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Wootton O, Shadrin AA, Bjella T, Smeland OB, van der Meer D, Frei O, O'Connell KS, Ueland T, Andreassen OA, Stein DJ, Dalvie S. Genomic insights into the shared and distinct genetic architecture of cognitive function and schizophrenia. Sci Rep 2024; 14:15356. [PMID: 38961113 PMCID: PMC11222449 DOI: 10.1038/s41598-024-66085-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024] Open
Abstract
Cognitive impairment is a major determinant of functional outcomes in schizophrenia, however, understanding of the biological mechanisms underpinning cognitive dysfunction in the disorder remains incomplete. Here, we apply Genomic Structural Equation Modelling to identify latent cognitive factors capturing genetic liabilities to 12 cognitive traits measured in the UK Biobank. We identified three broad factors that underly the genetic correlations between the cognitive tests. We explore the overlap between latent cognitive factors, schizophrenia, and schizophrenia symptom dimensions using a complementary set of statistical approaches, applied to data from the latest schizophrenia genome-wide association study (Ncase = 53,386, Ncontrol = 77,258) and the Thematically Organised Psychosis study (Ncase = 306, Ncontrol = 1060). Global genetic correlations showed a significant moderate negative genetic correlation between each cognitive factor and schizophrenia. Local genetic correlations implicated unique genomic regions underlying the overlap between schizophrenia and each cognitive factor. We found substantial polygenic overlap between each cognitive factor and schizophrenia and biological annotation of the shared loci implicated gene-sets related to neurodevelopment and neuronal function. Lastly, we show that the common genetic determinants of the latent cognitive factors are not predictive of schizophrenia symptoms in the Norwegian Thematically Organized Psychosis cohort. Overall, these findings inform our understanding of cognitive function in schizophrenia by demonstrating important differences in the shared genetic architecture of schizophrenia and cognitive abilities.
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Affiliation(s)
- Olivia Wootton
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - Alexey A Shadrin
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thomas Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Oleksandr Frei
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Blindern, Oslo, Norway
| | - Kevin S O'Connell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Shareefa Dalvie
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
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2
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Dong MS, Rokicki J, Dwyer D, Papiol S, Streit F, Rietschel M, Wobrock T, Müller-Myhsok B, Falkai P, Westlye LT, Andreassen OA, Palaniyappan L, Schneider-Axmann T, Hasan A, Schwarz E, Koutsouleris N. Multimodal workflows optimally predict response to repetitive transcranial magnetic stimulation in patients with schizophrenia: a multisite machine learning analysis. Transl Psychiatry 2024; 14:196. [PMID: 38664377 PMCID: PMC11045783 DOI: 10.1038/s41398-024-02903-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The response variability to repetitive transcranial magnetic stimulation (rTMS) challenges the effective use of this treatment option in patients with schizophrenia. This variability may be deciphered by leveraging predictive information in structural MRI, clinical, sociodemographic, and genetic data using artificial intelligence. We developed and cross-validated rTMS response prediction models in patients with schizophrenia drawn from the multisite RESIS trial. The models incorporated pre-treatment sMRI, clinical, sociodemographic, and polygenic risk score (PRS) data. Patients were randomly assigned to receive active (N = 45) or sham (N = 47) rTMS treatment. The prediction target was individual response, defined as ≥20% reduction in pre-treatment negative symptom sum scores of the Positive and Negative Syndrome Scale. Our multimodal sequential prediction workflow achieved a balanced accuracy (BAC) of 94% (non-responders: 92%, responders: 95%) in the active-treated group and 50% in the sham-treated group. The clinical, clinical + PRS, and sMRI-based classifiers yielded BACs of 65%, 76%, and 80%, respectively. Apparent sadness, inability to feel, educational attainment PRS, and unemployment were most predictive of non-response in the clinical + PRS model, while grey matter density reductions in the default mode, limbic networks, and the cerebellum were most predictive in the sMRI model. Our sequential modelling approach provided superior predictive performance while minimising the diagnostic burden in the clinical setting. Predictive patterns suggest that rTMS responders may have higher levels of brain grey matter in the default mode and salience networks which increases their likelihood of profiting from plasticity-inducing brain stimulation methods, such as rTMS. The future clinical implementation of our models requires findings to be replicated at the international scale using stratified clinical trial designs.
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Grants
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft und Kultur (Federal Ministry of Education, Science and Culture)
- ENP-161423 Gouvernement du Canada | Canadian Institutes of Health Research (Instituts de Recherche en Santé du Canada)
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Affiliation(s)
- Mark Sen Dong
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Jaroslav Rokicki
- Centre of Research and Education in Forensic Psychiatry, Oslo Univerisity Hospital, Oslo, Norway
| | - Dominic Dwyer
- The University of Melbourne, Melbourne, VIC, Australia
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Fabian Streit
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcella Rietschel
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thomas Wobrock
- Centre for Mental Health, Darmstadt-Dieburg District Clinic, Gross-Umstadt, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
| | | | - Ole A Andreassen
- Centre for Precision Psychiatry, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Robarts Research Institute, Western University, London Ontario, Canada
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Alkomiet Hasan
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Emanuel Schwarz
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany.
- Max Planck Institute of Psychiatry, Munich, Germany.
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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3
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Segura AG, Serna EDL, Sugranyes G, Baeza I, Valli I, Martínez-Serrano I, Díaz-Caneja CM, Andreu-Bernabeu Á, Moreno DM, Gassó P, Rodríguez N, Martínez-Pinteño A, Prohens L, Torrent C, García-Rizo C, Mas S, Castro-Fornieles J. Polygenic risk scores mediating functioning outcomes through cognitive and clinical features in youth at family risk and controls. Eur Neuropsychopharmacol 2024; 81:28-37. [PMID: 38310718 DOI: 10.1016/j.euroneuro.2024.01.009] [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: 11/03/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Schizophrenia and bipolar disorder exhibit substantial clinical overlap, particularly in individuals at familial high risk, who frequently present sub-threshold symptoms before the onset of illness. Severe mental disorders are highly polygenic traits, but their impact on the stages preceding the manifestation of mental disorders remains relatively unexplored. Our study aimed to examine the influence of polygenic risk scores (PRS) on sub-clinical outcomes over a 2-year period in youth at familial high risk for schizophrenia and bipolar disorder and controls. The sample included 222 children and adolescents, comprising offspring of parents with schizophrenia (n = 38), bipolar disorder (n = 80), and community controls (n = 104). We calculated PRS for psychiatric disorders, neuroticism and cognition using the PRS-CS method. Linear mixed-effects models were employed to investigate the association between PRS and cognition, symptom severity and functioning. Mediation analyses were conducted to explore whether clinical features acted as intermediaries in the impact of PRS on functioning outcomes. SZoff exhibited elevated PRS for schizophrenia. In the entire sample, PRS for depression, neuroticism, and cognitive traits showed associations with sub-clinical features. The effect of PRS for neuroticism and general intelligence on functioning outcomes were mediated by cognition and symptoms severity, respectively. This study delves into the interplay among genetics, the emergence of sub-clinical symptoms and functioning outcomes, providing novel evidence on mechanisms underpinning the continuum from sub-threshold features to the onset of mental disorders. The findings underscore the interplay of genetics, cognition, and clinical features, providing insights for personalized early interventions.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Isabel Valli
- Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Irene Martínez-Serrano
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores M Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Adolescent Inpatient Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Psychiatry Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Carla Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Fundació Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Clemente García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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4
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Sideli L, Aas M, Quattrone D, La Barbera D, La Cascia C, Ferraro L, Alameda L, Velthorst E, Trotta G, Tripoli G, Schimmenti A, Fontana A, Gayer-Anderson C, Stilo S, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D'Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Bentall R, Di Forti M, Murray RM, Morgan C, Fisher HL. The relationship between genetic liability, childhood maltreatment, and IQ: findings from the EU-GEI multicentric case-control study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1573-1580. [PMID: 37335320 PMCID: PMC10460355 DOI: 10.1007/s00127-023-02513-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
This study investigated if the association between childhood maltreatment and cognition among psychosis patients and community controls was partially accounted for by genetic liability for psychosis. Patients with first-episode psychosis (N = 755) and unaffected controls (N = 1219) from the EU-GEI study were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). Controlling for FH and SZ-PRS did not attenuate the association between childhood maltreatment and IQ in cases or controls. Findings suggest that these expressions of genetic liability cannot account for the lower levels of cognition found among adults maltreated in childhood.
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Affiliation(s)
- Lucia Sideli
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England.
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy.
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- Department of Behavioural Sciences, OsloMet, Oslo Metropolitan University, Oslo, Norway
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Seville, Spain
- Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Seville, Spain
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Eva Velthorst
- Department of Research, Mental Health Service Organization 'GGZ Noord-Holland-Noord', Hoorn, The Netherlands
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Andrea Fontana
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital "Virgen de La Luz", Cuenca, Spain
| | | | | | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
- EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier "Mondor", Pôle de Psychiatrie, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Richard Bentall
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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5
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Owen MJ, Legge SE, Rees E, Walters JTR, O'Donovan MC. Genomic findings in schizophrenia and their implications. Mol Psychiatry 2023; 28:3638-3647. [PMID: 37853064 PMCID: PMC10730422 DOI: 10.1038/s41380-023-02293-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
There has been substantial progress in understanding the genetics of schizophrenia over the past 15 years. This has revealed a highly polygenic condition with the majority of the currently explained heritability coming from common alleles of small effect but with additional contributions from rare copy number and coding variants. Many specific genes and loci have been implicated that provide a firm basis upon which mechanistic research can proceed. These point to disturbances in neuronal, and particularly synaptic, functions that are not confined to a small number of brain regions and circuits. Genetic findings have also revealed the nature of schizophrenia's close relationship to other conditions, particularly bipolar disorder and childhood neurodevelopmental disorders, and provided an explanation for how common risk alleles persist in the population in the face of reduced fecundity. Current genomic approaches only potentially explain around 40% of heritability, but only a small proportion of this is attributable to robustly identified loci. The extreme polygenicity poses challenges for understanding biological mechanisms. The high degree of pleiotropy points to the need for more transdiagnostic research and the shortcomings of current diagnostic criteria as means of delineating biologically distinct strata. It also poses challenges for inferring causality in observational and experimental studies in both humans and model systems. Finally, the Eurocentric bias of genomic studies needs to be rectified to maximise benefits and ensure these are felt across diverse communities. Further advances are likely to come through the application of new and emerging technologies, such as whole-genome and long-read sequencing, to large and diverse samples. Substantive progress in biological understanding will require parallel advances in functional genomics and proteomics applied to the brain across developmental stages. For these efforts to succeed in identifying disease mechanisms and defining novel strata they will need to be combined with sufficiently granular phenotypic data.
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Affiliation(s)
- Michael J Owen
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Sophie E Legge
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Elliott Rees
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James T R Walters
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael C O'Donovan
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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6
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Rammos A, Kirov G, Hubbard L, Walters JTR, Holmans P, Owen MJ, O'Donovan MC, Rees E. Family-based analysis of the contribution of rare and common genetic variants to school performance in schizophrenia. Mol Psychiatry 2023; 28:2081-2087. [PMID: 36914811 PMCID: PMC10575776 DOI: 10.1038/s41380-023-02013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/16/2023]
Abstract
Impaired cognition in schizophrenia is associated with worse functional outcomes. While genetic factors are known to contribute to variation in cognition in schizophrenia, few rare coding variants with strong effects have been identified, and the relative effects from de novo, inherited and non-transmitted alleles are unknown. We used array and exome sequencing data from 656 proband-parent trios to examine the contribution of common and rare variants to school performance, and by implication cognitive function, in schizophrenia. Parental transmission of common alleles contributing to higher educational attainment (p value = 0.00015; OR = 2.63) and intelligence (p value = 0.00009; OR = 2.80), but not to schizophrenia, were associated with higher proband school performance. No significant effects were seen for non-transmitted parental common alleles. Probands with lower school performance were enriched for damaging de novo coding variants in genes associated with developmental disorders (DD) (p value = 0.00026; OR = 11.6). Damaging, ultra-rare coding variants in DD genes that were transmitted or non-transmitted from parents, had no effects on school performance. Among probands with lower school performance, those with damaging de novo coding variants in DD genes had a higher rate of comorbid mild intellectual disability (p value = 0.0002; OR = 15.6). Overall, we provide evidence for rare and common genetic contributions to school performance in schizophrenia. The strong effects for damaging de novo coding variants in DD genes provide further evidence that cognitive impairment in schizophrenia has a shared aetiology with developmental disorders. Furthermore, we report no evidence in this sample that non-transmitted parental common alleles for cognitive traits contributed to school performance in schizophrenia via indirect effects on the environment.
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Affiliation(s)
- Alexandros Rammos
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - George Kirov
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Leon Hubbard
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James T R Walters
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Peter Holmans
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael J Owen
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael C O'Donovan
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Elliott Rees
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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7
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Jones SE, Harvey PD. Cross-diagnostic determinants of cognitive functioning: the muscarinic cholinergic receptor as a model system. Transl Psychiatry 2023; 13:100. [PMID: 36973270 PMCID: PMC10042838 DOI: 10.1038/s41398-023-02400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Cognitive impairment is a predictor of disability across different neuropsychiatric conditions, and cognitive abilities are also strongly related to educational attainment and indices of life success in the general population. Previous attempts at drug development for cognitive enhancement have commonly attempted to remedy defects in transmitters systems putatively associated with the conditions of interest such as the glutamate system in schizophrenia. Recent studies of the genomics of cognitive performance have suggested influences that are common in the general population and in different neuropsychiatric conditions. Thus, it seems possible that transmitter systems that are implicated for cognition across neuropsychiatric conditions and the general population would be a viable treatment target. We review the scientific data on cognition and the muscarinic cholinergic receptor system (M1 and M4) across different diagnoses, in aging, and in the general population. We suggest that there is evidence suggesting potential beneficial impacts of stimulation of critical muscarinic receptors for the enhancement of cognition in a broad manner, as well as the treatment of psychotic symptoms. Recent developments make stimulation of the M1 receptor more tolerable, and we identify the potential benefits of M1 and M4 receptor stimulation as a trans-diagnostic treatment model.
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Affiliation(s)
- Sara E Jones
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA.
- Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
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8
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Kato H, Kimura H, Kushima I, Takahashi N, Aleksic B, Ozaki N. The genetic architecture of schizophrenia: review of large-scale genetic studies. J Hum Genet 2023; 68:175-182. [PMID: 35821406 DOI: 10.1038/s10038-022-01059-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/12/2022] [Accepted: 06/20/2022] [Indexed: 11/09/2022]
Abstract
Schizophrenia is a complex and often chronic psychiatric disorder with high heritability. Diagnosis of schizophrenia is still made clinically based on psychiatric symptoms; no diagnostic tests or biomarkers are available. Pathophysiology-based diagnostic scheme and treatments are also not available. Elucidation of the pathogenesis is needed for development of pathology-based diagnostics and treatments. In the past few decades, genetic research has made substantial advances in our understanding of the genetic architecture of schizophrenia. Rare copy number variations (CNVs) and rare single-nucleotide variants (SNVs) detected by whole-genome CNV analysis and whole-genome/-exome sequencing analysis have provided the great advances. Common single-nucleotide polymorphisms (SNPs) detected by large-scale genome-wide association studies have also provided important information. Large-scale genetic studies have been revealed that both rare and common genetic variants play crucial roles in this disorder. In this review, we focused on CNVs, SNVs, and SNPs, and discuss the latest research findings on the pathogenesis of schizophrenia based on these genetic variants. Rare variants with large effect sizes can provide mechanistic hypotheses. CRISPR-based genetics approaches and induced pluripotent stem cell technology can facilitate the functional analysis of these variants detected in patients with schizophrenia. Recent advances in long-read sequence technology are expected to detect variants that cannot be detected by short-read sequence technology. Various studies that bring together data from common variant and transcriptomic datasets provide biological insight. These new approaches will provide additional insight into the pathophysiology of schizophrenia and facilitate the development of pathology-based therapeutics.
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Affiliation(s)
- Hidekazu Kato
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Kushima
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Medical Genomics Center, Nagoya University Hospital, Nagoya, Japan
| | - Nagahide Takahashi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Medical Genomics Center, Nagoya University Hospital, Nagoya, Japan.,Institute for Glyco-core Research (iGCORE), Nagoya University, Nagoya, Japan
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9
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Senner F, Schneider-Axmann T, Kaurani L, Zimmermann J, Wiltfang J, von Hagen M, Vogl T, Spitzer C, Senner S, Schulte EC, Schmauß M, Schaupp SK, Reimer J, Reich-Erkelenz D, Papiol S, Kohshour MO, Lang FU, Konrad C, Kirchner SK, Kalman JL, Juckel G, Heilbronner M, Heilbronner U, Figge C, Eyl RE, Dietrich D, Budde M, Angelescu IG, Adorjan K, Schmitt A, Fischer A, Falkai P, Schulze TG. Association of early life stress and cognitive performance in patients with schizophrenia and healthy controls. Schizophr Res Cogn 2023; 32:100280. [PMID: 36846489 PMCID: PMC9945796 DOI: 10.1016/j.scog.2023.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/13/2023]
Abstract
As core symptoms of schizophrenia, cognitive deficits contribute substantially to poor outcomes. Early life stress (ELS) can negatively affect cognition in patients with schizophrenia and healthy controls, but the exact nature of the mediating factors is unclear. Therefore, we investigated how ELS, education, and symptom burden are related to cognitive performance. The sample comprised 215 patients with schizophrenia (age, 42.9 ± 12.0 years; 66.0 % male) and 197 healthy controls (age, 38.5 ± 16.4 years; 39.3 % male) from the PsyCourse Study. ELS was assessed with the Childhood Trauma Screener (CTS). We used analyses of covariance and correlation analyses to investigate the association of total ELS load and ELS subtypes with cognitive performance. ELS was reported by 52.1 % of patients and 24.9 % of controls. Independent of ELS, cognitive performance on neuropsychological tests was lower in patients than controls (p < 0.001). ELS load was more closely associated with neurocognitive deficits (cognitive composite score) in controls (r = -0.305, p < 0.001) than in patients (r = -0.163, p = 0.033). Moreover, the higher the ELS load, the more cognitive deficits were found in controls (r = -0.200, p = 0.006), while in patients, this correlation was not significant after adjusting for PANSS. ELS load was more strongly associated with cognitive deficits in healthy controls than in patients. In patients, disease-related positive and negative symptoms may mask the effects of ELS-related cognitive deficits. ELS subtypes were associated with impairments in various cognitive domains. Cognitive deficits appear to be mediated through higher symptom burden and lower educational level.
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Affiliation(s)
- Fanny Senner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany,Corresponding author at: Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 München, Germany.
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
| | - Lalit Kaurani
- German Center of Neurodegenerative Diseases (DZNE), Göttingen 37075, Germany
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn 26160, Germany
| | - Jens Wiltfang
- German Center of Neurodegenerative Diseases (DZNE), Göttingen 37075, Germany,Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen 37075, Germany,Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Eschwege 37269, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock 18147, Germany
| | - Simon Senner
- Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Konstanz 78479, Germany
| | - Eva C. Schulte
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Max Schmauß
- Department of Psychiatry and Psychotherapy, Bezirkskrankenhaus Augsburg, Augsburg 86156, Germany
| | - Sabrina K. Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Sergi Papiol
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany,Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fabian U. Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, 89312, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg 27356, Germany
| | - Sophie-Kathrin Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Department of Psychiatry and Psychotherapy, Bezirkskrankenhaus Augsburg, Augsburg 86156, Germany
| | - Janos L. Kalman
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum 44791, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg 26160, Germany
| | - Ruth E. Eyl
- Stuttgart Cancer Center –Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart, Stuttgart 70174, Germany
| | | | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Ion-George Angelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Berlin 14050, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Andre Fischer
- German Center of Neurodegenerative Diseases (DZNE), Göttingen 37075, Germany,Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen 37075, Germany,Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), University of Göttingen, Göttingen, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany,Department of Psychiatry and Behavorial Sciences, SUNY Upstate Medical University, Syracuse, 54, NY, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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10
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Griffiths SL, Upthegrove R, Corsi-Zuelli F, Deakin B. Rethinking Immunity and Cognition in Clinical High Risk for Psychosis. Curr Top Behav Neurosci 2023; 63:475-497. [PMID: 36409457 DOI: 10.1007/7854_2022_399] [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] [Indexed: 06/16/2023]
Abstract
It is well known that schizophrenia is associated with cognitive impairment, reduced cortical grey matter and increased circulating concentrations of inflammatory cytokines. However, the relationship between these findings is not clear. We outline the influential neuroinflammatory hypotheses that raised cytokines provoke a damaging immune response in microglia that results in reduced grey matter and associated cognitive performance. We investigated whether such an interaction might be detectable in the prodromal period as illness emerges from the Clinical High Risk for Psychosis (CHR-P). Meta-analyses suggest that compared with controls, impaired cognition and reduced grey matter are already present by the prodrome and that greater decrements are present in those who later develop symptoms. In contrast, the few cytokine studies report no abnormalities in CHR-P except that interleukin-6 (IL-6) levels were raised versus controls and to a greater extent in the future patients, in one study. We noted that cognitive impairment and less cortical grey matter are more severe in schizophrenia than in affective disorders, but that increased cytokine levels are similarly prevalent across disorders. We found no studies correlating cytokine levels with cognitive impairment in CHR-P but such correlations seem unlikely given the minimal relationship reported in a recent meta-analysis of the many cytokine-cognition studies in established illness. From this and other evidence, we conclude that neuroinflammation is not a core feature of schizophrenia nor a substrate for reduced grey matter volume or cognitive function. We draw attention instead to the emerging evidence that brain-resident immune cells and signalling molecules such as Tregs and IL-6, which are influenced by schizophrenia risk genes, regulate and are necessary for the development and function of neuron-glia interaction. We suggest that cognitive impairment in schizophrenia can be seen as a convergence of genetic and immune-neurodevelopmental dysregulation whereas raised cytokines are a consequence of impaired Tregs control of systemic inflammation.
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Affiliation(s)
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Fabiana Corsi-Zuelli
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Bill Deakin
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK.
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11
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Kochunov P, Ma Y, Hatch KS, Gao S, Jahanshad N, Thompson PM, Adhikari BM, Bruce H, Van der vaart A, Goldwaser EL, Sotiras A, Kvarta MD, Ma T, Chen S, Nichols TE, Hong LE. Brain-wide versus genome-wide vulnerability biomarkers for severe mental illnesses. Hum Brain Mapp 2022; 43:4970-4983. [PMID: 36040723 PMCID: PMC9582367 DOI: 10.1002/hbm.26056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 01/06/2023] Open
Abstract
Severe mental illnesses (SMI), including major depressive (MDD), bipolar (BD), and schizophrenia spectrum (SSD) disorders have multifactorial risk factors and capturing their complex etiopathophysiology in an individual remains challenging. Regional vulnerability index (RVI) was used to measure individual's brain-wide similarity to the expected SMI patterns derived from meta-analytical studies. It is analogous to polygenic risk scores (PRS) that measure individual's similarity to genome-wide patterns in SMI. We hypothesized that RVI is an intermediary phenotype between genome and symptoms and is sensitive to both genetic and environmental risks for SMI. UK Biobank sample of N = 17,053/19,265 M/F (age = 64.8 ± 7.4 years) and an independent sample of SSD patients and controls (N = 115/111 M/F, age = 35.2 ± 13.4) were used to test this hypothesis. UKBB participants with MDD had significantly higher RVI-MDD (Cohen's d = 0.20, p = 1 × 10-23 ) and PRS-MDD (d = 0.17, p = 1 × 10-15 ) than nonpsychiatric controls. UKBB participants with BD and SSD showed significant elevation in the respective RVIs (d = 0.65 and 0.60; p = 3 × 10-5 and .009, respectively) and PRS (d = 0.57 and 1.34; p = .002 and .002, respectively). Elevated RVI-SSD were replicated in an independent sample (d = 0.53, p = 5 × 10-5 ). RVI-MDD and RVI-SSD but not RVI-BD were associated with childhood adversity (p < .01). In nonpsychiatric controls, elevation in RVI and PRS were associated with lower cognitive performance (p < 10-5 ) in six out of seven domains and showed specificity with disorder-associated deficits. In summary, the RVI is a novel brain index for SMI and shows similar or better specificity for SMI than PRS, and together they may complement each other in the efforts to characterize the genomic to brain level risks for SMI.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Yizhou Ma
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Kathryn S. Hatch
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Bhim M. Adhikari
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Andrew Van der vaart
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Eric L. Goldwaser
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Aris Sotiras
- Institute of Informatics, University of WashingtonSchool of MedicineSt. LouisMissouriUSA
| | - Mark D. Kvarta
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Tianzhou Ma
- Department of Epidemiology and BiostatisticsUniversity of MarylandCollege ParkMarylandUSA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Thomas E. Nichols
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
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12
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Schizophrenia: A Narrative Review of Etiopathogenetic, Diagnostic and Treatment Aspects. J Clin Med 2022; 11:jcm11175040. [PMID: 36078967 PMCID: PMC9457502 DOI: 10.3390/jcm11175040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Although schizophrenia is currently conceptualized as being characterized as a syndrome that includes a collection of signs and symptoms, there is strong evidence of heterogeneous and complex underpinned etiological, etiopathogenetic, and psychopathological mechanisms, which are still under investigation. Therefore, the present viewpoint review is aimed at providing some insights into the recently investigated schizophrenia research fields in order to discuss the potential future research directions in schizophrenia research. The traditional schizophrenia construct and diagnosis were progressively revised and revisited, based on the recently emerging neurobiological, genetic, and epidemiological research. Moreover, innovative diagnostic and therapeutic approaches are pointed to build a new construct, allowing the development of better clinical and treatment outcomes and characterization for schizophrenic individuals, considering a more patient-centered, personalized, and tailored-based dimensional approach. Further translational studies are needed in order to integrate neurobiological, genetic, and environmental studies into clinical practice and to help clinicians and researchers to understand how to redesign a new schizophrenia construct.
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13
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Karcher NR, Merchant J, Pine J, Kilciksiz CM. Cognitive Dysfunction as a Risk Factor for Psychosis. Curr Top Behav Neurosci 2022; 63:173-203. [PMID: 35989398 DOI: 10.1007/7854_2022_387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The current chapter summarizes recent evidence for cognition as a risk factor for the development of psychosis, including the range of cognitive impairments that exist across the spectrum of psychosis risk symptoms. The chapter examines several possible theories linking cognitive deficits with the development of psychotic symptoms, including evidence that cognitive deficits may be an intermediate risk factor linking genetic and/or neural metrics to psychosis spectrum symptoms. Although there is not strong evidence for unique cognitive markers associated specifically with psychosis compared to other forms of psychopathology, psychotic disorders are generally associated with the greatest severity of cognitive deficits. Cognitive deficits precede the development of psychotic symptoms and may be detectable as early as childhood. Across the psychosis spectrum, both the presence and severity of psychotic symptoms are associated with mild to moderate impairments across cognitive domains, perhaps most consistently for language, cognitive control, and working memory domains. Research generally indicates the size of these cognitive impairments worsens as psychosis symptom severity increases. The chapter points out areas of unclarity and unanswered questions in each of these areas, including regarding the mechanisms contributing to the association between cognition and psychosis, the timing of deficits, and whether any cognitive systems can be identified that function as specific predictors of psychosis risk symptoms.
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Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jaisal Merchant
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Jacob Pine
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Can Misel Kilciksiz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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14
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Fabbri C, Leggio GM, Drago F, Serretti A. Imputed expression of schizophrenia-associated genes and cognitive measures in patients with schizophrenia. Mol Genet Genomic Med 2022; 10:e1942. [PMID: 35488718 PMCID: PMC9184669 DOI: 10.1002/mgg3.1942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/07/2021] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cognitive dysfunction is a core manifestation of schizophrenia and one of the best predictors of long‐term disability. Genes increasing risk for schizophrenia may partly act through the modulation of cognition. Methods We imputed the expression of 130 genes recently prioritized for association with schizophrenia, using PsychENCODE variant weights and genotypes of patients with schizophrenia in CATIE. Processing speed, reasoning, verbal memory, working memory, vigilance, and a composite cognitive score were used as phenotypes. We performed linear regression models for each cognitive measure and gene expression score, adjusting for age, years of education, antipsychotic treatment, years since the first antipsychotic treatment and population principal components. Results We included 425 patients and expression scores of 91 genes (others had no heritable expression; Bonferroni corrected alpha = 5.49e‐4). No gene expression score was associated with cognitive measures, though ENOX1 expression was very close to the threshold for verbal memory (p = 6e‐4) and processing speed (p = 7e‐4). Other genes were nominally associated with multiple phenotypes (MAN2A1 and PCGF3). Conclusion A better understanding of the mechanisms mediating cognitive dysfunction in schizophrenia may help in the definition of disease prognosis and in the identification of new treatments, as the treatment of cognitive impairment remains an unmet therapeutic need.
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Affiliation(s)
- Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gian Marco Leggio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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15
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Song J, Yao S, Kowalec K, Lu Y, Sariaslan A, Szatkiewicz JP, Larsson H, Lichtenstein P, Hultman CM, Sullivan PF. The impact of educational attainment, intelligence and intellectual disability on schizophrenia: a Swedish population-based register and genetic study. Mol Psychiatry 2022; 27:2439-2447. [PMID: 35379910 PMCID: PMC9135619 DOI: 10.1038/s41380-022-01500-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 01/16/2023]
Abstract
Schizophrenia (SCZ) is highly heterogenous and no subtypes characterizing treatment response or longitudinal course well. Cognitive impairment is a core clinical feature of SCZ and a determinant of poorer outcome. Genetic overlap between SCZ and cognitive traits is complex, with limited studies of comprehensive epidemiological and genomic evidence. To examine the relation between SCZ and three cognitive traits, educational attainment (EDU), premorbid cognitive ability, and intellectual disability (ID), we used two Swedish samples: a national cohort (14,230 SCZ cases and 3,816,264 controls) and a subsample with comprehensive genetic data (4992 cases and 6009 controls). Population-based analyses confirmed worse cognition as a risk factor for SCZ, and the pedigree and SNP-based genetic correlations were comparable. In the genotyped cases, those with high EDU and premorbid cognitive ability tended to have higher polygenetic risk scores (PRS) of EDU and intelligence and fewer rare exonic variants. Finally, by applying an empirical clustering method, we dissected SCZ cases into four replicable subgroups characterized by EDU and ID. In particular, the subgroup with higher EDU in the national cohort had fewer adverse outcomes including long hospitalization and death. In the genotyped subsample, this subgroup had higher PRS of EDU and no excess of rare genetic burdens than controls. In conclusion, we found extensive evidence of a robust relation between cognitive traits and SCZ, underscoring the importance of cognition in dissecting the heterogeneity of SCZ.
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Affiliation(s)
- Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kaarina Kowalec
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amir Sariaslan
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Jin P Szatkiewicz
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebo University, Örebo, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Icahn School of Medicine, Department of Psychiatry, Mt Sinai Hospital, New York, NY, USA
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
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16
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Jacquemont S, Huguet G, Klein M, Chawner SJRA, Donald KA, van den Bree MBM, Sebat J, Ledbetter DH, Constantino JN, Earl RK, McDonald-McGinn DM, van Amelsvoort T, Swillen A, O'Donnell-Luria AH, Glahn DC, Almasy L, Eichler EE, Scherer SW, Robinson E, Bassett AS, Martin CL, Finucane B, Vorstman JAS, Bearden CE, Gur RE. Genes To Mental Health (G2MH): A Framework to Map the Combined Effects of Rare and Common Variants on Dimensions of Cognition and Psychopathology. Am J Psychiatry 2022; 179:189-203. [PMID: 35236119 PMCID: PMC9345000 DOI: 10.1176/appi.ajp.2021.21040432] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rare genomic disorders (RGDs) confer elevated risk for neurodevelopmental psychiatric disorders. In this era of intense genomics discoveries, the landscape of RGDs is rapidly evolving. However, there has not been comparable progress to date in scalable, harmonized phenotyping methods. As a result, beyond associations with categorical diagnoses, the effects on dimensional traits remain unclear for many RGDs. The nature and specificity of RGD effects on cognitive and behavioral traits is an area of intense investigation: RGDs are frequently associated with more than one psychiatric condition, and those studied to date affect, to varying degrees, a broad range of developmental and cognitive functions. Although many RGDs have large effects, phenotypic expression is typically influenced by additional genomic and environmental factors. There is emerging evidence that using polygenic risk scores in individuals with RGDs offers opportunities to refine prediction, thus allowing for the identification of those at greatest risk of psychiatric illness. However, translation into the clinic is hindered by roadblocks, which include limited genetic testing in clinical psychiatry, and the lack of guidelines for following individuals with RGDs, who are at high risk of developing psychiatric symptoms. The Genes to Mental Health Network (G2MH) is a newly funded National Institute of Mental Health initiative that will collect, share, and analyze large-scale data sets combining genomics and dimensional measures of psychopathology spanning diverse populations and geography. The authors present here the most recent understanding of the effects of RGDs on dimensional behavioral traits and risk for psychiatric conditions and discuss strategies that will be pursued within the G2MH network, as well as how expected results can be translated into clinical practice to improve patient outcomes.
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Affiliation(s)
- Sébastien Jacquemont
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Guillaume Huguet
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Marieke Klein
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Samuel J R A Chawner
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Kirsten A Donald
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Marianne B M van den Bree
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Jonathan Sebat
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - David H Ledbetter
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - John N Constantino
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Rachel K Earl
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Donna M McDonald-McGinn
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Therese van Amelsvoort
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Ann Swillen
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Anne H O'Donnell-Luria
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - David C Glahn
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Laura Almasy
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Evan E Eichler
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Stephen W Scherer
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Elise Robinson
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Anne S Bassett
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Christa Lese Martin
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Brenda Finucane
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Jacob A S Vorstman
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Carrie E Bearden
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
| | - Raquel E Gur
- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
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- Department of Pediatrics, University of Montreal, Montreal (Jacquemont, Huguet); Sainte Justine Hospital Research Center, Montreal (Jacquemont, Huguet); Department of Psychiatry, University of California San Diego, La Jolla (Klein, Sebat); Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom (Chawner, van den Bree); Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa (Donald); Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Donald); Autism and Developmental Medicine Institute, Geisinger, Danville, Pa. (Ledbetter, Martin, Finucane); Department of Psychiatry, Washington University School of Medicine, St. Louis (Constantino); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Earl); Division of Human Genetics, 22q and You Center, Section of Clinical Genetics and Genetic Counseling, Children's Hospital of Philadelphia and Department of Pediatrics, Philadelphia (McDonald-McGinn); Perelman School of Medicine, University of Pennsylvania, Philadelphia (McDonald-McGinn); Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands (van Amelsvoort); Center for Human Genetics, University Hospital UZ Leuven, Leuven, Belgium (Swillen); Department of Human Genetics, KU Leuven, Leuven, Belgium (Swillen); Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston (O'Donnell-Luria); Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (O'Donnell-Luria); Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston (Glahn); Department of Psychiatry, Harvard Medical School, Boston (Glahn); Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Almasy); Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Lifespan Brain Institute, University of Pennsylvania, Philadelphia (Almasy); Department of Genome Sciences, University of Washington School of Medicine, Seattle (Eichler); Howard Hughes Medical Institute, University of Washington, Seattle (Eichler); Center for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Scherer); McLaughlin Center and Department of Molecular Genetics, University of Toronto, Toronto (Scherer); Harvard T.H. Chan School of Public Health and Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge, Mass. (Robinson); Department of Psychiatry, Dalglish Family 22q Clinic, University Health Network, Toronto (Bassett); Department of Psychiatry, Toronto General Hospital Research Institute, University Health Network, Toronto (Bassett); Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto Clinical Genetics Research Program, Center for Addiction and Mental Health, Toronto (Bassett); Department of Psychiatry, University of Toronto, Toronto (Vorstman); Centre for Applied Genomics and Program in Genetics and Genomic Biology, Hospital for Sick Children, Toronto (Vorstman);Department of Psychiatry and Biobehavioral Sciences, Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (Bearden); Department of Psychology, University of California, Los Angeles (Bearden); Lifespan Brain Institute, Penn Medicine, and Children's Hospital of Philadelphia, Philadelphia (Gur); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Gur); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Gur)
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17
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Lynham AJ, Jones IR, Walters JTR. Web-Based Cognitive Testing in Psychiatric Research: Validation and Usability Study. J Med Internet Res 2022; 24:e28233. [PMID: 35142640 PMCID: PMC8874806 DOI: 10.2196/28233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/11/2021] [Accepted: 11/21/2021] [Indexed: 01/23/2023] Open
Abstract
Background Cognitive impairments are features of many psychiatric disorders and affect functioning. A barrier to cognitive research on psychiatric disorders is the lack of large cross-disorder data sets. However, the collection of cognitive data can be logistically challenging and expensive. Web-based collection may be an alternative; however, little is known about who does and does not complete web-based cognitive assessments for psychiatric research. Objective The aims of this study are to develop a web-based cognitive battery for use in psychiatric research, validate the battery against the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and compare the characteristics of the participants who chose to take part with those of the individuals who did not participate. Methods Tasks were developed by The Many Brains Project and selected to measure the domains specified by the MATRICS initiative. We undertook a cross-validation study of 65 participants with schizophrenia, bipolar disorder, depression, or no history of psychiatric disorders to compare the web-based tasks with the MATRICS Consensus Cognitive Battery. Following validation, we invited participants from 2 large ongoing genetic studies, which recruited participants with psychiatric disorders to complete the battery and evaluated the demographic and clinical characteristics of those who took part. Results Correlations between web-based and MATRICS tasks ranged between 0.26 and 0.73. Of the 961 participants, 887 (92.3%) completed at least one web-based task, and 644 (67%) completed all tasks, indicating adequate completion rates. Predictors of web-based participation included being female (odds ratio [OR] 1.3, 95% CI 1.07-1.58), ethnicity other than White European (OR 0.66, 95% CI 0.46-0.96), higher levels of education (OR 1.19, 95% CI 1.11-1.29), diagnosis of an eating disorder (OR 2.17, 95% CI 1.17-4) or depression and anxiety (OR 5.12, 95% CI 3.38-7.83), and absence of a diagnosis of schizophrenia (OR 0.59, 95% CI 0.35-0.94). Lower performance on the battery was associated with poorer functioning (B=−1.76, SE 0.26; P<.001). Conclusions Our findings offer valuable insights into the advantages and disadvantages of testing cognitive function remotely for mental health research.
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Affiliation(s)
- Amy Joanne Lynham
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ian R Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - James T R Walters
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
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18
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Association of polygenic risk for schizophrenia with fast sleep spindle density depends on pro-cognitive variants. Eur Arch Psychiatry Clin Neurosci 2022; 272:1193-1203. [PMID: 35723738 PMCID: PMC9508216 DOI: 10.1007/s00406-022-01435-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/15/2022] [Indexed: 11/14/2022]
Abstract
Cognitive impairment is a common feature in schizophrenia and the strongest prognostic factor for long-term outcome. Identifying a trait associated with the genetic background for cognitive outcome in schizophrenia may aid in a deeper understanding of clinical disease subtypes. Fast sleep spindles may represent such a biomarker as they are strongly genetically determined, associated with cognitive functioning and impaired in schizophrenia and unaffected relatives. We measured fast sleep spindle density in 150 healthy adults and investigated its association with a genome-wide polygenic score for schizophrenia (SCZ-PGS). The association between SCZ-PGS and fast spindle density was further characterized by stratifying it to the genetic background of intelligence. SCZ-PGS was positively associated with fast spindle density. This association mainly depended on pro-cognitive genetic variants. Our results strengthen the evidence for a genetic background of spindle abnormalities in schizophrenia. Spindle density might represent an easily accessible marker for a favourable cognitive outcome which should be further investigated in clinical samples.
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Giordano GM, Giuliani L, Perrottelli A, Bucci P, Di Lorenzo G, Siracusano A, Brando F, Pezzella P, Fabrazzo M, Altamura M, Bellomo A, Cascino G, Comparelli A, Monteleone P, Pompili M, Galderisi S, Maj M. Mismatch Negativity and P3a Impairment through Different Phases of Schizophrenia and Their Association with Real-Life Functioning. J Clin Med 2021; 10:5838. [PMID: 34945138 PMCID: PMC8707866 DOI: 10.3390/jcm10245838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Impairment in functioning since the onset of psychosis and further deterioration over time is a key aspect of subjects with schizophrenia (SCZ). Mismatch negativity (MMN) and P3a, indices of early attention processing that are often impaired in schizophrenia, might represent optimal electrophysiological candidate biomarkers of illness progression and poor outcome. However, contrasting findings are reported about the relationships between MMN-P3a and functioning. The study aimed to investigate in SCZ the influence of illness duration on MMN-P3a and the relationship of MMN-P3a with functioning. Pitch (p) and duration (d) MMN-P3a were investigated in 117 SCZ and 61 healthy controls (HCs). SCZ were divided into four illness duration groups: ≤ 5, 6 to 13, 14 to 18, and 19 to 32 years. p-MMN and d-MMN amplitude was reduced in SCZ compared to HCs, independently from illness duration, psychopathology, and neurocognitive deficits. p-MMN reduction was associated with lower "Work skills". The p-P3a amplitude was reduced in the SCZ group with longest illness duration compared to HCs. No relationship between P3a and functioning was found. Our results suggested that MMN amplitude reduction might represent a biomarker of poor functioning in SCZ.
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Affiliation(s)
- Giulia M. Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Paola Bucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Francesco Brando
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Michele Fabrazzo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Altamura
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Antonello Bellomo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
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Jiang W, Rootes-Murdy K, Chen J, Bizzozero NIP, Calhoun VD, van Erp TGM, Ehrlich S, Agartz I, Jönsson EG, Andreassen OA, Wang L, Pearlson GD, Glahn DC, Hong E, Liu J, Turner JA. Multivariate alterations in insula - Medial prefrontal cortex linked to genetics in 12q24 in schizophrenia. Psychiatry Res 2021; 306:114237. [PMID: 34655926 PMCID: PMC8643340 DOI: 10.1016/j.psychres.2021.114237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/29/2022]
Abstract
The direct effect of genetic variations on clinical phenotypes within schizophrenia (SZ) remains elusive. We examined the previously identified association of reduced gray matter concentration in the insula - medial prefrontal cortex and a quantitative trait locus located in 12q24 in a SZ dataset. The main analysis was performed on 1461 SNPs and 830 participants. The highest contributing SNPs were localized in five genes including TMEM119, which encodes a microglial marker, that is associated with neuroinflammation and Alzheimer's disease. The gene set in 12q4 may partially explain brain alterations in SZ, but they may also relate to other psychiatric and developmental disorders.
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Affiliation(s)
- Wenhao Jiang
- Department of Psychology, Georgia State University, United States of America; Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
| | - Kelly Rootes-Murdy
- Department of Psychology, Georgia State University, United States of America
| | - Jiayu Chen
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, United States of America
| | | | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, United States of America
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, United States of America; Qureshey Research Laboratory, Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA,United States of America
| | - Stefan Ehrlich
- Department of Psychiatry, Massachusetts General Hospital, United States of America; Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany
| | - Ingrid Agartz
- NORMENT, Institute of Clinical Medicine, University of Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik G Jönsson
- NORMENT, Institute of Clinical Medicine, University of Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ole A Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo, Norway
| | - Lei Wang
- Psychiatry and Behavioral Health, Ohio State Wexner Medical Center, United States of America
| | | | - David C Glahn
- Boston Children's Hospital and Harvard Medical School, United States of America
| | - Elliot Hong
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, United States of America
| | - Jingyu Liu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, United States of America
| | - Jessica A Turner
- Department of Psychology, Georgia State University, United States of America; Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, United States of America
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21
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Smigielski L, Papiol S, Theodoridou A, Heekeren K, Gerstenberg M, Wotruba D, Buechler R, Hoffmann P, Herms S, Adorjan K, Anderson-Schmidt H, Budde M, Comes AL, Gade K, Heilbronner M, Heilbronner U, Kalman JL, Klöhn-Saghatolislam F, Reich-Erkelenz D, Schaupp SK, Schulte EC, Senner F, Anghelescu IG, Arolt V, Baune BT, Dannlowski U, Dietrich DE, Fallgatter AJ, Figge C, Jäger M, Juckel G, Konrad C, Nieratschker V, Reimer J, Reininghaus E, Schmauß M, Spitzer C, von Hagen M, Wiltfang J, Zimmermann J, Gryaznova A, Flatau-Nagel L, Reitt M, Meyers M, Emons B, Haußleiter IS, Lang FU, Becker T, Wigand ME, Witt SH, Degenhardt F, Forstner AJ, Rietschel M, Nöthen MM, Andlauer TFM, Rössler W, Walitza S, Falkai P, Schulze TG, Grünblatt E. Polygenic risk scores across the extended psychosis spectrum. Transl Psychiatry 2021; 11:600. [PMID: 34836939 PMCID: PMC8626446 DOI: 10.1038/s41398-021-01720-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants hold the potential to predict complex diseases and index severity gradients. PRSs for schizophrenia (SZ) and bipolar disorder (BD) were computed using Bayesian regression and continuous shrinkage priors based on the latest SZ and BD genome-wide association studies (Psychiatric Genomics Consortium, third release). Eight well-phenotyped groups (n = 1580; 56% males) were assessed: control (n = 305), lower (n = 117) and higher (n = 113) schizotypy (both groups of healthy individuals), at-risk for psychosis (n = 120), BD type-I (n = 359), BD type-II (n = 96), schizoaffective disorder (n = 86), and SZ groups (n = 384). PRS differences were investigated for binary traits and the quantitative Positive and Negative Syndrome Scale. Both BD-PRS and SZ-PRS significantly differentiated controls from at-risk and clinical groups (Nagelkerke's pseudo-R2: 1.3-7.7%), except for BD type-II for SZ-PRS. Out of 28 pairwise comparisons for SZ-PRS and BD-PRS, 9 and 12, respectively, reached the Bonferroni-corrected significance. BD-PRS differed between control and at-risk groups, but not between at-risk and BD type-I groups. There was no difference between controls and schizotypy. SZ-PRSs, but not BD-PRSs, were positively associated with transdiagnostic symptomology. Overall, PRSs support the continuum model across the psychosis spectrum at the genomic level with possible irregularities for schizotypy. The at-risk state demands heightened clinical attention and research addressing symptom course specifiers. Continued efforts are needed to refine the diagnostic and prognostic accuracy of PRSs in mental healthcare.
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Affiliation(s)
- Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital, Cologne, Germany
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Per Hoffmann
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stefan Herms
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute, Berlin, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, Germany
- Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Jens Reimer
- Department of Psychiatry, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Max Schmauß
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Eschwege, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Anna Gryaznova
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Laura Flatau-Nagel
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Markus Reitt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Milena Meyers
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Barbara Emons
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Ida Sybille Haußleiter
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Moritz E Wigand
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, Universidade de São Paulo, São Paulo, Brazil
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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22
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Sex-specific effects of polygenic risk for schizophrenia on lifespan cognitive functioning in healthy individuals. Transl Psychiatry 2021; 11:520. [PMID: 34635642 PMCID: PMC8505489 DOI: 10.1038/s41398-021-01649-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/16/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Polygenic risk for schizophrenia has been associated with lower cognitive ability and age-related cognitive change in healthy individuals. Despite well-established neuropsychological sex differences in schizophrenia patients, genetic studies on sex differences in schizophrenia in relation to cognitive phenotypes are scarce. Here, we investigated whether the effect of a polygenic risk score (PRS) for schizophrenia on childhood, midlife, and late-life cognitive function in healthy individuals is modified by sex, and if PRS is linked to accelerated cognitive decline. Using a longitudinal data set from healthy individuals aged 25-100 years (N = 1459) spanning a 25-year period, we found that PRS was associated with lower cognitive ability (episodic memory, semantic memory, visuospatial ability), but not with accelerated cognitive decline. A significant interaction effect between sex and PRS was seen on cognitive task performance, and sex-stratified analyses showed that the effect of PRS was male-specific. In a sub-sample, we observed a male-specific effect of the PRS on school performance at age 12 (N = 496). Our findings of sex-specific effects of schizophrenia genetics on cognitive functioning across the lifespan indicate that the effects of underlying disease genetics on cognitive functioning is dependent on biological processes that differ between the sexes.
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23
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Influence of polygenic risk scores for schizophrenia and resilience on the cognition of individuals at-risk for psychosis. Transl Psychiatry 2021; 11:518. [PMID: 34628483 PMCID: PMC8502171 DOI: 10.1038/s41398-021-01624-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/25/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment is a core feature of schizophrenia which precedes the onset of full psychotic symptoms, even in the ultra-high-risk stage (UHR). Polygenic risk scores (PRS) can be computed for many psychiatric disorders and phenotyping traits, including scores for resilience. We explored the correlations between several PRS and neurocognition in UHR individuals. We included 107 UHR individuals; 29.9% of them converted to psychosis (UHR-C) while 57.0% did not (UHR-NC) during the 1-year follow-up. Cognitive performances were assessed with the Wechsler Adult Intelligence Scale estimating the Intelligence Quotient (IQ), the Trail Making Test, the verbal fluency, the Stroop test, and the Wisconsin card sorting test. Linear regression models were used to test their association with the PRS for schizophrenia, bipolar disorder, major depression, ADHD, cross-disorders, cognitive performance, intelligence, education attainment, and resilience to schizophrenia. UHR-C had a lower IQ than UHR-NC. The PRS for schizophrenia negatively correlated with IQ, while the PRS for cognitive performance and for resilience positively correlated with IQ. PRS for schizophrenia showed a significant correlation with working memory and processing speed indices. PRS for schizophrenia showed a higher effect on IQ in UHR-NC, and UHR-NC with high PRS for schizophrenia had a similar IQ as UHR-C. Conversely, UHR-C with a high PRS for resilience performed as well as UHR-NC. Our findings suggest that cognitive deficits may predate the onset of psychosis. The genetic architecture of schizophrenia seems to impacts the cognition in UHR-NC. Cognition is also mediated by PRS for resilience.
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24
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Legge SE, Cardno AG, Allardyce J, Dennison C, Hubbard L, Pardiñas AF, Richards A, Rees E, Di Florio A, Escott-Price V, Zammit S, Holmans P, Owen MJ, O’Donovan MC, Walters JTR. Associations Between Schizophrenia Polygenic Liability, Symptom Dimensions, and Cognitive Ability in Schizophrenia. JAMA Psychiatry 2021; 78:1143-1151. [PMID: 34347035 PMCID: PMC8340009 DOI: 10.1001/jamapsychiatry.2021.1961] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Schizophrenia is a clinically heterogeneous disorder. It is currently unclear how variability in symptom dimensions and cognitive ability is associated with genetic liability for schizophrenia. OBJECTIVE To determine whether phenotypic dimensions within schizophrenia are associated with genetic liability to schizophrenia, other neuropsychiatric disorders, and intelligence. DESIGN, SETTING, AND PARTICIPANTS In a genetic association study, 3 cross-sectional samples of 1220 individuals with a diagnosis of schizophrenia were recruited from community, inpatient, and voluntary sector mental health services across the UK. Confirmatory factor analysis was used to create phenotypic dimensions from lifetime ratings of the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and the MATRICS Consensus Cognitive Battery. Analyses of polygenic risk scores (PRSs) were used to assess whether genetic liability to schizophrenia, other neuropsychiatric disorders, and intelligence were associated with these phenotypic dimensions. Data collection for the cross-sectional studies occurred between 1993 and 2016. Data analysis for this study occurred between January 2019 and March 2021. MAIN OUTCOMES AND MEASURES Outcome measures included phenotypic dimensions defined from confirmatory factor analysis relating to positive symptoms, negative symptoms of diminished expressivity, negative symptoms of motivation and pleasure, disorganized symptoms, and current cognitive ability. Exposure measures included PRSs for schizophrenia, bipolar disorder, major depression, attention-deficit/hyperactivity disorder, autism spectrum disorder, and intelligence. RESULTS Of the 1220 study participants, 817 were men (67.0%). Participants' mean (SD) age at interview was 43.10 (12.74) years. Schizophrenia PRS was associated with increased disorganized symptom dimension scores in both a 5-factor model (β = 0.14; 95% CI, 0.07-0.22; P = 2.80 × 10-4) and a 3-factor model across all samples (β = 0.10; 95% CI, 0.05-0.15; P = 2.80 × 10-4). Current cognitive ability was associated with genetic liability to schizophrenia (β = -0.11; 95% CI, -0.19 to -0.04; P = 1.63 × 10-3) and intelligence (β = 0.23; 95% CI, 0.16-0.30; P = 1.52 × 10-10). After controlling for estimated premorbid IQ, current cognitive performance was associated with schizophrenia PRS (β = -0.08; 95% CI, -0.14 to -0.02; P = 8.50 × 10-3) but not intelligence PRS. CONCLUSIONS AND RELEVANCE The findings of this study suggest that genetic liability for schizophrenia is associated with higher disorganized dimension scores but not other symptom dimensions. Cognitive performance in schizophrenia appears to reflect distinct contributions from genetic liabilities to both intelligence and schizophrenia.
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Affiliation(s)
- Sophie E. Legge
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Alastair G. Cardno
- Leeds Institute of Health Sciences, Division of Psychological and Social Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Judith Allardyce
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Charlotte Dennison
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Leon Hubbard
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Antonio F. Pardiñas
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Alexander Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Elliott Rees
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Arianna Di Florio
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Valentina Escott-Price
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Stanley Zammit
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom,Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peter Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Michael C. O’Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - James T. R. Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
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25
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Rees E, Creeth HDJ, Hwu HG, Chen WJ, Tsuang M, Glatt SJ, Rey R, Kirov G, Walters JTR, Holmans P, Owen MJ, O'Donovan MC. Schizophrenia, autism spectrum disorders and developmental disorders share specific disruptive coding mutations. Nat Commun 2021; 12:5353. [PMID: 34504065 PMCID: PMC8429694 DOI: 10.1038/s41467-021-25532-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/16/2021] [Indexed: 12/24/2022] Open
Abstract
People with schizophrenia are enriched for rare coding variants in genes associated with neurodevelopmental disorders, particularly autism spectrum disorders and intellectual disability. However, it is unclear if the same changes to gene function that increase risk to neurodevelopmental disorders also do so for schizophrenia. Using data from 3444 schizophrenia trios and 37,488 neurodevelopmental disorder trios, we show that within shared risk genes, de novo variants in schizophrenia and neurodevelopmental disorders are generally of the same functional category, and that specific de novo variants observed in neurodevelopmental disorders are enriched in schizophrenia (P = 5.0 × 10-6). The latter includes variants known to be pathogenic for syndromic disorders, suggesting that schizophrenia be included as a characteristic of those syndromes. Our findings imply that, in part, neurodevelopmental disorders and schizophrenia have shared molecular aetiology, and therefore likely overlapping pathophysiology, and support the hypothesis that at least some forms of schizophrenia lie on a continuum of neurodevelopmental disorders.
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Affiliation(s)
- Elliott Rees
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Hugo D J Creeth
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Wei J Chen
- National Taiwan University, Taipei, Taiwan
| | - Ming Tsuang
- University of California, San Diego, La Jolla, CA, USA
| | | | - Romain Rey
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Peter Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
| | - Michael C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
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26
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Ohi K, Nishizawa D, Sugiyama S, Takai K, Kuramitsu A, Hasegawa J, Soda M, Kitaichi K, Hashimoto R, Ikeda K, Shioiri T. Polygenic Risk Scores Differentiating Schizophrenia From Bipolar Disorder Are Associated With Premorbid Intelligence in Schizophrenia Patients and Healthy Subjects. Int J Neuropsychopharmacol 2021; 24:562-569. [PMID: 33738471 PMCID: PMC8299820 DOI: 10.1093/ijnp/pyab014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/25/2021] [Accepted: 03/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Impairments in intelligence are more severe in patients with schizophrenia (SCZ) than in patients with bipolar disorder (BD) despite clinical and genetic similarities between the disorders. Genetic loci differentiating SCZ from BD, that is, SCZ-specific risk, have been identified. Polygenetic [risk] scores (PGSs) for SCZ-specific risk are higher in SCZ patients than in healthy controls (HCs). However, the influence of genetic risk on impaired intelligence is poorly understood. Here, we investigated whether SCZ-specific risk could predict impairments in intelligence in SCZ patients and HCs. METHODS Large-scale genome-wide association study datasets related to SCZ vs BD, childhood intelligence (CHI), and adulthood intelligence (n = 12 441-282 014) were utilized to compute PGSs. PGSs derived from the genome-wide association studies were calculated for 130 patients with SCZ and 146 HCs. Premorbid and current intelligence and the decline were measured in SCZ patients and HCs. Correlations between PGSs and intelligence functions were investigated. RESULTS High PGSs for SCZ-specific risk were correlated with low premorbid intelligence in SCZ patients and HCs (β = -0.17, P = 4.12 × 10-3). The correlation was still significant after adjusting for diagnostic status (β = -0.13, P = .024). There were no significant correlations between PGSs for SCZ-specific risk and current intelligence or intelligence decline (P > .05). PGSs for CHI were lower in SCZ patients than in HCs (R2 = 0.025, P = .025), while the PGSs for CHI were not significantly correlated with premorbid and current intelligence, the decline, or the PGSs for SCZ-specific risk (P > .05). CONCLUSIONS These findings suggest that genetic factors differentiating SCZ from BD might affect the pathogenesis of SCZ and/or pathological differences between SCZ and BD via the impairment of premorbid intelligence, that is, crystallized intelligence, while genetic factors for CHI might affect the pathogenesis of SCZ but not via impairments in intelligence.
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Affiliation(s)
- Kazutaka Ohi
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
- Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shunsuke Sugiyama
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kentaro Takai
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Ayumi Kuramitsu
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Midori Soda
- Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Kiyoyuki Kitaichi
- Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Toshiki Shioiri
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
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Davidson M, Gabos-Grecu C. Do DSM classifications help or hinder
drug development?
. DIALOGUES IN CLINICAL NEUROSCIENCE 2021; 22:73-79. [PMID: 32699507 PMCID: PMC7365297 DOI: 10.31887/dcns.2020.22.1/mdavidson] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Development and regulatory approval of psychotropic drugs targets individuals with
syndromes described in the current Diagnostic and Statistical Manual of Mental
Disorders (DSM). This helps drug developers and regulators to communicate
with prescribers, and prescribers to match a specific psychotropic with the individual
patient(s) most likely to benefit from it. However, this practice has been criticized on
the grounds that DSM syndromes are too heterogenous biologically, and
the effects of psychotropics are too nonspecific to allow for an effective match. This
review considers the advantages and disadvantages of the current practice and the
possible alternatives. It concludes that efforts should be made to explore psychotropic
development transdiagnostically, free of the DSM boundaries. However,
currently there exists no alternative diagnostic system that is clearly superior to the
DSM in terms of communications between the stakeholders in drug
development.
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Affiliation(s)
- Michael Davidson
- Professor and Chair, University of Nicosia Medical School, Nicosia, Cyprus
| | - Cristian Gabos-Grecu
- Assistant Professor University of Medicine
Pharmacy Science and Technology Targu Mureş, Romania
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28
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What makes the psychosis 'clinical high risk' state risky: psychosis itself or the co-presence of a non-psychotic disorder? Epidemiol Psychiatr Sci 2021; 30:e53. [PMID: 34225831 PMCID: PMC8264801 DOI: 10.1017/s204579602100041x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired 'comorbidity' epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the 'risk' in CHR-P is indexed by co-present NPD rather than attenuated psychosis per se. METHODS We examined the incidence of early psychotic experiences (PE) with and without NPD (mood disorders, anxiety disorders, alcohol/drug use disorders), in a prospective general population cohort (n = 6123 at risk of incident PE at baseline). Four interview waves were conducted between 2007 and 2018 (NEMESIS-2). The incidence of PE, alone (PE-only) or with NPD (PE + NPD) was calculated, as were differential associations with schizophrenia polygenic risk score (PRS-Sz), environmental, demographical, clinical and cognitive factors. RESULTS The incidence of PE + NPD (0.37%) was lower than the incidence of PE-only (1.04%), representing around a third of the total yearly incidence of PE. Incident PE + NPD was, in comparison with PE-only, differentially characterised by poor functioning, environmental risks, PRS-Sz, positive family history, prescription of antipsychotic medication and (mental) health service use. CONCLUSIONS The risk in 'clinical high risk' states is mediated not by attenuated psychosis per se but specifically the combination of attenuated psychosis and NPD. CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of non-psychotic DSM-disorders, as the 'pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes.
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29
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Wendt FR, Pathak GA, Lencz T, Krystal JH, Gelernter J, Polimanti R. Multivariate genome-wide analysis of education, socioeconomic status and brain phenome. Nat Hum Behav 2021; 5:482-496. [PMID: 33349686 PMCID: PMC8068566 DOI: 10.1038/s41562-020-00980-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/21/2020] [Indexed: 01/10/2023]
Abstract
Socioeconomic status (SES) and education (EDU) are phenotypically associated with psychiatric disorders and behaviours. It remains unclear how these associations influence genetic risk for psychopathology, psychosocial factors and EDU and/or SES (EDU/SES) individually. Using information from >1 million individuals, we conditioned the genetic risk for psychiatric disorders, personality traits, brain imaging phenotypes and externalizing behaviours with genome-wide data for EDU/SES. Accounting for EDU/SES significantly affected the observed heritability of psychiatric traits, ranging from 2.44% h2 decrease for bipolar disorder to 14.2% h2 decrease for Tourette syndrome. Neuroticism h2 significantly increased by 20.23% after conditioning with SES. After EDU/SES conditioning, neuronal cell types were identified for risky behaviour (excitatory), major depression (inhibitory), schizophrenia (excitatory and γ-aminobutyric acid (GABA) mediated) and bipolar disorder (excitatory). Conditioning with EDU/SES also revealed unidirectional causality between brain morphology, psychopathology and psychosocial factors. Our results indicate that genetic discoveries related to psychopathology and psychosocial factors may be limited by genetic overlap with EDU/SES.
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Affiliation(s)
- Frank R Wendt
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Gita A Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Heampstead, NY, USA
- Institute for Behavioral Science, Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
- VA CT Healthcare System, West Haven, CT, USA.
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30
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Crouse JJ, Carpenter JS, Iorfino F, Lin T, Ho N, Byrne EM, Henders AK, Wallace L, Hermens DF, Scott EM, Wray NR, Hickie IB. Schizophrenia polygenic risk scores in youth mental health: preliminary associations with diagnosis, clinical stage and functioning. BJPsych Open 2021; 7:e58. [PMID: 33612137 PMCID: PMC8058892 DOI: 10.1192/bjo.2021.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The schizophrenia polygenic risk score (SCZ-PRS) is an emerging tool in psychiatry. AIMS We aimed to evaluate the utility of SCZ-PRS in a young, transdiagnostic, clinical cohort. METHOD SCZ-PRSs were calculated for young people who presented to early-intervention youth mental health clinics, including 158 patients of European ancestry, 113 of whom had longitudinal outcome data. We examined associations between SCZ-PRS and diagnosis, clinical stage and functioning at initial assessment, and new-onset psychotic disorder, clinical stage transition and functional course over time in contact with services. RESULTS Compared with a control group, patients had elevated PRSs for schizophrenia, bipolar disorder and depression, but not for any non-psychiatric phenotype (for example cardiovascular disease). Higher SCZ-PRSs were elevated in participants with psychotic, bipolar, depressive, anxiety and other disorders. At initial assessment, overall SCZ-PRSs were associated with psychotic disorder (odds ratio (OR) per s.d. increase in SCZ-PRS was 1.68, 95% CI 1.08-2.59, P = 0.020), but not assignment as clinical stage 2+ (i.e. discrete, persistent or recurrent disorder) (OR = 0.90, 95% CI 0.64-1.26, P = 0.53) or functioning (R = 0.03, P = 0.76). Longitudinally, overall SCZ-PRSs were not significantly associated with new-onset psychotic disorder (OR = 0.84, 95% CI 0.34-2.03, P = 0.69), clinical stage transition (OR = 1.02, 95% CI 0.70-1.48, P = 0.92) or persistent functional impairment (OR = 0.84, 95% CI 0.52-1.38, P = 0.50). CONCLUSIONS In this preliminary study, SCZ-PRSs were associated with psychotic disorder at initial assessment in a young, transdiagnostic, clinical cohort accessing early-intervention services. Larger clinical studies are needed to further evaluate the clinical utility of SCZ-PRSs, especially among individuals with high SCZ-PRS burden.
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Affiliation(s)
- Jacob J Crouse
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Australia
| | - Joanne S Carpenter
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Australia
| | - Frank Iorfino
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Australia
| | - Tian Lin
- Queensland Brain Institute, University of Queensland, Australia; and Institute of Molecular Bioscience, University of Queensland, Australia
| | - Nicholas Ho
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Australia
| | - Enda M Byrne
- Institute of Molecular Bioscience, University of Queensland, Australia
| | - Anjali K Henders
- Institute of Molecular Bioscience, University of Queensland, Australia
| | - Leanne Wallace
- Institute of Molecular Bioscience, University of Queensland, Australia
| | - Daniel F Hermens
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Australia
| | - Elizabeth M Scott
- St Vincent's and Mater Clinical School, The University of Notre Dame, Australia
| | - Naomi R Wray
- Queensland Brain Institute, University of Queensland, Australia; and Institute of Molecular Bioscience, University of Queensland, Australia
| | - Ian B Hickie
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Australia
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31
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Schizophrenia polygenic risk predicts general cognitive deficit but not cognitive decline in healthy older adults. Transl Psychiatry 2020; 10:422. [PMID: 33293510 PMCID: PMC7722936 DOI: 10.1038/s41398-020-01114-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 12/22/2022] Open
Abstract
There has been a long argument over whether schizophrenia is a neurodegenerative disorder associated with progressive cognitive impairment. Given high heritability of schizophrenia, ascertaning if genetic susceptibility to schizophrenia is also associated with cognitive decline in healthy people would support the view that schizophrenia leads to an accelerated cognitive decline. Using the population representative sample of 6817 adults aged >50 years from the English Longitudinal Study of Ageing, we investigated associations between the biennial rate of decline in cognitive ability and the schizophrenia polygenic score (SZ-PGS) during the 10-year follow-up period. SZ-PGS was calculated based on summary statistics from the Schizophrenia Working Group of the Psychiatric Genomics Consortium. Cognition was measured sequentially across four time points using verbal memory and semantic fluency tests. The average baseline verbal memory was 10.4 (SD = 3.4) and semantic fluency was 20.7 (SD = 6.3). One standard deviation (1-SD) increase in SZ-PGS was associated with lower baseline semantic fluency (β = -0.25, 95%CI = -0.40 to -0.10, p = 0.002); this association was significant in men (β = -0.36, 95%CI = -0.59 to -0.12, p = 0.003) and in those who were aged 60-69 years old (β = -0.32, 95%CI = -0.58 to -0.05, p = 0.019). Similarly, 1-SD increase in SZ-PGS was associated with lower verbal memory score at baseline in men only (β = -0.12, 95%CI = -0.23 to -0.01, p = 0.040). However, SZ-PGS was not associated with a greater rate of decline in these cognitive domains during the 10-year follow-up. Our findings highlight that while genetic susceptibility to schizophrenia conveys developmental cognitive deficit, it is not associated with an ongoing cognitive decline, at least in later life. These results do not support the neo-Kraepelinian notion of schizophrenia as a genetically determined progressively deteriorating brain disease.
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32
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Polygenic scores for schizophrenia and general cognitive ability: associations with six cognitive domains, premorbid intelligence, and cognitive composite score in individuals with a psychotic disorder and in healthy controls. Transl Psychiatry 2020; 10:416. [PMID: 33257657 PMCID: PMC7705731 DOI: 10.1038/s41398-020-01094-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 10/04/2020] [Accepted: 10/26/2020] [Indexed: 01/24/2023] Open
Abstract
Cognitive impairments are considered core features in schizophrenia and other psychotic disorders. Cognitive impairments are, to a lesser degree, also documented in healthy first-degree relatives. Although recent studies have shown (negative) genetic correlations between schizophrenia and general cognitive ability, the association between polygenic risk for schizophrenia and individual cognitive phenotypes remains unclear. We here investigated the association between a polygenic score for schizophrenia (SCZPGS) and six well-defined cognitive domains, in addition to a composite measure of cognitive ability and a measure of premorbid intellectual ability in 731 participants with a psychotic disorder and 851 healthy controls. We also investigated the association between a PGS for general cognitive ability (COGPGS) and the same cognitive domains in the same sample. We found no significant associations between the SCZPGS and any cognitive phenotypes, in either patients with a psychotic disorder or healthy controls. For COGPGS we observed stronger associations with cognitive phenotypes in healthy controls than in participants with psychotic disorders. In healthy controls, the association between COGPGS (at the p value threshold of ≥0.01) and working memory remained significant after Bonferroni correction (β = 0.12, p = 8.6 × 10-5). Altogether, the lack of associations between SCZPGS and COGPGS with cognitive performance in participants with psychotic disorders suggests that either environmental factors or unassessed genetic factors play a role in the development of cognitive impairments in psychotic disorders. Working memory should be further studied as an important cognitive phenotype.
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33
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Trifu SC, Kohn B, Vlasie A, Patrichi BE. Genetics of schizophrenia (Review). Exp Ther Med 2020; 20:3462-3468. [PMID: 32905096 PMCID: PMC7465115 DOI: 10.3892/etm.2020.8973] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
A comprehensive review of the body of genetic studies on schizophrenia seems even more daunting than the battle a psychiatrist wages daily in the office with her archenemy of a thousand faces. The following article reunites some genetic, epigenetic and environmental factors of schizophrenia from revered and vast studies in a chronological and progressive fashion. Twin studies set the basics of heritability and a particular study by Davis and Phelps considers the widely ignored influence of prenatal environment in the development of schizophrenia. Mostly ignited by linkage studies, candidate gene studies explore further by fine-mapping the hypothesized variants [mostly in the forms single nucleotide polymorphisms (SNPs) and less but with greater impact copy number variations (CNVs)] associated with the disease. Genome-wide association studies (GWAS) increase considerably the sample sizes and thus the validity of the results, while the next-generation sequencing (NGS) attain the highest yet unreplicated level of validity results.
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Affiliation(s)
- Simona Corina Trifu
- Department of Neurosciences, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Bianca Kohn
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Andrei Vlasie
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Bogdan-Eduard Patrichi
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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34
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Fedorenko OY, Ivanova SA. [A new look at the genetics of neurocognitive deficits in schizophrenia]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:183-192. [PMID: 32929943 DOI: 10.17116/jnevro2020120081183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The article presents current literature data on genetic studies of neurocognitive deficit in schizophrenia, including the genes of neurotransmitter systems (dopaminergic, glutamatergic, and serotonergic); genes analyzed in genome-wide association studies (GWAS), as well as other genetic factors related to the pathophysiological mechanisms underlying schizophrenia and neurocognitive disorders.
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Affiliation(s)
- O Yu Fedorenko
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,National Research Tomsk Polytechnic University, Tomsk, Russia
| | - S A Ivanova
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,National Research Tomsk Polytechnic University, Tomsk, Russia
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Mäki-Marttunen V, Andreassen OA, Espeseth T. The role of norepinephrine in the pathophysiology of schizophrenia. Neurosci Biobehav Rev 2020; 118:298-314. [PMID: 32768486 DOI: 10.1016/j.neubiorev.2020.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022]
Abstract
Several lines of evidence have suggested for decades a role for norepinephrine (NE) in the pathophysiology and treatment of schizophrenia. Recent experimental findings reveal anatomical and physiological properties of the locus coeruleus-norepinephrine (LC-NE) system and its involvement in brain function and cognition. Here, we integrate these two lines of evidence. First, we review the functional and structural properties of the LC-NE system and its impact on functional brain networks, cognition, and stress, with special emphasis on recent experimental and theoretical advances. Subsequently, we present an update about the role of LC-associated functions for the pathophysiology of schizophrenia, focusing on the cognitive and motivational deficits. We propose that schizophrenia phenomenology, in particular cognitive symptoms, may be explained by an abnormal interaction between genetic susceptibility and stress-initiated LC-NE dysfunction. This in turn, leads to imbalance between LC activity modes, dysfunctional regulation of brain network integration and neural gain, and deficits in cognitive functions. Finally, we suggest how recent development of experimental approaches can be used to characterize LC function in schizophrenia.
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Affiliation(s)
| | - Ole A Andreassen
- CoE NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Building 49, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway
| | - Thomas Espeseth
- Department of Psychology, University of Oslo, Postboks 1094, Blindern, 0317 Oslo, Norway; Bjørknes College, Lovisenberggata 13, 0456 Oslo, Norway
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36
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van Os J, Pries LK, Delespaul P, Kenis G, Luykx JJ, Lin BD, Richards AL, Akdede B, Binbay T, Altınyazar V, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Ulaş H, Cankurtaran EŞ, Kaymak SU, Mihaljevic MM, Petrovic SA, Mirjanic T, Bernardo M, Cabrera B, Bobes J, Saiz PA, García-Portilla MP, Sanjuan J, Aguilar EJ, Santos JL, Jiménez-López E, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Maric NP, Atbaşoğlu C, Ucok A, Alptekin K, Saka MC, Arango C, O'Donovan M, Rutten BPF, Guloksuz S. Replicated evidence that endophenotypic expression of schizophrenia polygenic risk is greater in healthy siblings of patients compared to controls, suggesting gene-environment interaction. The EUGEI study. Psychol Med 2020; 50:1884-1897. [PMID: 31414981 DOI: 10.1017/s003329171900196x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes. METHODS We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS. RESULTS In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group. CONCLUSIONS The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene-environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
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Affiliation(s)
- Jim van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Bochao D Lin
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Berna Akdede
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | | | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Çankaya, Ankara, Turkey
| | - Haldun Soygür
- Department of Psychiatry, School of Medicine, Dokuz Eylül University (discharged by decree 701 on July 8, 2018 because of signing "Peace Petition")
| | - Halis Ulaş
- Department of Psychiatry, School of Medicine, Dokuz Eylül University (discharged by decree 701 on July 8, 2018 because of signing "Peace Petition")
| | | | | | - Marina M Mihaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry CCS, Belgrade, Serbia
| | | | - Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Julio Bobes
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Pilar A Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Eduardo J Aguilar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - José Luis Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
| | - Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
| | - Angel Carracedo
- Fundación Publica Galega de Medicina Xenómica, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Gonzalo López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nadja P Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry CCS, Belgrade, Serbia
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Ucok
- Department of Psychiatry, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Celso Arango
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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37
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McNeill RV, Ziegler GC, Radtke F, Nieberler M, Lesch KP, Kittel-Schneider S. Mental health dished up-the use of iPSC models in neuropsychiatric research. J Neural Transm (Vienna) 2020; 127:1547-1568. [PMID: 32377792 PMCID: PMC7578166 DOI: 10.1007/s00702-020-02197-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022]
Abstract
Genetic and molecular mechanisms that play a causal role in mental illnesses are challenging to elucidate, particularly as there is a lack of relevant in vitro and in vivo models. However, the advent of induced pluripotent stem cell (iPSC) technology has provided researchers with a novel toolbox. We conducted a systematic review using the PRISMA statement. A PubMed and Web of Science online search was performed (studies published between 2006–2020) using the following search strategy: hiPSC OR iPSC OR iPS OR stem cells AND schizophrenia disorder OR personality disorder OR antisocial personality disorder OR psychopathy OR bipolar disorder OR major depressive disorder OR obsessive compulsive disorder OR anxiety disorder OR substance use disorder OR alcohol use disorder OR nicotine use disorder OR opioid use disorder OR eating disorder OR anorexia nervosa OR attention-deficit/hyperactivity disorder OR gaming disorder. Using the above search criteria, a total of 3515 studies were found. After screening, a final total of 56 studies were deemed eligible for inclusion in our study. Using iPSC technology, psychiatric disease can be studied in the context of a patient’s own unique genetic background. This has allowed great strides to be made into uncovering the etiology of psychiatric disease, as well as providing a unique paradigm for drug testing. However, there is a lack of data for certain psychiatric disorders and several limitations to present iPSC-based studies, leading us to discuss how this field may progress in the next years to increase its utility in the battle to understand psychiatric disease.
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Affiliation(s)
- Rhiannon V McNeill
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Georg C Ziegler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Franziska Radtke
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy University Hospital, University of Würzburg, Würzburg, Germany
| | - Matthias Nieberler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Klaus-Peter Lesch
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.
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38
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Ferraro L, La Cascia C, Quattrone D, Sideli L, Matranga D, Capuccio V, Tripoli G, Gayer-Anderson C, Morgan C, Sami MB, Sham P, de Haan L, Velthorst E, Jongsma HE, Kirkbride JB, Rutten BPF, Richards AL, Roldan L, Arango C, Bernardo M, Bobes J, Sanjuan J, Santos JL, Arrojo M, Tarricone I, Tortelli A, Szöke A, Del-Ben CM, Selten JP, Lynskey M, Jones PB, Van Os J, La Barbera D, Murray RM, Di Forti M. Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use. Schizophr Bull 2020; 46:517-529. [PMID: 31361020 PMCID: PMC7147569 DOI: 10.1093/schbul/sbz077] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.
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Affiliation(s)
- Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,To whom correspondence should be addressed; Via Gaetano La Loggia, 1, 90129 Palermo, Italy; tel: 091-6555175, fax: 091-6555164, e-mail:
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Domenica Matranga
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Veronica Capuccio
- Department of Economic, Management and Statistical Sciences (DSEAS) University of Palermo, Palermo, Italy
| | - Giada Tripoli
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Musa B Sami
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Pak Sham
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands,Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Laura Roldan
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuan
- Department of Psychiatry, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,” Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris, France,INSERM, Créteil, France
| | | | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
| | - Michael Lynskey
- Department of Addiction, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jim Van Os
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | | | - Robin M Murray
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Marta Di Forti
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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39
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Waddington JL, Zhen X, O'Tuathaigh CMP. Developmental Genes and Regulatory Proteins, Domains of Cognitive Impairment in Schizophrenia Spectrum Psychosis and Implications for Antipsychotic Drug Discovery: The Example of Dysbindin-1 Isoforms and Beyond. Front Pharmacol 2020; 10:1638. [PMID: 32063853 PMCID: PMC7000454 DOI: 10.3389/fphar.2019.01638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Alongside positive and negative symptomatology, deficits in working memory, attention, selective learning processes, and executive function have been widely documented in schizophrenia spectrum psychosis. These cognitive abnormalities are strongly associated with impairment across multiple function domains and are generally treatment-resistant. The DTNBP1 (dystrobrevin-binding protein-1) gene, encoding dysbindin, is considered a risk factor for schizophrenia and is associated with variation in cognitive function in both clinical and nonclinical samples. Downregulation of DTNBP1 expression in dorsolateral prefrontal cortex and hippocampal formation of patients with schizophrenia has been suggested to serve as a primary pathophysiological process. Described as a "hub," dysbindin is an important regulatory protein that is linked with multiple complexes in the brain and is involved in a wide variety of functions implicated in neurodevelopment and neuroplasticity. The expression pattern of the various dysbindin isoforms (-1A, -1B, -1C) changes depending upon stage of brain development, tissue areas and subcellular localizations, and can involve interaction with different protein partners. We review evidence describing how sequence variation in DTNBP1 isoforms has been differentially associated with schizophrenia-associated symptoms. We discuss results linking these isoform proteins, and their interacting molecular partners, with cognitive dysfunction in schizophrenia, including evidence from drosophila through to genetic mouse models of dysbindin function. Finally, we discuss preclinical evidence investigating the antipsychotic potential of molecules that influence dysbindin expression and functionality. These studies, and other recent work that has extended this approach to other developmental regulators, may facilitate identification of novel molecular pathways leading to improved antipsychotic treatments.
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Affiliation(s)
- John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Xuechu Zhen
- Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Colm M P O'Tuathaigh
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Medical Education Unit, School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
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40
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Mallet J, Le Strat Y, Dubertret C, Gorwood P. Polygenic Risk Scores Shed Light on the Relationship between Schizophrenia and Cognitive Functioning: Review and Meta-Analysis. J Clin Med 2020; 9:E341. [PMID: 31991840 PMCID: PMC7074036 DOI: 10.3390/jcm9020341] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/14/2020] [Accepted: 01/23/2020] [Indexed: 12/26/2022] Open
Abstract
Schizophrenia is a multifactorial disease associated with widespread cognitive impairment. Although cognitive deficits are one of the factors most strongly associated with functional impairment in schizophrenia (SZ), current treatment strategies hardly tackle these impairments. To develop more efficient treatment strategies in patients, a better understanding of their pathogenesis is needed. Recent progress in genetics, driven by large genome-wide association studies (GWAS) and the use of polygenic risk scores (PRS), has provided new insights about the genetic architecture of complex human traits, including cognition and SZ. Here, we review the recent findings examining the genetic links between SZ and cognitive functions in population-based samples as well as in participants with SZ. The performed meta-analysis showed a negative correlation between the polygenetic risk score of schizophrenia and global cognition (p < 0.001) when the samples rely on general and healthy participants, while no significant correlation was detected when the three studies devoted to schizophrenia patients were meta-analysed (p > 0.05). Our review and meta-analysis therefore argues against universal pleiotropy for schizophrenia alleles and cognition, since cognition in SZ patients would be underpinned by the same genetic factors than in the general population, and substantially independent of common variant liability to the disorder.
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Affiliation(s)
- Jasmina Mallet
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Yann Le Strat
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Caroline Dubertret
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Philip Gorwood
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, F-75014 Paris, France
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41
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Abstract
PURPOSE OF REVIEW We review recent progress in uncovering the complex genetic architecture of cognition, arising primarily from genome-wide association studies (GWAS). We explore the genetic correlations between cognitive performance and neuropsychiatric disorders, the genetic and environmental factors associated with age-related cognitive decline, and speculate about the future role of genomics in the understanding of cognitive processes. RECENT FINDINGS Improvements in genomic methods, and the increasing availability of large datasets via consortia cooperation, have led to a greater understanding of the role played by common and rare variants in the genomics of cognition, the highly polygenic basis of cognitive function and dysfunction, and the multiple biological processes involved. Recent research has aided in our understanding of the complex biological nature of genomics of cognition. Further development of data banks and techniques to analyze this data hold significant promise for understanding cognitive ability, and for treating cognitively related disability.
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