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Vrublevska J. Case report: Successful administration of cariprazine in a young, severely ill patient with recurrent relapses of schizophrenia and persistent negative symptoms. Front Psychiatry 2023; 14:1134692. [PMID: 36970274 PMCID: PMC10034963 DOI: 10.3389/fpsyt.2023.1134692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/16/2023] [Indexed: 03/29/2023] Open
Abstract
The present case report describes a young man diagnosed with schizophrenia and presents a "revolving door" (RD) phenomenon. He was hospitalized in an acute psychiatric clinic three times in 1 year. After each hospitalization, he was discharged with incompletely reduced psychotic symptoms, persistent negative symptoms, low functioning, lack of insight, and adherence. He had an insufficient response to maximally tolerated doses of antipsychotic monotherapy with haloperidol and risperidone. Moreover, his treatment was complicated due to the low accessibility of long-acting injectable atypical antipsychotics (LAI) in the country and his refusal of the only available atypical LAI paliperidone palmitate and refusal to take clozapine. Due to limited alternatives, the decision to administer combinations of antipsychotics was made. Since his diagnosis, he received several combinations of antipsychotics, i.e., haloperidol + quetiapine, risperidone + quetiapine, haloperidol + olanzapine, risperidone + olanzapine, but without sufficient clinical effectiveness. Although combinations of antipsychotics reduced his positive symptoms to some degree, persistent negative symptoms and extrapyramidal side effects were observed. After initiating cariprazine, which was combined with olanzapine, improvement in the patient's positive symptoms, negative symptoms, and overall functioning was detected. The combination of medications mentioned above facilitated the therapeutic alliance, thus providing control over the symptoms and preventing psychiatric hospitalizations.
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Xiao X, Zhang CY, Zhang Z, Hu Z, Li M, Li T. Revisiting tandem repeats in psychiatric disorders from perspectives of genetics, physiology, and brain evolution. Mol Psychiatry 2022; 27:466-475. [PMID: 34650204 DOI: 10.1038/s41380-021-01329-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/16/2021] [Accepted: 09/28/2021] [Indexed: 01/28/2023]
Abstract
Genome-wide association studies (GWASs) have revealed substantial genetic components comprised of single nucleotide polymorphisms (SNPs) in the heritable risk of psychiatric disorders. However, genetic risk factors not covered by GWAS also play pivotal roles in these illnesses. Tandem repeats, which are likely functional but frequently overlooked by GWAS, may account for an important proportion in the "missing heritability" of psychiatric disorders. Despite difficulties in characterizing and quantifying tandem repeats in the genome, studies have been carried out in an attempt to describe impact of tandem repeats on gene regulation and human phenotypes. In this review, we have introduced recent research progress regarding the genomic distribution and regulatory mechanisms of tandem repeats. We have also summarized the current knowledge of the genetic architecture and biological underpinnings of psychiatric disorders brought by studies of tandem repeats. These findings suggest that tandem repeats, in candidate psychiatric risk genes or in different levels of linkage disequilibrium (LD) with psychiatric GWAS SNPs and haplotypes, may modulate biological phenotypes related to psychiatric disorders (e.g., cognitive function and brain physiology) through regulating alternative splicing, promoter activity, enhancer activity and so on. In addition, many tandem repeats undergo tight natural selection in the human lineage, and likely exert crucial roles in human brain evolution. Taken together, the putative roles of tandem repeats in the pathogenesis of psychiatric disorders is strongly implicated, and using examples from previous literatures, we wish to call for further attention to tandem repeats in the post-GWAS era of psychiatric disorders.
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Affiliation(s)
- Xiao Xiao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Chu-Yi Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Zhuohua Zhang
- Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Zhonghua Hu
- Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China. .,Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Hunan Key Laboratory of Animal Models for Human Diseases, School of Life Sciences, Central South University, Changsha, Hunan, China. .,Eye Center of Xiangya Hospital and Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China. .,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China.
| | - Ming Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China. .,KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China.
| | - Tao Li
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. .,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China.
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Mahmoudi E, Atkins JR, Quidé Y, Reay WR, Cairns HM, Fitzsimmons C, Carr VJ, Green MJ, Cairns MJ. The MIR137 VNTR rs58335419 Is Associated With Cognitive Impairment in Schizophrenia and Altered Cortical Morphology. Schizophr Bull 2020; 47:495-504. [PMID: 32910167 PMCID: PMC8370045 DOI: 10.1093/schbul/sbaa123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Genome-wide association studies (GWAS) of schizophrenia have strongly implicated a risk locus in close proximity to the gene for miR-137. While there are candidate single-nucleotide polymorphisms (SNPs) with functional implications for the microRNA's expression encompassed by the common haplotype tagged by rs1625579, there are likely to be others, such as the variable number tandem repeat (VNTR) variant rs58335419, that have no proxy on the SNP genotyping platforms used in GWAS to date. Using whole-genome sequencing data from schizophrenia patients (n = 299) and healthy controls (n = 131), we observed that the MIR137 4-repeats VNTR (VNTR4) variant was enriched in a cognitive deficit subtype of schizophrenia and associated with altered brain morphology, including thicker left inferior temporal gyrus and deeper right postcentral sulcus. These findings suggest that the MIR137 VNTR4 may impact neuroanatomical development that may, in turn, influence the expression of more severe cognitive symptoms in patients with schizophrenia.
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Affiliation(s)
- Ebrahim Mahmoudi
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia
| | - Joshua R Atkins
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia
| | - Yann Quidé
- School of Psychiatry, University of New South Wales, Sydney, New
South Wales, Australia,Neuroscience Research Australia, Randwick, New South Wales,
Australia
| | - William R Reay
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia
| | - Heath M Cairns
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia
| | - Chantel Fitzsimmons
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New
South Wales, Australia,Neuroscience Research Australia, Randwick, New South Wales,
Australia,Department of Psychiatry, School of Clinical Sciences, Monash
University, Clayton, Victoria, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, New
South Wales, Australia,Neuroscience Research Australia, Randwick, New South Wales,
Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, University of
Newcastle, Callaghan, New South Wales, Australia,Centre for Brain and Mental Health Research, University of
Newcastle, Callaghan, New South Wales, Australia,Hunter Medical Research Institute, New South Wales, New Lambton,
Australia,To whom correspondence should be addressed; tel: +61 (02) 4921 8670, fax:
+61 (02) 4921 7903, e-mail:
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González-Giraldo Y, Forero DA. A functional SNP in the synaptic SNAP25 gene is associated with impulsivity in a Colombian sample. 3 Biotech 2020; 10:134. [PMID: 32154047 DOI: 10.1007/s13205-020-2110-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/02/2020] [Indexed: 12/31/2022] Open
Abstract
The aim of the current study was to test the hypothesis that a functional polymorphism in the synaptosome associated protein 25 (SNAP25) gene could be associated with impulsivity scores in a sample of young Colombian subjects. Impulsivity has been postulated as an endophenotype for several psychiatric disorders of high epidemiological relevance. There is a need for the study of additional candidate genes for impulsivity. One hundred seventy-five young Colombian subjects completed the Spanish version of the short form of the Barratt Impulsiveness Scale (BIS-15S). A TaqMan assay was used to genotype a functional polymorphism (rs3746544) in the SNAP25 gene. A significant association was found between the functional polymorphism in the SNAP25 gene and impulsivity in the Colombian sample, with subjects carrying T/T and G/G genotypes showing lower mean scores in the non-planning subfactor (p = 0.02). This is the first report of an association of a functional polymorphism in the SNAP25 gene and a subfactor of the BIS-15S scale of impulsivity. In addition, this the first genetic study of impulsivity scores in a Latin American sample. Future studies should explore additional variants in brain-expressed miRNAs and in their binding sites as candidates for impulsivity in different populations.
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Pacheco A, Berger R, Freedman R, Law AJ. A VNTR Regulates miR-137 Expression Through Novel Alternative Splicing and Contributes to Risk for Schizophrenia. Sci Rep 2019; 9:11793. [PMID: 31409837 PMCID: PMC6692358 DOI: 10.1038/s41598-019-48141-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/29/2019] [Indexed: 12/12/2022] Open
Abstract
The MIR137HG gene encoding microRNA-137 (miR-137) is genome-wide associated with schizophrenia (SZ), however, the underlying molecular mechanisms remain unknown. Through cloning and sequencing of individual transcripts from fetal and adult human brain tissues we describe novel pri-miR-137 splice variants which exclude the mature miR-137 sequence termed ‘del-miR-137’ that would function to down-regulate miR-137 expression. Sequencing results demonstrate a significant positive association between del-miR-137 transcripts and the length of a proximal variable number tandem repeat (VNTR) element. Additionally, a significantly higher proportion of sequenced transcripts from fetal brain were del-miR-137 transcripts indicating neurodevelopmental splicing regulation. In-silico results predict an independent regulatory function for del-miR-137 transcripts through competitive endogenous RNA function. A case-control haplotype analysis (n = 998) in SZ implicates short VNTR length in risk, with longer lengths imparting a protective effect. Rare high risk haplotypes were also observed indicating multiple risk variants within the region. A second haplotype analysis was performed to evaluate recombination effects excluding the VNTR and results indicate that recombination of the region was found to independently contribute to risk. Evaluation of the evolutionary conservation of the VNTR reveals a human lineage specific expansion. These findings shed further light on the risk architecture of the miR-137 region and provide a novel regulatory mechanism through VNTR length and alternative MIR137HG transcripts which contribute to risk for SZ.
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Affiliation(s)
- Ashley Pacheco
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, 80045, USA
| | - Ralph Berger
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, 80045, USA
| | - Robert Freedman
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, 80045, USA
| | - Amanda J Law
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, 80045, USA. .,University of Colorado, School of Medicine, Department of Medicine, Aurora, CO, 80045, USA. .,University of Colorado, School of Medicine, Department of Cell and Developmental Biology, Aurora, CO, 80045, USA.
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Thomas KT, Gross C, Bassell GJ. microRNAs Sculpt Neuronal Communication in a Tight Balance That Is Lost in Neurological Disease. Front Mol Neurosci 2018; 11:455. [PMID: 30618607 PMCID: PMC6299112 DOI: 10.3389/fnmol.2018.00455] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 11/26/2018] [Indexed: 12/13/2022] Open
Abstract
Since the discovery of the first microRNA 25 years ago, microRNAs (miRNAs) have emerged as critical regulators of gene expression within the mammalian brain. miRNAs are small non-coding RNAs that direct the RNA induced silencing complex to complementary sites on mRNA targets, leading to translational repression and/or mRNA degradation. Within the brain, intra- and extracellular signaling events tune the levels and activities of miRNAs to suit the needs of individual neurons under changing cellular contexts. Conversely, miRNAs shape neuronal communication by regulating the synthesis of proteins that mediate synaptic transmission and other forms of neuronal signaling. Several miRNAs have been shown to be critical for brain function regulating, for example, enduring forms of synaptic plasticity and dendritic morphology. Deficits in miRNA biogenesis have been linked to neurological deficits in humans, and widespread changes in miRNA levels occur in epilepsy, traumatic brain injury, and in response to less dramatic brain insults in rodent models. Manipulation of certain miRNAs can also alter the representation and progression of some of these disorders in rodent models. Recently, microdeletions encompassing MIR137HG, the host gene which encodes the miRNA miR-137, have been linked to autism and intellectual disability, and genome wide association studies have linked this locus to schizophrenia. Recent studies have demonstrated that miR-137 regulates several forms of synaptic plasticity as well as signaling cascades thought to be aberrant in schizophrenia. Together, these studies suggest a mechanism by which miRNA dysregulation might contribute to psychiatric disease and highlight the power of miRNAs to influence the human brain by sculpting communication between neurons.
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Affiliation(s)
- Kristen T. Thomas
- Department of Developmental Neurobiology, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Christina Gross
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Gary J. Bassell
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, United States
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
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González-Giraldo Y, Trujillo ML, Forero DA. Two dopaminergic genes, DRD4 and SLC6A3, are associated with body mass index in a Colombian sample of young adults. Arch Physiol Biochem 2018; 124:330-334. [PMID: 29145734 DOI: 10.1080/13813455.2017.1401643] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Obesity is becoming an epidemic in Latin American countries. Genetic analyses of endophenotypes for obesity, such as body mass index (BMI), are quite useful for research. In this study, we analysed two functional polymorphisms in the dopamine receptor 4 (DRD4) and dopamine transporter (SLC6A3) genes. A sample of 232 Colombian young subjects were recruited and evaluated for BMI. Two functional polymorphisms in the DRD4 and SLC6A3 and genes were genotyped by PCR and electrophoresis. A significant association was found between BMI and the polymorphisms in DRD4 and SLC6A3 genes. DRD4 4/4 genotype was associated with a lower mean BMI and SLC6A3 10/10 genotype was associated with a higher mean BMI. Our work provides additional novel findings about the association of dopaminergic genes with BMI in healthy young adults. In addition, our study is one the first analyses of candidate genes for BMI in Latin American samples.
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Affiliation(s)
- Yeimy González-Giraldo
- a Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group , School of Medicine, Universidad Antonio Nariño , Bogotá , Colombia
| | - Martha L Trujillo
- a Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group , School of Medicine, Universidad Antonio Nariño , Bogotá , Colombia
| | - Diego A Forero
- a Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group , School of Medicine, Universidad Antonio Nariño , Bogotá , Colombia
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González-Giraldo Y, González-Reyes RE, Mueller ST, Piper BJ, Adan A, Forero DA. Situation Awareness Performance in Healthy Young Adults Is Associated With a Serotonin Transporter Gene Polymorphism. Psychol Rep 2018; 121:877-891. [PMID: 29298559 DOI: 10.1177/0033294117740136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Situation awareness (SA) is defined in three levels: SA1 is the perception of the elements in a specific context, SA2 is the comprehension of their meaning, and SA3 is the projection of their status. Purpose To analyze the possible association of a genetic polymorphism in the serotonin transporter ( SLC6A4) gene and performance on the Situational Awareness test (SAtest). Methods SAtest was applied to a sample of 230 healthy Colombian subjects, using the Psychology Experiment Building Language platform and a functional polymorphism in the SLC6A4 gene was genotyped by polymerase chain reaction. Results In the SA1 level, s/s genotype carriers had worse accuracy, in comparison with s/l and l/l genotypes. At SA2 level, l/l genotype carriers had better accuracy than s/s and s/l individuals and that in the SA3 level, l/l carriers also had better accuracy. These associations were significant after correction for multiple testing. Conclusions It is possible that l/l carriers have a better ability to perceive and focus their attention on the elements of their environment and to have the capacity to understand and predict what will happen with those elements. This is the first genetic study of SA performance in healthy participants. Additional investigations of other genes could contribute to the understanding of the molecular correlates of SA in healthy subjects and in neuropsychiatric patients.
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Affiliation(s)
- Yeimy González-Giraldo
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
| | - Rodrigo E González-Reyes
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
| | - Shane T Mueller
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, MI, USA
| | | | - Ana Adan
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain; Institute for Brain, Cognition and Behavior (IR3C), Barcelona, Spain
| | - Diego A Forero
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
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