance Publique-Hôpitaux de Paris, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT)
| | - Stéphane Jamain
- Fondation Fondamental, Créteil, France; University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Translational Neuro-Psychiatry, Assistance Publique-Hôpitaux de Paris, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT)
| | | | - Ludovic Samalin
- Fondation Fondamental, Créteil, France; Department of Psychiatry, Centre Hospitalier Universitaire Clermont-Ferrand, University of Clermont Auvergne, Centre National de la Recherche Scientifique, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Bruno Aouizerate
- Fondation Fondamental, Créteil, France; Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro, UMR Institut National de la Recherche Agronomique (1286), Université de Bordeaux, Bordeaux, France
| | - Valérie Aubin
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Romain Rey
- Fondation Fondamental, Créteil, France; Bipolar Disorder Expert Centre, Le Vinatier Hospital, University Lyon, Bron, France; University Lyon 1, Institut National de la Santé et de la Recherche Médicale U1028, Centre National de la Recherche Scientifique, UMR 5292, Villeurbanne, Lyon, France; Lyon Neuroscience Research Center, Psychiatric Disorders, Neuroscience Research and Clinical Research Team, Villeurbanne, Lyon, France
| | - Martina Contu
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Philippe Courtet
- Fondation Fondamental, Créteil, France; Centre Hospitalier Universitaire de Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence, Montpellier, France; L'Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalo-Universitaire Assistance Publique-Hôpitaux de Paris Nord, Département Médico-Universitaire de Psychiatrie et d'Addictologie ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Université de Paris, Institut National de la Santé et de la Recherche Médicale UMR 1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Emmanuel Haffen
- Fondation Fondamental, Créteil, France; Service de Psychiatrie de l'Adulte, CIC-1431 Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire de Besançon, Laboratoire de Neurosciences, Université Franche Comté, Université Bourgogne Franche Comté, Besançon, France
| | - Dominique Januel
- Fondation Fondamental, Créteil, France; Unité de Recherche Clinique, Etablissement public de santé Ville-Evrard, Neuilly-sur-Marne, France
| | - Marion Leboyer
- Fondation Fondamental, Créteil, France; University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Translational Neuro-Psychiatry, Assistance Publique-Hôpitaux de Paris, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT)
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France; Department of Psychiatry, Centre Hospitalier Universitaire Clermont-Ferrand, University of Clermont Auvergne, Centre National de la Recherche Scientifique, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Emeline Marlinge
- Fondation Fondamental, Créteil, France; Le Groupe Hospitalier Universitaire Paris Nord, DMU Neurosciences, Hôpital Fernand Widal Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Samantha Neilson
- Institut de Neurosciences de la Timone, Aix-Marseille University, Unité mixte de recherche (UMR) Centre National de la Recherche Scientifique, Marseille, France
| | - Emilie Olié
- Fondation Fondamental, Créteil, France; Centre Hospitalier Universitaire de Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence, Montpellier, France; L'Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | | | - Marco Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Lucio Bini Mood Disorder Centers, Cagliari, Italy
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France; Université Grenoble Alpes, Institut National de la Santé et de la Recherche Médicale U1216, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Paul Roux
- Fondation Fondamental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay, France; Université Paris-Saclay, Paris, France; Université de Versailles Saint-Quentin-En-Yvelines, Versailles, France; DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale UMR 1018, Villejuif, France
| | - Raymund Schwan
- Fondation Fondamental, Créteil, France; Université de Lorraine, Centre Psychothérapique de Nancy, Institut National de la Santé et de la Recherche Médicale U1254, Nancy, France
| | - Leonardo Tondo
- Lucio Bini Mood Disorder Centers, Cagliari, Italy; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Michel Walter
- Fondation Fondamental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, Centre Hospitalier Régional Univertsitaire de Brest, Hôpital de Bohars, Brest, France
| | - Eleni Tzavara
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; Université Paris Cité, Paris, France; Centre National de la Recherche Scientifique, UMR 8002, Paris, France
| | - Guillaume Auzias
- Institut de Neurosciences de la Timone, Aix-Marseille University, Unité mixte de recherche (UMR) Centre National de la Recherche Scientifique, Marseille, France
| | - Christine Deruelle
- Institut de Neurosciences de la Timone, Aix-Marseille University, Unité mixte de recherche (UMR) Centre National de la Recherche Scientifique, Marseille, France
| | - Bruno Etain
- Fondation Fondamental, Créteil, France; University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Translational Neuro-Psychiatry, Assistance Publique-Hôpitaux de Paris, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT)
| | - Raoul Belzeaux
- Fondation Fondamental, Créteil, France; Centre Hospitalier Universitaire de Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence, Montpellier, France; L'Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France.
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Kong L, Chen Y, Shen Y, Zhang D, Wei C, Lai J, Hu S. Progress and Implications from Genetic Studies of Bipolar Disorder. Neurosci Bull 2024; 40:1160-1172. [PMID: 38206551 PMCID: PMC11306703 DOI: 10.1007/s12264-023-01169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
With the advancements in gene sequencing technologies, including genome-wide association studies, polygenetic risk scores, and high-throughput sequencing, there has been a tremendous advantage in mapping a detailed blueprint for the genetic model of bipolar disorder (BD). To date, intriguing genetic clues have been identified to explain the development of BD, as well as the genetic association that might be applied for the development of susceptibility prediction and pharmacogenetic intervention. Risk genes of BD, such as CACNA1C, ANK3, TRANK1, and CLOCK, have been found to be involved in various pathophysiological processes correlated with BD. Although the specific roles of these genes have yet to be determined, genetic research on BD will help improve the prevention, therapeutics, and prognosis in clinical practice. The latest preclinical and clinical studies, and reviews of the genetics of BD, are analyzed in this review, aiming to summarize the progress in this intriguing field and to provide perspectives for individualized, precise, and effective clinical practice.
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Affiliation(s)
- Lingzhuo Kong
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yiqing Chen
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yuting Shen
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Danhua Zhang
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Chen Wei
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Jianbo Lai
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, China.
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China.
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China.
- Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Shaohua Hu
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, China.
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China.
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China.
- Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University School of Medicine, Hangzhou, 310003, China.
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Barizzone N, Cagliani R, Basagni C, Clarelli F, Mendozzi L, Agliardi C, Forni D, Tosi M, Mascia E, Favero F, Corà D, Corrado L, Sorosina M, Esposito F, Zuccalà M, Vecchio D, Liguori M, Comi C, Comi G, Martinelli V, Filippi M, Leone M, Martinelli-Boneschi F, Caputo D, Sironi M, Guerini FR, D’Alfonso S. An Investigation of the Role of Common and Rare Variants in a Large Italian Multiplex Family of Multiple Sclerosis Patients. Genes (Basel) 2021; 12:1607. [PMID: 34681001 PMCID: PMC8535321 DOI: 10.3390/genes12101607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/30/2022] Open
Abstract
Known multiple sclerosis (MS) susceptibility variants can only explain half of the disease's estimated heritability, whereas low-frequency and rare variants may partly account for the missing heritability. Thus, here we sought to determine the occurrence of rare functional variants in a large Italian MS multiplex family with five affected members. For this purpose, we combined linkage analysis and next-generation sequencing (NGS)-based whole exome and whole genome sequencing (WES and WGS, respectively). The genetic burden attributable to known common MS variants was also assessed by weighted genetic risk score (wGRS). We found a significantly higher burden of common variants in the affected family members compared to that observed among sporadic MS patients and healthy controls (HCs). We also identified 34 genes containing at least one low-frequency functional variant shared among all affected family members, showing a significant enrichment in genes involved in specific biological processes-particularly mRNA transport-or neurodegenerative diseases. Altogether, our findings point to a possible pathogenic role of different low-frequency functional MS variants belonging to shared pathways. We propose that these rare variants, together with other known common MS variants, may account for the high number of affected family members within this MS multiplex family.
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Affiliation(s)
- Nadia Barizzone
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
| | - Rachele Cagliani
- Bioinformatics, Scientific Institute IRCCS E.MEDEA, 23842 Bosisio Parini, Italy; (R.C.); (D.F.); (M.S.)
| | - Chiara Basagni
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
| | - Ferdinando Clarelli
- Laboratory of Genetics of Neurological Complex Disorders, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.C.); (E.M.); (M.S.); (F.E.)
| | - Laura Mendozzi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (L.M.); (C.A.); (D.C.); (F.R.G.)
| | - Cristina Agliardi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (L.M.); (C.A.); (D.C.); (F.R.G.)
| | - Diego Forni
- Bioinformatics, Scientific Institute IRCCS E.MEDEA, 23842 Bosisio Parini, Italy; (R.C.); (D.F.); (M.S.)
| | - Martina Tosi
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
| | - Elisabetta Mascia
- Laboratory of Genetics of Neurological Complex Disorders, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.C.); (E.M.); (M.S.); (F.E.)
| | - Francesco Favero
- Department of Translational Medicine, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (F.F.); (D.C.)
| | - Davide Corà
- Department of Translational Medicine, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (F.F.); (D.C.)
| | - Lucia Corrado
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
| | - Melissa Sorosina
- Laboratory of Genetics of Neurological Complex Disorders, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.C.); (E.M.); (M.S.); (F.E.)
| | - Federica Esposito
- Laboratory of Genetics of Neurological Complex Disorders, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.C.); (E.M.); (M.S.); (F.E.)
| | - Miriam Zuccalà
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
| | - Domizia Vecchio
- Department of Translational Medicine, IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (D.V.); (C.C.)
| | - Maria Liguori
- Institute of Biomedical Technologies, Bari Unit, National Research Council, 70126 Bari, Italy;
| | - Cristoforo Comi
- Department of Translational Medicine, IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (D.V.); (C.C.)
| | - Giancarlo Comi
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.C.); (M.F.)
| | - Vittorio Martinelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Massimo Filippi
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.C.); (M.F.)
- Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Maurizio Leone
- Dipartimento di Emergenza e Area Critica, UO Neurologia, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy;
| | - Filippo Martinelli-Boneschi
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, 20122 Milan, Italy;
- Neurology Unit and MS Centre, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Domenico Caputo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (L.M.); (C.A.); (D.C.); (F.R.G.)
| | - Manuela Sironi
- Bioinformatics, Scientific Institute IRCCS E.MEDEA, 23842 Bosisio Parini, Italy; (R.C.); (D.F.); (M.S.)
| | - Franca Rosa Guerini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (L.M.); (C.A.); (D.C.); (F.R.G.)
| | - Sandra D’Alfonso
- Department of Health Sciences, CAAD (Center for Translational Research on Autoimmune and Allergic Diseases), University of Eastern Piedmont, 28100 Novara, Italy; (C.B.); (M.T.); (L.C.); (M.Z.)
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