1
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Gur RC, Bearden CE, Jacquemont S, Swillen A, van Amelsvoort T, van den Bree M, Vorstman J, Sebat J, Ruparel K, Gallagher RS, McClellan E, White L, Crowley TB, Giunta V, Kushan L, O'Hora K, Verbesselt J, Vandensande A, Vingerhoets C, van Haelst M, Hall J, Harwood J, Chawner SJRA, Patel N, Palad K, Hong O, Guevara J, Martin CO, Jizi K, Bélanger AM, Scherer SW, Bassett AS, McDonald-McGinn DM, Gur RE. Neurocognitive profiles of 22q11.2 and 16p11.2 deletions and duplications. Mol Psychiatry 2024:10.1038/s41380-024-02661-y. [PMID: 39048645 DOI: 10.1038/s41380-024-02661-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024]
Abstract
Rare recurrent copy number variants (CNVs) at chromosomal loci 22q11.2 and 16p11.2 are genetic disorders with lifespan risk for neuropsychiatric disorders. Microdeletions and duplications are associated with neurocognitive deficits, yet few studies compared these groups using the same measures to address confounding measurement differences. We report a prospective international collaboration applying the same computerized neurocognitive assessment, the Penn Computerized Neurocognitive Battery (CNB), administered in a multi-site study on rare genomic disorders: 22q11.2 deletions (n = 492); 22q11.2 duplications (n = 106); 16p11.2 deletion (n = 117); and 16p11.2 duplications (n = 46). Domains examined include executive functions, episodic memory, complex cognition, social cognition, and psychomotor speed. Accuracy and speed for each domain were included as dependent measures in a mixed-model repeated measures analysis. Locus (22q11.2, 16p11.2) and Copy number (deletion/duplication) were grouping factors and Measure (accuracy, speed) and neurocognitive domain were repeated measures factors, with Sex and Site as covariates. We also examined correlation with IQ. We found a significant Locus × Copy number × Domain × Measure interaction (p = 0.0004). 22q11.2 deletions were associated with greater performance accuracy deficits than 22q11.2 duplications, while 16p11.2 duplications were associated with greater specific deficits than 16p11.2 deletions. Duplications at both loci were associated with reduced speed compared to deletions. Performance profiles differed among the groups with particularly poor memory performance of the 22q11.2 deletion group while the 16p11.2 duplication group had greatest deficits in complex cognition. Average accuracy on the CNB was moderately correlated with Full Scale IQ. Deletions and duplications of 22q11.2 and 16p11.2 have differential effects on accuracy and speed of neurocognition indicating locus specificity of performance profiles. These profile differences can help inform mechanistic substrates to heterogeneity in presentation and outcome, and can only be established in large-scale international consortia using the same neurocognitive assessment. Future studies could aim to link performance profiles to clinical features and brain function.
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Affiliation(s)
- Ruben C Gur
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
- Sainte Justine Hospital Research Center, Montreal, QC, Canada
| | - Ann Swillen
- Centre for Human Genetics, University Hospital Gasthuisberg and Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Therese van Amelsvoort
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Marianne van den Bree
- Centre for Neuropsychiatric Genetics and Genomics Division of Psychological Medicine and Clinical Neurosciences Cardiff, Cardiff, UK
| | - Jacob Vorstman
- Department of Psychiatry, Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jonathan Sebat
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Kosha Ruparel
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Sean Gallagher
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily McClellan
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren White
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Terrence Blaine Crowley
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania; 22q and You Center, Clinical Genetics Center, and Section of Genetic Counseling, CHOP, Philadelphia, PA, USA
| | - Victoria Giunta
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania; 22q and You Center, Clinical Genetics Center, and Section of Genetic Counseling, CHOP, Philadelphia, PA, USA
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Kathleen O'Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Jente Verbesselt
- Centre for Human Genetics, University Hospital Gasthuisberg and Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Ans Vandensande
- Centre for Human Genetics, University Hospital Gasthuisberg and Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Claudia Vingerhoets
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Mieke van Haelst
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Jessica Hall
- Centre for Neuropsychiatric Genetics and Genomics Division of Psychological Medicine and Clinical Neurosciences Cardiff, Cardiff, UK
| | - Janet Harwood
- Centre for Neuropsychiatric Genetics and Genomics Division of Psychological Medicine and Clinical Neurosciences Cardiff, Cardiff, UK
| | - Samuel J R A Chawner
- Centre for Neuropsychiatric Genetics and Genomics Division of Psychological Medicine and Clinical Neurosciences Cardiff, Cardiff, UK
| | - Nishi Patel
- Department of Psychiatry, Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Katrina Palad
- Department of Psychiatry, Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Oanh Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - James Guevara
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Khadije Jizi
- Sainte Justine Hospital Research Center, Montreal, QC, Canada
| | | | - Stephen W Scherer
- Department of Psychiatry, Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anne S Bassett
- Dalglish Family 22q Clinic and Toronto General Hospital Research Institute, University Health Network; Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Donna M McDonald-McGinn
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania; 22q and You Center, Clinical Genetics Center, and Section of Genetic Counseling, CHOP, Philadelphia, PA, USA
- Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy
| | - Raquel E Gur
- Lifespan Brain Institute of the Children's Hospital of Philadelphia (CHOP) and Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Schmock H, Stevenson MP, Hanebaum S, Vangkilde A, Rosengren A, Weinsheimer SM, Skovby F, Olesen C, Ullum H, Baaré WFC, Siebner HR, Didriksen M, Werge T, Olsen L, Jepsen JRM. Clinical segmentation in 22q11.2 deletion syndrome: Cognitive impairments and additional genetic load. J Psychiatr Res 2024; 177:153-161. [PMID: 39018710 DOI: 10.1016/j.jpsychires.2024.06.045] [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: 12/04/2022] [Revised: 01/29/2024] [Accepted: 06/17/2024] [Indexed: 07/19/2024]
Abstract
The 22q11.2 deletion syndrome (22q11.2DS) is associated with high psychiatric morbidity. However, large phenotypic heterogeneity hampers early detection of 22q11.2DS individuals at highest risk. Here, we investigated whether individuals with 22q11.2DS can be subdivided into clinically relevant subgroups based on their severity of cognitive impairments and whether such subgroups differ in polygenic risk. Using a cross-sectional design, we examined the number of lifetime psychiatric diagnoses and polygenic risk scores for schizophrenia in an unselected nationwide biobank cohort of individuals with 22q11.2DS (n = 183). Approximately 35% of this sample, aged 10-30 years, had a history with one or more psychiatric diagnosis. In a representative nested subgroup of 28 children and youth, we performed additional comprehensive cognitive evaluation and assessed psychiatric symptoms. Unsupervised hierarchical cluster analysis was performed to divide the subgroup of 22q11.2DS individuals, based on their performance on the cognitive testing battery. This produced two groups that did not differ in mean age or gender composition, but were characterized by low cognitive (LF) and high cognitive (HF) functional levels. The LF group, which had significantly lower global cognitive functioning scores, also displayed higher negative symptom scores; whereas, the HF group displayed lower rate of current psychiatric disorders than the LF group and the reminder of the biobank cohort. The polygenic risk score for schizophrenia was insignificantly lower for the low functioning group than for the high functioning group, after adjustment. Cognitive functioning may provide useful information on psychiatric risk.
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Affiliation(s)
- H Schmock
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - Matt P Stevenson
- Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, DK-2600 Glostrup, Copenhagen, Denmark
| | - S Hanebaum
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - A Vangkilde
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - A Rosengren
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - S M Weinsheimer
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - F Skovby
- Department of Clinical Genetics, Zealand University Hospital, DK-4000 Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, DK-2200 Copenhagen N, Denmark
| | - C Olesen
- Department of Pediatrics, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
| | - H Ullum
- Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - W F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark
| | - H R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, DK-2650 Hvidovre, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, DK-2600 Glostrup, Copenhagen, Denmark
| | - M Didriksen
- H. Lundbeck A/S, Ottiliavej 9, DK-2500 Valby, Denmark
| | - T Werge
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, DK-2200 Copenhagen N, Denmark
| | - L Olsen
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, DK-4000 Roskilde, Denmark
| | - J R M Jepsen
- Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, DK-2600 Glostrup, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, DK-2600 Glostrup, Copenhagen, Denmark.
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Kulikova K, Schneider M, McDonald McGinn DM, Dar S, Taler M, Schwartz-Lifshitz M, Eliez S, Gur RE, Gothelf D. The clinical course of individuals with 22q11.2 deletion syndrome converting to psychotic disorders: a long-term retrospective follow-up. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02469-9. [PMID: 38834873 DOI: 10.1007/s00787-024-02469-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 05/17/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This retrospective study aims to investigate the evolution and clinical course of psychotic disorders from three large international cohorts of individuals with 22q11.2 deletion syndrome (22q11.2DS) (Tel Aviv, Philadelphia, and Geneva). METHODS We followed 118 individuals with 22q11.2DS from several years before the onset to several years after the onset of psychotic disorders. Data from structured baseline assessment of psychiatric disorders, symptoms of prodrome, indicators and types of psychotic disorders were collected. Additionally, cognitive evaluation was conducted using the age-appropriate Wechsler Intelligence Scale. Electronic medical records were reviewed for medication usage, occupational status, living situation, and psychiatric hospitalizations. RESULTS At baseline evaluation, the most common psychiatric disorders were anxiety disorder (80%) and attention/deficit hyperactivity disorder (50%). The age of onset of prodromal symptoms and conversion to psychotic disorders were 18.6 ± 6.8 and 20.3 ± 7.2, respectively. The most common prodromal symptoms were exacerbation of anxiety symptoms and social isolation. Of the psychotic disorders, schizophrenia was the most common, occurring in 49% of cases. History of at least one psychiatric hospitalization was present in 43% of participants, and the number of psychiatric hospitalizations was 2.1 ± 1.4. Compared to the normalized chart, IQ scores in our cohort were lower after vs. before conversion to psychosis. Following conversion there was a decrease in the use of stimulants and antidepressants and an increase in antipsychotics use, and most individuals with 22q11.2DS were unemployed and lived with their parents. CONCLUSIONS Our results indicate that 22q11.2DS psychosis is like non-22q11.2DS in its course, symptoms, and cognitive and functional impairments.
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Affiliation(s)
- Katerina Kulikova
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- The Pediatric Molecular Psychiatry Laboratory Sheba, Tel Hashomer, Israel
- The Behavioural Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Donna M McDonald McGinn
- Division of Human Genetics, Department of Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
- Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy, Italy
| | - Shira Dar
- The Pediatric Molecular Psychiatry Laboratory Sheba, Tel Hashomer, Israel
| | - Michal Taler
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- The Pediatric Molecular Psychiatry Laboratory Sheba, Tel Hashomer, Israel
- The Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Maya Schwartz-Lifshitz
- The Behavioural Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
- The Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Stephan Eliez
- Developmental Imaging and Psychopathology lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
- Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Geneva, Switzerland
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Doron Gothelf
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
- The Behavioural Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
- The Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
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4
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Feller C, Ilen L, Eliez S, Schneider M. Loneliness in daily life: A comparison between youths with autism spectrum disorders and 22q11.2 deletion syndrome (22q11DS). Autism Res 2024. [PMID: 38828648 DOI: 10.1002/aur.3173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/20/2024] [Indexed: 06/05/2024]
Abstract
Loneliness is a negative emotional experience that can stem from a gap between desires and the reality of social relationships. It is also a predictor of mental health. Loneliness is therefore important to investigate in neurodevelopmental populations known for having difficulties in the social sphere. This co-registered study involved 48 youths with autism spectrum disorders (ASD), 54 youths with 22q11.2 deletion syndrome (22q11DS) and 65 typically developing youths (TD) aged 12-30. State loneliness was assessed with an ecological momentary assessment. Paper-pencil questionnaires assessing attitude toward aloneness, trait loneliness, and mental health, were completed by the youths and their caregivers. A comparable level of state loneliness between clinical groups and TD were found, with greater loneliness when alone than in a social context. Clinical groups showed a greater intra-individual variability. Both individuals with ASD and 22q11DS revealed a greater affinity toward being alone than TD, but only individuals with ASD reported greater trait loneliness. However, no significant association was found between attitude toward aloneness, trait and state loneliness. Emotional reactivity to loneliness was different between the clinical groups. Self-reported mental health only was associated with loneliness in the clinical groups. These results provide new insights into the understanding of loneliness in these clinical populations and have an impact on clinical care by highlighting the need to remain vigilant when encountering youths who report feeling lonely, and that these youths need to be supported in developing their social network, which appears to be a protective factor against loneliness.
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Affiliation(s)
- Clémence Feller
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Laura Ilen
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Pimenta LSE, de Mello CB, Benedetto LMD, Soares DCDQ, Kulikowski LD, Dantas AG, Melaragno MI, Kim CA. Neuropsychological Profile of 25 Brazilian Patients with 22q11.2 Deletion Syndrome: Effects of Clinical and Socioeconomic Variables. Genes (Basel) 2024; 15:595. [PMID: 38790224 PMCID: PMC11121403 DOI: 10.3390/genes15050595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
The 22q11.2 deletion syndrome (22q11.2DS) is associated with a heterogeneous neurocognitive phenotype, which includes psychiatric disorders. However, few studies have investigated the influence of socioeconomic variables on intellectual variability. The aim of this study was to investigate the cognitive profile of 25 patients, aged 7 to 32 years, with a typical ≈3 Mb 22q11.2 deletion, considering intellectual, adaptive, and neuropsychological functioning. Univariate linear regression analysis explored the influence of socioeconomic variables on intellectual quotient (IQ) and global adaptive behavior. Associations with relevant clinical conditions such as seizures, recurrent infections, and heart diseases were also considered. Results showed IQ scores ranging from 42 to 104. Communication, executive functions, attention, and visuoconstructive skills were the most impaired in the sample. The study found effects of access to quality education, family socioeconomic status (SES), and caregiver education level on IQ. Conversely, age at diagnosis and language delay were associated with outcomes in adaptive behavior. This characterization may be useful for better understanding the influence of social-environmental factors on the development of patients with 22q11.2 deletion syndrome, as well as for intervention processes aimed at improving their quality of life.
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Affiliation(s)
| | - Claudia Berlim de Mello
- Departament of Psychobiology, Universidade Federal de São Paulo, São Paulo 04024-002, Brazil;
| | | | - Diogo Cordeiro de Queiroz Soares
- Genetics Unit, Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.C.d.Q.S.); (L.D.K.); (C.A.K.)
| | - Leslie Domenici Kulikowski
- Genetics Unit, Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.C.d.Q.S.); (L.D.K.); (C.A.K.)
| | - Anelisa Gollo Dantas
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo 04023-062, Brazil; (A.G.D.); (M.I.M.)
| | - Maria Isabel Melaragno
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de São Paulo, São Paulo 04023-062, Brazil; (A.G.D.); (M.I.M.)
| | - Chong Ae Kim
- Genetics Unit, Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.C.d.Q.S.); (L.D.K.); (C.A.K.)
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6
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Sefik E, Guest RM, Aberizk K, Espana R, Goines K, Novacek DM, Murphy MM, Goldman-Yassen AE, Cubells JF, Ousley O, Li L, Shultz S, Walker EF, Mulle JG. Psychosis spectrum symptoms among individuals with schizophrenia-associated copy number variants and evidence of cerebellar correlates of symptom severity. Psychiatry Res 2024; 335:115867. [PMID: 38537595 DOI: 10.1016/j.psychres.2024.115867] [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: 09/21/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024]
Abstract
The 3q29 deletion (3q29Del) is a copy number variant (CNV) with one of the highest effect sizes for psychosis-risk (>40-fold). Systematic research offers avenues for elucidating mechanism; however, compared to CNVs like 22q11.2Del, 3q29Del remains understudied. Emerging findings indicate that posterior fossa abnormalities are common among carriers, but their clinical relevance is unclear. We report the first in-depth evaluation of psychotic symptoms in participants with 3q29Del (N=23), using the Structured Interview for Psychosis-Risk Syndromes, and compare this profile to 22q11.2Del (N=31) and healthy controls (N=279). We also explore correlations between psychotic symptoms and posterior fossa abnormalities. Cumulatively, 48% of the 3q29Del sample exhibited a psychotic disorder or attenuated positive symptoms, with a subset meeting criteria for clinical high-risk. 3q29Del had more severe ratings than controls on all domains and only exhibited less severe ratings than 22q11.2Del in negative symptoms; ratings demonstrated select sex differences but no domain-wise correlations with IQ. An inverse relationship was identified between positive symptoms and cerebellar cortex volume in 3q29Del, documenting the first clinically-relevant neuroanatomical connection in this syndrome. Our findings characterize the profile of psychotic symptoms in the largest 3q29Del sample reported to date, contrast with another high-impact CNV, and highlight cerebellar involvement in psychosis-risk.
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Affiliation(s)
- Esra Sefik
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, Atlanta, GA, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Katrina Aberizk
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Roberto Espana
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Katrina Goines
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Derek M Novacek
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; Desert Pacific Mental Illness, Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Melissa M Murphy
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Adam E Goldman-Yassen
- Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph F Cubells
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Opal Ousley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Longchuan Li
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Shultz
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Jennifer G Mulle
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA; Center for Advanced Biotechnology and Medicine, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
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7
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Latrèche C, Mancini V, Rochas V, Maeder J, Cantonas LM, Férat V, Schneider M, Michel CM, Eliez S. Using transcranial alternating current stimulation to enhance working memory skills in youths with 22q11.2 deletion syndrome: A randomized double-blind sham-controlled study. Psychiatry Res 2024; 335:115835. [PMID: 38460352 DOI: 10.1016/j.psychres.2024.115835] [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: 09/12/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
Abnormal cognitive development, particularly working memory (WM) deficits, is among the first apparent manifestations of psychosis. Yet, cognitive impairment only shows limited response to current pharmacological treatment. Alternative interventions to target cognition are highly needed in individuals at high risk for psychosis, like carriers of 22q11.2 deletion syndrome (22q11.2DS). Here we applied theta-tuned transcranial alternating current stimulation (tACS) between frontal and temporal regions during a visual WM task in 34 deletion carriers. We conducted a double-blind sham-controlled study over three consecutive days. The stimulation parameters were derived from individual structural MRI scan and HD-EEG data acquired at baseline (Day 1) to model current intensity and individual preferential theta peak. Participants were randomized to either sham or tACS (Days 2 and 3) and then completed a visual WM task and a control task. Our findings reveal that tACS was safe and well-tolerated among participants. We found a significantly increased accuracy in the visual WM but not the control task following tACS. Moreover, this enhancement in WM accuracy was greater after tACS than during tACS, indicating stronger offline effects than online effects. Our study therefore supports the application of repeated sessions of brain stimulation in 22q11.2DS.
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Affiliation(s)
- Caren Latrèche
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland.
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland
| | - Vincent Rochas
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland; Human Neuroscience Platform, Fondation Campus Biotech Geneva, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland
| | - Lucia M Cantonas
- Autism Brain and Behavior Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Victor Férat
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Developmental and Intellectual Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of Medicine, Switzerland
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8
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White LK, Hillman N, Ruparel K, Moore TM, Gallagher RS, McClellan EJ, Roalf DR, Scott JC, Calkins ME, McGinn DE, Giunta V, Tran O, Crowley TB, Zackai EH, Emanuel BS, McDonald-McGinn DM, Gur RE, Gur RC. Remote assessment of the Penn computerised neurocognitive battery in individuals with 22q11.2 deletion syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:369-376. [PMID: 38229473 DOI: 10.1111/jir.13115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Neurocognitive functioning is an integral phenotype of 22q11.2 deletion syndrome relating to severity of psychopathology and outcomes. A neurocognitive battery that could be administered remotely to assess multiple cognitive domains would be especially beneficial to research on rare genetic variants, where in-person assessment can be unavailable or burdensome. The current study compares in-person and remote assessments of the Penn computerised neurocognitive battery (CNB). METHODS Participants (mean age = 17.82, SD = 6.94 years; 48% female) completed the CNB either in-person at a laboratory (n = 222) or remotely (n = 162). RESULTS Results show that accuracy of CNB performance was equivalent across the two testing locations, while slight differences in speed were detected in 3 of the 11 tasks. CONCLUSIONS These findings suggest that the CNB can be used in remote settings to assess multiple neurocognitive domains.
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Affiliation(s)
- L K White
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - N Hillman
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - K Ruparel
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - T M Moore
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - R S Gallagher
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - E J McClellan
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - D R Roalf
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - J C Scott
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- VISN4 Mental Illness Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - M E Calkins
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - D E McGinn
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - V Giunta
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - O Tran
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - T B Crowley
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - E H Zackai
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B S Emanuel
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D M McDonald-McGinn
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy
| | - R E Gur
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - R C Gur
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
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9
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Genovese AC, Butler MG. Behavioral and Psychiatric Disorders in Syndromic Autism. Brain Sci 2024; 14:343. [PMID: 38671997 PMCID: PMC11048128 DOI: 10.3390/brainsci14040343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Syndromic autism refers to autism spectrum disorder diagnosed in the context of a known genetic syndrome. The specific manifestations of any one of these syndromic autisms are related to a clinically defined genetic syndrome that can be traced to certain genes and variants, genetic deletions, or duplications at the chromosome level. The genetic mutations or defects in single genes associated with these genetic disorders result in a significant elevation of risk for developing autism relative to the general population and are related to recurrence with inheritance patterns. Additionally, these syndromes are associated with typical behavioral characteristics or phenotypes as well as an increased risk for specific behavioral or psychiatric disorders and clinical findings. Knowledge of these associations helps guide clinicians in identifying potentially treatable conditions that can help to improve the lives of affected patients and their families.
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Affiliation(s)
- Ann C. Genovese
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS 66160, USA;
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10
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Smerconish S, Schmitt JE. Neuroanatomical Correlates of Cognitive Dysfunction in 22q11.2 Deletion Syndrome. Genes (Basel) 2024; 15:440. [PMID: 38674375 PMCID: PMC11050060 DOI: 10.3390/genes15040440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
22q11.2 Deletion Syndrome (22q11.2DS), the most common chromosomal microdeletion, presents as a heterogeneous phenotype characterized by an array of anatomical, behavioral, and cognitive abnormalities. Individuals with 22q11.2DS exhibit extensive cognitive deficits, both in overall intellectual capacity and focal challenges in executive functioning, attentional control, perceptual abilities, motor skills, verbal processing, as well as socioemotional operations. Heterogeneity is an intrinsic factor of the deletion's clinical manifestation in these cognitive domains. Structural imaging has identified significant changes in volume, thickness, and surface area. These alterations are closely linked and display region-specific variations with an overall increase in abnormalities following a rostral-caudal gradient. Despite the extensive literature developing around the neurocognitive and neuroanatomical profiles associated with 22q11.2DS, comparatively little research has addressed specific structure-function relationships between aberrant morphological features and deficient cognitive processes. The current review attempts to categorize these limited findings alongside comparisons to populations with phenotypic and structural similarities in order to answer to what degree structural findings can explain the characteristic neurocognitive deficits seen in individuals with 22q11.2DS. In integrating findings from structural neuroimaging and cognitive assessments, this review seeks to characterize structural changes associated with the broad neurocognitive challenges faced by individuals with 22q11.2DS.
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11
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Shin D, Kim CN, Ross J, Hennick KM, Wu SR, Paranjape N, Leonard R, Wang JC, Keefe MG, Pavlovic BJ, Donohue KC, Moreau C, Wigdor EM, Larson HH, Allen DE, Cadwell CR, Bhaduri A, Popova G, Bearden CE, Pollen AA, Jacquemont S, Sanders SJ, Haussler D, Wiita AP, Frost NA, Sohal VS, Nowakowski TJ. Thalamocortical organoids enable in vitro modeling of 22q11.2 microdeletion associated with neuropsychiatric disorders. Cell Stem Cell 2024; 31:421-432.e8. [PMID: 38382530 PMCID: PMC10939828 DOI: 10.1016/j.stem.2024.01.010] [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: 08/19/2022] [Revised: 12/14/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024]
Abstract
Thalamic dysfunction has been implicated in multiple psychiatric disorders. We sought to study the mechanisms by which abnormalities emerge in the context of the 22q11.2 microdeletion, which confers significant genetic risk for psychiatric disorders. We investigated early stages of human thalamus development using human pluripotent stem cell-derived organoids and show that the 22q11.2 microdeletion underlies widespread transcriptional dysregulation associated with psychiatric disorders in thalamic neurons and glia, including elevated expression of FOXP2. Using an organoid co-culture model, we demonstrate that the 22q11.2 microdeletion mediates an overgrowth of thalamic axons in a FOXP2-dependent manner. Finally, we identify ROBO2 as a candidate molecular mediator of the effects of FOXP2 overexpression on thalamic axon overgrowth. Together, our study suggests that early steps in thalamic development are dysregulated in a model of genetic risk for schizophrenia and contribute to neural phenotypes in 22q11.2 deletion syndrome.
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Affiliation(s)
- David Shin
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Chang N Kim
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jayden Ross
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Kelsey M Hennick
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Sih-Rong Wu
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Neha Paranjape
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Rachel Leonard
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jerrick C Wang
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Matthew G Keefe
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Bryan J Pavlovic
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Kevin C Donohue
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Clara Moreau
- Sainte Justine Research Center, University of Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Emilie M Wigdor
- Institute of Developmental and Regenerative Medicine, University of Oxford, Headington, Oxford OX3 7TY, UK
| | - H Hanh Larson
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Denise E Allen
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Cathryn R Cadwell
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Aparna Bhaduri
- Department of Biological Chemistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Galina Popova
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Carrie E Bearden
- Integrative Center for Neurogenetics, Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Alex A Pollen
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Sebastien Jacquemont
- Sainte Justine Research Center, University of Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada
| | - Stephan J Sanders
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Institute of Developmental and Regenerative Medicine, University of Oxford, Headington, Oxford OX3 7TY, UK
| | - David Haussler
- UC Santa Cruz Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95060, USA; Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA 95064, USA; Howard Hughes Medical Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Arun P Wiita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94107, USA; Chan Zuckerberg Biohub, San Francisco, CA 94158
| | - Nicholas A Frost
- Department of Neurology, University of Utah, Salt Lake City, UT 84108, USA
| | - Vikaas S Sohal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Tomasz J Nowakowski
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94158, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA; Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA 94158, USA.
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12
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Park J, Lee E, Cho G, Hwang H, Kim BG, Kim G, Joo YY, Cha J. Gene-environment pathways to cognitive intelligence and psychotic-like experiences in children. eLife 2024; 12:RP88117. [PMID: 38441539 PMCID: PMC10942586 DOI: 10.7554/elife.88117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced by genetic and environmental factors, is hypothesized to mediate the relationship between these factors and childhood PLEs. Using large-scale longitudinal data, we tested the relationships of genetic and environmental factors (such as familial and neighborhood environment) with cognitive intelligence and their relationships with current and future PLEs in children. We leveraged large-scale multimodal data of 6,602 children from the Adolescent Brain and Cognitive Development Study. Linear mixed model and a novel structural equation modeling (SEM) method that allows estimation of both components and factors were used to estimate the joint effects of cognitive phenotypes polygenic scores (PGSs), familial and neighborhood socioeconomic status (SES), and supportive environment on NIH Toolbox cognitive intelligence and PLEs. We adjusted for ethnicity (genetically defined), schizophrenia PGS, and additionally unobserved confounders (using computational confound modeling). Our findings indicate that lower cognitive intelligence and higher PLEs are significantly associated with lower PGSs for cognitive phenotypes, lower familial SES, lower neighborhood SES, and less supportive environments. Specifically, cognitive intelligence mediates the effects of these factors on PLEs, with supportive parenting and positive school environments showing the strongest impact on reducing PLEs. This study underscores the influence of genetic and environmental factors on PLEs through their effects on cognitive intelligence. Our findings have policy implications in that improving school and family environments and promoting local economic development may enhance cognitive and mental health in children.
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Affiliation(s)
- Junghoon Park
- Interdisciplinary Program in Artificial Intelligence, College of Engineering, Seoul National UniversitySeoulRepublic of Korea
| | - Eunji Lee
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Gyeongcheol Cho
- Department of Psychology, College of Arts and Sciences, The Ohio State UniversityColumbusUnited States
| | - Heungsun Hwang
- Department of Psychology, McGill UniversityMontréalCanada
| | - Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Yoonjung Yoonie Joo
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan UniversitySeoulRepublic of Korea
- Samsung Medical CenterSeoulRepublic of Korea
| | - Jiook Cha
- Interdisciplinary Program in Artificial Intelligence, College of Engineering, Seoul National UniversitySeoulRepublic of Korea
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National UniversitySeoulRepublic of Korea
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13
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Ge R, Ching CRK, Bassett AS, Kushan L, Antshel KM, van Amelsvoort T, Bakker G, Butcher NJ, Campbell LE, Chow EWC, Craig M, Crossley NA, Cunningham A, Daly E, Doherty JL, Durdle CA, Emanuel BS, Fiksinski A, Forsyth JK, Fremont W, Goodrich‐Hunsaker NJ, Gudbrandsen M, Gur RE, Jalbrzikowski M, Kates WR, Lin A, Linden DEJ, McCabe KL, McDonald‐McGinn D, Moss H, Murphy DG, Murphy KC, Owen MJ, Villalon‐Reina JE, Repetto GM, Roalf DR, Ruparel K, Schmitt JE, Schuite‐Koops S, Angkustsiri K, Sun D, Vajdi A, van den Bree M, Vorstman J, Thompson PM, Vila‐Rodriguez F, Bearden CE. Source-based morphometry reveals structural brain pattern abnormalities in 22q11.2 deletion syndrome. Hum Brain Mapp 2024; 45:e26553. [PMID: 38224541 PMCID: PMC10785196 DOI: 10.1002/hbm.26553] [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: 05/31/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 01/17/2024] Open
Abstract
22q11.2 deletion syndrome (22q11DS) is the most frequently occurring microdeletion in humans. It is associated with a significant impact on brain structure, including prominent reductions in gray matter volume (GMV), and neuropsychiatric manifestations, including cognitive impairment and psychosis. It is unclear whether GMV alterations in 22q11DS occur according to distinct structural patterns. Then, 783 participants (470 with 22q11DS: 51% females, mean age [SD] 18.2 [9.2]; and 313 typically developing [TD] controls: 46% females, mean age 18.0 [8.6]) from 13 datasets were included in the present study. We segmented structural T1-weighted brain MRI scans and extracted GMV images, which were then utilized in a novel source-based morphometry (SBM) pipeline (SS-Detect) to generate structural brain patterns (SBPs) that capture co-varying GMV. We investigated the impact of the 22q11.2 deletion, deletion size, intelligence quotient, and psychosis on the SBPs. Seventeen GMV-SBPs were derived, which provided spatial patterns of GMV covariance associated with a quantitative metric (i.e., loading score) for analysis. Patterns of topographically widespread differences in GMV covariance, including the cerebellum, discriminated individuals with 22q11DS from healthy controls. The spatial extents of the SBPs that revealed disparities between individuals with 22q11DS and controls were consistent with the findings of the univariate voxel-based morphometry analysis. Larger deletion size was associated with significantly lower GMV in frontal and occipital SBPs; however, history of psychosis did not show a strong relationship with these covariance patterns. 22q11DS is associated with distinct structural abnormalities captured by topographical GMV covariance patterns that include the cerebellum. Findings indicate that structural anomalies in 22q11DS manifest in a nonrandom manner and in distinct covarying anatomical patterns, rather than a diffuse global process. These SBP abnormalities converge with previously reported cortical surface area abnormalities, suggesting disturbances of early neurodevelopment as the most likely underlying mechanism.
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Affiliation(s)
- Ruiyang Ge
- Department of PsychiatryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Djavad Mowafaghian Centre for Brain HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Anne S. Bassett
- Clinical Genetics Research ProgramCentre for Addiction and Mental HealthTorontoOntarioCanada
- The Dalglish Family 22q Clinic, Department of Psychiatry and Division of Cardiology, Department of Medicine, and Toronto General Hospital Research InstituteUniversity Health NetworkTorontoOntarioCanada
- Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | | | | | - Geor Bakker
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtNetherlands
| | - Nancy J. Butcher
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Child Health Evaluative SciencesThe Hospital for Sick ChildrenTorontoOntarioCanada
| | | | - Eva W. C. Chow
- Clinical Genetics Research ProgramCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Michael Craig
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- National Autism UnitBethlem Royal HospitalBeckenhamUK
| | - Nicolas A. Crossley
- Department of PsychiatryPontificia Universidad Catolica de ChileSantiagoChile
| | - Adam Cunningham
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Eileen Daly
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Joanne L. Doherty
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
| | - Courtney A. Durdle
- Department of PediatricsUC Davis MIND InstituteDavisCaliforniaUSA
- Department of Psychological and Brain SciencesUC Santa BarbaraSanta BarbaraCaliforniaUSA
| | - Beverly S. Emanuel
- Division of Human GeneticsThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Pediatrics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Ania Fiksinski
- Department of Psychology and Department of Pediatrics, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtNetherlands
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNSMaastricht UniversityMaastrichtNetherlands
| | - Jennifer K. Forsyth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Department of PsychologyUniversity of WashingtonSeattleWashingtonUSA
| | - Wanda Fremont
- Department of Psychiatry and Behavioral Sciences State University of New YorkUpstate Medical University SyracuseNew YorkUSA
| | - Naomi J. Goodrich‐Hunsaker
- Department of PediatricsUC Davis MIND InstituteDavisCaliforniaUSA
- Department of NeurologyUniversity of UtahSalt Lake CityUtahUSA
| | - Maria Gudbrandsen
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- Centre for Research in Psychological Wellbeing (CREW), School of PsychologyUniversity of RoehamptonLondonUK
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of MedicineUniversity of Pennsylvania and Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Maria Jalbrzikowski
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
- Department of Psychiatry and Behavioral SciencesBoston Children's HospitalBostonMassachusettsUSA
| | - Wendy R. Kates
- Department of Psychiatry and Behavioral Sciences State University of New YorkUpstate Medical University SyracuseNew YorkUSA
| | - Amy Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Graduate Interdepartmental Program in NeuroscienceUCLA School of MedicineLos AngelesCaliforniaUSA
| | - David E. J. Linden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Kathryn L. McCabe
- School of PsychologyUniversity of NewcastleCallaghanAustralia
- Department of PediatricsUC Davis MIND InstituteDavisCaliforniaUSA
| | - Donna McDonald‐McGinn
- Department of Pediatrics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- 22q and You Center, Clinical Genetics Center, and Division of Human GeneticsThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Human Biology and Medical GeneticsSapienza UniversityRomeItaly
| | - Hayley Moss
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Declan G. Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic GroupSouth London and Maudsley Foundation NHS TrustLondonUK
| | - Kieran C. Murphy
- Department of PsychiatryRoyal College of Surgeons in IrelandDublinIreland
| | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | | | - Gabriela M. Repetto
- Centro de Genetica y Genomica, Facultad de MedicinaClinica Alemana Universidad del DesarrolloSantiagoChile
| | - David R. Roalf
- Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Kosha Ruparel
- Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - J. Eric Schmitt
- Department of Radiology and PsychiatryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Sanne Schuite‐Koops
- Department of PsychiatryUniversity Medical Center Groningen, Rijksuniversiteit GroningenGroningenNetherlands
| | | | - Daqiang Sun
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Ariana Vajdi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Kaiser Permanente Bernard J. Tyson School of Medicine PasadenaCaliforniaUSA
| | - Marianne van den Bree
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Jacob Vorstman
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Program in Genetics and Genome Biology, Research Institute, and Department of PsychiatryThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Paul M. Thompson
- Departments of Neurology, Psychiatry, Radiology, Engineering, Pediatrics and OphthalmologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Fidel Vila‐Rodriguez
- Department of PsychiatryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Djavad Mowafaghian Centre for Brain HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- School of Biomedical Engineering University of British Columbia VancouverBritish ColumbiaCanada
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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Gur R, Bearden C, Jacquemont S, Jizi K, Amelsvoort van T, van den Bree M, Vorstman J, Sebat J, Ruparel K, Gallagher R, Swillen A, McClellan E, White L, Crowley T, Giunta V, Kushan L, O'Hora K, Verbesselt J, Vandensande A, Vingerhoets C, van Haelst M, Hall J, Harwood J, Chawner S, Patel N, Palad K, Hong O, Guevara J, Martin CO, Bélanger AM, Scherer S, Bassett A, McDonald-McGinn D, Gur R. Neurocognitive Profiles of 22q11.2 and 16p11.2 Deletions and Duplications. RESEARCH SQUARE 2023:rs.3.rs-3393845. [PMID: 38234766 PMCID: PMC10793509 DOI: 10.21203/rs.3.rs-3393845/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Rare recurrent copy number variants (CNVs) at chromosomal loci 22q11.2 and 16p11.2 are among the most common rare genetic disorders associated with significant risk for neuropsychiatric disorders across the lifespan. Microdeletions and duplications in these loci are associated with neurocognitive deficits, yet there are few studies comparing these groups using the same measures. We address this gap in a prospective international collaboration applying the same computerized neurocognitive assessment. The Penn Computerized Neurocognitive Battery (CNB) was administered in a multi-site study on rare genomic disorders: 22q11.2 deletion (n = 397); 22q11.2 duplication (n = 77); 16p11.2 deletion (n = 94); and 16p11.2 duplication (n = 26). Domains examined include executive functions, episodic memory, complex cognition, social cognition, and sensori-motor speed. Accuracy and speed for each neurocognitive domain were included as dependent measures in a mixed-model repeated measures analysis, with locus (22q11.2, 16p11.2) and copy number (deletion/duplication) as grouping factors and neurocognitive domain as a repeated measures factor, with age and sex as covariates. We also examined correlation with IQ and site effects. We found that 22q11.2 deletions were associated with greater deficits in overall performance accuracy than 22q11.2 duplications, while 16p11.2 duplications were associated with greater deficits than 16p11.2 deletions. Duplications at both loci were associated with reduced speed. Performance profiles differed among the groups with particularly poor performance of 16p11.2 duplication on non-verbal reasoning and social cognition. Average accuracy on the CNB was moderately correlated with Full Scale IQ. No site effects were observed. Deletions and duplications of 22q11.2 and 16p11.2 have varied effects on neurocognition indicating locus specificity, with performance profiles differing among the groups. These profile differences can help inform mechanistic substrates to heterogeneity in presentation and outcome. Future studies could aim to link performance profiles to clinical features and brain function.
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Walkowiak D, Domaradzki J. Parental experiences and needs of caring for a child with 22q11.2 deletion syndrome. Orphanet J Rare Dis 2023; 18:379. [PMID: 38049864 PMCID: PMC10696670 DOI: 10.1186/s13023-023-02980-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/18/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND For a variety of reasons, raising a child with 22q11.2DS has significant psychosocial and financial repercussions for the family caregivers. Our aim was to identify and explain the expectations and concerns of Polish parents of 22q11.2DS children. An online survey was developed consisting of four sections: demographics, emotions experienced by caregivers while performing their duties, attitudes of the respondents about providing care, and finally different aspects of the caregivers' life satisfaction. The study was conducted with the support of the Polish 22q11 Association. RESULTS Forty-four caregivers of Polish origin completed the survey, all but one of whom were mothers. Thirty-four per cent (n = 15/44) declared full-time employment. According to 73% (n = 32/44) of those surveyed, the child's disease has not harmed their relationship with the partner. In spite of the fact that the median diagnosis time was 1.9 years (ranging from 0 to 12 years), the caregivers indicated that they had contacted on average 3.9 doctors before obtaining the right diagnosis (range 1-17). The Internet was the main source of information and knowledge about their child's disease for 93% of respondents (n = 41/44), while for 54% (n = 24/44) it was the association for people with 22q11DS. Only 26% rated as very good or good the support for caregivers offered by the central and local government or its agendas. The physicians' knowledge about 22q11DS was positively rated by 14% of respondents (n = 6/44). The most frequently chosen source of support for 66% of respondents (n = 29/44) turned out to be their families, and for 34% - a Facebook support group (n = 15/44). Asked how often they rated their quality of life (QoL) highly, none of our respondents chose the option "always", although 64% (28/44) gave the answer "often". CONCLUSION Our study is the first one in Poland to develop an online survey specifically for use with caregivers of paediatric patients with 22q11.2DS. Our respondents revealed that caring for 22q11.2 children entails a burden that extends far beyond clinical facets and has a significant impact on every dimension of the caregivers' lives, including their mental health, everyday activities, families, professional career and social lives. At the same time, caregivers are de facto left alone with the bureaucracy of the healthcare system.
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Affiliation(s)
- Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Przybyszewskiego 39, Poznań, 60-356, Poland.
| | - Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Poznań, Poland
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O’Hora KP, Kushan-Wells L, Schleifer CH, Cruz S, Hoftman GD, Jalbrzikowski M, Gur RE, Gur RC, Bearden CE. Distinct neurocognitive profiles and clinical phenotypes associated with copy number variation at the 22q11.2 locus. Autism Res 2023; 16:2247-2262. [PMID: 37997544 PMCID: PMC10872774 DOI: 10.1002/aur.3049] [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: 03/13/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
Rare genetic variants that confer large effects on neurodevelopment and behavioral phenotypes can reveal novel gene-brain-behavior relationships relevant to autism. Copy number variation at the 22q11.2 locus offer one compelling example, as both the 22q11.2 deletion (22qDel) and duplication (22qDup) confer increased likelihood of autism spectrum disorders (ASD) and cognitive deficits, but only 22qDel confers increased psychosis risk. Here, we used the Penn Computerized Neurocognitive Battery (Penn-CNB) to characterized neurocognitive profiles of 126 individuals: 55 22qDel carriers (MAge = 19.2 years, 49.1% male), 30 22qDup carriers (MAge = 17.3 years, 53.3% male), and 41 typically developing (TD) subjects (MAge = 17.3 years, 39.0% male). We performed linear mixed models to assess group differences in overall neurocognitive profiles, domain scores, and individual test scores. We found all three groups exhibited distinct overall neurocognitive profiles. 22qDel and 22qDup carriers showed significant accuracy deficits across all domains relative to controls (episodic memory, executive function, complex cognition, social cognition, and sensorimotor speed), with 22qDel carriers exhibiting more severe accuracy deficits, particularly in episodic memory. However, 22qDup carriers generally showed greater slowing than 22qDel carriers. Notably, slower social cognition speed was uniquely associated with increased global psychopathology and poorer psychosocial functioning in 22qDup. Compared to TD, 22q11.2 copy number variants (CNV) carriers failed to show age-associated improvements in multiple cognitive domains. Exploratory analyses revealed 22q11.2 CNV carriers with ASD exhibited differential neurocognitive profiles, based on 22q11.2 copy number. These results suggest that there are distinct neurocognitive profiles associated with either a loss or gain of genomic material at the 22q11.2 locus.
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Affiliation(s)
- Kathleen P. O’Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Charles H. Schleifer
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Shayne Cruz
- College of Natural and Agricultural Science, University of California, Riverside, CA, USA
| | - Gil D. Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
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Tadros S, Burns SO. Transition of care in inborn errors of immunity. Curr Opin Allergy Clin Immunol 2023; 23:455-460. [PMID: 37797181 PMCID: PMC10621636 DOI: 10.1097/aci.0000000000000948] [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: 10/07/2023]
Abstract
PURPOSE OF REVIEW This review outlines the principles of transition, summarizes current information about transition practices in inborn errors of immunity (IEI) and highlights general and specific considerations for transition of patients with these conditions. RECENT FINDINGS Recent surveys demonstrate the variability in access to and transition practices in IEI. Key challenges of transition in IEI from the perspective of healthcare professionals include lack of adult subspecialists, lack of access to holistic care and fragmentation of adult services. Limited research focused on IEI patient and carer perspectives highlight information gaps, poor coordination and difficulty adapting to adult healthcare structures as important challenges for smooth transition. SUMMARY Local policies and practices for transition in IEI are highly variable with limited assessment of outcomes or patient experience. There is a need for IEI-focused transition research and for development of national and international consensus statements to guide improved transition in IEI.
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Affiliation(s)
- Susan Tadros
- Department of Immunology, Royal Free London NHS Foundation Trust
- University College London Institute of Immunity and Transplantation, London, UK
| | - Siobhan O. Burns
- Department of Immunology, Royal Free London NHS Foundation Trust
- University College London Institute of Immunity and Transplantation, London, UK
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Modasi J, Khachadourian V, O'Hora K, Kushan L, Slavich GM, Shields GS, Velthorst E, Bearden CE. Associations between acute and chronic lifetime stressors and psychosis-risk symptoms in individuals with 22q11.2 copy number variants. Psychol Med 2023; 53:7222-7231. [PMID: 37078394 PMCID: PMC10719673 DOI: 10.1017/s0033291723000740] [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: 07/21/2022] [Revised: 02/28/2023] [Accepted: 03/06/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND The 22q11.2 deletion (22q11Del) is among the strongest known genetic risk factors for psychosis. Stress, a known risk factor for psychosis in the general population, has seldom been studied in 22q11Del. We investigated how lifetime stressors related to symptomatic outcomes in patients with 22q11Del. We also explored this association in individuals with 22q11.2 duplications (22q11Dup), which may be potentially protective against psychosis. METHOD One hundred individuals (46 with 22q11Del, 30 with 22q11Dup, and 24 healthy controls; Mage = 17.30 years±10.15) were included. Logistic models were used to examine cross-sectional associations between lifetime acute and chronic stressors (severity and count) and the presence (score ⩾3) of positive, negative, and general symptoms, assessed via the Structured Interview for Psychosis-risk Syndromes (SIPS). RESULTS The 22q11Dup group reported the greatest number and severity of acute lifetime stressors, but did not differ from 22q11Del in chronic stressor count or severity. Lifetime chronic and acute stressors were uniquely associated with positive symptoms in 22q11Del (chronic count: odds ratio [OR] = 2.35, p = 0.02; chronic severity: OR = 1.88, p = 0.03; acute count: OR = 1.78, p = 0.03), but not with negative or general symptoms (ps > 0.05). CONCLUSION Findings suggest that stress may play a role in psychotic symptoms in 22q1Del, while the 22q11Dup CNV appears protective against psychotic symptoms despite higher rates of stressors. Interventions that mitigate effects of stressors in 22qDel may reduce the odds of psychosis in this group. Prospective longitudinal research is needed to replicate these findings.
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Affiliation(s)
- Jasmine Modasi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vahe Khachadourian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kathleen O'Hora
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Interdepartmental Program for Neuroscience, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
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Frascarelli M, Accinni T, Buzzanca A, Carlone L, Ghezzi F, Moschillo A, Kotzalidis GD, Bucci P, Giordano GM, Fanella M, Di Bonaventura C, Putotto C, Marino B, Pasquini M, Biondi M, Di Fabio F. Social cognition and real-life functioning in patient samples with 22q11.2 deletion syndrome with or without psychosis, compared to a large sample of patients with schizophrenia only and healthy controls. J Neuropsychol 2023; 17:564-583. [PMID: 37159847 DOI: 10.1111/jnp.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
Patients with the 22q11.2 deletion syndrome (DS) show an increased risk of developing a psychotic illness lifetime. 22q11.2DS may represent a reliable model for studying the neurobiological underpinnings of schizophrenia. The study of social inference abilities in a genetic condition at high risk for psychosis, like 22q11.2DS, may shed light on the relationships between neurocognitive processes and patients' daily general functioning. The study sample consisted of 1736 participants, divided into four groups: 22q11.2DS patients with diagnosis of psychotic disorder (DEL SCZ, N = 20); 22q11.2DS subjects with no diagnosis of psychosis (DEL, N = 43); patients diagnosed with schizophrenia without 22q11.2DS (SCZ, N = 893); and healthy controls (HC, N = 780). Social cognition was assessed through The Awareness of Social Inference Test (TASIT) and general functioning through the Specific Levels of Functioning (SLoF) scale. We analysed data through regression analysis. The SCZ and DEL groups had similar levels of global functioning; they both had significantly lower SLoF Total scores than HC (p < .001); the DEL SCZ group showed significantly lower scores compared to the other groups (SCZ, p = .004; DEL, p = .003; HC, p < .001). A significant deficit in social cognition was observed in the three clinical groups. In the DEL SCZ and SCZ groups, TASIT scores significantly predicted global functioning (p < .05). Our findings of social cognition deficit in psychosis-prone patients point to the possible future adoption of rehabilitation programmes, like Social Skills Training and Cognitive Remediation, during premorbid stages of psychosis.
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Affiliation(s)
| | - Tommaso Accinni
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | - Luca Carlone
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | | | - Georgios D Kotzalidis
- Department of Human Neurosciences, Mental Health and Sensory Organs, Sapienza University, Rome, Italy
| | - Paola Bucci
- Department of Psychiatry, Campania University "Luigi Vanvitelli", Naples, Italy
| | | | - Martina Fanella
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | | | - Bruno Marino
- Department of Paediatrics, Sapienza University, Rome, Italy
| | | | - Massimo Biondi
- Department of Neurosciences, Sapienza University, Rome, Italy
| | - Fabio Di Fabio
- Department of Neurosciences, Sapienza University, Rome, Italy
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20
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Latrèche C, Maeder J, Mancini V, Bortolin K, Schneider M, Eliez S. Altered developmental trajectories of verbal learning skills in 22q11.2DS: associations with hippocampal development and psychosis. Psychol Med 2023; 53:4923-4932. [PMID: 35775360 PMCID: PMC10476015 DOI: 10.1017/s0033291722001842] [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: 10/12/2021] [Revised: 03/02/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The cognitive profile in 22q11.2 deletion syndrome (22q11.2DS) is often characterized by a discrepancy between nonverbal vs. verbal reasoning skills, in favor of the latter skills. This dissociation has also been observed in memory, with verbal learning skills described as a relative strength. Yet the development of these skills is still to be investigated. We thus aimed to explore verbal learning longitudinally. Furthermore, we explored verbal learning and its respective associations with hippocampal alterations and psychosis, which remain largely unknown despite their high prevalence in 22q11.2DS. METHODS In total, 332 individuals (173 with 22q11.2DS) aged 5-30 years completed a verbal-paired associates task. Mixed-models regression analyses were conducted to explore developmental trajectories with threefold objectives. First, verbal learning and retention trajectories were compared between 22q11.2DS vs. HC. Second, we examined hippocampal volume development in 22q11.2DS participants with lower vs. higher verbal learning performance. Third, we explored verbal learning trajectories in 22q11.2DS participants with vs. without positive psychotic symptoms and with vs. without a psychotic spectrum disorder (PSD). RESULTS Our findings first reveal lower verbal learning performance in 22q11.2DS, with a developmental plateau emerging from adolescence. Second, participants with lower verbal learning scores displayed a reduced left hippocampal tail volume. Third, participants with PSD showed a deterioration of verbal learning performance, independently of verbal reasoning skills. CONCLUSION Our study challenges the current view of preserved verbal learning skills in 22q11.2DS and highlights associations with specific hippocampal alterations. We further identify verbal learning as a novel cognitive marker for psychosis in 22q11.2DS.
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Affiliation(s)
- Caren Latrèche
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Karin Bortolin
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Department of Neurosciences, KU Leuven, Center for Contextual Psychiatry, Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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21
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Francisco AA, Foxe JJ, Molholm S. Event-related potential (ERP) markers of 22q11.2 deletion syndrome and associated psychosis. J Neurodev Disord 2023; 15:19. [PMID: 37328766 PMCID: PMC10273715 DOI: 10.1186/s11689-023-09487-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 06/07/2023] [Indexed: 06/18/2023] Open
Abstract
22q11.2 deletion syndrome (22q11.2DS) is a multisystemic disorder characterized by a wide range of clinical features, ranging from life-threatening to less severe conditions. One-third of individuals with the deletion live with mild to moderate intellectual disability; approximately 60% meet criteria for at least one psychiatric condition.22q11.2DS has become an important model for several medical, developmental, and psychiatric disorders. We have been particularly interested in understanding the risk for psychosis in this population: Approximately 30% of the individuals with the deletion go on to develop schizophrenia. The characterization of cognitive and neural differences between those individuals who develop schizophrenia and those who do not, despite being at genetic risk, holds important promise in what pertains to the clarification of paths to disease and to the development of tools for early identification and intervention.Here, we review our previous event-related potential (ERP) findings as potential markers for 22q11.2DS and the associated risk for psychosis, while discussing others' work. We focus on auditory processing (auditory-evoked potentials, auditory adaptation, and auditory sensory memory), visual processing (visual-evoked potentials and visual adaptation), and inhibition and error monitoring.The findings discussed suggest basic mechanistic and disease process effects on neural processing in 22q11.2DS that are present in both early sensory and later cognitive processing, with possible implications for phenotype. In early sensory processes, both during auditory and visual processing, two mechanisms that impact neural responses in opposite ways seem to coexist-one related to the deletion, which increases brain responses; another linked to psychosis, decreasing neural activity. Later, higher-order cognitive processes may be equally relevant as markers for psychosis. More specifically, we argue that components related to error monitoring may hold particular promise in the study of risk for schizophrenia in the general population.
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Affiliation(s)
- Ana A Francisco
- Department of Pediatrics, The Cognitive Neurophysiology Laboratory, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - John J Foxe
- Department of Pediatrics, The Cognitive Neurophysiology Laboratory, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neuroscience, Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Neuroscience, The Frederick J. and Marion A, Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monde Institute for Neuroscience, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
| | - Sophie Molholm
- Department of Pediatrics, The Cognitive Neurophysiology Laboratory, Albert Einstein College of Medicine, Bronx, NY, USA.
- Department of Neuroscience, Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA.
- Department of Neuroscience, The Frederick J. and Marion A, Schindler Cognitive Neurophysiology Laboratory, The Ernest J. Del Monde Institute for Neuroscience, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA.
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22
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Chawner SJRA, Paine AL, Dunn MJ, Walsh A, Sloane P, Thomas M, Evans A, Hopkins‐Jones L, Struik S, Hall J, Erichsen JT, Leekam SR, Owen MJ, Hay D, van den Bree MBM. Neurodevelopmental dimensional assessment of young children at high genomic risk of neuropsychiatric conditions. JCPP ADVANCES 2023; 3:e12162. [PMID: 37753151 PMCID: PMC10519742 DOI: 10.1002/jcv2.12162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/13/2023] [Indexed: 09/28/2023] Open
Abstract
Background Individuals with 22q11.2 deletion are at considerably increased risk of neurodevelopmental and psychiatric conditions. There have been very few studies investigating how this risk manifests in early childhood and what factors may underlie developmental variability. Insights into this can elucidate transdiagnostic markers of risk that may underlie later development of neuropsychiatric outcomes. Methods Thirty two children with 22q11.2 Deletion Syndrome (22q11.2DS) (mean age = 4.1 [SD = 1.2] years) and 12 sibling controls (mean age = 4.1 [SD = 1.5] years) underwent in-depth dimensional phenotyping across several developmental domains selected as being potential early indicators of neurodevelopmental and psychiatric liability. Comparisons were conducted of the dimensional developmental phenotype of 22q11.2DS and sibling controls. For autistic traits, both parents and children were phenotyped using the Social Responsiveness Scale. Results Young children with 22q11.2DS exhibited large impairments (Hedge's g ≥ 0.8) across a range of developmental domains relative to sibling controls, as well as high rates of transdiagnostic neurodevelopmental and psychiatric traits. Cluster analysis revealed a subgroup of children with 22q11.2DS (n = 16; 53%) in whom neurodevelopmental and psychiatric liability was particularly increased and who differed from other children with 22q11.2DS and non-carrier siblings. Exploratory analyses revealed that early motor and sleep impairments indexed liability for neurodevelopmental and psychiatric outcomes. Maternal autism trait scores were predictive of autism traits in children with 22q11.2DS (intraclass correlation coefficients = 0.47, p = 0.046, n = 31). Conclusions Although psychiatric conditions typically emerge later in adolescence and adulthood in 22q11.2DS, our exploratory study was able to identify a range of early risk indicators. Furthermore, findings indicate the presence of a subgroup who appeared to have increased neurodevelopmental and psychiatric liability. Our findings highlight the scope for future studies of early risk mechanisms and early intervention within this high genetic risk patient group.
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Affiliation(s)
- Samuel J. R. A. Chawner
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Cardiff University Centre for Human Developmental ScienceSchool of PsychologyCardiff UniversityCardiffUK
| | - Amy L. Paine
- Cardiff University Centre for Human Developmental ScienceSchool of PsychologyCardiff UniversityCardiffUK
| | - Matt J. Dunn
- School of Optometry and Vision SciencesCardiff UniversityCardiffUK
| | - Alice Walsh
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Poppy Sloane
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Megan Thomas
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Alexandra Evans
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Lucinda Hopkins‐Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Siske Struik
- Immunodeficiency Centre for WalesUniversity Hospital of WalesCardiffUK
| | - Jeremy Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | | | - Susan R. Leekam
- Cardiff University Centre for Human Developmental ScienceSchool of PsychologyCardiff UniversityCardiffUK
| | - Michael J. Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
| | - Dale Hay
- Cardiff University Centre for Human Developmental ScienceSchool of PsychologyCardiff UniversityCardiffUK
| | - Marianne B. M. van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
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23
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O’Hora KP, Kushan-Wells L, Hoftman GD, Jalbrzikowski M, Gur RC, Gur R, Bearden CE. Distinct Neurocognitive Profiles and Clinical Phenotypes Associated with Copy Number Variation at the 22q11.2 Locus. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.12.23289905. [PMID: 37292882 PMCID: PMC10246073 DOI: 10.1101/2023.05.12.23289905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Rare genetic variants that confer large effects on neurodevelopment and behavioral phenotypes can reveal novel gene-brain-behavior relationships relevant to autism. Copy number variation at the 22q11.2 locus offer one compelling example, as both the 22q11.2 deletion (22qDel) and duplication (22qDup) confer increased likelihood of autism spectrum disorders (ASD) and cognitive deficits, but only 22qDel confers increased psychosis risk. Here, we used the Penn Computerized Neurocognitive Battery (Penn-CNB) to characterized neurocognitive profiles of 126 individuals: 55 22qDel carriers (MAge=19.2 years, 49.1% male), 30 22qDup carriers (MAge=17.3 years, 53.3 % male), and 41 typically developing (TD) subjects (MAge=17.3 years, 39.0 % male). We performed linear mixed models to assess group differences in overall neurocognitive profiles, domain scores, and individual test scores. We found all three groups exhibited distinct overall neurocognitive profiles. 22qDel and 22qDup carriers showed significant accuracy deficits across all domains relative to controls (Episodic Memory, Executive Function, Complex Cognition, Social Cognition, and Sensorimotor Speed), with 22qDel carriers exhibiting more severe accuracy deficits, particularly in Episodic Memory. However, 22qDup carriers generally showed greater slowing than 22qDel carriers. Notably, slower social cognition speed was uniquely associated with increased global psychopathology and poorer psychosocial functioning in 22qDup. Compared to TD, 22q11.2 CNV carriers failed to show age-associated improvements in multiple cognitive domains. Exploratory analyses revealed 22q11.2 CNV carriers with ASD exhibited differential neurocognitive profiles, based on 22q11.2 copy number. These results suggest that there are distinct neurocognitive profiles associated with either a loss or gain of genomic material at the 22q11.2 locus.
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Affiliation(s)
- Kathleen P. O’Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Gil D. Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
| | - Raquel C. Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Ruben Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
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24
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Mollon J, Almasy L, Jacquemont S, Glahn DC. The contribution of copy number variants to psychiatric symptoms and cognitive ability. Mol Psychiatry 2023; 28:1480-1493. [PMID: 36737482 PMCID: PMC10213133 DOI: 10.1038/s41380-023-01978-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
Copy number variants (CNVs) are deletions and duplications of DNA sequence. The most frequently studied CNVs, which are described in this review, are recurrent CNVs that occur in the same locations on the genome. These CNVs have been strongly implicated in neurodevelopmental disorders, namely autism spectrum disorder (ASD), intellectual disability (ID), and developmental delay (DD), but also in schizophrenia. More recent work has also shown that CNVs increase risk for other psychiatric disorders, namely, depression, bipolar disorder, and post-traumatic stress disorder. Many of the same CNVs are implicated across all of these disorders, and these neuropsychiatric CNVs are also associated with cognitive ability in the general population, as well as with structural and functional brain alterations. Neuropsychiatric CNVs also show incomplete penetrance, such that carriers do not always develop any psychiatric disorder, and may show only mild symptoms, if any. Variable expressivity, whereby the same CNVs are associated with many different phenotypes of varied severity, also points to highly complex mechanisms underlying disease risk in CNV carriers. Comprehensive and longitudinal phenotyping studies of individual CNVs have provided initial insights into these mechanisms. However, more work is needed to estimate and predict the effect of non-recurrent, ultra-rare CNVs, which also contribute to psychiatric and cognitive outcomes. Moreover, delineating the broader phenotypic landscape of neuropsychiatric CNVs in both clinical and general population cohorts may also offer important mechanistic insights.
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Affiliation(s)
- Josephine Mollon
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Sebastien Jacquemont
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
- Center Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC, Canada
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
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25
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Hashimoto Y, Greene C, Munnich A, Campbell M. The CLDN5 gene at the blood-brain barrier in health and disease. Fluids Barriers CNS 2023; 20:22. [PMID: 36978081 PMCID: PMC10044825 DOI: 10.1186/s12987-023-00424-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
The CLDN5 gene encodes claudin-5 (CLDN-5) that is expressed in endothelial cells and forms tight junctions which limit the passive diffusions of ions and solutes. The blood-brain barrier (BBB), composed of brain microvascular endothelial cells and associated pericytes and end-feet of astrocytes, is a physical and biological barrier to maintain the brain microenvironment. The expression of CLDN-5 is tightly regulated in the BBB by other junctional proteins in endothelial cells and by supports from pericytes and astrocytes. The most recent literature clearly shows a compromised BBB with a decline in CLDN-5 expression increasing the risks of developing neuropsychiatric disorders, epilepsy, brain calcification and dementia. The purpose of this review is to summarize the known diseases associated with CLDN-5 expression and function. In the first part of this review, we highlight the recent understanding of how other junctional proteins as well as pericytes and astrocytes maintain CLDN-5 expression in brain endothelial cells. We detail some drugs that can enhance these supports and are being developed or currently in use to treat diseases associated with CLDN-5 decline. We then summarise mutagenesis-based studies which have facilitated a better understanding of the physiological role of the CLDN-5 protein at the BBB and have demonstrated the functional consequences of a recently identified pathogenic CLDN-5 missense mutation from patients with alternating hemiplegia of childhood. This mutation is the first gain-of-function mutation identified in the CLDN gene family with all others representing loss-of-function mutations resulting in mis-localization of CLDN protein and/or attenuated barrier function. Finally, we summarize recent reports about the dosage-dependent effect of CLDN-5 expression on the development of neurological diseases in mice and discuss what cellular supports for CLDN-5 regulation are compromised in the BBB in human diseases.
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Affiliation(s)
- Yosuke Hashimoto
- Trinity College Dublin, Smurfit Institute of Genetics, Dublin, D02 VF25, Ireland.
| | - Chris Greene
- Trinity College Dublin, Smurfit Institute of Genetics, Dublin, D02 VF25, Ireland
| | - Arnold Munnich
- Institut Imagine, INSERM UMR1163, Université Paris Cité, Paris, F-75015, France
- Departments of Pediatric Neurology and Medical Genetics, Hospital Necker Enfants Malades, Université Paris Cité, Paris, F-75015, France
| | - Matthew Campbell
- Trinity College Dublin, Smurfit Institute of Genetics, Dublin, D02 VF25, Ireland.
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26
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Óskarsdóttir S, Boot E, Crowley TB, Loo JCY, Arganbright JM, Armando M, Baylis AL, Breetvelt EJ, Castelein RM, Chadehumbe M, Cielo CM, de Reuver S, Eliez S, Fiksinski AM, Forbes BJ, Gallagher E, Hopkins SE, Jackson OA, Levitz-Katz L, Klingberg G, Lambert MP, Marino B, Mascarenhas MR, Moldenhauer J, Moss EM, Nowakowska BA, Orchanian-Cheff A, Putotto C, Repetto GM, Schindewolf E, Schneider M, Solot CB, Sullivan KE, Swillen A, Unolt M, Van Batavia JP, Vingerhoets C, Vorstman J, Bassett AS, McDonald-McGinn DM. Updated clinical practice recommendations for managing children with 22q11.2 deletion syndrome. Genet Med 2023; 25:100338. [PMID: 36729053 DOI: 10.1016/j.gim.2022.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 02/03/2023] Open
Abstract
This review aimed to update the clinical practice guidelines for managing children and adolescents with 22q11.2 deletion syndrome (22q11.2DS). The 22q11.2 Society, the international scientific organization studying chromosome 22q11.2 differences and related conditions, recruited expert clinicians worldwide to revise the original 2011 pediatric clinical practice guidelines in a stepwise process: (1) a systematic literature search (1992-2021), (2) study selection and data extraction by clinical experts from 9 different countries, covering 24 subspecialties, and (3) creation of a draft consensus document based on the literature and expert opinion, which was further shaped by survey results from family support organizations regarding perceived needs. Of 2441 22q11.2DS-relevant publications initially identified, 2344 received full-text reviews, including 1545 meeting criteria for potential relevance to clinical care of children and adolescents. Informed by the available literature, recommendations were formulated. Given evidence base limitations, multidisciplinary recommendations represent consensus statements of good practice for this evolving field. These recommendations provide contemporary guidance for evaluation, surveillance, and management of the many 22q11.2DS-associated physical, cognitive, behavioral, and psychiatric morbidities while addressing important genetic counseling and psychosocial issues.
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Affiliation(s)
- Sólveig Óskarsdóttir
- Department of Pediatric Rheumatology and Immunology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Erik Boot
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
| | - Terrence Blaine Crowley
- The 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Joanne C Y Loo
- The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada
| | - Jill M Arganbright
- Department of Otorhinolaryngology, Children's Mercy Hospital and University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Marco Armando
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Adriane L Baylis
- Department of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Elemi J Breetvelt
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Genetics & Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - René M Castelein
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Madeline Chadehumbe
- Division of Neurology, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Christopher M Cielo
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Pulmonary and Sleep Medicine, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Steven de Reuver
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stephan Eliez
- Fondation Pôle Autisme, Department of Psychiatry, Geneva University School of Medecine, Geneva, Switzerland
| | - Ania M Fiksinski
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; Department of Pediatric Psychology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Brian J Forbes
- Division of Ophthalmology, The 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Emily Gallagher
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA
| | - Sarah E Hopkins
- Division of Neurology, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Oksana A Jackson
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Cleft Lip and Palate Program, Division of Plastic, Reconstructive and Oral Surgery, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Lorraine Levitz-Katz
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Endocrinology and Diabetes, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Michele P Lambert
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Hematology, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Bruno Marino
- Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Maria R Mascarenhas
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Gastroenterology, Hepatology and Nutrition, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Julie Moldenhauer
- Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, 22q and You Center, The Children's Hospital of Philadelphia, Philadelphia, PA; Departments of Obstetrics and Gynecology and Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | | | - Ani Orchanian-Cheff
- Library and Information Services and The Institute of Education Research (TIER), University Health Network, Toronto, Ontario, Canada
| | - Carolina Putotto
- Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Gabriela M Repetto
- Rare Diseases Program, Institute for Sciences and Innovation in Medicine, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Erica Schindewolf
- Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, 22q and You Center, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Cynthia B Solot
- Department of Speech-Language Pathology and Center for Childhood Communication, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kathleen E Sullivan
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Allergy and Immunology, 22q and You Center, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ann Swillen
- Center for Human Genetics, University Hospital UZ Leuven, and Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Marta Unolt
- Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy; Department of Pediatric Cardiology and Cardiac Surgery, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Jason P Van Batavia
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Urology, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Claudia Vingerhoets
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada; Genetics & Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne S Bassett
- The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Genetics & Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Donna M McDonald-McGinn
- The 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy.
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27
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Boot E, Óskarsdóttir S, Loo JCY, Crowley TB, Orchanian-Cheff A, Andrade DM, Arganbright JM, Castelein RM, Cserti-Gazdewich C, de Reuver S, Fiksinski AM, Klingberg G, Lang AE, Mascarenhas MR, Moss EM, Nowakowska BA, Oechslin E, Palmer L, Repetto GM, Reyes NGD, Schneider M, Silversides C, Sullivan KE, Swillen A, van Amelsvoort TAMJ, Van Batavia JP, Vingerhoets C, McDonald-McGinn DM, Bassett AS. Updated clinical practice recommendations for managing adults with 22q11.2 deletion syndrome. Genet Med 2023; 25:100344. [PMID: 36729052 DOI: 10.1016/j.gim.2022.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 02/03/2023] Open
Abstract
This review aimed to update the clinical practice guidelines for managing adults with 22q11.2 deletion syndrome (22q11.2DS). The 22q11.2 Society recruited expert clinicians worldwide to revise the original clinical practice guidelines for adults in a stepwise process according to best practices: (1) a systematic literature search (1992-2021), (2) study selection and synthesis by clinical experts from 8 countries, covering 24 subspecialties, and (3) formulation of consensus recommendations based on the literature and further shaped by patient advocate survey results. Of 2441 22q11.2DS-relevant publications initially identified, 2344 received full-text review, with 2318 meeting inclusion criteria (clinical care relevance to 22q11.2DS) including 894 with potential relevance to adults. The evidence base remains limited. Thus multidisciplinary recommendations represent statements of current best practice for this evolving field, informed by the available literature. These recommendations provide guidance for the recognition, evaluation, surveillance, and management of the many emerging and chronic 22q11.2DS-associated multisystem morbidities relevant to adults. The recommendations also address key genetic counseling and psychosocial considerations for the increasing numbers of adults with this complex condition.
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Affiliation(s)
- Erik Boot
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
| | - Sólveig Óskarsdóttir
- Department of Pediatric Rheumatology and Immunology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Joanne C Y Loo
- The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Terrence Blaine Crowley
- 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ani Orchanian-Cheff
- Library and Information Services, and The Institute of Education Research (TIER), University Health Network, Toronto, Ontario, Canada
| | - Danielle M Andrade
- Adult Genetic Epilepsy Program, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Jill M Arganbright
- Division of Otolaryngology, Children's Mercy Hospital and University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - René M Castelein
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Steven de Reuver
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ania M Fiksinski
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; Department of Pediatric Psychology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | | | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Maria R Mascarenhas
- Division of Gastroenterology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | | | | | - Erwin Oechslin
- Toronto Adult Congenital Heart Disease Program, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Lisa Palmer
- The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Gabriela M Repetto
- Rare Diseases Program, Institute for Sciences and Innovation in Medicine, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Nikolai Gil D Reyes
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Candice Silversides
- Toronto ACHD Program, Mount Sinai and Toronto General Hospitals, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen E Sullivan
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Division of Allergy and Immunology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ann Swillen
- Center for Human Genetics, University Hospital UZ Leuven, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | | | - Jason P Van Batavia
- Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Division of Urology and 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Claudia Vingerhoets
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Donna M McDonald-McGinn
- 22q and You Center, Clinical Genetics Center, and Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA; Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy.
| | - Anne S Bassett
- The Dalglish Family 22q Clinic, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Mental Health and Division of Cardiology, Department of Medicine, and Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.
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28
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Fiksinski AM, Hoftman GD, Vorstman JAS, Bearden CE. A genetics-first approach to understanding autism and schizophrenia spectrum disorders: the 22q11.2 deletion syndrome. Mol Psychiatry 2023; 28:341-353. [PMID: 36192458 PMCID: PMC9812786 DOI: 10.1038/s41380-022-01783-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 02/03/2023]
Abstract
Recently, increasing numbers of rare pathogenic genetic variants have been identified that are associated with variably elevated risks of a range of neurodevelopmental outcomes, notably including Autism Spectrum Disorders (ASD), Schizophrenia Spectrum Disorders (SSD), and Intellectual Disability (ID). This review is organized along three main questions: First, how can we unify the exclusively descriptive basis of our current psychiatric diagnostic classification system with the recognition of an identifiable, highly penetrant genetic risk factor in an increasing proportion of patients with ASD or SSD? Second, what can be learned from studies of individuals with ASD or SSD who share a common genetic basis? And third, what accounts for the observed variable penetrance and pleiotropy of neuropsychiatric phenotypes in individuals with the same pathogenic variant? In this review, we focus on findings of clinical and preclinical studies of the 22q11.2 deletion syndrome (22q11DS). This particular variant is not only one of the most common among the increasing list of known rare pathogenic variants, but also one that benefits from a relatively long research history. Consequently, 22q11DS is an appealing model as it allows us to: (1) elucidate specific genotype-phenotype associations, (2) prospectively study behaviorally defined classifications, such as ASD or SSD, in the context of a known, well-characterized genetic basis, and (3) elucidate mechanisms underpinning variable penetrance and pleiotropy, phenomena with far-reaching ramifications for research and clinical practice. We discuss how findings from animal and in vitro studies relate to observations in human studies and can help elucidate factors, including genetic, environmental, and stochastic, that impact the expression of neuropsychiatric phenotypes in 22q11DS, and how this may inform mechanisms underlying neurodevelopmental expression in the general population. We conclude with research priorities for the field, which may pave the way for novel therapeutics.
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Affiliation(s)
- Ania M Fiksinski
- Department of Psychology and Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, Maastricht University, Maastricht, The Netherlands
| | - Gil D Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jacob A S Vorstman
- Program in Genetics and Genome Biology, Research Institute, and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
- Department of Psychology, University of California, Los Angeles, CA, USA.
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29
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Feller C, Ilen L, Eliez S, Schneider M. Characterizing Daily-Life Social Interactions in Adolescents and Young Adults with Neurodevelopmental Disorders: A Comparison Between Individuals with Autism Spectrum Disorders and 22q11.2 Deletion Syndrome. J Autism Dev Disord 2023; 53:245-262. [PMID: 35018586 PMCID: PMC9889413 DOI: 10.1007/s10803-021-05423-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
Social impairments are common features of 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). The Ecological Momentary Assessment (EMA) allowed access to daily-life information in order to explore the phenomenology of social interactions. 32 individuals with 22q11DS, 26 individuals with ASD and 44 typically developing peers (TD) aged 12-30 were assessed during 6 days 8 times a day using a mobile app. Participants with 22q11DS and ASD did not spend more time alone but showed distinct implication in the social sphere than TD. Distinct profiles emerged between the two conditions regarding the subjective experience of aloneness and the subjective experience of social interactions. This study highlights distinct social functioning profiles in daily-life in 22q11DS and ASD that points towards different therapeutic targets.
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Affiliation(s)
- Clémence Feller
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Laura Ilen
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Stephan Eliez
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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30
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Buzzanca A, Accinni T, Frascarelli M, Troisi E, Kotzalidis GD, Di Bonaventura C, Fanella M, Putotto C, Marino B, Pasquini M, Biondi M, Di Fabio F. Recognition of facial emotion expressions and perceptual processes in 22q11.2 deletion syndrome. Early Interv Psychiatry 2023; 17:76-84. [PMID: 35347860 PMCID: PMC10078714 DOI: 10.1111/eip.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/25/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Social cognition (SC) deficits and of its facial emotion expression (FEE) component have been described in 22q11.2 Deletion Syndrome (22q11.2DS), a high-risk for schizophrenia (SCZ) systemic genetic syndrome. Correlations between deficits in FEE skills and visual-spatial abilities in people with 22q11.2DS warrant investigation. METHODS The sample consisted of 37 patients with 22q11.2DS (DEL), 19 with 22q11.2DS and psychosis (DEL-SCZ), 23 with idiopathic SCZ, and 48 healthy controls. We assessed FEE through The Ekman 60 Faces test (EK-F60), visual-spatial skills with Raven's Standard Progressive Matrices, and symptom severity with the positive And negative syndrome scale. Statistics were conducted through multivariate analysis of variance and correlation analysis. RESULTS Patients with 22q11.2DS performed worse that the other groups in recognizing Surprise, Disgust, Rage, Fear, and Neutral expressions on the EK-F60. Recognition of Surprise and Disgust correlated positively with visual-spatial abilities in patients with 22q11.2DS; negative and cognitive symptoms correlated negatively with recognition of Sadness, Surprise, and Disgust. CONCLUSIONS Patients with 22q11.2DS show impairments of both peripheral and central steps of the emotional recognition process, leading to SC deficits. The latter are present regardless of the presence of a full-blown psychosis.
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Affiliation(s)
- Antonino Buzzanca
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Tommaso Accinni
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marianna Frascarelli
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Eloisa Troisi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Georgios D Kotzalidis
- Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Carlo Di Bonaventura
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Martina Fanella
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Bruno Marino
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Fabio Di Fabio
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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31
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Chauvière L. Early cognitive comorbidities before disease onset: A common symptom towards prevention of related brain diseases? Heliyon 2022; 8:e12259. [PMID: 36590531 PMCID: PMC9800323 DOI: 10.1016/j.heliyon.2022.e12259] [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: 08/08/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Brain diseases are very heterogeneous; however they also display multiple common risk factors and comorbidities. With a paucity of disease-modifying therapies, prevention became a health priority. Towards prevention, one strategy is to focus on similar symptoms of brain diseases occurring before disease onset. Cognitive deficits are a promising candidate as they occur across brain diseases before disease onset. Based on recent research, this review highlights the similarity of brain diseases and discusses how early cognitive deficits can be exploited to tackle disease prevention. After briefly introducing common risk factors, I review common comorbidities across brain diseases, with a focus on cognitive deficits before disease onset, reporting both experimental and clinical findings. Next, I describe network abnormalities associated with early cognitive deficits and discuss how these abnormalities can be targeted to prevent disease onset. A scenario on brain disease etiology with the idea that early cognitive deficits may constitute a common symptom of brain diseases is proposed.
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32
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Van de Woestyne K, Vandensande A, Vansteelandt K, Maes B, Vergaelen E, Swillen A. Resilience and quality of life in young adults with a 22q11.2 deletion syndrome: a patient's perspective. Eur Child Adolesc Psychiatry 2022; 31:1885-1894. [PMID: 34115224 PMCID: PMC9979632 DOI: 10.1007/s00787-021-01822-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/05/2021] [Indexed: 01/26/2023]
Abstract
In the transition period between adolescence and young adulthood, individuals with 22q11.2DS are at an increased risk of developing severe psychiatric disorders. Various studies have focused on detecting risk factors, but until now protective factors are still understudied in 22q11.2DS. The current case-control study focuses on the role of resilience and quality of life (QoL) in young adults with 22q11.2DS and behavioural problems, in comparison with persons with an intellectual disability (ID) without a known genetic disorder. Self-report (and caregiver report) standardized questionnaires were used. Predictive general linear models were constructed to compare the resilience and quality of life across both groups (22q11.2DS vs ID-group) and to analyse the association between personal characteristics in both groups. Young adults with a 22q11.2DS show less resilience compared with both the general population norms and young adults with ID. Only a subscale of resilience (Acceptance of self and life) contributes to the reported level of QoL. Reported health problems are not related to resilience, but have an important effect on QoL. Our results suggest different factors are underlying resilience and the relation with QoL in 22q11.2DS and ID in general. These factors deserve more research and are important to take into account in clinical practice.
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Affiliation(s)
| | | | | | - Bea Maes
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
| | - Elfi Vergaelen
- University Psychiatric Center KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Ann Swillen
- Department of Human Genetics, KU Leuven, Leuven, Belgium,Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
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33
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Provenzani U, Damiani S, Bersano I, Singh S, Moschillo A, Accinni T, Brondino N, Oliver D, Fusar-Poli P. Prevalence and incidence of psychotic disorders in 22q11.2 deletion syndrome: a meta-analysis. Int Rev Psychiatry 2022; 34:676-688. [PMID: 36786112 DOI: 10.1080/09540261.2022.2123273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
22q11.2 deletion syndrome (22q.11.2DS) might be one of the strongest genetic risk factors for psychosis, but robust estimates of prevalence and incidence of psychotic disorders in this condition are not available. To address this gap, we performed a multistep systematic PRISMA/MOOSE-compliant literature search of articles reporting prevalence (primary outcome) or incidence (secondary outcome) of psychotic disorders in 22q11.2DS samples (protocol: https://osf.io/w6hpg) using random-effects meta-analysis, subgroup analyses and meta-regressions. The pooled prevalence of psychotic disorders was 11.50% (95%CI:9.40-14.00%), largely schizophrenia (9.70%, 95%CI:6.50-14.20). Prevalence was significantly higher in samples with a mean age over 18 years, with both psychiatric and non-psychiatric comorbidities and recruited from healthcare services (compared to the community). Mean age was also significantly positively associated with prevalence in meta-regressions (p < 0.01). The pooled incidence of psychotic disorders was 10.60% (95%CI:6.60%-16.70%) at a mean follow-up time of 59.27 ± 40.55 months; meta-regressions were not significant. To our knowledge, this is the first comprehensive systematic review and meta-analysis of the prevalence and incidence of psychotic disorders in 22q11.2DS individuals. It demonstrates that around one in ten individuals with 22q11.2DS displays comorbid psychotic disorders, and around one in ten will develop psychosis in the following five years, indicating that preventive approaches should be implemented systematically in 22q11.2DS.
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Affiliation(s)
- Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bersano
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Simran Singh
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Tommaso Accinni
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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34
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McGinn DE, Crowley TB, Heung T, Tran O, Moss E, Zackai EH, Emanuel BS, Chow EWC, Morrow BE, Swillen A, Bassett AS, McDonald-McGinn DM. Influence of Parent-of-Origin on Intellectual Outcomes in the Chromosome 22q11.2 Deletion Syndrome. Genes (Basel) 2022; 13:genes13101800. [PMID: 36292685 PMCID: PMC9602066 DOI: 10.3390/genes13101800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 01/21/2023] Open
Abstract
Learning and intellectual disabilities are hallmark features of 22q11.2 deletion syndrome. Data are limited, however, regarding influences on full-scale IQ (FSIQ). Here, we investigated possible 22q11.2 deletion parent-of-origin effects. In 535 individuals, we compared FSIQ (≥50), 481 with de novo and 54 with inherited 22q11.2 deletions. In the subsets with data available, we examined parent-of-origin effects on FSIQ. We used linear regression models to account for covariates. Median FSIQ was significantly higher in de novo vs. inherited deletions (77; range 50−116 vs. 67; range 50−96, p < 0.0001). Results remained significant using a regression model accounting for age at IQ testing, sex and cohort site. No significant parent-of-origin differences in FSIQ were observed for de novo deletions (n = 81, 63.0% maternal; p = 0.6882). However, median FSIQ was significantly lower in maternally than in paternally inherited familial deletions (65, range 50−86 vs. 71.5, range 58−96, respectively, p = 0.0350), with the regression model indicating an ~8 point decrement in FSIQ for this variable (p = 0.0061). FSIQ is higher on average in de novo than in inherited 22q11.2 deletions, regardless of parental origin. However, parent-of-origin appears relevant in inherited deletions. The results have potential clinical implications with further research needed to delineate possible actionable mechanisms.
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Affiliation(s)
- Daniel E. McGinn
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - T. Blaine Crowley
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Tracy Heung
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON M5G 2C4, Canada
- The Dalglish Family 22q Clinic, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Oanh Tran
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Edward Moss
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Elaine H. Zackai
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Beverly S. Emanuel
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Eva W. C. Chow
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 2C4, Canada
| | | | - Ann Swillen
- The Centre for Human Genetics, University Hospital of Leuven, Department of Human Genetics, University of Leuven (KU Leuven), 3000 Leuven, Belgium
- Correspondence: (A.S.); (A.S.B.); (D.M.M.-M.)
| | - Anne S. Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON M5G 2C4, Canada
- The Dalglish Family 22q Clinic, University Health Network, Toronto, ON M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 2C4, Canada
- Toronto General Hospital Research Institute, and Campbell Family Mental Health Research Institute, Toronto, ON M5G 2C4, Canada
- Correspondence: (A.S.); (A.S.B.); (D.M.M.-M.)
| | - Donna M. McDonald-McGinn
- The 22q and You Center, Clinical Genetics Center, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence: (A.S.); (A.S.B.); (D.M.M.-M.)
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35
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Fiksinski AM, Heung T, Corral M, Breetvelt EJ, Costain G, Marshall CR, Kahn RS, Vorstman JA, Bassett AS. Within-family influences on dimensional neurobehavioral traits in a high-risk genetic model. Psychol Med 2022; 52:3184-3192. [PMID: 33443009 PMCID: PMC9693655 DOI: 10.1017/s0033291720005279] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/08/2020] [Accepted: 12/17/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Genotype-first and within-family studies can elucidate factors that contribute to psychiatric illness. Combining these approaches, we investigated the patterns of influence of parental scores, a high-impact variant, and schizophrenia on dimensional neurobehavioral phenotypes implicated in major psychiatric disorders. METHODS We quantitatively assessed cognitive (FSIQ, VIQ, PIQ), social, and motor functioning in 82 adult individuals with a de novo 22q11.2 deletion (22 with schizophrenia), and 148 of their unaffected parents. We calculated within-family correlations and effect sizes of the 22q11.2 deletion and schizophrenia, and used linear regressions to assess contributions to neurobehavioral measures. RESULTS Proband-parent intra-class correlations (ICC) were significant for cognitive measures (e.g. FSIQ ICC = 0.549, p < 0.0001), but not for social or motor measures. Compared to biparental scores, the 22q11.2 deletion conferred significant impairments for all phenotypes assessed (effect sizes -1.39 to -2.07 s.d.), strongest for PIQ. There were further decrements in those with schizophrenia. Regression models explained up to 37.7% of the variance in IQ and indicated that for proband IQ, parental IQ had larger effects than schizophrenia. CONCLUSIONS This study, for the first time, disentangles the impact of a high-impact variant from the modifying effects of parental scores and schizophrenia on relevant neurobehavioral phenotypes. The robust proband-parent correlations for cognitive measures, independent of the impact of the 22q11.2 deletion and of schizophrenia, suggest that, for certain phenotypes, shared genetic variation plays a significant role in expression. Molecular genetic and predictor studies are needed to elucidate shared factors and their contribution to psychiatric illness in this and other high-risk groups.
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Affiliation(s)
- Ania M. Fiksinski
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Tracy Heung
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Maria Corral
- The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Elemi J. Breetvelt
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gregory Costain
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christian R. Marshall
- Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Rene S. Kahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacob A.S. Vorstman
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne S. Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Toronto General Hospital Research Institute and Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
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36
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van Hooijdonk CFM, Tse DHY, Roosenschoon J, Ceccarini J, Booij J, van Amelsvoort TAMJ, Vingerhoets C. The Relationships between Dopaminergic, Glutamatergic, and Cognitive Functioning in 22q11.2 Deletion Syndrome: A Cross-Sectional, Multimodal 1H-MRS and 18F-Fallypride PET Study. Genes (Basel) 2022; 13:1672. [PMID: 36140839 PMCID: PMC9498700 DOI: 10.3390/genes13091672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Individuals with 22q11.2 deletion syndrome (22q11DS) are at increased risk of developing psychosis and cognitive impairments, which may be related to dopaminergic and glutamatergic abnormalities. Therefore, in this exploratory study, we examined the association between dopaminergic and glutamatergic functioning in 22q11DS. Additionally, the associations between glutamatergic functioning and brain volumes in 22q11DS and healthy controls (HC), as well as those between dopaminergic and cognitive functioning in 22q11DS, were also examined. METHODS In this cross-sectional, multimodal imaging study, glutamate, glutamine, and their combined concentration (Glx) were assessed in the anterior cingulate cortex (ACC) and striatum in 17 22q11DS patients and 20 HC using 7T proton magnetic resonance spectroscopy. Ten 22q11DS patients also underwent 18F-fallypride positron emission tomography to measure dopamine D2/3 receptor (D2/3R) availability in the ACC and striatum. Cognitive performance was assessed with the Cambridge Neuropsychological Test Automated Battery. RESULTS No significant associations were found between ACC or striatal (1) glutamate, glutamine, or Glx concentrations and (2) D2/3R availability. In HC but not in 22q11DS patients, we found a significant relationship between ACC volume and ACC glutamate, glutamine, and Glx concentration. In addition, some aspects of cognitive functioning were significantly associated with D2/3R availability in 22q11DS. However, none of the associations remained significant after Bonferroni correction. CONCLUSIONS Although our results did not reach statistical significance, our findings suggest an association between glutamatergic functioning and brain volume in HC but not in 22q11DS. Additionally, D2/3R availability seems to be related to cognitive functioning in 22q11DS. Studies in larger samples are needed to further elucidate our findings.
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Affiliation(s)
- Carmen F. M. van Hooijdonk
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6226 NB Maastricht, The Netherlands
- Rivierduinen, Institute for Mental Health Care, 2333 ZZ Leiden, The Netherlands
| | - Desmond H. Y. Tse
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Julia Roosenschoon
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6226 NB Maastricht, The Netherlands
| | - Jenny Ceccarini
- Department of Nuclear Medicine and Molecular Imaging, Division of Imaging and Pathology, KU Leuven, B-3000 Leuven, Belgium
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Therese A. M. J. van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6226 NB Maastricht, The Netherlands
| | - Claudia Vingerhoets
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6226 NB Maastricht, The Netherlands
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Harvey PD, Bosia M, Cavallaro R, Howes OD, Kahn RS, Leucht S, Müller DR, Penadés R, Vita A. Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art. Schizophr Res Cogn 2022; 29:100249. [PMID: 35345598 PMCID: PMC8956816 DOI: 10.1016/j.scog.2022.100249] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/12/2022]
Abstract
Cognitive impairment in schizophrenia represents one of the main obstacles to clinical and functional recovery. This expert group paper brings together experts in schizophrenia treatment to discuss scientific progress in the domain of cognitive impairment to address cognitive impairments and their consequences in the most effective way. We report on the onset and course of cognitive deficits, linking them to the alterations in brain function and structure in schizophrenia and discussing their role in predicting the transition to psychosis in people at risk. We then address the assessment tools with reference to functioning and social cognition, examining the role of subjective measures and addressing new methods for measuring functional outcomes including technology based approaches. Finally, we briefly review treatment options for cognitive deficits, focusing on cognitive remediation programs, highlighting their effects on brain activity and conclude with the potential benefit of individualized integrated interventions combing cognitive remediation with other approaches.
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Affiliation(s)
- Philip D Harvey
- Division of Psychology, Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marta Bosia
- Vita-Salute San Raffaele University School of Medicine, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Roberto Cavallaro
- Vita-Salute San Raffaele University School of Medicine, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.,MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefan Leucht
- Section Evidence-Based Medicine in Psychiatry and Psychotherapy, Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Daniel R Müller
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rafael Penadés
- Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel Street, 08036 Barcelona, Spain
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy
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Lee T, Park KJ, Shon SH, Kim S, Kim HW. Predictors of Developmental Outcome in 4- to 6-Year-Olds With Developmental Disability. Psychiatry Investig 2022; 19:519-526. [PMID: 35903054 PMCID: PMC9334806 DOI: 10.30773/pi.2021.0385] [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: 12/20/2021] [Accepted: 05/02/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Studies on the early trajectories of developmental disability (DD) are limited. This study aimed to evaluate the diagnostic stability and developmental trajectories of autism spectrum disorder (ASD) and intellectual disability (ID), and to determine baseline clinical characteristics that affect future diagnosis. METHODS We analyzed 192 children who were referred for possible DD through retrospective chart review. Clinical diagnosis was assessed once at baseline, aged 2-4, and at follow-up, aged 4-6. The participants' developmental profiles were measured by Psychoeducational Profile-Revised (PEP-R), Vineland Social Maturity Scale (VSMS), Beery-Buktenica Developmental Test of Visual Motor Integration (VMI), and Childhood Autism Rating Scale (CARS). RESULTS On comparing the diagnostic change, 5% of children were no longer diagnosed as ASD, and 13% of children were no longer diagnosed as ID at follow-up. Trajectories of developmental profiles were compared between children with and without ID at follow-up, and significant time-by-group interaction were observed in PEP-R (p<0.001), VSMS (p<0.001), and VMI (p=0.003) scores, indicating that children without ID at follow-up showed significant improvement over time compared to children with ID. ASD diagnosis (p<0.001) and CARS score (p=0.007) at baseline were significantly associated with ASD at follow-up, while VSMS score (p=0.004) and VMI score (p=0.019) at baseline were significantly associated with ID at follow-up. CONCLUSION A subset of children lost their diagnosis at follow-up, and such diagnostic change was significantly more common in ID compared to ASD. Baseline autism symptomatology was related to ASD at follow-up, and baseline adaptive and visuo-motor function was related to ID at follow-up.
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Affiliation(s)
- Taeyeop Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kee Jeong Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Hyun Shon
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo-Won Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Fiksinski AM, Bearden CE, Bassett AS, Kahn RS, Zinkstok JR, Hooper SR, Tempelaar W, McDonald-McGinn D, Swillen A, Emanuel B, Morrow B, Gur R, Chow E, van den Bree M, Vermeesch J, Warren S, Owen M, van Amelsvoort T, Eliez S, Gothelf D, Arango C, Kates W, Simon T, Murphy K, Repetto G, Suner DH, Vicari S, Cubells J, Armando M, Philip N, Campbell L, Garcia-Minaur S, Schneider M, Shashi V, Vorstman J, Breetvelt EJ. A normative chart for cognitive development in a genetically selected population. Neuropsychopharmacology 2022; 47:1379-1386. [PMID: 33782512 PMCID: PMC9117666 DOI: 10.1038/s41386-021-00988-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/12/2021] [Accepted: 01/30/2021] [Indexed: 02/03/2023]
Abstract
Certain pathogenic genetic variants impact neurodevelopment and cause deviations from typical cognitive trajectories. Understanding variant-specific cognitive trajectories is clinically important for informed monitoring and identifying patients at risk for comorbid conditions. Here, we demonstrate a variant-specific normative chart for cognitive development for individuals with 22q11.2 deletion syndrome (22q11DS). We used IQ data from 1365 individuals with 22q11DS to construct variant-specific normative charts for cognitive development (Full Scale, Verbal, and Performance IQ). This allowed us to calculate Z-scores for each IQ datapoint. Then, we calculated the change between first and last available IQ assessments (delta Z-IQ-scores) for each individual with longitudinal IQ data (n = 708). We subsequently investigated whether using the variant-specific IQ-Z-scores would decrease required sample size to detect an effect with schizophrenia risk, as compared to standard IQ-scores. The mean Z-IQ-scores for FSIQ, VIQ, and PIQ were close to 0, indicating that participants had IQ-scores as predicted by the normative chart. The mean delta-Z-IQ-scores were equally close to 0, demonstrating a good fit of the normative chart and indicating that, as a group, individuals with 22q11DS show a decline in IQ-scores as they grow into adulthood. Using variant-specific IQ-Z-scores resulted in 30% decrease of required sample size, as compared to the standard IQ-based approach, to detect the association between IQ-decline and schizophrenia (p < 0.01). Our findings suggest that using variant-specific normative IQ data significantly reduces required sample size in a research context, and may facilitate a more clinically informative interpretation of IQ data. This approach allows identification of individuals that deviate from their expected, variant-specific, trajectory. This group may be at increased risk for comorbid conditions, such as schizophrenia in the case of 22q11DS.
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Affiliation(s)
- Ania M Fiksinski
- Wilhelmina Children's Hospital & University Medical Center Utrecht, Brain Center, Utrecht, The Netherlands.
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, Maastricht University, Maastricht, The Netherlands.
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
| | - Anne S Bassett
- The Dalglish Family 22q Clinic, Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Canada
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - René S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janneke R Zinkstok
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stephen R Hooper
- Department of Allied Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Wanda Tempelaar
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Donna McDonald-McGinn
- Division of Human Genetics, 22q and You Center, Clinical Genetics Center, and Section of Genetic Counseling, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ann Swillen
- Center for Human Genetics, University Hospital Gasthuisberg, Leuven, Belgium
- Department of Human Genetics KU Leuven, Leuven, Belgium
| | - Beverly Emanuel
- Division of Human Genetics, 22q and You Center, Clinical Genetics Center, and Section of Genetic Counseling, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bernice Morrow
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Raquel Gur
- Department of Psychiatry and Lifespan Brain Institute, Penn Medicine-CHOP, University of Pennsylvania, Philadelphia, PA, USA
| | - Eva Chow
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marianne van den Bree
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Joris Vermeesch
- Center for Human Genetics, University Hospital Gasthuisberg, Leuven, Belgium
| | - Stephen Warren
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, Maastricht University, Maastricht, The Netherlands
| | - Stephan Eliez
- Developmental Imaging and Psychopathology, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Doron Gothelf
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Wendy Kates
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Tony Simon
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
| | - Kieran Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Gabriela Repetto
- Centro de Genética y Genómica, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Damian Heine Suner
- Genomics of Health Group and Molecular Diagnostics and Clinical Genetics Unit (UDMGC), Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Stefano Vicari
- Department of Life Sciences and Public Health, Catholic University; Child and Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Joseph Cubells
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Marco Armando
- Developmental Imaging and Psychopathology, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Nicole Philip
- Département de Génétique Médicale, APHM, CHU Timone Enfants, Marseille, France
- Aix Marseille Université, MMG, INSERM, Marseille, France
| | - Linda Campbell
- School of Psychology, University of Newcastle, Newcastle, Australia
| | - Sixto Garcia-Minaur
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | - Maude Schneider
- Developmental Imaging and Psychopathology, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Vandana Shashi
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Jacob Vorstman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elemi J Breetvelt
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
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de Oliveira Figueiredo EC, Bondiolotti BM, Laugeray A, Bezzi P. Synaptic Plasticity Dysfunctions in the Pathophysiology of 22q11 Deletion Syndrome: Is There a Role for Astrocytes? Int J Mol Sci 2022; 23:ijms23084412. [PMID: 35457231 PMCID: PMC9028090 DOI: 10.3390/ijms23084412] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 01/01/2023] Open
Abstract
The 22q11 deletion syndrome (DS) is the most common microdeletion syndrome in humans and gives a high probability of developing psychiatric disorders. Synaptic and neuronal malfunctions appear to be at the core of the symptoms presented by patients. In fact, it has long been suggested that the behavioural and cognitive impairments observed in 22q11DS are probably due to alterations in the mechanisms regulating synaptic function and plasticity. Often, synaptic changes are related to structural and functional changes observed in patients with cognitive dysfunctions, therefore suggesting that synaptic plasticity has a crucial role in the pathophysiology of the syndrome. Most interestingly, among the genes deleted in 22q11DS, six encode for mitochondrial proteins that, in mouse models, are highly expressed just after birth, when active synaptogenesis occurs, therefore indicating that mitochondrial processes are strictly related to synapse formation and maintenance of a correct synaptic signalling. Because correct synaptic functioning, not only requires correct neuronal function and metabolism, but also needs the active contribution of astrocytes, we summarize in this review recent studies showing the involvement of synaptic plasticity in the pathophysiology of 22q11DS and we discuss the relevance of mitochondria in these processes and the possible involvement of astrocytes.
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Affiliation(s)
| | - Bianca Maria Bondiolotti
- Department of Fundamental Neurosciences, University of Lausanne, 1005 Lausanne, Switzerland; (E.C.d.O.F.); (B.M.B.); (A.L.)
| | - Anthony Laugeray
- Department of Fundamental Neurosciences, University of Lausanne, 1005 Lausanne, Switzerland; (E.C.d.O.F.); (B.M.B.); (A.L.)
| | - Paola Bezzi
- Department of Fundamental Neurosciences, University of Lausanne, 1005 Lausanne, Switzerland; (E.C.d.O.F.); (B.M.B.); (A.L.)
- Department of Pharmacology and Physiology, University of Rome Sapienza, 00185 Rome, Italy
- Correspondence: or
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Breetvelt EJ, Smit KC, van Setten J, Merico D, Wang X, Vaartjes I, Bassett AS, Boks MPM, Szatmari P, Scherer SW, Kahn RS, Vorstman JAS. A Regional Burden of Sequence-Level Variation in the 22q11.2 Region Influences Schizophrenia Risk and Educational Attainment. Biol Psychiatry 2022; 91:718-726. [PMID: 35063188 DOI: 10.1016/j.biopsych.2021.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Genomic loci where recurrent pathogenic copy number variants are associated with psychiatric phenotypes in the population may also be sensitive to the collective impact of multiple functional low-frequency single nucleotide variants (SNVs). METHODS We examined the cumulative impact of low-frequency, functional SNVs within the 22q11.2 region on schizophrenia risk in a discovery cohort and an independent replication cohort (N = 1933 and N = 11,128, respectively), as well as the impact on educational attainment (EA) in a third, independent, general population cohort (N = 2081). In the discovery and EA cohorts, SNVs were identified using genotyping arrays; in the replication cohort, whole-exome sequencing was available. For verification, we compared the regional SNV count for schizophrenia cases in the discovery cohort with a normative count distribution derived from a large population dataset (N = 26,500) using bootstrap procedures. RESULTS In both schizophrenia cohorts, an increased regional SNV burden (≥4 low-frequency SNVs) in the 22q11.2 region was associated with schizophrenia (discovery cohort: odds ratio = 7.48, p = .039; replication cohort: odds ratio = 1.92, p = .004). In the EA cohort, an increased regional SNV burden at 22q11.2 was associated with decreased EA (odds ratio = 4.65, p = .049). Comparing the SNV count for schizophrenia cases with a normative distribution confirmed the unique nature of the distribution for schizophrenia cases (p = .002). CONCLUSIONS In the general population, an increased burden of low-frequency, functional SNVs in the 22q11.2 region is associated with schizophrenia risk and a decrease in EA. These findings suggest that in addition to structural variation, a cumulative regional burden of low-frequency, functional SNVs in the 22q11.2 region can also have a relevant phenotypic impact.
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Affiliation(s)
- Elemi J Breetvelt
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - Karel C Smit
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands; Department of Medical Oncology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Jessica van Setten
- Department of Cardiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Daniele Merico
- Center for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada; Deep Genomics Inc., Toronto, Ontario, Canada
| | - Xiao Wang
- Center for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ilonca Vaartjes
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Anne S Bassett
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Dalglish Family 22q Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada; Medical Genetics and Genomics Residency Training Program, University of Toronto, Toronto, Ontario, Canada; Toronto General Research Institute, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
| | - Marco P M Boks
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Peter Szatmari
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Stephen W Scherer
- Center for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada; McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - René S Kahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NewYork, New York
| | - Jacob A S Vorstman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
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Age-Related Improvements in Executive Functions and Focal Attention in 22q11.2 Deletion Syndrome Vary Across Domain and Task. J Int Neuropsychol Soc 2022; 28:337-350. [PMID: 33952381 DOI: 10.1017/s135561772100059x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Executive functions (EF) and focal attention have been identified as a weakness in the profile of 22q11.2 deletion syndrome (22q11DS). However, due to a high variety of tasks used across previous studies, it remains unclear whether impairments may be more pronounced for specific subdomains of EF and focal attention. Furthermore, age-related changes have only been examined in a few studies, so far only yielding a partial view of the overall developmental profile. METHOD In a broad age range (8-35 years) composed of longitudinal data, 183 participants (103 diagnosed with 22q11DS) completed an extensive assessment of EF and attention. To get a more comprehensive overview of specific versus global impairments, several tasks were assessed within multiple domains. RESULTS Results suggest differential impairments and trajectories in specific EF subdomains. Specifically, our findings suggest that individuals with 22q11DS not only showed lower overall inhibition skills, but also that initiation skills developed at a slower pace compared to healthy controls. Results are less clear regarding cognitive flexibility, updating and focal attention, for which performance strongly depended on the tasks that was selected to assess the domain. CONCLUSIONS Findings confirm and extend knowledge on differential developmental patterns of EF and attention domains in 22q11DS. They further stress the necessity to administer extensive, multifaceted evaluations to gain a more reliable overview of patients' cognitive profile.
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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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NISHIOKA MASAKI. The Current Progress of Psychiatric Genomics. JUNTENDO IJI ZASSHI = JUNTENDO MEDICAL JOURNAL 2022; 68:2-11. [PMID: 38911007 PMCID: PMC11189800 DOI: 10.14789/jmj.jmj21-0038-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 06/25/2024]
Abstract
Psychiatric disorders such as bipolar disorder and schizophrenia are highly heritable. While the genetic contribution to psychiatric disorders is quite sure, specific genetic factors contributing to particular conditions have long been a mystery. Empowered by the initial report of the Human Genome Project, the analysis of the comprehensive set of the human genome, called "genomics," became possible. Subsequent development of large-scale genomic technologies enabled us to elucidate various disease-related genetic information, accelerating our understanding of various diseases. Genomic research on psychiatric disorders is not an exception. In this Review, I introduce significant advancements in psychiatric genomics with a special focus on our investigation of bipolar disorder. International consortiums and advocacy groups accelerate psychiatric genomics, increasing the sample size and statistical power for robust findings. The genetic architecture of schizophrenia has been elucidated in both common and rare variant studies. The genetic architecture of autism spectrum disorder (ASD) has been elucidated mainly by rare variant analysis. As to bipolar disorder, common variant analysis precedes rare variant analysis, but we are struggling to elucidate relevant rare variants. While the genomic approach has explained specific genetic factors for particular disorders, overlapping risk genes or pleiotropy has been observed more than expected. The boundary in the current nosology of psychiatric disorders is more or less challenged. To understand the genotype-phenotype relation more deeply, an attempt to understand phenotypes based on genotypes, called the "genotype first" approach, has started. I discuss this new approach for better understanding and treatment of psychiatric disorders.
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Affiliation(s)
- MASAKI NISHIOKA
- Corresponding author: Masaki Nishioka, Department of Psychiatry, Faculty of Medicine, Juntendo University, Department of Molecular Pathology of Mood Disorders, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan, TEL&FAX: +81-3-5802-1070 E-mail:
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Hiramoto T, Sumiyoshi A, Yamauchi T, Tanigaki K, Shi Q, Kang G, Ryoke R, Nonaka H, Enomoto S, Izumi T, Bhat MA, Kawashima R, Hiroi N. Tbx1, a gene encoded in 22q11.2 copy number variant, is a link between alterations in fimbria myelination and cognitive speed in mice. Mol Psychiatry 2022; 27:929-938. [PMID: 34737458 PMCID: PMC9054676 DOI: 10.1038/s41380-021-01318-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/18/2022]
Abstract
Copy number variants (CNVs) have provided a reliable entry point to identify the structural correlates of atypical cognitive development. Hemizygous deletion of human chromosome 22q11.2 is associated with impaired cognitive function; however, the mechanisms by which the CNVs contribute to cognitive deficits via diverse structural alterations in the brain remain unclear. This study aimed to determine the cellular basis of the link between alterations in brain structure and cognitive functions in mice with a heterozygous deletion of Tbx1, one of the 22q11.2-encoded genes. Ex vivo whole-brain diffusion-tensor imaging (DTI)-magnetic resonance imaging (MRI) in Tbx1 heterozygous mice indicated that the fimbria was the only region with significant myelin alteration. Electron microscopic and histological analyses showed that Tbx1 heterozygous mice exhibited an apparent absence of large myelinated axons and thicker myelin in medium axons in the fimbria, resulting in an overall decrease in myelin. The fimbria of Tbx1 heterozygous mice showed reduced mRNA levels of Ng2, a gene required to produce oligodendrocyte precursor cells. Moreover, postnatal progenitor cells derived from the subventricular zone, a source of oligodendrocytes in the fimbria, produced fewer oligodendrocytes in vitro. Behavioral analyses of these mice showed selectively slower acquisition of spatial memory and cognitive flexibility with no effects on their accuracy or sensory or motor capacities. Our findings provide a genetic and cellular basis for the compromised cognitive speed in patients with 22q11.2 hemizygous deletion.
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Affiliation(s)
- Takeshi Hiramoto
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Akira Sumiyoshi
- Institute of Development, Aging, and Cancer, Tohoku University, 4-1, Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1, Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Takahira Yamauchi
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Kenji Tanigaki
- Research Institute, Shiga Medical Center, 5-4-30 Moriyama, Moriyama-shi, Shiga, Japan
| | - Qian Shi
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Gina Kang
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Rie Ryoke
- Institute of Development, Aging, and Cancer, Tohoku University, 4-1, Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Hiroi Nonaka
- Institute of Development, Aging, and Cancer, Tohoku University, 4-1, Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Shingo Enomoto
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Takeshi Izumi
- Department of Pharmacology, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu, Ishikari, Hokkaido, 061-0293, Japan
- Advanced Research Promotion Center, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu, Ishikari, Hokkaido, 061-0293, Japan
| | - Manzoor A Bhat
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Ryuta Kawashima
- Institute of Development, Aging, and Cancer, Tohoku University, 4-1, Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Noboru Hiroi
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
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Contribution of schizophrenia polygenic burden to longitudinal phenotypic variance in 22q11.2 deletion syndrome. Mol Psychiatry 2022; 27:4191-4200. [PMID: 35768638 PMCID: PMC9718680 DOI: 10.1038/s41380-022-01674-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
While the recurrent 22q11.2 deletion is one of the strongest genetic risk factors for schizophrenia (SCZ), variability of its associated neuropsychiatric endophenotypes reflects its incomplete penetrance for psychosis development. To assess whether this phenotypic variability is linked to common variants associated with SCZ, we studied the association between SCZ polygenic risk score (PRS) and longitudinally acquired phenotypic information of the Swiss 22q11.2DS cohort (n = 97, 50% females, mean age 17.7 yr, mean visit interval 3.8 yr). The SCZ PRS with the best predictive performance was ascertained in the Estonian Biobank (n = 201,146) with LDpred. The infinitesimal SCZ PRS model showed the strongest capacity in discriminating SCZ cases from controls with one SD difference in SCZ PRS corresponding to an odds ratio (OR) of 1.73 (95% CI 1.57-1.90, P = 1.47 × 10-29). In 22q11.2 patients, random-effects ordinal regression modelling using longitudinal data showed SCZ PRS to have the strongest effect on social anhedonia (OR = 2.09, P = 0.0002), and occupational functioning (OR = 1.82, P = 0.0003) within the negative symptoms course, and dysphoric mood (OR = 2.00, P = 0.002) and stress intolerance (OR = 1.76, P = 0.0002) within the general symptoms course. Genetic liability for SCZ was additionally associated with full scale cognitive decline (β = -0.25, P = 0.02) and with longitudinal volumetric reduction of the right and left hippocampi (β = -0.28, P = 0.005; β = -0.23, P = 0.02, respectively). Our results indicate that the polygenic contribution to SCZ acts upon the threshold-lowering first hit (i.e., the deletion). It modifies the endophenotypes of 22q11.2DS and augments the derailment of developmental trajectories of negative and general symptoms, cognition, and hippocampal volume.
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Latrèche C, Maeder J, Mancini V, Schneider M, Eliez S. Effects of risperidone on psychotic symptoms and cognitive functions in 22q11.2 deletion syndrome: Results from a clinical trial. Front Psychiatry 2022; 13:972420. [PMID: 36386982 PMCID: PMC9643534 DOI: 10.3389/fpsyt.2022.972420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Carriers of the 22q11.2 deletion syndrome (22q11DS) have an enhanced risk of developing psychotic disorders. Full-blown psychosis is typically diagnosed by late adolescence/adulthood. However, cognitive decline is already apparent as early as childhood. Recent findings in mice show that antipsychotic medication administered during adolescence has a long-lasting neuroprotective effect. These findings offer promising evidence for implementing preventive treatment in humans at risk for psychosis. METHODS We conducted a 12-week double-blind randomized controlled clinical trial with individuals with 22q11DS. Recruitment difficulties resulted in a final sample size of 13 participants (n = 6 treated with antipsychotics and n = 7 receiving placebo). We examined the response to treatment and assessed its short- and long-term effects on psychotic symptomatology using the Structured Interview for Psychosis-Risk Syndromes (SIPS) and cognitive measures. RESULTS First, two treated participants discontinued treatment after experiencing adverse events. Second, treated participants showed a short-term improvement in 33.3% of the SIPS items, mainly those targeting negative symptoms. Third, reliable improvements in at least one measure of working memory and attention were respectively found in 83.3 and 66.7% of treated participants. CONCLUSION This is the first double-blind study to investigate the potential neuroprotective effect of antipsychotics in humans at risk for psychosis. Our preliminary results suggest that antipsychotic treatment may prevent long-term deterioration in clinical symptoms and cognitive skills. Yet, given the limited sample size, our findings need to be replicated in larger samples. To do so, future studies may rather adopt open-label or retrospective designs to ensure sufficient power. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NCT04639960].
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Affiliation(s)
- Caren Latrèche
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Developmental and Intellectual Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Research Group Psychiatry, Department of Neuroscience, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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Kochunov P, Hong LE, Dennis EL, Morey RA, Tate DF, Wilde EA, Logue M, Kelly S, Donohoe G, Favre P, Houenou J, Ching CRK, Holleran L, Andreassen OA, van Velzen LS, Schmaal L, Villalón-Reina JE, Bearden CE, Piras F, Spalletta G, van den Heuvel OA, Veltman DJ, Stein DJ, Ryan MC, Tan Y, van Erp TGM, Turner JA, Haddad L, Nir TM, Glahn DC, Thompson PM, Jahanshad N. ENIGMA-DTI: Translating reproducible white matter deficits into personalized vulnerability metrics in cross-diagnostic psychiatric research. Hum Brain Mapp 2022; 43:194-206. [PMID: 32301246 PMCID: PMC8675425 DOI: 10.1002/hbm.24998] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/06/2020] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
The ENIGMA-DTI (diffusion tensor imaging) workgroup supports analyses that examine the effects of psychiatric, neurological, and developmental disorders on the white matter pathways of the human brain, as well as the effects of normal variation and its genetic associations. The seven ENIGMA disorder-oriented working groups used the ENIGMA-DTI workflow to derive patterns of deficits using coherent and coordinated analyses that model the disease effects across cohorts worldwide. This yielded the largest studies detailing patterns of white matter deficits in schizophrenia spectrum disorder (SSD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and 22q11 deletion syndrome. These deficit patterns are informative of the underlying neurobiology and reproducible in independent cohorts. We reviewed these findings, demonstrated their reproducibility in independent cohorts, and compared the deficit patterns across illnesses. We discussed translating ENIGMA-defined deficit patterns on the level of individual subjects using a metric called the regional vulnerability index (RVI), a correlation of an individual's brain metrics with the expected pattern for a disorder. We discussed the similarity in white matter deficit patterns among SSD, BD, MDD, and OCD and provided a rationale for using this index in cross-diagnostic neuropsychiatric research. We also discussed the difference in deficit patterns between idiopathic schizophrenia and 22q11 deletion syndrome, which is used as a developmental and genetic model of schizophrenia. Together, these findings highlight the importance of collaborative large-scale research to provide robust and reproducible effects that offer insights into individual vulnerability and cross-diagnosis features.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Emily L Dennis
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA, Salt Lake City, Utah, USA
| | - Rajendra A Morey
- Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA, Salt Lake City, Utah, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA, Salt Lake City, Utah, USA
| | - Mark Logue
- VA Boston Healthcare System, National Center for PTSD, Boston, Massachusetts, USA
- Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
- Boston University School of Medicine, Biomedical Genetics, Boston, Massachusetts, USA
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, USA
| | - Sinead Kelly
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Gary Donohoe
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Pauline Favre
- Neurospin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
- INSERM Unit U955, team "Translational Neuro-Psychiatry", Créteil, France
| | - Josselin Houenou
- Neurospin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
- INSERM Unit U955, team "Translational Neuro-Psychiatry", Créteil, France
- Psychiatry Department, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Mondor, Créteil, France
- Faculté de Médecine, Université Paris Est Créteil, Créteil, France
| | - Christopher R K Ching
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Laurena Holleran
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Laura S van Velzen
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Lianne Schmaal
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Julio E Villalón-Reina
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, USA
- Department of Psychology, University of California at Los Angeles, Los Angeles, California, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Dick J Veltman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Dan J Stein
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry, University of California Irvine, Irvine, California, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, California, USA
| | - Jessica A Turner
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Liz Haddad
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Talia M Nir
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Olin Neuropsychiatric Research Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Paul M Thompson
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Neda Jahanshad
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
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Souchay C, Padula M, Schneider M, Debbané M, Eliez S. Developmental trajectories and brain correlates of directed forgetting in 22q11.2 deletion syndrome. Brain Res 2021; 1773:147683. [PMID: 34626595 DOI: 10.1016/j.brainres.2021.147683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/28/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
22q11.2 deletion syndrome (22q11DS), also known as velo-cardio-facial syndrome (VCFS) is the most common copy number variant (CNV) in humans caused by a microdeletion on chromosome 22q11.2. The phenotype encompasses heart anomalies, cleft palate and cognitive difficulties. Alongside brain differences in VCFS, such as reduced hippocampal volume, different cognitive developmental trajectories can be observed. The aim of this study was to explore the developmental trajectories of cognitive inhibition in memory using longitudinal data acquired in a large cohort of individuals with 22q11DS and the brain correlates to those developmental changes. 51 participants with 22q11DS (mean age: 13.75 ± 4.26, mean IQ score: 70.50 ± 10.75) and 43 typically developing individuals matched for age (M = 13.50 ± 4.91) and gender were recruited. To explore inhibition in memory, the Directed Forgetting paradigm was used. 30 words were presented, half were 'To be remembered items'(TBR) and the other half 'To be forgotten items' (TBF). To measure source memory, participants were asked during the recognition stage to say if the world was a TBR or a TBF item. Participants were tested during two consecutive visits, with a mean interval of 3 years. T1-weighted images were acquired using a 1.5 T Philips or a 3 T Siemens scanner at both visits. Both groups recognized more TBR than TBF items (Directed forgetting effect), however, participants with 22q11DS recognized fewer TBR items and did not show an increased recognition of TBR items with age. Furthermore, in participants with VCFS increased source memory errors with age was associated with a decline in hippocampal volume.
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Affiliation(s)
| | - Maria Padula
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Friedrich Miescher Institute of Biomedical Research, Basel, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Martin Debbané
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Stéphan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Feller C, Ilen L, Eliez S, Schneider M. Psychotic experiences in daily-life in adolescents and young adults with 22q11.2 deletion syndrome: An Ecological Momentary Assessment study. Schizophr Res 2021; 238:54-61. [PMID: 34607254 DOI: 10.1016/j.schres.2021.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 01/02/2023]
Abstract
22q11.2 deletion syndrome (22q11DS) is a genetic condition associated with a markedly increased risk for psychosis. Psychotic experiences are classically evaluated by clinical interviews that give little information about these symptoms' fluctuation in daily-life. The current study aims to investigate these phenomena using the Ecological Momentary Assessment (EMA), a structured diary technique that collects real-life measures in the everyday-life context, and to examine how these manifestations relate to a gold standard semi-structured assessment of psychotic experiences. Eighty-six individuals with 22q11DS as well as healthy controls (HC) aged 11-27 years were recruited. They completed a 6-day EMA protocol assessing momentary psychotic experiences as well as positive and negative affect. The presence of (attenuated) psychotic symptoms was assessed in 22q11DS participants with the SIPS interview. Participants with 22q11DS reported more intense (p = .005) and more frequent (p = .006) momentary psychotic experiences than HC. Significant associations between negative affect and momentary psychotic experiences were observed in both groups (p = .001). In participants with 22q11DS, more intense (p = <.001) and more frequent (p = <.001) momentary psychotic experiences measured by EMA were associated with the severity of SIPS positive symptoms. Participants with 22q11DS reporting at least attenuated positive symptoms of psychosis on the SIPS had more intense (p = .027) and more frequent (p = .023) momentary psychotic experiences than participants with 22q11DS without psychotic symptoms. This study highlights the validity of EMA to assess psychotic experiences in the context of daily-life and sets correspondence between EMA and the SIPS. Furthermore, it expands our current understanding of the associations between mood and psychotic experiences.
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Affiliation(s)
- Clémence Feller
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
| | - Laura Ilen
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
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