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Zaks N, Mahjani B, Reichenberg A, Birnbaum R. CLINICAL AND COGNITIVE PHENOTYPING OF COPY NUMBER VARIANTS PATHOGENIC FOR NEURODEVELOPMENTAL DISORDERS FROM A MULTI-ANCESTRY BIOBANK. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.16.24310489. [PMID: 39072027 PMCID: PMC11275656 DOI: 10.1101/2024.07.16.24310489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background Rare copy number variants (CNVs) are pathogenic for neurodevelopmental disorders (NDDs) and effect neurocognitive impairment. In aggregate, NDD CNVs may present in up to 2% of population cohorts with implications for neuropsychiatric disease risk and cognitive health. However, analyses of NDD CNVs in biobanks or population cohorts have been hindered by limited clinical or cognitive phenotypes, and a lack of ancestral diversity. In the current proof-of-concept study, NDD CNV carriers were recontacted from BioMe, a multi-ancestry biobank derived from the Mount Sinai healthcare system, to enable 'deep phenotyping' beyond electronic health record outcomes. Methods From BioMe biobank, 892 adult participants were recontacted, including 335 harboring NDD CNVs, 217 with schizophrenia and 340 neurotypical controls as comparators. Clinical and cognitive assessments were administered to each recruited participant. Results Seventy-three participants completed study assessments (mean age=48.8 years; 66% female; 36% African, 26% European, 34% Hispanic), or 8% of the recontacted subset, including 30 NDD CNV carriers across 15 loci. Among NDD CNV carriers, assessments indicated 40% with mood and anxiety disorders, 30% with learning disorders, and 13% with a history of special education. NDD CNV carriers were significantly cognitively impaired compared to controls on digit span backwards (Beta=-1.76, FDR=0.04) and digit span sequencing (Beta=-2.01, FDR=0.04). Conclusions Feasibility of "recall-by-genotype" from a multi-ancestry biobank was established for NDD CNV carriers, along with comparator groups. The current study corroborated past reports of NDD CNVs effects of cognitive impairment, while elucidating clinical phenotypes for recalled individuals. Future "recall-by-genotype" studies may further facilitate clinical characterization of disease-relevant genomic variants.
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Affiliation(s)
- Nina Zaks
- Department of Child and Adolescent Psychiatry, NYU Langone Health
| | - Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai
| | - Rebecca Birnbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Genetic and Genomics Sciences, Icahn School of Medicine at Mount Sinai
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Wright JR, Astrovskaya I, Barns SD, Goler A, Zhou X, Shu C, Snyder LG, Han B, Shen Y, Volfovsky N, Hall JB, Feliciano P, Chung WK. Return of genetic research results in 21,532 individuals with autism. Genet Med 2024; 26:101202. [PMID: 38958063 DOI: 10.1016/j.gim.2024.101202] [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: 01/30/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE The aim of this study is to identify likely pathogenic (LP) and pathogenic (P) genetic results for autism that can be returned to participants in SPARK (SPARKforAutism.org): a large recontactable cohort of people with autism in the United States. We also describe the process to return these clinically confirmed genetic findings. METHODS We present results from microarray genotyping and exome sequencing of 21,532 individuals with autism and 17,785 of their parents. We returned LP and P (American College of Medical Genetics criteria) copy-number variants, chromosomal aneuploidies, and variants in genes with strong evidence of association with autism and intellectual disability. RESULTS We identified 1903 returnable LP/P variants in 1861 individuals with autism (8.6%). 89.5% of these variants were not known to participants. The diagnostic genetic result was returned to 589 participants (53% of those contacted). Features associated with a higher probability of having a returnable result include cognitive and medically complex features, being female, being White (versus non-White) and being diagnosed more than 20 years ago. We also find results among autistics across the spectrum, as well as in transmitting parents with neuropsychiatric features but no autism diagnosis. CONCLUSION SPARK offers an opportunity to assess returnable results among autistic people who have not been ascertained clinically. SPARK also provides practical experience returning genetic results for a behavioral condition at a large scale.
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Affiliation(s)
- Jessica R Wright
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | | | - Sarah D Barns
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Alexandra Goler
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Xueya Zhou
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY
| | - Chang Shu
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | | | - Yufeng Shen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY; Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY
| | | | | | - Pamela Feliciano
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Wendy K Chung
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
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Vaez M, Montalbano S, Calle Sánchez X, Georgii Hellberg KL, Dehkordi SR, Krebs MD, Meijsen J, Shorter J, Bybjerg-Grauholm J, Mortensen PB, Børglum AD, Hougaard DM, Nordentoft M, Geschwind DH, Buil A, Schork AJ, Helenius D, Raznahan A, Thompson WK, Werge T, Ingason A. Population-Based Risk of Psychiatric Disorders Associated With Recurrent Copy Number Variants. JAMA Psychiatry 2024:2820398. [PMID: 38922630 PMCID: PMC11209205 DOI: 10.1001/jamapsychiatry.2024.1453] [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: 11/28/2023] [Accepted: 04/17/2024] [Indexed: 06/27/2024]
Abstract
Importance Recurrent copy number variants (rCNVs) have been associated with increased risk of psychiatric disorders in case-control studies, but their population-level impact is unknown. Objective To provide unbiased population-based estimates of prevalence and risk associated with psychiatric disorders for rCNVs and to compare risks across outcomes, rCNV dosage type (deletions or duplications), and locus features. Design, Setting, and Participants This genetic association study is an analysis of data from the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) case-cohort sample of individuals born in Denmark in 1981-2008 and followed up until 2015, including (1) all individuals (n = 92 531) with a hospital discharge diagnosis of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), or schizophrenia spectrum disorder (SSD) and (2) a subcohort (n = 50 625) randomly drawn from the source population. Data were analyzed from January 2021 to August 2023. Exposures Carrier status of deletions and duplications at 27 autosomal rCNV loci was determined from neonatal blood samples genotyped on single-nucleotide variant microarrays. Main Outcomes and Measures Population-based rCNV prevalence was estimated with a survey model using finite population correction to account for oversampling of cases. Hazard ratio (HR) estimates and 95% CIs for psychiatric disorders were derived using weighted Cox proportional hazard models. Risks were compared across outcomes, dosage type, and locus features using generalized estimating equation models. Results A total of 3547 rCNVs were identified in 64 735 individuals assigned male at birth (53.8%) and 55 512 individuals assigned female at birth (46.2%) whose age at the end of follow-up ranged from 7.0 to 34.7 years (mean, 21.8 years). Most observed increases in rCNV-associated risk for ADHD, ASD, or SSD were moderate, and risk estimates were highly correlated across these disorders. Notable exceptions included high ASD-associated risk observed for Prader-Willi/Angelman syndrome duplications (HR, 20.8; 95% CI, 7.9-55). No rCNV was associated with increased MDD risk. Also, rCNV-associated risk was positively correlated with locus size and gene constraint but not with dosage type. Comparison with published case-control and community-based studies revealed a higher prevalence of deletions and lower associated increase in risk for several rCNVs in iPSYCH2015. Conclusions and Relevance This study found that several rCNVs were more prevalent and conferred less risk of psychiatric disorders than estimated previously. Most case-control studies overestimate rCNV-associated risk of psychiatric disorders, likely because of selection bias. In an era where genetics is increasingly being clinically applied, these results highlight the importance of population-based risk estimates for genetics-based predictions.
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Affiliation(s)
- Morteza Vaez
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Simone Montalbano
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Xabier Calle Sánchez
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Kajsa-Lotta Georgii Hellberg
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Saeid Rasekhi Dehkordi
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Morten Dybdahl Krebs
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Joeri Meijsen
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - John Shorter
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Jonas Bybjerg-Grauholm
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Preben B. Mortensen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Anders D. Børglum
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Department of Biomedicine – Human Genetics and the iSEQ Center, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - David M. Hougaard
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Merete Nordentoft
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniel H. Geschwind
- Department of Neurology, University of California, Los Angeles
- Department of Human Genetics, University of California, Los Angeles
- Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles
- Center for Human Development, University of California, San Diego
- Program in Neurobehavioral Genetics, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles
| | - Alfonso Buil
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Lundbeck Foundation Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Andrew J. Schork
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Lundbeck Foundation Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
- Neurogenomics Division, Translational Genomics Research Institute (TGEN), Phoenix, Arizona
| | - Dorte Helenius
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
| | - Armin Raznahan
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, Bethesda, Maryland
| | - Wesley K. Thompson
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Lundbeck Foundation Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Andrés Ingason
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Roskilde, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark
- Lundbeck Foundation Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
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Zhang F, Gu Q, Song J, Zhao Y, Wang Z, Men S, Wang L. Prenatal diagnosis and family analysis of 17q12 microdeletion syndrome with fetal renal abnormalities. Front Genet 2024; 15:1401315. [PMID: 38957807 PMCID: PMC11217314 DOI: 10.3389/fgene.2024.1401315] [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: 03/15/2024] [Accepted: 05/23/2024] [Indexed: 07/04/2024] Open
Abstract
Purpose To analyze the prenatal diagnosis, parental verification, and pregnancy outcomes of three fetuses with 17ql2 microdeletion syndrome. Methods We retrospectively reviewed 46 singleton pregnancies with anomalies in the urinary system who underwent amniocentesis from Feb 2022 to October 2023 in the Prenatal Diagnosis Center of Lianyungang Maternal and Child Health Hospital. These fetuses were subjected to chromosomal microarray analysis (CMA) and/or trio whole-exome sequencing (Trio-WES). We specifically evaluated these cases' prenatal renal ultrasound findings and clinical characteristics of the affected parents. Results Three fetuses were diagnosed as 17q12 microdeletions, and the detection rate was 6.5% in fetuses with anomalies in the urinary system (3/46). The heterogeneous deletions range from 1.494 to 1.66 Mb encompassing the complete hepatocyte nuclear factor 1 homeobox B (HNF1B) gene. Fetuses with 17q12 deletion exhibited varied renal phenotypes. Moreover, the clinical phenotypes of the affected parents differed greatly in the two cases (case 2 and case 3) in which the deletion was inherited. For case 3, the mother manifested classic symptoms of 17q12 deletion syndrome as well as unreported characteristics, such as very high myopia. Conclusion Our findings demonstrate the necessity and significance of offering prenatal genetic testing when various renal anomalies are detected. In addition, our study broadens the phenotypic spectrum of 17q12 deletions. Most importantly, our findings may allow timely supportive genetic counseling and guidance for pregnancy in affected families, e.g., with the help of preimplantation genetic testing (PGT).
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Affiliation(s)
| | | | | | | | | | | | - Leilei Wang
- Department of Prenatal Diagnosis, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
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Lee R, Choi JE, Mun E, Kim KH, Choi SA, Kim HS. A Case of Chromosome 17q12 Deletion Syndrome with Type 2 Mayer-Rokitansky-Küster-Hauser Syndrome and Maturity-Onset Diabetes of the Young Type 5. CHILDREN (BASEL, SWITZERLAND) 2024; 11:404. [PMID: 38671621 PMCID: PMC11049139 DOI: 10.3390/children11040404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Chromosome 17q12 deletion syndrome (OMIM #614527) is a rare genetic disorder associated with a heterozygous 1.4-1.5 Mb deletion at chromosome 17q12, leading to a spectrum of clinical manifestations, including kidney abnormalities, neurodevelopmental delay, maturity-onset diabetes of the young type 5 (MODY5), and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. We present the case of a 14-year-old Korean female diagnosed with chromosome 17q12 deletion syndrome, confirmed by chromosomal microarray analysis. The patient exhibited MODY5 with pancreatic agenesis, MRKH syndrome, dysmorphic facial features, developmental delay, kidney rotation anomaly, portal vein thrombosis with liver hypoplasia, short stature, and scoliosis. Management involved the initiation of multiple daily insulin injections for diabetes control, gynecological evaluation for MRKH syndrome, and multidisciplinary care for associated complications. This case highlights the complexity and varied organ involvement in chromosome 17q12 deletion syndrome. A comprehensive and multidisciplinary approach is crucial for the management of affected individuals, including regular monitoring, tailored interventions across various medical specialties, and providing psychosocial support.
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Affiliation(s)
- Rosie Lee
- Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu 42601, Republic of Korea;
| | - Jung Eun Choi
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Eunji Mun
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Kyung hee Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Sun Ah Choi
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea; (J.E.C.); (E.M.); (K.h.K.); (S.A.C.)
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Schmidt RJ, Steeves M, Bayrak-Toydemir P, Benson KA, Coe BP, Conlin LK, Ganapathi M, Garcia J, Gollob MH, Jobanputra V, Luo M, Ma D, Maston G, McGoldrick K, Palculict TB, Pesaran T, Pollin TI, Qian E, Rehm HL, Riggs ER, Schilit SLP, Sergouniotis PI, Tvrdik T, Watkins N, Zec L, Zhang W, Lebo MS. Recommendations for risk allele evidence curation, classification, and reporting from the ClinGen Low Penetrance/Risk Allele Working Group. Genet Med 2024; 26:101036. [PMID: 38054408 PMCID: PMC10939896 DOI: 10.1016/j.gim.2023.101036] [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: 06/22/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE Genetic variants at the low end of the penetrance spectrum have historically been challenging to interpret because their high population frequencies exceed the disease prevalence of the associated condition, leading to a lack of clear segregation between the variant and disease. There is currently substantial variation in the classification of these variants, and no formal classification framework has been widely adopted. The Clinical Genome Resource Low Penetrance/Risk Allele Working Group was formed to address these challenges and promote harmonization within the clinical community. METHODS The work presented here is the product of internal and community Likert-scaled surveys in combination with expert consensus within the Working Group. RESULTS We formally recognize risk alleles and low-penetrance variants as distinct variant classes from those causing highly penetrant disease that require special considerations regarding their clinical classification and reporting. First, we provide a preferred terminology for these variants. Second, we focus on risk alleles and detail considerations for reviewing relevant studies and present a framework for the classification these variants. Finally, we discuss considerations for clinical reporting of risk alleles. CONCLUSION These recommendations support harmonized interpretation, classification, and reporting of variants at the low end of the penetrance spectrum.
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Affiliation(s)
- Ryan J Schmidt
- Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA.
| | | | - Pinar Bayrak-Toydemir
- Department of Pathology, University of Utah Molecular Genetics and Genomics, ARUP Laboratories, Salt Lake City, UT
| | - Katherine A Benson
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Ireland
| | - Bradley P Coe
- Department of Pathology & Lab Medicine, BC Children's & BC Women's Hospitals, Vancouver, Canada
| | - Laura K Conlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Genomic Diagnostics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Mythily Ganapathi
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
| | | | - Michael H Gollob
- Inherited Arrhythmia and Cardiomyopathy Program, Division of Cardiology, Toronto General Hospital and Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Vaidehi Jobanputra
- New York Genome Center, New York, NY; Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
| | - Minjie Luo
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Genomic Diagnostics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Deqiong Ma
- DNA diagnostic lab, Department of Genetics, School of Medicine, Yale University, New Haven, CT
| | | | | | | | | | - Toni I Pollin
- University of Maryland School of Medicine, Baltimore, MD
| | - Emily Qian
- Department of Genetics, Yale University School of Medicine, New Haven, CT
| | - Heidi L Rehm
- Center for Genomics Medicine, Massachusetts General Hospital, Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Erin R Riggs
- Geisinger Autism & Developmental Medicine Institute, Lewisburg, PA
| | - Samantha L P Schilit
- Mass General Brigham, Brigham and Woman's Hospital, Harvard Medical School, Boston, MA
| | | | - Tatiana Tvrdik
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Nicholas Watkins
- Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, Ontario, Canada Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | | | - Wenying Zhang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Matthew S Lebo
- Mass General Brigham, Brigham and Woman's Hospital, Harvard Medical School, Broad Institute of MIT and Harvard, Cambridge, MA.
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Porubsky D, Eichler EE. A 25-year odyssey of genomic technology advances and structural variant discovery. Cell 2024; 187:1024-1037. [PMID: 38290514 DOI: 10.1016/j.cell.2024.01.002] [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: 10/07/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024]
Abstract
This perspective focuses on advances in genome technology over the last 25 years and their impact on germline variant discovery within the field of human genetics. The field has witnessed tremendous technological advances from microarrays to short-read sequencing and now long-read sequencing. Each technology has provided genome-wide access to different classes of human genetic variation. We are now on the verge of comprehensive variant detection of all forms of variation for the first time with a single assay. We predict that this transition will further transform our understanding of human health and biology and, more importantly, provide novel insights into the dynamic mutational processes shaping our genomes.
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Affiliation(s)
- David Porubsky
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA; Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA.
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Verscaj CP, Velez-Bartolomei F, Bodle E, Chan K, Lyons MJ, Thorson W, Tan WH, Rodig N, Graham JM, Peron A, Quintero-Rivera F, Zackai EH, Thomas MA, Stevens CA, Adam MP, Bird LM, Jones MC, Matalon DR. Characterization of the prenatal renal phenotype associated with 17q12, HNF1B, microdeletions. Prenat Diagn 2024; 44:237-246. [PMID: 37632214 DOI: 10.1002/pd.6424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE Recurrent deletions involving 17q12 are associated with a variety of clinical phenotypes, including congenital abnormalities of the kidney and urinary tract (CAKUT), maturity onset diabetes of the young, type 5, and neurodevelopmental disorders. Structural and/or functional renal disease is the most common phenotypic feature, although the prenatal renal phenotypes and the postnatal correlates have not been well characterized. METHOD We reviewed pre- and postnatal medical records of 26 cases with prenatally or postnatally identified 17q12/HNF1B microdeletions (by chromosomal microarray or targeted gene sequencing), obtained through a multicenter collaboration. We specifically evaluated 17 of these cases (65%) with reported prenatal renal ultrasound findings. RESULTS Heterogeneous prenatal renal phenotypes were noted, most commonly renal cysts (41%, n = 7/17) and echogenic kidneys (41%), although nonspecific dysplasia, enlarged kidneys, hydronephrosis, pelvic kidney with hydroureter, and lower urinary tract obstruction were also reported. Postnatally, most individuals developed renal cysts (73%, 11/15 live births), and there were no cases of end-stage renal disease during childhood or the follow-up period. CONCLUSION Our findings demonstrate that copy number variant analysis to assess for 17q12 microdeletion should be considered for a variety of prenatally detected renal anomalies. It is important to distinguish 17q12 microdeletion from other etiologies of CAKUT as the prognosis for renal function and presence of associated findings are distinct and may influence pregnancy and postnatal management.
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Affiliation(s)
| | | | - Ethan Bodle
- Stanford University, Palo Alto, California, USA
| | - Katie Chan
- Stanford University, Palo Alto, California, USA
| | | | - Willa Thorson
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wen-Hann Tan
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - Nancy Rodig
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - John M Graham
- Department of Pediatrics, Cedars-Sinai Medical Center, David Geffen School of Medicine, Los Angeles, California, USA
| | - Angela Peron
- Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Fabiola Quintero-Rivera
- Departments of Pathology, Laboratory Medicine, and Pediatrics, Division of Genetic and Genomic Medicine School of Medicine, University of California Irvine, Irvine, California, USA
| | - Elaine H Zackai
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mary Ann Thomas
- Departments of Medical Genetics and Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Cathy A Stevens
- Department of Pediatrics, University of Tennessee College of Medicine, Chattanooga, Tennessee, USA
| | | | - Lynne M Bird
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, California, USA
| | - Marilyn C Jones
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, California, USA
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Detera-Wadleigh SD, Kassem L, Besancon E, Lopes F, Akula N, Sung H, Blattner M, Sheridan L, Lacbawan LN, Garcia J, Gordovez F, Hosey K, Donner C, Salvini C, Schulze T, Chen DTW, England B, Cross J, Jiang X, Corona W, Russ J, Mallon B, Dutra A, Pak E, Steiner J, Malik N, de Guzman T, Horato N, Mallmann MB, Mendes V, Dűck AL, Nardi AE, McMahon FJ. A resource of induced pluripotent stem cell (iPSC) lines including clinical, genomic, and cellular data from genetically isolated families with mood and psychotic disorders. Transl Psychiatry 2023; 13:397. [PMID: 38104115 PMCID: PMC10725500 DOI: 10.1038/s41398-023-02641-w] [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: 04/18/2022] [Revised: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023] Open
Abstract
Genome-wide (GWAS) and copy number variant (CNV) association studies have reproducibly identified numerous risk alleles associated with bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SCZ), but biological characterization of these alleles lags gene discovery, owing to the inaccessibility of live human brain cells and inadequate animal models for human psychiatric conditions. Human-derived induced pluripotent stem cells (iPSCs) provide a renewable cellular reagent that can be differentiated into living, disease-relevant cells and 3D brain organoids carrying the full complement of genetic variants present in the donor germline. Experimental studies of iPSC-derived cells allow functional characterization of risk alleles, establishment of causal relationships between genes and neurobiology, and screening for novel therapeutics. Here we report the creation and availability of an iPSC resource comprising clinical, genomic, and cellular data obtained from genetically isolated families with BD and related conditions. Results from the first 324 study participants, 61 of whom have validated pluripotent clones, show enrichment of rare single nucleotide variants and CNVs overlapping many known risk genes and pathogenic CNVs. This growing iPSC resource is available to scientists pursuing functional genomic studies of BD and related conditions.
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Affiliation(s)
- Sevilla D Detera-Wadleigh
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA.
| | - Layla Kassem
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA.
| | - Emily Besancon
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Fabiana Lopes
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Nirmala Akula
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Heejong Sung
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Meghan Blattner
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Laura Sheridan
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Ley Nadine Lacbawan
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Joshua Garcia
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Francis Gordovez
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Katherine Hosey
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Cassandra Donner
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Claudio Salvini
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Thomas Schulze
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
- Institute of Psychiatric Phenomics and Genomics, LMU Munich, 80336, München, Germany
- Department of Psychiatry and Behavioral Sciences, Upstate University Hospital, Syracuse, NY, 13210, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - David T W Chen
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Bryce England
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Joanna Cross
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Xueying Jiang
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Winston Corona
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Jill Russ
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Barbara Mallon
- Center for Scientific Review, Neurotechnology and Vision Branch, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Amalia Dutra
- Cytogenetics and Microscopy Core, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Evgenia Pak
- Cytogenetics and Microscopy Core, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Joe Steiner
- Neurotherapeutics Development Unit, NINDS, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nasir Malik
- Neurotherapeutics Development Unit, NINDS, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Theresa de Guzman
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
| | - Natia Horato
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Mariana B Mallmann
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Victoria Mendes
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Amanda L Dűck
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Antonio E Nardi
- Laboratorio de Panico e Respiracao, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil
| | - Francis J McMahon
- Genetic Basis of Mood & Anxiety Disorders Section, Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, 35 Convent Drive, Bethesda, MD, 20892, USA
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10
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DiCriscio AS, Beiler D, Smith J, Asdell P, Dickey S, DiStefano M, Troiani V. Assessment of autonomic symptom scales in patients with neurodevelopmental diagnoses using electronic health record data. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 108:102234. [PMID: 37982012 PMCID: PMC10653282 DOI: 10.1016/j.rasd.2023.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Background Sleep disturbances, gastrointestinal problems, and atypical heart rate are commonly observed in patients with autism spectrum disorder (ASD) and may relate to underlying function of the autonomic nervous system (ANS). The overall objective of the current study was to quantitatively characterize features of ANS function using symptom scales and available electronic health record (EHR) data in a clinically and genetically characterized pediatric cohort. Methods We assessed features of ANS function via chart review of patient records adapted from items drawn from a clinical research questionnaire of autonomic symptoms. This procedure coded for the presence and/or absence of targeted symptoms and was completed in 3 groups of patients, including patients with a clinical neurodevelopmental diagnosis and identified genetic etiology (NPD, n=244), those with an ASD diagnosis with no known genetic cause (ASD, n=159), and age and sex matched controls (MC, n=213). Symptoms were assessed across four main categories: (1) Mood, Behavior, and Emotion; (2) Secretomotor, Sensory Integration; (3) Urinary, Gastrointestinal, and Digestion; and (4) Circulation, Thermoregulation, Circadian function, and Sleep/Wake cycles. Results Chart review scores indicate an increased rate of autonomic symptoms across all four sections in our NPD group as compared to scores with ASD and/or MC. Additionally, we note several significant relationships between individual differences in autonomic symptoms and quantitative ASD traits. Conclusion These results highlight EHR review as a potentially useful method for quantifying variance in symptoms adapted from a questionnaire or survey. Further, using this method indicates that autonomic features are more prevalent in children with genetic disorders conferring risk for ASD and other neurodevelopmental diagnoses.
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Affiliation(s)
- A S DiCriscio
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - D Beiler
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - J Smith
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Behavioral Health, Danville, PA, United States
| | - P Asdell
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Summa Health, Ohio, United States
| | - S Dickey
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - M DiStefano
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Precision Health Program, Danville, PA, United States
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - V Troiani
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Department of Imaging Science and Innovation, Center for Health Research, Danville, PA, United States
- Geisinger Neuroscience Institute, Danville, PA, United States
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, PA, United States
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11
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Zarrei M, Burton CL, Engchuan W, Higginbotham EJ, Wei J, Shaikh S, Roslin NM, MacDonald JR, Pellecchia G, Nalpathamkalam T, Lamoureux S, Manshaei R, Howe J, Trost B, Thiruvahindrapuram B, Marshall CR, Yuen RKC, Wintle RF, Strug LJ, Stavropoulos DJ, Vorstman JAS, Arnold P, Merico D, Woodbury-Smith M, Crosbie J, Schachar RJ, Scherer SW. Gene copy number variation and pediatric mental health/neurodevelopment in a general population. Hum Mol Genet 2023; 32:2411-2421. [PMID: 37154571 PMCID: PMC10360394 DOI: 10.1093/hmg/ddad074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023] Open
Abstract
We assessed the relationship of gene copy number variation (CNV) in mental health/neurodevelopmental traits and diagnoses, physical health and cognition in a community sample of 7100 unrelated children and youth of European or East Asian ancestry (Spit for Science). Clinically significant or susceptibility CNVs were present in 3.9% of participants and were associated with elevated scores on a continuous measure of attention-deficit/hyperactivity disorder (ADHD) traits (P = 5.0 × 10-3), longer response inhibition (a cognitive deficit found in several mental health and neurodevelopmental disorders; P = 1.0 × 10-2) and increased prevalence of mental health diagnoses (P = 1.9 × 10-6, odds ratio: 3.09), specifically ADHD, autism spectrum disorder anxiety and learning problems/learning disorder (P's < 0.01). There was an increased burden of rare deletions in gene-sets related to brain function or expression in brain associated with more ADHD traits. With the current mental health crisis, our data established a baseline for delineating genetic contributors in pediatric-onset conditions.
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Affiliation(s)
- Mehdi Zarrei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Christie L Burton
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Worrawat Engchuan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Edward J Higginbotham
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - John Wei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sabah Shaikh
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Nicole M Roslin
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jeffrey R MacDonald
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Giovanna Pellecchia
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Thomas Nalpathamkalam
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sylvia Lamoureux
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Roozbeh Manshaei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Ted Rogers Centre for Heart Research, Cardiac Genome Clinic, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jennifer Howe
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Brett Trost
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | | | - Christian R Marshall
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Ryan K C Yuen
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Richard F Wintle
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Lisa J Strug
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
- Departments of Statistical Sciences, Computer Science and Biostatistics, University of Toronto, Toronto, ON M5G 1Z5, Canada
| | - Dimitri J Stavropoulos
- Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jacob A S Vorstman
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Paul Arnold
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB T2N 1N4, Canada
- Departments of Psychiatry & Medical Genetics, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Daniele Merico
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Deep Genomics Inc., Toronto, ON M5G 1M1, Canada
| | - Marc Woodbury-Smith
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Jennifer Crosbie
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Russell J Schachar
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
- Department of Molecular Genetics, McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A8, Canada
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12
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Miller EG, Young JL, Rao A, Ward-Lev E, Halley MC. Demographic Characteristics Associated With Perceptions of Personal Utility in Genetic and Genomic Testing: A Systematic Review. JAMA Netw Open 2023; 6:e2310367. [PMID: 37145601 PMCID: PMC10163389 DOI: 10.1001/jamanetworkopen.2023.10367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/14/2023] [Indexed: 05/06/2023] Open
Abstract
Importance The expansion of genetic and genomic testing in health care has led to recognition that these tests provide personal as well as clinical utility to patients and families. However, available systematic reviews on this topic have not reported the demographic backgrounds of participants in studies of personal utility, leaving generalizability unclear. Objective To determine the demographic characteristics of participants in studies examining the personal utility of genetic and genomic testing in health care. Evidence Review For this systematic review, we utilized and updated the results of a highly cited 2017 systematic review on the personal utility of genetics and genomics, which identified relevant articles published between January 1, 2003, and August 4, 2016. We also used the original methods to update this bibliography with literature published subsequently up to January 1, 2022. Studies were screened for eligibility by 2 independent reviewers. Eligible studies reported empirical data on the perspectives of patients, family members, and/or the general public in the US on the personal utility of any type of health-related genetic or genomic test. We utilized a standardized codebook to extract study and participant characteristics. We summarized demographic characteristics descriptively across all studies and by subgroup based on study and participant characteristics. Findings We included 52 studies with 13 251 eligible participants. Sex or gender was the most frequently reported demographic characteristic (48 studies [92.3%]), followed by race and ethnicity (40 studies [76.9%]), education (38 studies [73.1%]), and income (26 studies [50.0%]). Across studies, participants disproportionately were women or female (mean [SD], 70.8% [20.5%]), were White (mean [SD], 76.1% [22.0%]), had a college degree or higher (mean [SD], 64.5% [19.9%]), and reported income above the US median (mean [SD], 67.4% [19.2%]). Examination of subgroups of results by study and participant characteristics evidenced only small shifts in demographic characteristics. Conclusions and Relevance This systematic review examined the demographic characteristics of individual participants in studies of the personal utility of health-related genetic and genomic testing in the US. The results suggest that participants in these studies were disproportionately White, college-educated women with above-average income. Understanding the perspectives of more diverse individuals regarding the personal utility of genetic and genomic testing may inform barriers to research recruitment and uptake of clinical testing in currently underrepresented populations.
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Affiliation(s)
- Emily G. Miller
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
| | - Jennifer L. Young
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anoushka Rao
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
| | - Eliana Ward-Lev
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
| | - Meghan C. Halley
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
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13
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Adams RL, Baird A, Smith J, Williams N, van den Bree MBM, Linden DEJ, Owen MJ, Hall J, Linden SC. Psychopathology in adults with copy number variants. Psychol Med 2023; 53:3142-3149. [PMID: 35144709 PMCID: PMC10244007 DOI: 10.1017/s0033291721005201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 11/03/2021] [Accepted: 11/30/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Copy number variants (CNVs) have been associated with the risk of schizophrenia, autism and intellectual disability. However, little is known about their spectrum of psychopathology in adulthood. METHODS We investigated the psychiatric phenotypes of adult CNV carriers and compared probands, who were ascertained through clinical genetics services, with carriers who were not. One hundred twenty-four adult participants (age 18-76), each bearing one of 15 rare CNVs, were recruited through a variety of sources including clinical genetics services, charities for carriers of genetic variants, and online advertising. A battery of psychiatric assessments was used to determine psychopathology. RESULTS The frequencies of psychopathology were consistently higher for the CNV group compared to general population rates. We found particularly high rates of neurodevelopmental disorders (NDDs) (48%), mood disorders (42%), anxiety disorders (47%) and personality disorders (73%) as well as high rates of psychiatric multimorbidity (median number of diagnoses: 2 in non-probands, 3 in probands). NDDs [odds ratio (OR) = 4.67, 95% confidence interval (CI) 1.32-16.51; p = 0.017) and psychotic disorders (OR = 6.8, 95% CI 1.3-36.3; p = 0.025) occurred significantly more frequently in probands (N = 45; NDD: 39[87%]; psychosis: 8[18%]) than non-probands (N = 79; NDD: 20 [25%]; psychosis: 3[4%]). Participants also had somatic diagnoses pertaining to all organ systems, particularly conotruncal cardiac malformations (in individuals with 22q11.2 deletion syndrome specifically), musculoskeletal, immunological, and endocrine diseases. CONCLUSIONS Adult CNV carriers had a markedly increased rate of anxiety and personality disorders not previously reported and high rates of psychiatric multimorbidity. Our findings support in-depth psychiatric and medical assessments of carriers of CNVs and the establishment of multidisciplinary clinical services.
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Affiliation(s)
- Rachael L. Adams
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Alister Baird
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jacqueline Smith
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Nigel Williams
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Marianne B. M. van den Bree
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - David E. J. Linden
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Live Sciences, Maastricht University, Maastricht, The Netherlands
| | - Michael J. Owen
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Stefanie C. Linden
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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14
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White LK, Crowley TB, Finucane B, McClellan EJ, Donoghue S, Garcia-Minaur S, Repetto GM, Fischer M, Jacquemont S, Gur RE, Maillard AM, Donald KA, Bassett AS, Swillen A, McDonald-McGinn DM. Gathering the Stakeholder's Perspective: Experiences and Opportunities in Rare Genetic Disease Research. Genes (Basel) 2023; 14:169. [PMID: 36672911 PMCID: PMC9859499 DOI: 10.3390/genes14010169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Research participant feedback is rarely collected; therefore, investigators have limited understanding regarding stakeholders' (affected individuals/caregivers) motivation to participate. Members of the Genes to Mental Health Network (G2MH) surveyed stakeholders affected by copy number variants (CNVs) regarding perceived incentives for study participation, opinions concerning research priorities, and the necessity for future funding. Respondents were also asked about feelings of preparedness, research burden, and satisfaction with research study participation. METHODS Modified validated surveys were used to assess stakeholders´ views across three domains: (1) Research Study Enrollment, Retainment, Withdrawal, and Future Participation; (2) Overall Research Experience, Burden, and Preparedness; (3) Research Priorities and Obstacles. Top box score analyses were performed. RESULTS A total of 704 stakeholders´ responded from 29 countries representing 55 CNVs. The top reasons for initial participation in the research included reasons related to education and altruism. The top reasons for leaving a research study included treatment risks and side effects. The importance of sharing research findings and laboratory results with stakeholders was underscored by participants. Most stakeholders reported positive research experiences. CONCLUSIONS This study provides important insight into how individuals and families affected with a rare CNV feel toward research participation and their overall experience in rare disease research. There are clear targets for areas of improvement for study teams, although many stakeholders reported positive research experiences. Key findings from this international survey may help advance collaborative research and improve the experience of participants, investigators, and other stakeholders moving forward.
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Affiliation(s)
- Lauren K. White
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | | | - Emily J. McClellan
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sarah Donoghue
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sixto Garcia-Minaur
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, 28046 Madrid, Spain
| | | | - Matthias Fischer
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Rostock, 18147 Rostock, Germany
- Sigma-Zentrum, 79713 Bad Säckingen, Germany
| | - Sebastien Jacquemont
- Sainte Justine Research Center, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Raquel E. Gur
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, Rondebosch, Cape Town 7700, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town 7935, South Africa
| | - Anne S. Bassett
- The Dalglish Family 22q Clinic, University Health Network, Toronto, ON M5G 2C4, Canada
- Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, ON M5S 2S1, Canada
- Division of Cardiology, Department of Medicine, and Centre for Mental Health, and Toronto General Hospital Research Institute, University Health Network, Toronto, ON M5G 2N2, Canada
| | - Ann Swillen
- Center for Human Genetics, University Hospital UZ Leuven, and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Donna M. McDonald-McGinn
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Human Biology and Medical Genetics, Sapienza University, 00185 Roma, Italy
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15
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Savatt JM, Oetjens MT, Myers SM, Finucane BM. Response to van Riel et al. Genet Med 2023; 25:161-163. [PMID: 36609148 DOI: 10.1016/j.gim.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Juliann M Savatt
- Autism & Developmental Medicine Institute, Geisinger, Lewisburg, PA; Department of Genomic Health, Geisinger, Danville, PA.
| | | | - Scott M Myers
- Autism & Developmental Medicine Institute, Geisinger, Lewisburg, PA
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16
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Kalin NH. Childhood- and Neurodevelopment-Related Psychiatric Disorders. Am J Psychiatry 2023; 180:1-4. [PMID: 36587272 DOI: 10.1176/appi.ajp.20220952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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17
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Shimelis H, Oetjens MT, Walsh LK, Wain KE, Znidarsic M, Myers SM, Finucane BM, Ledbetter DH, Martin CL. Prevalence and Penetrance of Rare Pathogenic Variants in Neurodevelopmental Psychiatric Genes in a Health Care System Population. Am J Psychiatry 2023; 180:65-72. [PMID: 36475376 PMCID: PMC10017070 DOI: 10.1176/appi.ajp.22010062] [Citation(s) in RCA: 5] [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] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Autism, schizophrenia, and other clinically distinct neurodevelopmental psychiatric disorders (NPDs) have shared genetic etiologies, including single-gene and multigenic copy number variants (CNVs). Because rare variants are primarily investigated in clinical cohorts, population-based estimates of their prevalence and penetrance are lacking. The authors determined the prevalence, penetrance, and NPD risk of pathogenic single-gene variants in a large health care system population. METHODS The authors analyzed linked genomic and electronic health record (EHR) data in a subset of 90,595 participants from Geisinger's MyCode Community Health Initiative, known as the DiscovEHR cohort. Loss-of-function pathogenic variants in 94 high-confidence NPD genes were identified through exome sequencing, and NPD penetrance was calculated using preselected EHR diagnosis codes. NPD risk was estimated using a case-control comparison of DiscovEHR participants with and without NPD diagnoses. Results from single-gene variant analyses were also compared with those from 31 previously reported pathogenic NPD CNVs. RESULTS Pathogenic variants were identified in 0.34% of the DiscovEHR cohort and demonstrated a 34.3% penetrance for NPDs. Similar to CNVs, sequence variants collectively conferred a substantial risk for several NPD diagnoses, including autism, schizophrenia, and bipolar disorder. Significant NPD risk remained after participants with intellectual disability were excluded from the analysis, confirming the association with major psychiatric disorders in individuals without severe cognitive deficits. CONCLUSIONS Collectively, rare single-gene variants and CNVs were found in >1% of individuals in a large health care system population and play an important contributory role in mental health disorders. Diagnostic genetic testing for pathogenic variants among symptomatic individuals with NPDs could improve clinical outcomes through early intervention and anticipatory therapeutic support.
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Affiliation(s)
- Hermela Shimelis
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Matthew T Oetjens
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Lauren K Walsh
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Karen E Wain
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Masa Znidarsic
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Scott M Myers
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Brenda M Finucane
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - David H Ledbetter
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
| | - Christa Lese Martin
- Autism and Developmental Medicine Institute, Geisinger, Lewisburg, Pa. (all authors)
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18
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Bastos GC, Tolezano GC, Krepischi ACV. Rare CNVs and Known Genes Linked to Macrocephaly: Review of Genomic Loci and Promising Candidate Genes. Genes (Basel) 2022; 13:genes13122285. [PMID: 36553552 PMCID: PMC9778424 DOI: 10.3390/genes13122285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Macrocephaly frequently occurs in single-gene disorders affecting the PI3K-AKT-MTOR pathway; however, epigenetic mutations, mosaicism, and copy number variations (CNVs) are emerging relevant causative factors, revealing a higher genetic heterogeneity than previously expected. The aim of this study was to investigate the role of rare CNVs in patients with macrocephaly and review genomic loci and known genes. We retrieved from the DECIPHER database de novo <500 kb CNVs reported on patients with macrocephaly; in four cases, a candidate gene for macrocephaly could be pinpointed: a known microcephaly gene-TRAPPC9, and three genes based on their functional roles-RALGAPB, RBMS3, and ZDHHC14. From the literature review, 28 pathogenic CNV genomic loci and over 300 known genes linked to macrocephaly were gathered. Among the genomic regions, 17 CNV loci (~61%) exhibited mirror phenotypes, that is, deletions and duplications having opposite effects on head size. Identifying structural variants affecting head size can be a preeminent source of information about pathways underlying brain development. In this study, we reviewed these genes and recurrent CNV loci associated with macrocephaly, as well as suggested novel potential candidate genes deserving further studies to endorse their involvement with this phenotype.
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19
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DiCriscio AS, Wain KE, Smith J, Beiler D, Walsh LK, Holdren K, Troiani V. Higher scores on autonomic symptom scales in pediatric patients with neurodevelopmental disorders of known genetic etiology. Brain Behav 2022; 12:e2813. [PMID: 36423250 PMCID: PMC9759134 DOI: 10.1002/brb3.2813] [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: 05/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Features of underlying autonomic dysfunction, including sleep disturbances, gastrointestinal problems, and atypical heart rate, have been reported in neurodevelopmental conditions, including autism spectrum disorder (ASD). The current cross-sectional, between-groups study aimed to quantify symptoms of autonomic dysfunction in a neurodevelopmental pediatric cohort characterized by clinical diagnoses as well as genetic etiology. METHOD The Pediatric Autonomic Symptom Scales (PASS) questionnaire was used to assess autonomic features across a group of patients with clinical neurodevelopmental diagnoses (NPD; N = 90) and genetic etiologies. Patients were subdivided based on either having a clinical ASD diagnosis (NPD-ASD; n = 37) or other non-ASD neurodevelopmental diagnoses, such as intellectual disability without ASD, speech and language disorders, and/or attention deficit hyperactivity disorder (NPD-OTHER; n = 53). Analyses focused on characterizing differences between the NPD group compared to previously published reference samples, as well as differences between the two NPD subgroups (NPD-ASD and NPD-OTHER). RESULTS Our results indicate higher PASS scores in our NPD cohort relative to children with and without ASD from a previously published cohort. However, we did not identify significant group differences between our NPD-ASD and NPD-OTHER subgroups. Furthermore, we find a significant relationship between quantitative ASD traits and symptoms of autonomic function. CONCLUSION This work demonstrates the utility of capturing quantitative estimates of autonomic trait dimensions that may be significantly linked with psychosocial impairments and other core clinical features of ASD.
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Affiliation(s)
- Antoinette S DiCriscio
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K E Wain
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - J Smith
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - D Beiler
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - L K Walsh
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K Holdren
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - Vanessa Troiani
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA.,Department of Imaging Science and Innovation, Center for Health Research, Geisinger, Danville, Pennsylvania, USA.,Neuroscience Institute, Geisinger, Danville, Pennsylvania, USA.,Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
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20
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Brownstein CA, Douard E, Mollon J, Smith R, Hojlo MA, Das A, Goldman M, Garvey E, Cabral K, Li J, Bowen J, Rao AS, Genetti C, Carroll D, Knowles EEM, Deaso E, Agrawal PB, Beggs AH, D'Angelo E, Almasy L, Alexander-Bloch A, Saci Z, Moreau CA, Huguet G, Deo AJ, Jacquemont S, Glahn DC, Gonzalez-Heydrich J. Similar Rates of Deleterious Copy Number Variants in Early-Onset Psychosis and Autism Spectrum Disorder. Am J Psychiatry 2022; 179:853-861. [PMID: 36000218 PMCID: PMC9633349 DOI: 10.1176/appi.ajp.21111175] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Copy number variants (CNVs) are strongly associated with neurodevelopmental and psychotic disorders. Early-onset psychosis (EOP), where symptoms appear before 18 years of age, is thought to be more strongly influenced by genetic factors than adult-onset psychotic disorders. However, the prevalence and effect of CNVs in EOP is unclear. METHODS The authors documented the prevalence of recurrent CNVs and the functional impact of deletions and duplications genome-wide in 137 children and adolescents with EOP compared with 5,540 individuals with autism spectrum disorder (ASD) and 16,504 population control subjects. Specifically, the frequency of 47 recurrent CNVs previously associated with neurodevelopmental and neuropsychiatric illnesses in each cohort were compared. Next, CNV risk scores (CRSs), indices reflecting the dosage sensitivity for any gene across the genome that is encapsulated in a deletion or duplication separately, were compared between groups. RESULTS The prevalence of recurrent CNVs was significantly higher in the EOP group than in the ASD (odds ratio=2.30) and control (odds ratio=5.06) groups. However, the difference between the EOP and ASD groups was attenuated when EOP participants with co-occurring ASD were excluded. CRS was significantly higher in the EOP group compared with the control group for both deletions (odds ratio=1.30) and duplications (odds ratio=1.09). In contrast, the EOP and ASD groups did not differ significantly in terms of CRS. CONCLUSIONS Given the high frequency of recurrent CNVs in the EOP group and comparable CRSs in the EOP and ASD groups, the findings suggest that all children and adolescents with a psychotic diagnosis should undergo genetic screening, as is recommended in ASD.
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Affiliation(s)
- Catherine A Brownstein
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Elise Douard
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Josephine Mollon
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Richard Smith
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Margaret A Hojlo
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Ananth Das
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Maria Goldman
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Emily Garvey
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Kristin Cabral
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Jianqiao Li
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Joshua Bowen
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Abhijit S Rao
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Casie Genetti
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Devon Carroll
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Emma E M Knowles
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Emma Deaso
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Pankaj B Agrawal
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Alan H Beggs
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Eugene D'Angelo
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Laura Almasy
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Aaron Alexander-Bloch
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Zohra Saci
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Clara A Moreau
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Guillaume Huguet
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Anthony J Deo
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Sébastien Jacquemont
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - David C Glahn
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
| | - Joseph Gonzalez-Heydrich
- Early Psychosis Investigation Center (Brownstein, Mollon, Smith, Hojlo, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Division of Genetics and Genomics (Brownstein, Smith, Cabral, Li, Bowen, Rao, Genetti, Agrawal, Beggs, Glahn), Manton Center for Orphan Disease Research (Brownstein, Smith, Cabral, Li, Bowen, Genetti, Agrawal, Beggs, Glahn), Department of Psychiatry and Behavioral Sciences (Mollon, Hojlo, Das, Goldman, Garvey, Carroll, Knowles, Deaso, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Tommy Fuss Center for Neuropsychiatric Disease Research (Deo, Glahn, Gonzalez-Heydrich), and Division of Newborn Medicine (Agrawal), Boston Children's Hospital, Boston; Department of Pediatrics (Brownstein, Smith, Genetti, Agrawal, Beggs, Deo) and Department of Psychiatry (Mollon, Carroll, Knowles, D'Angelo, Deo, Glahn, Gonzalez-Heydrich), Harvard Medical School, Boston; Department of Pediatrics (Jacquemont) and Department of Neuroscience (Douard, Moreau), Université de Montréal, Montreal; Sainte-Justine Hospital Research Center, Montreal (Douard, Saci, Moreau, Huguet, Jacquemont); Department of Biomedical and Health Informatics (Almasy) and Department of Psychiatry (Alexander-Bloch), Children's Hospital of Philadelphia, Philadelphia; Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, N.J. (Deo); Rutgers University Behavioral Health Care, Piscataway, N.J. (Deo). Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia (Almasy); Department of Genetics, University of Pennsylvania, Philadelphia (Almasy); Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago (Smith)
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21
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Lencz T, Sabatello M, Docherty A, Peterson RE, Soda T, Austin J, Bierut L, Crepaz-Keay D, Curtis D, Degenhardt F, Huckins L, Lazaro-Munoz G, Mattheisen M, Meiser B, Peay H, Rietschel M, Walss-Bass C, Davis LK. Concerns about the use of polygenic embryo screening for psychiatric and cognitive traits. Lancet Psychiatry 2022; 9:838-844. [PMID: 35931093 PMCID: PMC9930635 DOI: 10.1016/s2215-0366(22)00157-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/01/2022] [Accepted: 04/23/2022] [Indexed: 12/19/2022]
Abstract
Private companies have begun offering services to allow parents undergoing in-vitro fertilisation to screen embryos for genetic risk of complex diseases, including psychiatric disorders. This procedure, called polygenic embryo screening, raises several difficult scientific and ethical issues, as discussed in this Personal View. Polygenic embryo screening depends on the statistical properties of polygenic risk scores, which are complex and not well studied in the context of this proposed clinical application. The clinical, social, and ethical implications of polygenic embryo screening have barely been discussed among relevant stakeholders. To our knowledge, the International Society of Psychiatric Genetics is the first professional biomedical organisation to issue a statement regarding polygenic embryo screening. For the reasons discussed in this Personal View, the Society urges caution and calls for additional research and oversight on the use of polygenic embryo screening.
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Affiliation(s)
- Todd Lencz
- Divison of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA; Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA.
| | - Maya Sabatello
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Anna Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roseann E Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Takahiro Soda
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jehannine Austin
- Departments of Psychiatry and Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Laura Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | | | - David Curtis
- UCL Genetics Institute, University College London, London, United Kingdom
| | - Franziska Degenhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Laura Huckins
- Departments of Psychiatry and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Manuel Mattheisen
- Department of Psychiatry, Dalhousie Medical School, Halifax, NS, Canada
| | - Bettina Meiser
- Prince of Wales Clinical School, University of New South Wales, NSW, Australia
| | - Holly Peay
- Genomics, Bioinformatics, and Translational Research Center, RTI International, Raleigh, NC, USA
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
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22
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Chawner SJRA, Owen MJ. Autism: A model of neurodevelopmental diversity informed by genomics. Front Psychiatry 2022; 13:981691. [PMID: 36117659 PMCID: PMC9479184 DOI: 10.3389/fpsyt.2022.981691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/10/2022] [Indexed: 01/28/2023] Open
Abstract
Definitions of autism are constantly in flux and the validity and utility of diagnostic criteria remain hotly debated. The boundaries of autism are unclear and there is considerable heterogeneity within autistic individuals. Autistic individuals experience a range of co-occurring conditions notably including other childhood onset neurodevelopmental conditions such as intellectual disability, epilepsy and ADHD, but also other neuropsychiatric conditions. Recently, the neurodiversity movement has challenged the conception of autism as a medical syndrome defined by functional deficits. Whereas others have argued that autistic individuals with the highest support needs, including those with intellectual disability and limited functional communication, are better represented by a medical model. Genomic research indicates that, rather than being a circumscribed biological entity, autism can be understood in relation to two continua. On the one hand, it can be conceived as lying on a continuum of population variation in social and adaptive functioning traits, reflecting in large part the combination of multiple alleles of small effect. On the other, it can be viewed as lying on a broader neurodevelopmental continuum whereby rare genetic mutations and environmental risk factors impact the developing brain, resulting in a diverse spectrum of outcomes including childhood-onset neurodevelopmental conditions as well as adult-onset psychiatric conditions such as schizophrenia. This model helps us understand heterogeneity within autism and to reconcile the view that autism is a part of natural variability, as advocated by the neurodiversity movement, with the presence of co-occurring disabilities and impairments of function in some autistic individuals.
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Affiliation(s)
| | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
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23
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Kushima I, Nakatochi M, Aleksic B, Okada T, Kimura H, Kato H, Morikawa M, Inada T, Ishizuka K, Torii Y, Nakamura Y, Tanaka S, Imaeda M, Takahashi N, Yamamoto M, Iwamoto K, Nawa Y, Ogawa N, Iritani S, Hayashi Y, Lo T, Otgonbayar G, Furuta S, Iwata N, Ikeda M, Saito T, Ninomiya K, Okochi T, Hashimoto R, Yamamori H, Yasuda Y, Fujimoto M, Miura K, Itokawa M, Arai M, Miyashita M, Toriumi K, Ohi K, Shioiri T, Kitaichi K, Someya T, Watanabe Y, Egawa J, Takahashi T, Suzuki M, Sasaki T, Tochigi M, Nishimura F, Yamasue H, Kuwabara H, Wakuda T, Kato TA, Kanba S, Horikawa H, Usami M, Kodaira M, Watanabe K, Yoshikawa T, Toyota T, Yokoyama S, Munesue T, Kimura R, Funabiki Y, Kosaka H, Jung M, Kasai K, Ikegame T, Jinde S, Numata S, Kinoshita M, Kato T, Kakiuchi C, Yamakawa K, Suzuki T, Hashimoto N, Ishikawa S, Yamagata B, Nio S, Murai T, Son S, Kunii Y, Yabe H, Inagaki M, Goto YI, Okumura Y, Ito T, Arioka Y, Mori D, Ozaki N. Cross-Disorder Analysis of Genic and Regulatory Copy Number Variations in Bipolar Disorder, Schizophrenia, and Autism Spectrum Disorder. Biol Psychiatry 2022; 92:362-374. [PMID: 35667888 DOI: 10.1016/j.biopsych.2022.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND We aimed to determine the similarities and differences in the roles of genic and regulatory copy number variations (CNVs) in bipolar disorder (BD), schizophrenia (SCZ), and autism spectrum disorder (ASD). METHODS Based on high-resolution CNV data from 8708 Japanese samples, we performed to our knowledge the largest cross-disorder analysis of genic and regulatory CNVs in BD, SCZ, and ASD. RESULTS In genic CNVs, we found an increased burden of smaller (<100 kb) exonic deletions in BD, which contrasted with the highest burden of larger (>500 kb) exonic CNVs in SCZ/ASD. Pathogenic CNVs linked to neurodevelopmental disorders were significantly associated with the risk for each disorder, but BD and SCZ/ASD differed in terms of the effect size (smaller in BD) and subtype distribution of CNVs linked to neurodevelopmental disorders. We identified 3 synaptic genes (DLG2, PCDH15, and ASTN2) as risk factors for BD. Whereas gene set analysis showed that BD-associated pathways were restricted to chromatin biology, SCZ and ASD involved more extensive and similar pathways. Nevertheless, a correlation analysis of gene set results indicated weak but significant pathway similarities between BD and SCZ or ASD (r = 0.25-0.31). In SCZ and ASD, but not BD, CNVs were significantly enriched in enhancers and promoters in brain tissue. CONCLUSIONS BD and SCZ/ASD differ in terms of CNV burden, characteristics of CNVs linked to neurodevelopmental disorders, and regulatory CNVs. On the other hand, they have shared molecular mechanisms, including chromatin biology. The BD risk genes identified here could provide insight into the pathogenesis of BD.
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Affiliation(s)
- Itaru Kushima
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Medical Genomics Center, Nagoya University Hospital, Nagoya, Japan.
| | - Masahiro Nakatochi
- Public Health Informatics Unit, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Developmental Disorders, National Institute of Mental Health National Center of Neurology and Psychiatry, Nagoya, Japan
| | - Hiroki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidekazu Kato
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mako Morikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiya Inada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kanako Ishizuka
- Health Support Center, Nagoya Institute of Technology, Nagoya, Japan
| | - Youta Torii
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoshi Tanaka
- National Hospital Organization Higashi Owari National Hospital, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Miho Imaeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Nagahide Takahashi
- Department of Integrated Health Sciences, Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Maeri Yamamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Nawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nanayo Ogawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Okehazama Hospital Brain Research Institute, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yu Hayashi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tzuyao Lo
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Gantsooj Otgonbayar
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sho Furuta
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masashi Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takeo Saito
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kohei Ninomiya
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tomo Okochi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry, Tokyo, Japan; Medical Corporation Foster, Osaka, Japan
| | - Michiko Fujimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masanari Itokawa
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Makoto Arai
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan; Department of Psychiatry, Takatsuki Hospital, Tokyo, Japan
| | - Kazuya Toriumi
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan; Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Toshiki Shioiri
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kiyoyuki Kitaichi
- Laboratory of Pharmaceutics, Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuichiro Watanabe
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Egawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsukasa Sasaki
- Laboratory of Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Mamoru Tochigi
- Department of Neuropsychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Fumichika Nishimura
- Center for Research on Counseling and Support Services, University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoyasu Wakuda
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Japan Depression Center, Tokyo, Japan; Kyushu University, Fukuoka, Japan
| | - Hideki Horikawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Horikawa Hospital, Kurume, Japan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masaki Kodaira
- Department of Child and Adolescent Mental Health, Aiiku Clinic, Tokyo, Japan
| | - Kyota Watanabe
- Hiroshima City Center for Children's Health and Development, Hiroshima, Japan
| | - Takeo Yoshikawa
- Laboratory for Molecular Psychiatry, RIKEN Center for Brain Science, Wako, Japan
| | - Tomoko Toyota
- Laboratory for Molecular Psychiatry, RIKEN Center for Brain Science, Wako, Japan
| | - Shigeru Yokoyama
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Toshio Munesue
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Ryo Kimura
- Department of Anatomy and Developmental Biology, Kyoto University, Kyoto, Japan
| | - Yasuko Funabiki
- Department of Cognitive and Behavioral Science, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minyoung Jung
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Cognitive Science Group, Korea Brain Research Institute, Daegu, South Korea
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; International Research Center for Neurointelligence at University of Tokyo Institutes for Advanced Study, Tokyo, Japan
| | - Tempei Ikegame
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Seiichiro Jinde
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Chihiro Kakiuchi
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuhiro Yamakawa
- Department of Neurodevelopmental Disorder Genetics, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshimitsu Suzuki
- Department of Neurodevelopmental Disorder Genetics, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Shuhei Ishikawa
- Department of Psychiatry, Hokkaido University Hospital, Hokkaido, Japan
| | - Bun Yamagata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Nio
- Department of Psychiatry, Saiseikai Central Hospital, Tokyo, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuraku Son
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuto Kunii
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masumi Inagaki
- Department of Pediatrics, Tottori Prefecture Rehabilitation Center, Tottori, Japan
| | - Yu-Ichi Goto
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuto Okumura
- Public Health Informatics Unit, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Basic Medicinal Sciences, Graduate School of Pharmaceutical Sciences, Nagoya University, Nagoya, Japan
| | - Tomoya Ito
- Public Health Informatics Unit, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Basic Medicinal Sciences, Graduate School of Pharmaceutical Sciences, Nagoya University, Nagoya, Japan
| | - Yuko Arioka
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Daisuke Mori
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; Institute for Glyco-core Research, Nagoya University, Nagoya, Japan.
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24
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Silver A, Lazarin GA, Silver M, Miller M, Jansen M, Wechsberg C, Dekanek E, Grossfeld S, Herpel T, Gunatilake D, Bisignano A, Jaremko M. Technical Performance of a 430-Gene Preventative Genomics Assay to Identify Multiple Variant Types Associated with Adult-Onset Monogenic Conditions, Susceptibility Loci, and Pharmacogenetic Insights. J Pers Med 2022; 12:667. [PMID: 35629091 PMCID: PMC9147210 DOI: 10.3390/jpm12050667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/08/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
DNA-based screening in individuals without known risk factors potentially identifies those who may benefit from genetic counseling, early medical interventions, and/or avoidance of late or missed diagnoses. While not currently in widespread usage, technological advances in genetic analysis overcome barriers to access by enabling less labor-intensive and more cost-efficient means to discover variants of clinical importance. This study describes the technical validation of a 430-gene next-generation sequencing based assay, GeneCompassTM, indicated for the screening of healthy individuals in the areas of actionable health risks, pharmaceutical drug response, and wellness traits. The test includes genes associated with Mendelian disorders and genetic susceptibility loci, encompassing 14 clinical areas and pharmacogenetic variants. The custom-designed target enrichment capture and bioinformatics pipelines interrogate multiple variant types, including single nucleotide variants, insertions/deletions (indels), copy number variants, and functional haplotypes (star alleles), including tandem alleles and structural variants. Validation was performed against reference DNA from three sources: 1000 Genomes Project (n = 3), Coriell biobank (n = 105), and previously molecularly characterized biological specimens: blood (n = 15) and saliva (n = 11). Analytical sensitivity and specificity for single nucleotide variants (SNVs) were 97.57% and 99.99%, respectively, and for indels were 74.57% and 97.34%, respectively. This study demonstrates the validity of an NGS assay for genetic screening and the broadening of access to preventative genomics.
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Affiliation(s)
- Ari Silver
- Phosphorus, Inc., 1140 Broadway, 12th Floor, New York, NY 10001, USA; (G.A.L.); (M.S.); (M.M.); (M.J.); (C.W.); (E.D.); (S.G.); (T.H.); (D.G.); (A.B.); (M.J.)
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25
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Auwerx C, Lepamets M, Sadler MC, Patxot M, Stojanov M, Baud D, Mägi R, Porcu E, Reymond A, Kutalik Z. The individual and global impact of copy-number variants on complex human traits. Am J Hum Genet 2022; 109:647-668. [PMID: 35240056 PMCID: PMC9069145 DOI: 10.1016/j.ajhg.2022.02.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/09/2022] [Indexed: 12/25/2022] Open
Abstract
The impact of copy-number variations (CNVs) on complex human traits remains understudied. We called CNVs in 331,522 UK Biobank participants and performed genome-wide association studies (GWASs) between the copy number of CNV-proxy probes and 57 continuous traits, revealing 131 signals spanning 47 phenotypes. Our analysis recapitulated well-known associations (e.g., 1q21 and height), revealed the pleiotropy of recurrent CNVs (e.g., 26 and 16 traits for 16p11.2-BP4-BP5 and 22q11.21, respectively), and suggested gene functionalities (e.g., MARF1 in female reproduction). Forty-eight CNV signals (38%) overlapped with single-nucleotide polymorphism (SNP)-GWASs signals for the same trait. For instance, deletion of PDZK1, which encodes a urate transporter scaffold protein, decreased serum urate levels, while deletion of RHD, which encodes the Rhesus blood group D antigen, associated with hematological traits. Other signals overlapped Mendelian disorder regions, suggesting variable expressivity and broad impact of these loci, as illustrated by signals mapping to Rotor syndrome (SLCO1B1/3), renal cysts and diabetes syndrome (HNF1B), or Charcot-Marie-Tooth (PMP22) loci. Total CNV burden negatively impacted 35 traits, leading to increased adiposity, liver/kidney damage, and decreased intelligence and physical capacity. Thirty traits remained burden associated after correcting for CNV-GWAS signals, pointing to a polygenic CNV architecture. The burden negatively correlated with socio-economic indicators, parental lifespan, and age (survivorship proxy), suggesting a contribution to decreased longevity. Together, our results showcase how studying CNVs can expand biological insights, emphasizing the critical role of this mutational class in shaping human traits and arguing in favor of a continuum between Mendelian and complex diseases.
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Affiliation(s)
- Chiara Auwerx
- Center for Integrative Genomics, University of Lausanne, Lausanne 1015, Switzerland; Department of Computational Biology, University of Lausanne, Lausanne 1015, Switzerland; Swiss Institute of Bioinformatics, Lausanne 1015, Switzerland; University Center for Primary Care and Public Health, Lausanne 1010, Switzerland
| | - Maarja Lepamets
- Institute of Molecular and Cell Biology, University of Tartu, Tartu 51010, Estonia; Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | - Marie C Sadler
- Swiss Institute of Bioinformatics, Lausanne 1015, Switzerland; University Center for Primary Care and Public Health, Lausanne 1010, Switzerland
| | - Marion Patxot
- Department of Computational Biology, University of Lausanne, Lausanne 1015, Switzerland
| | - Miloš Stojanov
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, CHUV, Lausanne 1011, Switzerland
| | - David Baud
- Materno-fetal and Obstetrics Research Unit, Department Woman-Mother-Child, CHUV, Lausanne 1011, Switzerland
| | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | - Eleonora Porcu
- Center for Integrative Genomics, University of Lausanne, Lausanne 1015, Switzerland; Swiss Institute of Bioinformatics, Lausanne 1015, Switzerland; University Center for Primary Care and Public Health, Lausanne 1010, Switzerland
| | - Alexandre Reymond
- Center for Integrative Genomics, University of Lausanne, Lausanne 1015, Switzerland.
| | - Zoltán Kutalik
- Department of Computational Biology, University of Lausanne, Lausanne 1015, Switzerland; Swiss Institute of Bioinformatics, Lausanne 1015, Switzerland; University Center for Primary Care and Public Health, Lausanne 1010, Switzerland.
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26
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White LK, Crowley TB, Finucane B, Garcia-Minaur S, Repetto GM, van den Bree M, Fischer M, Jacquemont S, Barzilay R, Maillard AM, Donald KA, Gur RE, Bassett AS, Swillen A, McDonald-McGinn DM. The COVID-19 pandemic's impact on worry and medical disruptions reported by individuals with chromosome 22q11.2 copy number variants and their caregivers. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:313-322. [PMID: 35191118 PMCID: PMC9725107 DOI: 10.1111/jir.12918] [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: 08/10/2021] [Revised: 01/04/2022] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The world has suffered immeasurably during the COVID-19 pandemic. Increased distress and mental and medical health concerns are collateral consequences to the disease itself. The Genes to Mental Health (G2MH) Network consortium sought to understand how individuals affected by the rare copy number variations of 22q11.2 deletion and duplication syndrome, associated with neurodevelopmental/neuropsychiatric conditions, were coping. The article focuses on worry and disruptions in medical care caused by the pandemic. METHODS The University of Pennsylvania COVID-19 Stressor List and care disruption questions were circulated by 22 advocacy groups in English and 11 other languages. RESULTS A total of 512 people from 23 countries completed the survey; most were caregivers of affected individuals. Worry about family members acquiring COVID-19 had the highest average endorsed worry, whilst currently having COVID-19 had the lowest rated worry. Total COVID-19 worries were higher in individuals completing the survey towards the end of the study (later pandemic wave); 36% (n = 186) of the sample reported a significant effect on health due to care interruption during the pandemic; 44% of individuals (n = 111) receiving care for their genetic syndrome in a hospital setting reported delaying appointments due to COVID-19 fears; 12% (n = 59) of the sample reported disruptions to treatments; and of those reporting no current disruptions, 59% (n = 269) worried about future disruptions if the pandemic continued. Higher levels of care disruptions were related to higher COVID-19 worries (Ps < 0.005). Minimal differences by respondent type or copy number variation type emerged. CONCLUSIONS Widespread medical care disruptions and pandemic-related worries were reported by individuals with 22q11.2 syndrome and their family members. Reported worries were broadly consistent with research results from prior reports in the general population. The long-term effects of COVID-19 worries, interruptions to care and hospital avoidance require further study.
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Affiliation(s)
- L K White
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - T B Crowley
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - B Finucane
- Geisinger Autism & Developmental Medicine Institute, Geisinger Health System, Lewisburg, PA, USA
| | - S Garcia-Minaur
- Instituto de Genética Médica y Molecular, Hospital Universitario La Paz, Madrid, Spain
| | - G M Repetto
- Center for Genetics and Genomics, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
| | - M van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - M Fischer
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - S Jacquemont
- Sainte Justine Research Center, University of Montreal, Montreal, Canada
| | - R Barzilay
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - A M Maillard
- Service des Troubles du Spectre de l'Autisme (STSA), Lausanne University Hospital, Lausanne, Switzerland
| | - K A Donald
- Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - R E Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - A S Bassett
- Centre for Addiction and Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - A Swillen
- Center for Human Genetics, University Hospital Leuven and Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - D M McDonald-McGinn
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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27
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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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28
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Birnbaum R, Mahjani B, Loos RJF, Sharp AJ. Clinical Characterization of Copy Number Variants Associated With Neurodevelopmental Disorders in a Large-scale Multiancestry Biobank. JAMA Psychiatry 2022; 79:250-259. [PMID: 35080590 PMCID: PMC8792794 DOI: 10.1001/jamapsychiatry.2021.4080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/30/2021] [Indexed: 01/28/2023]
Abstract
IMPORTANCE Past studies identified rare copy number variants (CNVs) as risk factors for neurodevelopmental disorders (NDDs), including autism spectrum disorder and schizophrenia. However, the clinical characterization of NDD CNVs is understudied in population cohorts unselected for neuropsychiatric disorders and in cohorts of diverse ancestry. OBJECTIVE To identify individuals harboring NDD CNVs in a multiancestry biobank and to query their enrichment for select neuropsychiatric disorders as well as association with multiple medical disorders. DESIGN, SETTINGS, AND PARTICIPANTS In a series of phenotypic enrichment and association analyses, NDD CNVs were clinically characterized among 24 877 participants in the BioMe biobank, an electronic health record-linked biobank derived from the Mount Sinai Health System, New York, New York. Participants were recruited into the biobank since September 2007 across diverse ancestry and medical and neuropsychiatric specialties. For the current analyses, electronic health record data were analyzed from May 2004 through May 2019. MAIN OUTCOMES AND MEASURES NDD CNVs were identified using a consensus of 2 CNV calling algorithms, based on whole-exome sequencing and genotype array data, followed by novel in-silico clinical assessments. RESULTS Of 24 877 participants, 14 586 (58.7%) were female; self-reported ancestry categories included 5965 (24.0%) who were of African ancestry, 7892 (31.7%) who were of European ancestry, and 8536 (34.3%) who were of Hispanic ancestry; and the mean (SD) age was 50.5 (17.3) years. Among 24 877 individuals, the prevalence of 64 NDD CNVs was 2.5% (n = 627), with prevalence varying by locus, corroborating the presence of some relatively highly prevalent NDD CNVs (eg, 15q11.2 deletion/duplication). An aggregate set of NDD CNVs were enriched for congenital disorders (odds ratio, 2.0; 95% CI, 1.1-3.5; P = .01) and major depressive disorder (odds ratio, 1.5; 95% CI, 1.1-2.0; P = .01). In a meta-analysis of medical diagnoses (n = 195 hierarchically clustered diagnostic codes), NDD CNVs were significantly associated with several medical outcomes, including essential hypertension (z score = 3.6; P = 2.8 × 10-4), kidney failure (z score = 3.3; P = 1.1 × 10-3), and obstructive sleep apnea (z score = 3.4; P = 8.1 × 10-4) and, in another analysis, morbid obesity (z score = 3.8; P = 1.3 × 10-4). Further, NDD CNVs were associated with increased body mass index in a multiancestry analysis (β = 0.19; 95% CI, 0.10-0.31; P = .003). For 36 common serum tests, there was no association with NDD CNVs. CONCLUSIONS AND RELEVANCE Clinical features of individuals harboring NDD CNVs were elucidated in a large-scale, multiancestry biobank, identifying enrichments for congenital disorders and major depressive disorder as well as associations with several medical outcomes, including hypertension, kidney failure, and obesity and obesity-related phenotypes, specifically obstructive sleep apnea and increased body mass index. The association between NDD CNVs and obesity outcomes indicate further potential pleiotropy of NDD CNVs beyond neurodevelopmental outcomes previously reported. Future clinical genetic investigations may lead to insights of at-risk individuals and therapeutic strategies targeting specific genetic variants. The importance of diverse inclusion within biobanks and considering the effect of rare genetic variants in a multiancestry context is evident.
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Affiliation(s)
- Rebecca Birnbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ruth J. F. Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- NovoNordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Andrew J. Sharp
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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29
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Richter LD, Morley TJ, Hooker GW, Peay HL, Cox NJ, Ruderfer DM. Leveraging electronic health records to inform genetic counseling practice surrounding psychiatric disorders. J Genet Couns 2022; 31:1008-1015. [PMID: 35191121 DOI: 10.1002/jgc4.1565] [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: 07/16/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 11/07/2022]
Abstract
Since nearly one-fifth of US adults have a psychiatric disorder, genetic counselors (GCs) will see many patients with these indications. However, GCs' reports of inadequate preparation and low confidence in providing care for patients with psychiatric disorders can limit their ability to meet patient's needs. How frequently psychiatric disorders present in GC sessions is currently unclear. Here, we used deidentified electronic health records (EHR) to estimate the prevalence of 16 psychiatric disorders. In 7,155 GC patients, 34% had a diagnostic code associated with a psychiatric disorder; 23% with anxiety/phobic disorders; 21% with mood disorder/depression; 5% with attention deficit hyperactivity disorder (ADHD); and 1% with psychotic disorders. Compared to 415,709 demographically matched controls, GC patients showed a significantly higher prevalence of psychiatric disorders (GC prevalence: 34%, matched prevalence: 30%, p-value < 0.0001) driven predominantly by anxiety disorder, major depressive disorder, generalized anxiety disorder, and ADHD. Within GC specialties (prenatal: n = 2,674, cancer: n = 1,474, pediatric: n = 465), only pediatric GC patients showed a significant increase in psychiatric disorder prevalence overall (pediatric GC prevalence: 28%, matched prevalence: 13%, p-value < 0.0001). However, significant evidence of increased prevalence existed for generalized anxiety disorder (prenatal GC prevalence 6.4%, matched prevalence: 4.9%, p-value < 0.0001), anxiety disorders (cancer GC prevalence: 26%, matched prevalence: 21%, p-value < 0.0001 and pediatric GC prevalence: 12%, matched prevalence: 5.5%), and ADHD (pediatric GC prevalence: 18%, matched prevalence: 7.9%, p-value < 0.0001). These results highlight the need for additional guidance around care for patients with psychiatric disorders and the value of EHR-based research in genetic counseling.
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Affiliation(s)
- Lucas D Richter
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Theodore J Morley
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Gillian W Hooker
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Holly L Peay
- RTI International, Research Triangle Park, North Carolina, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Douglas M Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Informatics, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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30
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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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31
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Wainberg M, Merico D, Huguet G, Zarrei M, Jacquemont S, Scherer SW, Tripathy SJ. Deletion of Loss-of-Function-Intolerant Genes and Risk of 5 Psychiatric Disorders. JAMA Psychiatry 2022; 79:78-81. [PMID: 34851367 PMCID: PMC8733829 DOI: 10.1001/jamapsychiatry.2021.3211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study examines 2 gene-level metrics of variation constraint against protein-truncating variants—probability of loss-of-function intolerance and loss-of-function observed/expected upper bound fraction—and their association with the psychiatric consequences of both recurrent and nonrecurrent gene deletions.
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Affiliation(s)
- Michael Wainberg
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Daniele Merico
- Deep Genomics Inc, Toronto, Ontario, Canada,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Guillaume Huguet
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada,UHC Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Mehdi Zarrei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sebastien Jacquemont
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada,UHC Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Stephen W. Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada,McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Shreejoy J. Tripathy
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
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32
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Cheng MC, Chien WH, Huang YS, Fang TH, Chen CH. Translational Study of Copy Number Variations in Schizophrenia. Int J Mol Sci 2021; 23:ijms23010457. [PMID: 35008879 PMCID: PMC8745588 DOI: 10.3390/ijms23010457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/11/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022] Open
Abstract
Rare copy number variations (CNVs) are part of the genetics of schizophrenia; they are highly heterogeneous and personalized. The CNV Analysis Group of the Psychiatric Genomic Consortium (PGC) conducted a large-scale analysis and discovered that recurrent CNVs at eight genetic loci were pathogenic to schizophrenia, including 1q21.1, 2p16.3 (NRXN1), 3q29, 7q11.23, 15q13.3, distal 16p11.2, proximal 16p11.2, and 22q11.2. We adopted a two-stage strategy to translate this knowledge into clinical psychiatric practice. As a screening test, we first developed a real-time quantitative PCR (RT-qPCR) panel that simultaneously detected these pathogenic CNVs. Then, we tested the utility of this screening panel by investigating a sample of 557 patients with schizophrenia. Chromosomal microarray analysis (CMA) was used to confirm positive cases from the screening test. We detected and confirmed thirteen patients who carried CNVs at these hot loci, including two patients at 1q21.1, one patient at 7q11.2, three patients at 15q13.3, two patients at 16p11.2, and five patients at 22q11.2. The detection rate in this sample was 2.3%, and the concordance rate between the RT-qPCR test panel and CMA was 100%. Our results suggest that a two-stage approach is cost-effective and reliable in achieving etiological diagnosis for some patients with schizophrenia and improving the understanding of schizophrenia genetics.
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Affiliation(s)
- Min-Chih Cheng
- Department of Psychiatry, Yuli Branch, Taipei Veterans General Hospital, Hualien 981, Taiwan;
| | - Wei-Hsien Chien
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Yu-Shu Huang
- Department of Psychiatry, Chang Gung Memorial Hospital-Linkou, Taoyuan 333, Taiwan;
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Ting-Hsuan Fang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital-Linkou, Taoyuan 333, Taiwan;
- Department and Institute of Biomedical Sciences, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence:
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Cable J, Purcell RH, Robinson E, Vorstman JAS, Chung WK, Constantino JN, Sanders SJ, Sahin M, Dolmetsch RE, Shah B, Thurm A, Martin CL, Bearden CE, Mulle JG. Harnessing rare variants in neuropsychiatric and neurodevelopment disorders-a Keystone Symposia report. Ann N Y Acad Sci 2021; 1506:5-17. [PMID: 34342000 PMCID: PMC8688183 DOI: 10.1111/nyas.14658] [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: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
Neurodevelopmental neuropsychiatric disorders, such as autism spectrum disorder and schizophrenia, have strong genetic risk components, but the underlying mechanisms have proven difficult to decipher. Rare, high-risk variants may offer an opportunity to delineate the biological mechanisms responsible more clearly for more common idiopathic diseases. Indeed, different rare variants can cause the same behavioral phenotype, demonstrating genetic heterogeneity, while the same rare variant can cause different behavioral phenotypes, demonstrating variable expressivity. These observations suggest convergent underlying biological and neurological mechanisms; identification of these mechanisms may ultimately reveal new therapeutic targets. At the 2021 Keystone eSymposium "Neuropsychiatric and Neurodevelopmental Disorders: Harnessing Rare Variants" a panel of experts in the field described significant progress in genomic discovery and human phenotyping and raised several consistent issues, including the need for detailed natural history studies of rare disorders, the challenges in cohort recruitment, and the importance of viewing phenotypes as quantitative traits that are impacted by rare variants.
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Affiliation(s)
| | - Ryan H. Purcell
- Department of Cell Biology, Emory University School of Medicine, Atlanta, Georgia
| | - Elise Robinson
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jacob A. S. Vorstman
- Department of Psychiatry and The Centre for Applied Genomics, Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Wendy K. Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, New York
- Simons Foundation, New York, New York
| | - John N. Constantino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Stephan J. Sanders
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Mustafa Sahin
- Rosamund Stone Zander Translational Neuroscience Center, F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Bina Shah
- Project 8p Foundation, Commission on Novel Technologies for Neurodevelopmental CNVs, New York, New York
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping, NIMH, National Institutes of Health, Bethesda, Maryland
| | - Christa L. Martin
- Autism & Developmental Medicine Institute, Geisinger, Danville, Pennsylvania
| | - Carrie E. Bearden
- Integrative Center for Neurogenetics, Departments of Psychiatry and Biobehavioral Science and Psychology, University of California Los Angeles, Los Angeles, California
| | - Jennifer G. Mulle
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
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Finucane B, Oetjens MT, Johns A, Myers SM, Fisher C, Habegger L, Maxwell EK, Reid JG, Ledbetter DH, Kirchner HL, Martin CL. Medical manifestations and health care utilization among adult MyCode participants with neurodevelopmental psychiatric copy number variants. Genet Med 2021; 24:703-711. [PMID: 34906480 DOI: 10.1016/j.gim.2021.11.010] [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: 06/21/2021] [Revised: 10/07/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Recurrent pathogenic copy number variants (pCNVs) have large-effect impacts on brain function and represent important etiologies of neurodevelopmental psychiatric disorders (NPDs), including autism and schizophrenia. Patterns of health care utilization in adults with pCNVs have gone largely unstudied and are likely to differ in significant ways from those of children. METHODS We compared the prevalence of NPDs and electronic health record-based medical conditions in 928 adults with 26 pCNVs to a demographically-matched cohort of pCNV-negative controls from >135,000 patient-participants in Geisinger's MyCode Community Health Initiative. We also evaluated 3 quantitative health care utilization measures (outpatient, inpatient, and emergency department visits) in both groups. RESULTS Adults with pCNVs (24.9%) were more likely than controls (16.0%) to have a documented NPD. They had significantly higher rates of several chronic diseases, including diabetes (29.3% in participants with pCNVs vs 20.4% in participants without pCNVs) and dementia (2.2% in participants with pCNVs vs 1.0% participants without pCNVs), and twice as many annual emergency department visits. CONCLUSION These findings highlight the potential for genetic information-specifically, pCNVs-to inform the study of health care outcomes and utilization in adults. If, as our findings suggest, adults with pCNVs have poorer health and require disproportionate health care resources, early genetic diagnosis paired with patient-centered interventions may help to anticipate problems, improve outcomes, and reduce the associated economic burden.
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Affiliation(s)
- Brenda Finucane
- Geisinger, Autism & Developmental Medicine Institute, Lewisburg, PA.
| | | | - Alicia Johns
- Geisinger, Department of Population Health Sciences, Danville, PA
| | - Scott M Myers
- Geisinger, Autism & Developmental Medicine Institute, Lewisburg, PA
| | - Ciaran Fisher
- Geisinger, Autism & Developmental Medicine Institute, Lewisburg, PA
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35
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An ethical analysis of divergent clinical approaches to the application of genetic testing for autism and schizophrenia. Hum Genet 2021; 141:1069-1084. [PMID: 34453583 DOI: 10.1007/s00439-021-02349-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/16/2021] [Indexed: 12/27/2022]
Abstract
Genetic testing to identify genetic syndromes and copy number variants (CNVs) via whole genome platforms such as chromosome microarray (CMA) or exome sequencing (ES) is routinely performed clinically, and is considered by a variety of organizations and societies to be a "first-tier" test for individuals with developmental delay (DD), intellectual disability (ID), or autism spectrum disorder (ASD). However, in the context of schizophrenia, though CNVs can have a large effect on risk, genetic testing is not typically a part of routine clinical care, and no clinical practice guidelines recommend testing. This raises the question of whether CNV testing should be similarly performed for individuals with schizophrenia. Here we consider this proposition in light of the history of genetic testing for ID/DD and ASD, and through the application of an ethical analysis designed to enable robust, accountable and justifiable decision-making. Using a systematic framework and application of relevant bioethical principles (beneficence, non-maleficence, autonomy, and justice), our examination highlights that while CNV testing for the indication of ID has considerable benefits, there is currently insufficient evidence to suggest that overall, the potential harms are outweighed by the potential benefits of CNV testing for the sole indications of schizophrenia or ASD. However, although the application of CNV tests for children with ASD or schizophrenia without ID/DD is, strictly speaking, off-label use, there may be clinical utility and benefits substantive enough to outweigh the harms. Research is needed to clarify the harms and benefits of testing in pediatric and adult contexts. Given that genetic counseling has demonstrated benefits for schizophrenia, and has the potential to mitigate many of the potential harms from genetic testing, any decisions to implement genetic testing for schizophrenia should involve high-quality evidence-based genetic counseling.
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36
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Dinneen TJ, Ghrálaigh FN, Walsh R, Lopez LM, Gallagher L. How does genetic variation modify ND-CNV phenotypes? Trends Genet 2021; 38:140-151. [PMID: 34364706 DOI: 10.1016/j.tig.2021.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023]
Abstract
Rare copy-number variants (CNVs) associated with neurodevelopmental disorders (NDDs), i.e., ND-CNVs, provide an insight into the neurobiology of NDDs and, potentially, a link between biology and clinical outcomes. However, ND-CNVs are characterised by incomplete penetrance resulting in heterogeneous carrier phenotypes, ranging from non-affected to multimorbid psychiatric, neurological, and physical phenotypes. Recent evidence indicates that other variants in the genome, or 'other hits', may partially explain the variable expressivity of ND-CNVs. These may be other rare variants or the aggregated effects of common variants that modify NDD risk. Here we discuss the recent findings, current questions, and future challenges relating to other hits research in the context of ND-CNVs and their potential for improved clinical diagnostics and therapeutics for ND-CNV carriers.
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Affiliation(s)
- Thomas J Dinneen
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
| | - Fiana Ní Ghrálaigh
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Department of Biology, National University of Ireland Maynooth, Maynooth, Ireland
| | - Ruth Walsh
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Lorna M Lopez
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Department of Biology, National University of Ireland Maynooth, Maynooth, Ireland
| | - Louise Gallagher
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
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37
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Mortillo M, Mulle JG. A cross-comparison of cognitive ability across 8 genomic disorders. Curr Opin Genet Dev 2021; 68:106-116. [PMID: 34082144 DOI: 10.1016/j.gde.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 12/23/2022]
Abstract
Genomic disorders result from rearrangement of the human genome. Most genomic disorders are caused by copy number variants (CNV), deletions or duplications of several hundred kilobases. Many CNV loci are associated with autism, schizophrenia, and most commonly, intellectual disability (ID). However, there is little comparison of cognitive ability measures across these CNV disorders. This study aims to understand whether existing data can be leveraged for a cross-comparison of cognitive ability among multiple CNV. We found there is a lack of harmonization among assessment instruments and little standardization for reporting summary data across studies. Despite these limitations, we identified a differential impact of CNV loci on cognitive ability. Our data suggest that future cross-comparisons of CNV disorders will reveal meaningful differences across the phenotypic spectrum, especially if standardized phenotypic assessment is achieved.
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Affiliation(s)
- Michael Mortillo
- Department of Human Genetics, Emory University, Atlanta, GA, United States
| | - Jennifer G Mulle
- Department of Human Genetics, Emory University, Atlanta, GA, United States.
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38
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Chawner SJ, Watson CJ, Owen MJ. Clinical evaluation of patients with a neuropsychiatric risk copy number variant. Curr Opin Genet Dev 2021; 68:26-34. [PMID: 33461126 PMCID: PMC8219523 DOI: 10.1016/j.gde.2020.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022]
Abstract
Several copy number variants (CNVs) have been identified to confer high risk for a range of neuropsychiatric conditions. Because of advances in genetic testing within clinical settings, patients are increasingly receiving diagnoses of copy number variant genomic disorders. However, clinical guidelines surrounding assessment and management are limited. This review synthesises recent research and makes preliminary recommendations regarding the clinical evaluation of patients with neuropsychiatric risk CNVs. We recommend multi-system assessment beyond the initial referral reason, recognition of the potential need for co-ordinated multidisciplinary care, and that interventions take account of relevant multimorbidity. The frequently complex needs of patients with CNVs across the life-course pose challenges for many health care systems and may be best provided for by the establishment of specialist clinics.
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Affiliation(s)
- Samuel Jra Chawner
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK; Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff, UK
| | - Cameron J Watson
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK; Barts Health NHS Trust, London, UK
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK.
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Mulle JG, Sullivan PF, Hjerling-Leffler J. Editorial overview: Rare CNV disorders and neuropsychiatric phenotypes: opportunities, challenges, solutions. Curr Opin Genet Dev 2021; 68:iii-ix. [PMID: 34059379 PMCID: PMC8722467 DOI: 10.1016/j.gde.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jennifer Gladys Mulle
- Department of Human Genetics, Emory University School of Medicine, Atlanta GA 30322, United States.
| | - Patrick F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, United States; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Jens Hjerling-Leffler
- Laboratory of Molecular Neurobiology, Department Medical Biochemistry and Biophysics, Karolinska Institutet, SE-17177 Stockholm, Sweden.
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Rees E, Kirov G. Copy number variation and neuropsychiatric illness. Curr Opin Genet Dev 2021; 68:57-63. [PMID: 33752146 PMCID: PMC8219524 DOI: 10.1016/j.gde.2021.02.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
Abstract
Copy number variants (CNVs) at specific loci have been identified as important risk factors for several neuropsychiatric disorders, such as schizophrenia, autism spectrum disorder, intellectual disability (ID) and depression. These CNVs are individually rare (<0.5% frequency), have high effect sizes, and show pleiotropic effects for multiple neuropsychiatric disorders, which implies a shared aetiology. Neuropsychiatric CNVs are also associated with cognitive impairment and other medical morbidities, such as heart defects and obesity. As most neuropsychiatric CNVs are multigenic, it has been challenging to map their effects onto specific biological processes, although gene-set analyses have implicated genes related to the synapse and chromatin regulation. However, future whole-genome sequencing studies have potential for identifying novel single-gene CNV associations, which could provide insights into the pathophysiology underlying neuropsychiatric disorders.
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Affiliation(s)
- Elliott Rees
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom.
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom.
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Population Genomic Screening for Genetic Etiologies of Neurodevelopmental/Psychiatric Disorders Demonstrates Personal Utility and Positive Participant Responses. J Pers Med 2021; 11:jpm11050365. [PMID: 34062946 PMCID: PMC8147408 DOI: 10.3390/jpm11050365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Genomic variants that cause neurodevelopmental/psychiatric disorders (NPD) are relatively prevalent and highly penetrant. This study aimed to understand adults’ immediate responses to receiving NPD-related results to inform inclusion in population-based genomic screening programs. Nine recurrent, pathogenic copy number variants (CNVs) were identified from research exome data, clinically confirmed, and disclosed to adult participants of the Geisinger MyCode Community Health Initiative DiscovEHR cohort by experienced genetic counselors. A subset of in-person genetic counseling sessions (n = 27) were audio-recorded, transcribed, and coded using a grounded theory approach. Participant reactions were overwhelmingly positive and indicated that an NPD genetic etiology was highly valuable and personally useful. Participants frequently reported learning disabilities or other NPD that were not documented in their electronic health records and noted difficulties obtaining support for NPD needs. Most intended to share their genetic result with family members and health care providers and were interested in how their result could improve their healthcare. This study indicates that results from population-based NPD genomic screening can provide personal value for adults with NPD, were viewed positively by participants, and could improve clinical outcomes by informing symptom monitoring for NPD and co-morbidities, promoting improved health behaviors, and enhancing psychotherapeutic approaches.
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The "missing heritability"-Problem in psychiatry: Is the interaction of genetics, epigenetics and transposable elements a potential solution? Neurosci Biobehav Rev 2021; 126:23-42. [PMID: 33757815 DOI: 10.1016/j.neubiorev.2021.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders exhibit an enormous burden on the health care systems worldwide accounting for around one-third of years lost due to disability among adults. Their etiology is largely unknown and diagnostic classification is based on symptomatology and course of illness and not on objective biomarkers. Most psychiatric disorders are moderately to highly heritable. However, it is still unknown what mechanisms may explain the discrepancy between heritability estimates and the present data from genetic analysis. In addition to genetic differences also epigenetic modifications are considered as potentially relevant in the transfer of susceptibility to psychiatric diseases. Though, whether or not epigenetic alterations can be inherited for many generations is highly controversial. In the present article, we will critically summarize both the genetic findings and the results from epigenetic analyses, including also those of noncoding RNAs. We will argue that one possible solution to the "missing heritability" problem in psychiatry is a potential role of retrotransposons, the exploration of which is presently only in its beginnings.
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Kelly MA, Leader JB, Wain KE, Bodian D, Oetjens MT, Ledbetter DH, Martin CL, Strande NT. Leveraging population-based exome screening to impact clinical care: The evolution of variant assessment in the Geisinger MyCode research project. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2021; 187:83-94. [PMID: 33576083 DOI: 10.1002/ajmg.c.31887] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 02/06/2023]
Abstract
Exome and genome sequencing are increasingly utilized in research studies and clinical care and can provide clinically relevant information beyond the initial intent for sequencing, including medically actionable secondary findings. Despite ongoing debate about sharing this information with patients and participants, a growing number of clinical laboratories and research programs routinely report secondary findings that increase the risk for selected diseases. Recently, there has been a push to maximize the potential benefit of this practice by implementing proactive genomic screening at the population level irrespective of medical history, but the feasibility of deploying population-scale proactive genomic screening requires scaling key elements of the genomic data evaluation process. Herein, we describe the motivation, development, and implementation of a population-scale variant-first screening pipeline combining bioinformatics-based filtering with a manual review process to screen for clinically relevant findings in research exomes generated through the DiscovEHR collaboration within Geisinger's MyCode® research project. Consistent with other studies, this pipeline yields a screen-positive detection rate between 2.1 and 2.6% (depending on inclusion of those with prior indication-based testing) in 130,048 adult MyCode patient-participants screened for clinically relevant findings in 60 genes. Our variant-first pipeline affords cost and time savings by filtering out negative cases, thereby avoiding analysis of each exome one-by-one, as typically employed in the diagnostic setting. While research is still needed to fully appreciate the benefits of population genomic screening, MyCode provides the first demonstration of a program at scale to help shape how population genomic screening is integrated into routine clinical care.
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Affiliation(s)
| | | | - Karen E Wain
- Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Dale Bodian
- Geisinger Medical Center, Danville, Pennsylvania, USA
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44
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Vorstman J, Scherer SW. What a finding of gene copy number variation can add to the diagnosis of developmental neuropsychiatric disorders. Curr Opin Genet Dev 2021; 68:18-25. [PMID: 33454514 DOI: 10.1016/j.gde.2020.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
Among medical disciplines, diagnosis in psychiatry depends highly upon descriptive signs and symptoms, rather than biomarkers. Clear descriptions of specific genetic etiologies have been lacking; genomic technologies, however, are rapidly changing that landscape. Notably, chromosomal microarrays-which detect gene copy number variants (CNVs)-are a recommended standard of care for neurodevelopmental disorders. As a result, an increasing number of patients now receive a clinical diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and an identified genetic etiological variant. However, psychiatric and genetic diagnoses are frequently communicated and managed as two disconnected diagnostic parameters. Here, we advocate for a transition model, allowing the integration of genetic etiological information-starting with diagnostically proven CNVs-within the DSM-5 classification framework.
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Affiliation(s)
- Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, Hospital for Sick Children, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Canada
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, Hospital for Sick Children, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Canada; McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Canada.
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Abstract
Gains and losses of large segments of genomic DNA, known as copy number variants (CNVs) gained considerable interest in clinical diagnostics lately, as particular forms may lead to inherited genetic diseases. In recent decades, researchers developed a wide variety of cytogenetic and molecular methods with different detection capabilities to detect clinically relevant CNVs. In this review, we summarize methodological progress from conventional approaches to current state of the art techniques capable of detecting CNVs from a few bases up to several megabases. Although the recent rapid progress of sequencing methods has enabled precise detection of CNVs, determining their functional effect on cellular and whole-body physiology remains a challenge. Here, we provide a comprehensive list of databases and bioinformatics tools that may serve as useful assets for researchers, laboratory diagnosticians, and clinical geneticists facing the challenge of CNV detection and interpretation.
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Finucane BM, Ledbetter DH, Vorstman JA. Diagnostic genetic testing for neurodevelopmental psychiatric disorders: closing the gap between recommendation and clinical implementation. Curr Opin Genet Dev 2021; 68:1-8. [PMID: 33434711 DOI: 10.1016/j.gde.2020.12.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/09/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022]
Abstract
Advances in laboratory testing have significantly increased the detection of rare genetic etiologies of neurodevelopmental psychiatric disorders (NPD), particularly developmental delay/ intellectual disability, autism spectrum disorder, and schizophrenia. Establishing a genetic diagnosis has important medical and personal utility for individuals with these conditions. Diagnostic genetic tests for NPD are clinically available but underutilized outside of medical genetics settings. Without clear multidisciplinary consensus recommendations, active involvement of medical specialists working with NPD patients, and practical education and training, the implementation of genetic testing for NPD will continue to lag behind other areas of medicine. In the long-term, collaborative efforts to address educational, logistical, and workforce obstacles will improve patient care and pave the way for targeted, effective NPD treatments.
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Affiliation(s)
- Brenda M Finucane
- Autism & Developmental Medicine Institute, Geisinger, Lewisburg, PA USA.
| | - David H Ledbetter
- Autism & Developmental Medicine Institute, Geisinger, Lewisburg, PA USA
| | - Jacob As Vorstman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
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Error in Figure and Table. JAMA Psychiatry 2020; 77:1310. [PMID: 32876661 PMCID: PMC7489370 DOI: 10.1001/jamapsychiatry.2020.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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