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Wang J, Luo C, Wang Z, Liu T, Bai C, Wang Y, Tian Y, Li Q, Wang Z, Wu L, Wang S, Gu X. Clinical management of children with tic disorder: insights from therapeutic visits in China-a real-world study. Front Pediatr 2024; 12:1360470. [PMID: 39188641 PMCID: PMC11345627 DOI: 10.3389/fped.2024.1360470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/05/2024] [Indexed: 08/28/2024] Open
Abstract
Objective This retrospective study aims to investigate the treatment of tic disorder (TD) in Dongfang Hospital affiliated with Beijing University of Chinese Medicine, explore its underlying mechanism, and provide valuable insights for future research and clinical management of TD. Methods The electronic medical records of children with TD, from 2015 to 2021, were extracted from the information system of Dongfang Hospital affiliated with Beijing University of Chinese Medicine. The clinical characteristics of TD, utilization patterns of Chinese herbal medicine and synthetic drugs in prescriptions, as well as their pharmacological effects, were statistically described and categorized. In addition, association rules and network pharmacology were employed to identify core prescriptions (CPs) and elucidate their microscopic molecular mechanisms in treating TD. Results The age range of the children was from 6 to 11 years, with a higher proportion of male participants than female ones. The average duration of treatment was 6 weeks. Regimen Z for the treatment of TD can be summarized as follows: Chinese herbal medicine [Saposhnikoviae Radix (FangFeng), Puerariae Lobatae Radix (GeGen), Uncariae Ramulus cum Uncis (GouTeng), Acori Tatarinowii Rhizoma (ShiChangPu), Chuanxiong Rhizoma (ChuanXiong)] and vitamins [lysine, inosite, and vitamin B12 oral solution] form the basic treatment, combined with immunomodulators, antibiotics, electrolyte-balancing agents, and antiallergic agents. CPs primarily exerted their effects through the modulation of gene expression (transcription), the immune system, and signal transduction pathways, with interleukin-4 and interleukin-13 pathways being particularly crucial. Among the lysine synthetic drugs used, inosite and vitamin B12 oral solution were the most frequently prescribed. Conclusion The regimen Z drug treatment holds significant importance in the field, as it exerts its therapeutic effects through a multitude of pathways and intricate interventions. Chinese herbal medicine primarily regulates immune system-related pathways, while synthetic drugs predominantly consist of vitamins.
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Affiliation(s)
- Jing Wang
- Pediatric Department, Wangjing Hospital of CACMS, Beijing, China
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Changyong Luo
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhendong Wang
- Gulou Hospital of Traditional Chinese Medicine of Beijing, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tiegang Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Bai
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yang Wang
- Department of Chinese Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Yuanshuo Tian
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Qianqian Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhaoxin Wang
- Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Liqun Wu
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Sumei Wang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaohong Gu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Reid M, Lin A, Farhat LC, Fernandez TV, Olfson E. The genetics of trichotillomania and excoriation disorder: A systematic review. Compr Psychiatry 2024; 133:152506. [PMID: 38833896 DOI: 10.1016/j.comppsych.2024.152506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/09/2024] [Accepted: 05/30/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Trichotillomania (TTM) and excoriation disorder (ED) are impairing obsessive-compulsive related disorders that are common in the general population and for which there are no clear first-line medications, highlighting the need to better understand the underlying biology of these disorders to inform treatments. Given the importance of genetics in obsessive-compulsive disorder (OCD), evaluating genetic factors underlying TTM and ED may advance knowledge about the pathophysiology of these body-focused repetitive behaviors. AIM In this systematic review, we summarize the available evidence on the genetics of TTM and ED and highlight gaps in the field warranting further research. METHOD We systematically searched Embase, PsycInfo, PubMed, Medline, Scopus, and Web of Science for original studies in genetic epidemiology (family or twin studies) and molecular genetics (candidate gene and genome-wide) published up to June 2023. RESULTS Of the 3536 records identified, 109 studies were included in this review. These studies indicated that genetic factors play an important role in the development of TTM and ED, some of which may be shared across the OCD spectrum, but there are no known high-confidence specific genetic risk factors for either TTM or ED. CONCLUSIONS Our review underscores the need for additional genome-wide research conducted on the genetics of TTM and ED, for instance, genome-wide association and whole-genome/whole-exome DNA sequencing studies. Recent advances in genomics have led to the discovery of risk genes in several psychiatric disorders, including related conditions such as OCD, but to date, TTM and ED have remained understudied.
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Affiliation(s)
- Madison Reid
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA; The University of the South, USA
| | - Ashley Lin
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Luis C Farhat
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Thomas V Fernandez
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Emily Olfson
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
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Miller-Fleming TW, Allos A, Gantz E, Yu D, Isaacs DA, Mathews CA, Scharf JM, Davis LK. Developing a phenotype risk score for tic disorders in a large, clinical biobank. Transl Psychiatry 2024; 14:311. [PMID: 39069519 DOI: 10.1038/s41398-024-03011-w] [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: 03/17/2023] [Revised: 06/28/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Tics are a common feature of early-onset neurodevelopmental disorders, characterized by involuntary and repetitive movements or sounds. Despite affecting up to 2% of children and having a genetic contribution, the underlying causes remain poorly understood. In this study, we leverage dense phenotype information to identify features (i.e., symptoms and comorbid diagnoses) of tic disorders within the context of a clinical biobank. Using de-identified electronic health records (EHRs), we identified individuals with tic disorder diagnosis codes. We performed a phenome-wide association study (PheWAS) to identify the EHR features enriched in tic cases versus controls (n = 1406 and 7030; respectively) and found highly comorbid neuropsychiatric phenotypes, including: obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, and anxiety (p < 7.396 × 10-5). These features (among others) were then used to generate a phenotype risk score (PheRS) for tic disorder, which was applied across an independent set of 90,051 individuals. A gold standard set of tic disorder cases identified by an EHR algorithm and confirmed by clinician chart review was then used to validate the tic disorder PheRS; the tic disorder PheRS was significantly higher among clinician-validated tic cases versus non-cases (p = 4.787 × 10-151; β = 1.68; SE = 0.06). Our findings provide support for the use of large-scale medical databases to better understand phenotypically complex and underdiagnosed conditions, such as tic disorders.
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Affiliation(s)
- Tyne W Miller-Fleming
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, TN, Nashville, USA.
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Annmarie Allos
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, TN, Nashville, USA
- Department of Cognitive Science, Dartmouth College, Hanover, NH, USA
| | - Emily Gantz
- Department of Pediatric Neurology, Children's Hospital of Alabama, Birmingham, AL, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - David A Isaacs
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, TN, Nashville, USA.
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Biomedical Informatics, Vanderbilt University Medical Center, TN, Nashville, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, TN, Nashville, USA.
- Department of Molecular Physiology and Biophysics, Vanderbilt University, TN, Nashville, USA.
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Lu Q, Zhou Y, Qian Q, Chen Z, Tan Q, Chen H, Yin F, Wang Y, Liu Z, Tian P, Sun D. Whole-exome sequencing identifies high-confidence genes for tic disorders in a Chinese Han population. Clin Chim Acta 2024; 561:119759. [PMID: 38880274 DOI: 10.1016/j.cca.2024.119759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/23/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Tic disorder (TD) is a polygenic neurodevelopmental disorder with high susceptibility. However, identifying high-confidence risk genes has been challenging due to poor replication across multiple studies. METHODS Whole-exome sequencing was performed on 390 TD patients and 372 unaffected individuals in a Chinese Han population. Analysis of variance, burden analysis and in silico prediction were used to identify candidate genes for TD. To facilitate data analysis and to focus on high-confidence genes, we defined a panel of 160 genes as known causal or candidate TD genes from previous studies. Gene enrichment and protein-protein interaction analysis were utilized to detect potential novel TD risk genes. RESULTS Totally, 14 variants across 12 known TD candidate genes were considered potential susceptibility variants. Ten variants across 10 known TD candidate genes were identified as potential disease-causing variants. Burden analysis identified variants of 28 known genes were significantly excess in TD patients. In addition, 354 previously unproven TD genes are over-represented in patients. Genes enriched in the PI3K-Akt signaling, sphingolipid metabolism and serotonergic synaptic pathways, as well as those interacting with FN1, were considered potential new candidate genes for TD. CONCLUSIONS This is the largest WES study focusing on TD patients in a Chinese Han population. Several variants recurring in our cohort were identified as high-confidence risk loci for TD. Moreover, we provided potential new risk genes that may be prioritized for further investigation.
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Affiliation(s)
- Qing Lu
- Department of Neurology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Yong Zhou
- Puluo (Wuhan) Medical Biotechnology Co., LTD, Wuhan 430070, China; Department of Marketing, Wuhan Kindstar Clinical Diagnostic Institute Co., Ltd., Wuhan 430000, China
| | - Qiaoqiao Qian
- Department of Neurology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Zhigang Chen
- Puluo (Wuhan) Medical Biotechnology Co., LTD, Wuhan 430070, China
| | - Qianqian Tan
- Puluo (Wuhan) Medical Biotechnology Co., LTD, Wuhan 430070, China; Department of Marketing, Wuhan Kindstar Clinical Diagnostic Institute Co., Ltd., Wuhan 430000, China
| | - Haiyun Chen
- Puluo (Wuhan) Medical Biotechnology Co., LTD, Wuhan 430070, China; Department of Marketing, Wuhan Kindstar Clinical Diagnostic Institute Co., Ltd., Wuhan 430000, China
| | - Fan Yin
- Puluo (Wuhan) Medical Biotechnology Co., LTD, Wuhan 430070, China; Department of Marketing, Wuhan Kindstar Clinical Diagnostic Institute Co., Ltd., Wuhan 430000, China
| | - Yue Wang
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zhisheng Liu
- Department of Neurology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Peichao Tian
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Dan Sun
- Department of Neurology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
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Tsetsos F, Topaloudi A, Jain P, Yang Z, Yu D, Kolovos P, Tumer Z, Rizzo R, Hartmann A, Depienne C, Worbe Y, Müller-Vahl KR, Cath DC, Boomsma DI, Wolanczyk T, Zekanowski C, Barta C, Nemoda Z, Tarnok Z, Padmanabhuni SS, Buxbaum JD, Grice D, Glennon J, Stefansson H, Hengerer B, Yannaki E, Stamatoyannopoulos JA, Benaroya-Milshtein N, Cardona F, Hedderly T, Heyman I, Huyser C, Mir P, Morer A, Mueller N, Munchau A, Plessen KJ, Porcelli C, Roessner V, Walitza S, Schrag A, Martino D, Tischfield JA, Heiman GA, Willsey AJ, Dietrich A, Davis LK, Crowley JJ, Mathews CA, Scharf JM, Georgitsi M, Hoekstra PJ, Paschou P. Genome-Wide Association Study Points to Novel Locus for Gilles de la Tourette Syndrome. Biol Psychiatry 2024; 96:114-124. [PMID: 36738982 PMCID: PMC10783199 DOI: 10.1016/j.biopsych.2023.01.023] [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: 05/11/2022] [Revised: 11/23/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder of complex genetic architecture and is characterized by multiple motor tics and at least one vocal tic persisting for more than 1 year. METHODS We performed a genome-wide meta-analysis integrating a novel TS cohort with previously published data, resulting in a sample size of 6133 individuals with TS and 13,565 ancestry-matched control participants. RESULTS We identified a genome-wide significant locus on chromosome 5q15. Integration of expression quantitative trait locus, Hi-C (high-throughput chromosome conformation capture), and genome-wide association study data implicated the NR2F1 gene and associated long noncoding RNAs within the 5q15 locus. Heritability partitioning identified statistically significant enrichment in brain tissue histone marks, while polygenic risk scoring of brain volume data identified statistically significant associations with right and left thalamus volumes and right putamen volume. CONCLUSIONS Our work presents novel insights into the neurobiology of TS, thereby opening up new directions for future studies.
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Affiliation(s)
- Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Apostolia Topaloudi
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Pritesh Jain
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Zhiyu Yang
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Petros Kolovos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Zeynep Tumer
- Department of Clinical Genetics, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Renata Rizzo
- Child and Adolescent Neurology and Psychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andreas Hartmann
- Department of Neurology, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Christel Depienne
- Institute for Human Genetics, University Hospital Essen, Essen, Germany
| | - Yulia Worbe
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Kirsten R. Müller-Vahl
- Department of Psychiatry, Social psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Danielle C. Cath
- Department of Clinical and health Psychology, Utrecht University, Utrecht, Netherlands
| | - Dorret I. Boomsma
- Institute for Anatomy and Cell Biology, Ulm University, Ulm, Germany
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands
| | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Cezary Zekanowski
- Laboratory of Neurogenetics, Department of Neurodegenerative Disorders, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Csaba Barta
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Zsofia Nemoda
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Clinic for Child and Adolescent Psychiatry, Hungary
| | | | - Joseph D. Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, USA
| | - Dorothy Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, USA
- Division of Tics, OCD, and Related Disorders, Icahn School of Medicine at Mount Sinai, USA
| | - Jeffrey Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Netherlands
| | | | - Bastian Hengerer
- Boehringer Ingelheim Pharma GmbH & Co. KG, CNS Research, Germany
| | - Evangelia Yannaki
- Hematology Department- Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center, George Papanikolaou Hospital, Greece
- Department of Medicine, University of Washington, WA, USA
| | - John A. Stamatoyannopoulos
- Altius Institute for Biomedical Sciences, WA, USA
- Department of Genome Sciences, University of Washington, WA, USA
- Department of Medicine, Division of Oncology, University of Washington, WA, USA
| | - Noa Benaroya-Milshtein
- Child and Adolescent Psychiatry Department, Schneider Children’s Medical Centre of Israel, Petah-Tikva. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Francesco Cardona
- Department of Human Neurosciences, University La Sapienza of Rome, Rome, Italy
| | - Tammy Hedderly
- Evelina London Children’s Hospital GSTT, Kings Health Partners AHSC, London, UK
| | - Isobel Heyman
- Psychological Medicine, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK
| | - Chaim Huyser
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Amsterdam UMC, Department of Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Pablo Mir
- Unidad de Trastornos del Movimiento. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla. Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain
- Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigacion en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Spain
| | - Norbert Mueller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alexander Munchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Kerstin J Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Cesare Porcelli
- ASL BA, Maternal and Childood Department; Adolescence and Childhood Neuropsychiatry Unit; Bari, Italy
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Anette Schrag
- Department of Clinical Neuroscience, UCL Institute of Neurology, University College London, London, UK
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine & Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | | | | | | | | | | | | | - Jay A. Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Gary A. Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - A. Jeremy Willsey
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Quantitative Biosciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Andrea Dietrich
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Lea K. Davis
- Division of Genetic Medicine, Department of Medicine Vanderbilt University Medical Center Nashville, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James J. Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carol A. Mathews
- Department of Psychiatry and Genetics Institute, University of Florida College of Medicine, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women’s Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Marianthi Georgitsi
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
- 1st Laboratory of Medical Biology-Genetics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pieter J. Hoekstra
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
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Bai L, Wang X, Niu R, Zhao M, Zhao Z, Jia P, Sun S. Association between body mass index and tic disorders in school-age children. BMC Pediatr 2024; 24:261. [PMID: 38643075 PMCID: PMC11031855 DOI: 10.1186/s12887-024-04592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE To explore the relationship between body mass index (BMI ) and the severity of tic disorders (TDs) in children 6-14 years old. METHODS A total of 86 children diagnosed with TDs in a hospital between Jan. 2023 and Sept. 2023 were collected by convenient sampling method, and the general data and TD-specific data were collected and analyzed. RESULTS Univariate analysis showed that patients with different Yale Global Tic Severity Scale (YGTSS) grades had statistically significant differences in age, BMI, residence, snacking pattern, weekly physical exercise frequency, weekly physical exercise time, and proportion of cesarean birth. Multiple linear regression analysis showed that the YGTSS score grades were related to BMI, snacking pattern, and cesarean birth of the patients. Correlation analysis revealed a positive correlation between BMI grades and the YGTSS score grades, with a higher BMI indicating more severe TDs. Predictive value evaluation showed that BMI, snacking pattern, and cesarean birth had predictive values for TD severity, and the highest value was found in the combined prediction. CONCLUSION BMI, snacking pattern, and cesarean birth are of predictive values for the severity of TDs. In addition, BMI is positively correlated with the severity of TDs, and a higher BMI suggests more severe TDs.
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Affiliation(s)
- Lu Bai
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Xia Wang
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Ruijie Niu
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Mengchuan Zhao
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Ziwei Zhao
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Pengyu Jia
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Suzhen Sun
- Hebei Medical University, Shijiazhuang, 050017, China.
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China.
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7
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Lin WD, Liu TY, Chen YC, Chou IC, Tsai FJ. Genome-wide association study identifies DRAM1 associated with Tourette syndrome in Taiwan. Biomed J 2024:100725. [PMID: 38608873 DOI: 10.1016/j.bj.2024.100725] [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: 06/27/2023] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. Several susceptibility loci associated with TS have been identified previously in populations of European descent using genome-wide association studies (GWAS). However, the exact pathogenic mechanism underlying TS is unknown; additionally, the results of previous GWAS for TS were based on Western populations, which may not translate to other populations. Therefore, we conducted a GWAS in Taiwanese patients with TS and chronic tic disorders (CTDs), with an aim to elucidate the genetic basis and potential risk factors for TS in this population. METHODS GWAS was performed on a Taiwanese TS/CTDs cohort with a sample size of 1,007 patients with TS and 25,522 ancestry-matched controls. Additionally, polygenic risk score was calculated and assessed. RESULTS Genome-wide significant locus, rs12313062 (p=1.43 × 10-8) and other 9 single nucleotide polymorphisms, were identified in chromosomes 12q23.2, associated with DRAM1 and was a novel susceptibility locus identified in TS/CTDs group. DRAM1, a lysosomal transmembrane protein regulated by p53, modulates autophagy and apoptosis, with potential implications for neuropsychiatric conditions associated with autophagy disruption. CONCLUSIONS This study conducted the first GWAS for TS in a Taiwanese population, identifying a significant locus on chromosome 12q23.2 associated with DRAM1. These findings provide novel insights into the neurobiology of TS and potential directions for future research in this area.
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Affiliation(s)
- Wei-De Lin
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ting-Yuan Liu
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chia Chen
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - I-Ching Chou
- Division of Pediatrics Neurology, China Medical University Children's Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Division of Genetics and Metabolism, China Medical University Children's Hospital, Taichung, Taiwan; Department of Medical Genetics, China Medical University Hospital, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan.
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8
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Burton CL, Longaretti A, Zlatanovic A, Gomes GM, Tonini R. Striatal insights: a cellular and molecular perspective on repetitive behaviors in pathology. Front Cell Neurosci 2024; 18:1386715. [PMID: 38601025 PMCID: PMC11004256 DOI: 10.3389/fncel.2024.1386715] [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: 02/15/2024] [Accepted: 03/15/2024] [Indexed: 04/12/2024] Open
Abstract
Animals often behave repetitively and predictably. These repetitive behaviors can have a component that is learned and ingrained as habits, which can be evolutionarily advantageous as they reduce cognitive load and the expenditure of attentional resources. Repetitive behaviors can also be conscious and deliberate, and may occur in the absence of habit formation, typically when they are a feature of normal development in children, or neuropsychiatric disorders. They can be considered pathological when they interfere with social relationships and daily activities. For instance, people affected by obsessive-compulsive disorder, autism spectrum disorder, Huntington's disease and Gilles de la Tourette syndrome can display a wide range of symptoms like compulsive, stereotyped and ritualistic behaviors. The striatum nucleus of the basal ganglia is proposed to act as a master regulator of these repetitive behaviors through its circuit connections with sensorimotor, associative, and limbic areas of the cortex. However, the precise mechanisms within the striatum, detailing its compartmental organization, cellular specificity, and the intricacies of its downstream connections, remain an area of active research. In this review, we summarize evidence across multiple scales, including circuit-level, cellular, and molecular dimensions, to elucidate the striatal mechanisms underpinning repetitive behaviors and offer perspectives on the implicated disorders. We consider the close relationship between behavioral output and transcriptional changes, and thereby structural and circuit alterations, including those occurring through epigenetic processes.
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Affiliation(s)
| | | | | | | | - Raffaella Tonini
- Neuromodulation of Cortical and Subcortical Circuits Laboratory, Istituto Italiano di Tecnologia, Genoa, Italy
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9
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Ettetuani B, Chahboune R, Moussa A. Adjustment of p-value expression to ontology using machine learning for genetic prediction, prioritization, interaction, and its validation in glomerular disease. Front Genet 2023; 14:1215232. [PMID: 37900183 PMCID: PMC10603191 DOI: 10.3389/fgene.2023.1215232] [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: 05/01/2023] [Accepted: 08/28/2023] [Indexed: 10/31/2023] Open
Abstract
The results of gene expression analysis based on p-value can be extracted and sorted by their absolute statistical significance and then applied to multiple similarity scores of their gene ontology (GO) terms to promote the combination and adjustment of these scores as essential predictive tasks for understanding biological/clinical pathways. The latter allows the possibility to assess whether certain aspects of gene function may be associated with other varieties of genes, to evaluate regulation, and to link them into networks that prioritize candidate genes for classification by applying machine learning techniques. We then detect significant genetic interactions based on our algorithm to validate the results. Finally, based on specifically selected tissues according to their normalized gene expression and frequencies of occurrence from their different biological and clinical inputs, a reported classification of genes under the subject category has validated the abstract (glomerular diseases) as a case study.
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Affiliation(s)
- Boutaina Ettetuani
- Systems and Data Engineering Team, National School of Applied Sciences, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Rajaa Chahboune
- Life and Health Sciences Team, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Ahmed Moussa
- Systems and Data Engineering Team, National School of Applied Sciences, Abdelmalek Essaadi University, Tétouan, Morocco
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10
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Kanaan AS, Yu D, Metere R, Schäfer A, Schlumm T, Bilgic B, Anwander A, Mathews CA, Scharf JM, Müller-Vahl K, Möller HE. Convergent imaging-transcriptomic evidence for disturbed iron homeostasis in Gilles de la Tourette syndrome. Neurobiol Dis 2023; 185:106252. [PMID: 37536382 DOI: 10.1016/j.nbd.2023.106252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/11/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a neuropsychiatric movement disorder with reported abnormalities in various neurotransmitter systems. Considering the integral role of iron in neurotransmitter synthesis and transport, it is hypothesized that iron exhibits a role in GTS pathophysiology. As a surrogate measure of brain iron, quantitative susceptibility mapping (QSM) was performed in 28 patients with GTS and 26 matched controls. Significant susceptibility reductions in the patients, consistent with reduced local iron content, were obtained in subcortical regions known to be implicated in GTS. Regression analysis revealed a significant negative association of tic scores and striatal susceptibility. To interrogate genetic mechanisms that may drive these reductions, spatially specific relationships between susceptibility and gene-expression patterns from the Allen Human Brain Atlas were assessed. Correlations in the striatum were enriched for excitatory, inhibitory, and modulatory neurochemical signaling mechanisms in the motor regions, mitochondrial processes driving ATP production and iron‑sulfur cluster biogenesis in the executive subdivision, and phosphorylation-related mechanisms affecting receptor expression and long-term potentiation in the limbic subdivision. This link between susceptibility reductions and normative transcriptional profiles suggests that disruptions in iron regulatory mechanisms are involved in GTS pathophysiology and may lead to pervasive abnormalities in mechanisms regulated by iron-containing enzymes.
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Affiliation(s)
- Ahmad Seif Kanaan
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
| | - Dongmei Yu
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Riccardo Metere
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Andreas Schäfer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Siemens Healthcare GmbH, Diagnostic Imaging, Magnetic Resonance, Research and Development, Erlangen, Germany
| | - Torsten Schlumm
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Berkin Bilgic
- Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA; Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Alfred Anwander
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kirsten Müller-Vahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Harald E Möller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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11
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Lin K, Wang Y, Wang J, Zhang C, Feng Q. Treatment of Tourette syndrome by acupuncture combined with Chinese medicine based on syndrome differentiation: A review. Medicine (Baltimore) 2023; 102:e34268. [PMID: 37478233 PMCID: PMC10662812 DOI: 10.1097/md.0000000000034268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/19/2023] [Indexed: 07/23/2023] Open
Abstract
Tourette syndrome (TS) is a chronic neurodevelopmental disorder characterized by involuntary motor and speech tics, which can greatly reduce the quality of life of patients. The pathophysiology of TS involves both genetic and environmental factors. Assessing TS pathogenesis is complex, and its underlying pathophysiology is not fully understood. It is gratifying that the research in the past 5 years has brought new research progress on the genetic, neurophysiological and brain network changes of TS. However, despite the progress of research, the treatment methods and drugs of modern medicine are still unsatisfactory, and it is difficult to achieve satisfactory results. Traditional Chinese medicine, as a part of complementary and alternative medicine, has unique efficacy in the treatment of TS, and the safety of its treatment is also worthy of attention. Based on the latest achievements in the pathophysiology of TS, this article will discuss the treatment of TS by acupuncture combined with medicine.
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Affiliation(s)
- Kexin Lin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yijie Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiaqi Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Chuanyu Zhang
- The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Qiuju Feng
- The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China
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12
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Kanaan AS, Yu D, Metere R, Schäfer A, Schlumm T, Bilgic B, Anwander A, Mathews CA, Scharf JM, Müller-Vahl K, Möller HE. Convergent imaging-transcriptomic evidence for disturbed iron homeostasis in Gilles de la Tourette syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.15.23289978. [PMID: 37292704 PMCID: PMC10246056 DOI: 10.1101/2023.05.15.23289978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Gilles de la Tourette syndrome (GTS) is a neuropsychiatric movement disorder with reported abnormalities in various neurotransmitter systems. Considering the integral role of iron in neurotransmitter synthesis and transport, it is hypothesized that iron exhibits a role in GTS pathophysiology. As a surrogate measure of brain iron, quantitative susceptibility mapping (QSM) was performed in 28 patients with GTS and 26 matched controls. Significant susceptibility reductions in the patient cohort, consistent with reduced local iron content, were obtained in subcortical regions known to be implicated in GTS. Regression analysis revealed a significant negative association of tic scores and striatal susceptibility. To interrogate genetic mechanisms that may drive these reductions, spatially specific relationships between susceptibility and gene-expression patterns extracted from the Allen Human Brain Atlas were assessed. Correlations in the striatum were enriched for excitatory, inhibitory, and modulatory neurochemical signaling mechanisms in the motor regions, mitochondrial processes driving ATP production and iron-sulfur cluster biogenesis in the executive subdivision, and phosphorylation-related mechanisms that affect receptor expression and long-term potentiation. This link between susceptibility reductions and normative transcriptional profiles suggests that disruptions in iron regulatory mechanisms are involved in GTS pathophysiology and may lead to pervasive abnormalities in mechanisms regulated by iron-containing enzymes.
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Affiliation(s)
- Ahmad Seif Kanaan
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Dongmei Yu
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Riccardo Metere
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Andreas Schäfer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Siemens Healthcare GmbH, Diagnostic Imaging, Magnetic Resonance, Research and Development, Erlangen, Germany
| | - Torsten Schlumm
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Berkin Bilgic
- Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Alfred Anwander
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carol A. Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jeremiah M. Scharf
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kirsten Müller-Vahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Harald E. Möller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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13
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Saia F, Prato A, Saccuzzo L, Madia F, Barone R, Fichera M, Rizzo R. Copy Number Variations in Children with Tourette Syndrome: Systematic Investigation in a Clinical Setting. Genes (Basel) 2023; 14:500. [PMID: 36833427 PMCID: PMC9956985 DOI: 10.3390/genes14020500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Tourette syndrome (TS) is a neurodevelopmental disturbance with heterogeneous and not completely known etiology. Clinical and molecular appraisal of affected patients is mandatory for outcome amelioration. The current study aimed to understand the molecular bases underpinning TS in a vast cohort of pediatric patients with TS. Molecular analyses included array-CGH analyses. The primary goal was to define the neurobehavioral phenotype of patients with or without pathogenic copy number variations (CNVs). Moreover, we compared the CNVs with CNVs described in the literature in neuropsychiatric disorders, including TS, to describe an effective clinical and molecular characterization of patients for prognostic purposes and for correctly taking charge. Moreover, this study showed that rare deletions and duplications focusing attention on significant genes for neurodevelopment had a statistically higher occurrence in children with tics and additional comorbidities. In our cohort, we determined an incidence of potentially causative CNVs of about 12%, in line with other literature studies. Clearly, further studies are needed to delineate the genetic background of patients with tic disorders in a superior way to elucidate the complex genetic architecture of these disorders, to describe the outcome, and to identify new possible therapeutic targets.
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Affiliation(s)
- Federica Saia
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
| | - Adriana Prato
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, 98121 Messina, Italy
| | - Lucia Saccuzzo
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, 95124 Catania, Italy
| | - Francesca Madia
- Laboratory of Neurogenetics and Neuroscience, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Rita Barone
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
| | - Marco Fichera
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, 95124 Catania, Italy
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Renata Rizzo
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
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14
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Alshammery S, Patel S, Jones HF, Han VX, Gloss BS, Gold WA, Dale RC. Common targetable inflammatory pathways in brain transcriptome of autism spectrum disorders and Tourette syndrome. Front Neurosci 2022; 16:999346. [PMID: 36590292 PMCID: PMC9799059 DOI: 10.3389/fnins.2022.999346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Neurodevelopmental disorders (NDDs), including autism-spectrum disorders (ASD) and Tourette syndrome (TS) are common brain conditions which often co-exist, and have no approved treatments targeting disease mechanisms. Accumulating literature implicates the immune system in NDDs, and transcriptomics of post-mortem brain tissue has revealed an inflammatory signal. We interrogated two RNA-sequencing datasets of ASD and TS and identified differentially expressed genes, to explore commonly enriched pathways through GO, KEGG, and Reactome. The DEGs [False Discovery Rate (FDR) <0.05] in the ASD dataset (n = 248) and the TS dataset (n = 156) enriched pathways involving inflammation, cytokines, signal transduction and cell signalling. Of the DEGs from the ASD and TS analyses, 23 were shared, all of which were up-regulated: interaction networks of the common protein-coding genes using STRING revealed 5 central up-regulated hub genes: CCL2, ICAM1, HMOX1, MYC, and SOCS3. Applying KEGG and Reactome analysis to the 23 common genes identified pathways involving the innate immune response such as interleukin and interferon signalling pathways. These findings bring new evidence of shared immune signalling in ASD and TS brain transcriptome, to support the overlapping symptoms that individuals with these complex disorders experience.
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Affiliation(s)
- Sarah Alshammery
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Shrujna Patel
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Hannah F. Jones
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,Department of Neuroservices, Starship Children’s Hospital, Auckland, New Zealand
| | - Velda X. Han
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Brian S. Gloss
- Westmead Research Hub, Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Wendy A. Gold
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Russell C. Dale
- Kids Neuroscience Centre, The Children’s Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,The Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,*Correspondence: Russell C. Dale,
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15
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Ryan N, Ormond C, Chang YC, Contreras J, Raventos H, Gill M, Heron E, Mathews CA, Corvin A. Identity-by-descent analysis of a large Tourette's syndrome pedigree from Costa Rica implicates genes involved in neuronal development and signal transduction. Mol Psychiatry 2022; 27:5020-5027. [PMID: 36224258 PMCID: PMC9763103 DOI: 10.1038/s41380-022-01771-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 05/13/2022] [Accepted: 08/30/2022] [Indexed: 01/14/2023]
Abstract
Tourette Syndrome (TS) is a heritable, early-onset neuropsychiatric disorder that typically begins in early childhood. Identifying rare genetic variants that make a significant contribution to risk in affected families may provide important insights into the molecular aetiology of this complex and heterogeneous syndrome. Here we present a whole-genome sequencing (WGS) analysis from the 11-generation pedigree (>500 individuals) of a densely affected Costa Rican family which shares ancestry from six founder pairs. By conducting an identity-by-descent (IBD) analysis using WGS data from 19 individuals from the extended pedigree we have identified putative risk haplotypes that were not seen in controls, and can be linked with four of the six founder pairs. Rare coding and non-coding variants present on the haplotypes and only seen in haplotype carriers show an enrichment in pathways such as regulation of locomotion and signal transduction, suggesting common mechanisms by which the haplotype-specific variants may be contributing to TS-risk in this pedigree. In particular we have identified a rare deleterious missense variation in RAPGEF1 on a chromosome 9 haplotype and two ultra-rare deleterious intronic variants in ERBB4 and IKZF2 on the same chromosome 2 haplotype. All three genes play a role in neurodevelopment. This study, using WGS data in a pedigree-based approach, shows the importance of investigating both coding and non-coding variants to identify genes that may contribute to disease risk. Together, the genes and variants identified on the IBD haplotypes represent biologically relevant targets for investigation in other pedigree and population-based TS data.
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Affiliation(s)
- Niamh Ryan
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Cathal Ormond
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Yi-Chieh Chang
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, USA
| | - Javier Contreras
- Centro de Investigación en Biología Celular y Molecular, Universidad de Costa Rica, San José, Costa Rica
| | - Henriette Raventos
- Centro de Investigación en Biología Celular y Molecular, Universidad de Costa Rica, San José, Costa Rica
- School of Biology, Universidad de Costa Rica, San José, Costa Rica
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Elizabeth Heron
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, USA.
- University of Florida Genetics Institute, University of Florida, Gainesville, FL, USA.
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
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16
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Ramteke A, Lamture Y. Tics and Tourette Syndrome: A Literature Review of Etiological, Clinical, and Pathophysiological Aspects. Cureus 2022; 14:e28575. [PMID: 36185878 PMCID: PMC9520955 DOI: 10.7759/cureus.28575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/30/2022] [Indexed: 11/07/2022] Open
Abstract
Tourette syndrome (TS) is a condition characterized by tics produced because of neuropsychiatric malfunctioning occurring in childhood, which becomes less severe in adulthood, followed by a difference in the severity of tics between two persons. TS is a diverse variable in which symptoms vary in different patients. It is associated with comorbidities like obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and depression, and hampers the quality of life. Comorbid disorders must be investigated and treated as part of the clinical approach for all TS patients. Clinicians should be aware of the infrequent but serious neurological problems that can occur in these patients and recommend aggressively treating tics. Currently, there is more emphasis on symptom-based treatments by medicines, but as etiological knowledge improves, we will divert to disease-modifying medications in the future. Behavioral, pharmacological, and surgical methods can treat TS. Neuroleptics, other drugs, and behavioral therapies are the first-line options. Deep brain stimulation is evolving but has its pros and cons. The main focus of this review is on tics characteristics, how to manage and assess them, and limitations in the clinical spectrum.
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Jiang P, Zhu T, Liu J, Tao X, Xue Z, Tao Y, Chen H, Zeng X, Zhu W, Shu Q, Yu L. Mitochondrial DNA variants spectrum and the association with chronic Tic disorders. Eur J Neurol 2022; 29:3187-3196. [PMID: 35781907 DOI: 10.1111/ene.15484] [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: 01/25/2022] [Revised: 05/05/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Tic disorders (TD) are childhood-onset neuropsychiatric disorders characterized by single or multiple sudden, rapid, recurrent, and motor tics and/or vocal tics. Several nuclear genes that involved in mitochondrial functions suggest potential role of mitochondria in tic deficit. METHODS To evaluate the association of mitochondrial DNA (mtDNA) variants with Tic disorders, we screened the whole mitochondrial genomes in 493 TD patients and 109 age- and sex matched healthy controls using next-generation sequencing technology. RESULTS A total of 1918 mtDNA variants including 1220 variants in patients only, 154 variants in controls only, and 544 variants shared by both cases and controls were identified. We found higher number of overall mtDNA variants in TD patients (P =0.00028). The variant density in MT-ATP6/8 and MT-CYB coding regions had significant difference between TD patients and controls (P=0.0025 and P=0.003, respectively). Furthermore, we observed a significant association of 15 common variants with TD based on additive model, including m.14766C>T, m.14783T>C, m.14905G>A, and m.15301G>A in MT-CYB; m.4769A>G, m.10398A>G, m.12705C>T, and m.12850A>G in MT-ND genes; m.7028C>T in MT-CO1; m.8701A>G in MT-ATP6; two noncoding variants with m.16223C>T, m.5580T>C; and three rRNA variants with m.1438A>G and m.750A>G in RNR1, and m.2352T>C in RNR2. CONCLUSIONS Our data provide the evidence of mtDNA variants associated with tic disorders. The accumulation of the heteroplasmic levels may increase the risk of TD. Replication studies with larger samples are necessary to understand the pathogenesis of TD.
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Affiliation(s)
- Peifang Jiang
- Department of Neurology at The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Tao Zhu
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiajing Liu
- Department of Neurology at The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiaohan Tao
- Department of Neurology at The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ziru Xue
- Department of Neurology at The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yiling Tao
- Department of Neurology at The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hongyu Chen
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiaojing Zeng
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weiyi Zhu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Qiang Shu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Lan Yu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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18
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Szejko N, Robinson S, Hartmann A, Ganos C, Debes NM, Skov L, Haas M, Rizzo R, Stern J, Münchau A, Czernecki V, Dietrich A, Murphy TL, Martino D, Tarnok Z, Hedderly T, Müller-Vahl KR, Cath DC. European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment. Eur Child Adolesc Psychiatry 2022; 31:383-402. [PMID: 34661764 PMCID: PMC8521086 DOI: 10.1007/s00787-021-01842-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/30/2021] [Indexed: 11/03/2022]
Abstract
In 2011 a working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines for Tourette syndrome (TS). Now, we present an updated version 2.0 of these European clinical guidelines for Tourette syndrome and other tic disorders, part I: assessment. Therefore, the available literature has been thoroughly screened, supplemented with national guidelines across countries and discussions among ESSTS experts. Diagnostic changes between DSM-IV and DSM-5 classifications were taken into account and new information has been added regarding differential diagnoses, with an emphasis on functional movement disorders in both children and adults. Further, recommendations regarding rating scales to evaluate tics, comorbidities, and neuropsychological status are provided. Finally, results from a recently performed survey among ESSTS members on assessment in TS are described. We acknowledge that the Yale Global Tic Severity Scale (YGTSS) is still the gold standard for assessing tics. Recommendations are provided for scales for the assessment of tics and psychiatric comorbidities in patients with TS not only in routine clinical practice, but also in the context of clinical research. Furthermore, assessments supporting the differential diagnosis process are given as well as tests to analyse cognitive abilities, emotional functions and motor skills.
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Affiliation(s)
- Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
- Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, USA
| | - Sally Robinson
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | | | - Christos Ganos
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nanette M Debes
- Paediatric Department, Herlev University Hospital, Herlev, Denmark
| | - Liselotte Skov
- Paediatric Department, Herlev University Hospital, Herlev, Denmark
| | - Martina Haas
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Renata Rizzo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Jeremy Stern
- Department of Neurology, St George's Hospital, St George's University of London, London, UK
| | | | | | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tara L Murphy
- Tic Disorder Clinic, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | | | - Tammy Hedderly
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Kirsten R Müller-Vahl
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen, Rijks Universiteit Groningen, GGZ Drenthe Mental Health Institution, Hanzeplein 1, Assen, 9713, Groningen, The Netherlands.
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19
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Research on Frequent Itemset Mining of Imaging Genetics GWAS in Alzheimer’s Disease. Genes (Basel) 2022; 13:genes13020176. [PMID: 35205221 PMCID: PMC8871801 DOI: 10.3390/genes13020176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 12/04/2022] Open
Abstract
As an efficient method, genome-wide association study (GWAS) is used to identify the association between genetic variation and pathological phenotypes, and many significant genetic variations founded by GWAS are closely associated with human diseases. However, it is not enough to mine only a single marker effect variation on complex biological phenotypes. Mining highly correlated single nucleotide polymorphisms (SNP) is more meaningful for the study of Alzheimer's disease (AD). In this paper, we used two frequent pattern mining (FPM) framework, the FP-Growth and Eclat algorithms, to analyze the GWAS results of functional magnetic resonance imaging (fMRI) phenotypes. Moreover, we applied the definition of confidence to FP-Growth and Eclat to enhance the FPM framework. By calculating the conditional probability of identified SNPs, we obtained the corresponding association rules to provide support confidence between these important SNPs. The resulting SNPs showed close correlation with hippocampus, memory, and AD. The experimental results also demonstrate that our framework is effective in identifying SNPs and provide candidate SNPs for further research.
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20
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Current Understanding of the Genetics of Tourette Syndrome. Biomed J 2022; 45:271-279. [PMID: 35042017 PMCID: PMC9250083 DOI: 10.1016/j.bj.2022.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 12/13/2022] Open
Abstract
Gilles de la Tourette syndrome (TS) is a common, childhood-onset psychiatric disorder characterized by persistent motor and vocal tics. It is a heterogeneous disorder in which the phenotypic expression may be affected by environmental factors, such as immune responses. Furthermore, several studies have shown that genetic factors play a vital role in the etiology of TS, as well as its comorbidity with other disorders, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, and autism spectrum disorder. TS has a complex inheritance pattern and, according to various genetic studies, several genes and loci have been correlated with TS. Genome-wide linkage studies have identified Slit and Trk-like 1 (SLITRK1) and histidine decarboxylase (HDC) genes, and candidate gene association studies have extensively investigated the dopamine and serotonin system genes, but there have been no consistent results. Moreover, genome-wide association studies have implicated several genetic loci; however, larger study cohorts are needed to confirm this. Copy number variations, which are polymorphisms in the number of gene copies due to chromosomal deletions or duplications, are considered another significant source of mutations in TS. In the last decade, whole genome/exome sequencing has identified several novel genetic mutations in patients with TS. In conclusion, more studies are needed to reveal the exact mechanisms of underlying TS, which may help to provide more information on the prognosis and therapeutic plans for TS.
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21
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Gao M, Lin H, Li B, Wen J, Wang Y, Zhang Z, Chen W. Lack of Association of FLT3 rs2504235 and Absence of SLITRK1 var321 in Patients with Tic Disorders from Guangdong Province, China. Neuropsychiatr Dis Treat 2022; 18:155-161. [PMID: 35140465 PMCID: PMC8818983 DOI: 10.2147/ndt.s340197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 12/26/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Tic disorders (TDs) are highly polygenic and heritable neurodevelopmental disorders characterized by the presence of movements (motor tics) and/or vocalizations (phonic tics). SLITRK1 is a pathogenic variation of TD, and in a recent genome-wide association study in those of European ancestry, a single-nucleotide polymorphism (rs2504235) in the FLT3 gene was significantly associated with TDs/Tourette's syndrome. However, these results need to be proved in different populations. This study aimed to determine whether these two genetic variants were also associated with TD patients in south China. METHODS A total of 116 child TD patients and 114 healthy controls were included. All children underwent peripheral blood sampling for genomic DNA extraction. Gene fragments with two single-nucleotide polymorphisms were amplified by PCR and sequenced by Sanger chain termination before genotype analysis. RESULTS SLITRK1 var321 was not observed in any of the TD patients or controls. No significant difference was observed in allelic frequencies or genotypic distributions of rs2504235 between TD patients and controls. CONCLUSION Our results provide no evidence to support the previous conclusion that SLITRK1 var321 plays a major role in TDs, and FLT3 rs2504235 was not significantly associated with TDs in our cohort.
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Affiliation(s)
- Ming Gao
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, People's Republic of China
| | - Haisheng Lin
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Bingxiao Li
- Department of Pediatrics, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, People's Republic of China
| | - Junjie Wen
- Department of Pediatrics, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, People's Republic of China
| | - Yingying Wang
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, People's Republic of China
| | - Zhanhui Zhang
- Clinical Medicine Research Institute, First Affiliated Hospital, Jinan University, Guangzhou, 510630, People's Republic of China
| | - Wenxiong Chen
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
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22
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Katz TC, Bui TH, Worhach J, Bogut G, Tomczak KK. Tourettic OCD: Current understanding and treatment challenges of a unique endophenotype. Front Psychiatry 2022; 13:929526. [PMID: 35966462 PMCID: PMC9363583 DOI: 10.3389/fpsyt.2022.929526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Obsessive compulsive disorder (OCD) and chronic tic disorders (CTD) including Tourette Syndrome (TS) are often comorbid conditions. While some patients present with distinct symptoms of CTD and/or OCD, a subset of patients demonstrate a unique overlap of symptoms, known as Tourettic OCD (TOCD), in which tics, compulsions, and their preceding premonitory urges are overlapping and tightly intertwined. The specific behaviors seen in TOCD are typically complex tic-like behaviors although with a compulsive and partially anxious nature reminiscent of OCD. TOCD is not classified within the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as an independent diagnostic entity, but mounting evidence suggests that TOCD is an intermediate neuropsychiatric disorder distinct from either TS or OCD alone and as such represents a unique phenomenology. In this review of TOCD we discuss clinical, genetic, environmental, neurodevelopmental, and neurocircuit-based research to better characterize our current understanding of this disorder. TOCD is characterized by earlier age of onset, male predominance, and specific symptom clusters such as lower tendency toward compulsions related to checking, cleaning, and reassurance seeking and higher tendency toward compulsions such as rubbing, tapping, or touching associated with symmetry concerns or thoughts of exactness. Functional magnetic resonance imaging (fMRI) imaging suggests that TOCD symptoms may arise from involvement of an intermediate neurocircuitry distinct from classic OCD or classic CTD. Small cumulative contributions from multiple genetic loci have been implicated, as have environmental factors such as infection and perinatal trauma. In addition, this review addresses the treatment of TOCD which is especially complex and often treatment resistant and requires pharmacology and behavioral therapy in multiple modalities. Given the distressing impact of TOCD on patients' functioning, the goal of this review is to raise awareness of this distinct entity toward the goal of improving standards of care.
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Affiliation(s)
- Tamar C Katz
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Thanh Hoa Bui
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Jennifer Worhach
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Gabrielle Bogut
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Kinga K Tomczak
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
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23
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Bond M, Moll N, Rosello A, Bond R, Schnell J, Burger B, Hoekstra PJ, Dietrich A, Schrag A, Kocovska E, Martino D, Mueller N, Schwarz M, Meier UC. Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre study. Eur Child Adolesc Psychiatry 2022; 31:1-12. [PMID: 33851280 PMCID: PMC9343310 DOI: 10.1007/s00787-021-01757-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/08/2021] [Indexed: 11/24/2022]
Abstract
This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3-16 years) with CTD (n = 327); first-degree relatives (3-10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period (n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment (n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27-3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36-0.84, p = 0.01) and was inversely associated with ADHD symptom severity (β = - 2.52, 95% CI - 4.16-0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.
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Affiliation(s)
- Molly Bond
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK.
| | - Natalie Moll
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Alicia Rosello
- Statistics, Modelling and Economic Department, National Infection Service, PHE, London, UK ,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Rod Bond
- University of Sussex, Brighton, UK
| | - Jaana Schnell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Bianka Burger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Pieter J. Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anette Schrag
- Department of Clinical Neuroscience, UCL Institute of Neurology, University College London, London, UK
| | - Eva Kocovska
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT UK
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine and Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Norbert Mueller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Markus Schwarz
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Ute-Christiane Meier
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,Ludwig-Maximilians-University Munich, Munich, Germany
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24
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Farkas BC, Tóth-Fáber E, Janacsek K, Nemeth D. A Process-Oriented View of Procedural Memory Can Help Better Understand Tourette's Syndrome. Front Hum Neurosci 2021; 15:683885. [PMID: 34955784 PMCID: PMC8707288 DOI: 10.3389/fnhum.2021.683885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Tourette's syndrome (TS) is a neurodevelopmental disorder characterized by repetitive movements and vocalizations, also known as tics. The phenomenology of tics and the underlying neurobiology of the disorder have suggested that the altered functioning of the procedural memory system might contribute to its etiology. However, contrary to the robust findings of impaired procedural memory in neurodevelopmental disorders of language, results from TS have been somewhat mixed. We review the previous studies in the field and note that they have reported normal, impaired, and even enhanced procedural performance. These mixed findings may be at least partially be explained by the diversity of the samples in both age and tic severity, the vast array of tasks used, the low sample sizes, and the possible confounding effects of other cognitive functions, such as executive functions, working memory or attention. However, we propose that another often overlooked factor could also contribute to the mixed findings, namely the multiprocess nature of the procedural system itself. We propose that a process-oriented view of procedural memory functions could serve as a theoretical framework to help integrate these varied findings. We discuss evidence suggesting heterogeneity in the neural regions and their functional contributions to procedural memory. Our process-oriented framework can help to deepen our understanding of the complex profile of procedural functioning in TS and atypical development in general.
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Affiliation(s)
- Bence Cs. Farkas
- LNC, Département d’Études Cognitives, École Normale Supérieure, INSERM, PSL Research University, Paris, France
| | - Eszter Tóth-Fáber
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Brain, Memory and Language Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Karolina Janacsek
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre for Thinking and Learning, Institute for Lifecourse Development, School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom
| | - Dezso Nemeth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Brain, Memory and Language Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Lyon, France
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25
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Polikowsky HG, Shaw DM, Petty LE, Chen HH, Pruett DG, Linklater JP, Viljoen KZ, Beilby JM, Highland HM, Levitt B, Avery CL, Mullan Harris K, Jones RM, Below JE, Kraft SJ. Population-based genetic effects for developmental stuttering. HGG ADVANCES 2021; 3:100073. [PMID: 35047858 PMCID: PMC8756529 DOI: 10.1016/j.xhgg.2021.100073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Despite a lifetime prevalence of at least 5%, developmental stuttering, characterized by prolongations, blocks, and repetitions of speech sounds, remains a largely idiopathic speech disorder. Family, twin, and segregation studies overwhelmingly support a strong genetic influence on stuttering risk; however, its complex mode of inheritance combined with thus-far underpowered genetic studies contribute to the challenge of identifying and reproducing genes implicated in developmental stuttering susceptibility. We conducted a trans-ancestry genome-wide association study (GWAS) and meta-analysis of developmental stuttering in two primary datasets: The International Stuttering Project comprising 1,345 clinically ascertained cases from multiple global sites and 6,759 matched population controls from the biobank at Vanderbilt University Medical Center (VUMC), and 785 self-reported stuttering cases and 7,572 controls ascertained from The National Longitudinal Study of Adolescent to Adult Health (Add Health). Meta-analysis of these genome-wide association studies identified a genome-wide significant (GWS) signal for clinically reported developmental stuttering in the general population: a protective variant in the intronic or genic upstream region of SSUH2 (rs113284510, protective allele frequency = 7.49%, Z = -5.576, p = 2.46 × 10-8) that acts as an expression quantitative trait locus (eQTL) in esophagus-muscularis tissue by reducing its gene expression. In addition, we identified 15 loci reaching suggestive significance (p < 5 × 10-6). This foundational population-based genetic study of a common speech disorder reports the findings of a clinically ascertained study of developmental stuttering and highlights the need for further research.
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Affiliation(s)
- Hannah G. Polikowsky
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas M. Shaw
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren E. Petty
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hung-Hsin Chen
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dillon G. Pruett
- Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | | | | | - Janet M. Beilby
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Heather M. Highland
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brandt Levitt
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christy L. Avery
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robin M. Jones
- Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA,Corresponding author
| | - Shelly Jo Kraft
- Communication Sciences and Disorders, Wayne State University, Detroit, MI, USA,Corresponding author
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26
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Elevated common variant genetic risk for tourette syndrome in a densely-affected pedigree. Mol Psychiatry 2021; 26:7522-7529. [PMID: 34526668 PMCID: PMC8881309 DOI: 10.1038/s41380-021-01277-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/29/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022]
Abstract
Tourette syndrome (TS) is a highly heritable neuropsychiatric disorder with complex patterns of genetic inheritance. Recent genetic findings in TS have highlighted both numerous common variants with small effects and a few rare variants with moderate or large effects. Here we searched for genetic causes of TS in a large, densely-affected British pedigree using a systematic genomic approach. This pedigree spans six generations and includes 122 members, 85 of whom were individually interviewed, and 53 of whom were diagnosed as "cases" (consisting of 28 with definite or probable TS, 20 with chronic multiple tics [CMT], and five with obsessive-compulsive behaviors [OCB]). A total of 66 DNA samples were available (25 TS, 15 CMT, 4 OCB cases, and 22 unaffecteds) and all were genotyped using a dense single nucleotide polymorphism (SNP) array to identify shared segments, copy number variants (CNVs), and to calculate genetic risk scores. Eight cases were also whole genome sequenced to test whether any rare variants were shared identical by descent. While we did not identify any notable CNVs, single nucleotide variants, indels or repeat expansions of near-Mendelian effect, the most distinctive feature of this family proved to be an unusually high load of common risk alleles for TS. We found that cases within this family carried a higher load of TS common variant risk similar to that previously found in unrelated TS cases. Thus far, the strongest evidence from genetic data for contribution to TS risk in this family comes from multiple common risk variants rather than one or a few variants of strong effect.
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27
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Abdulkadir M, Yu D, Osiecki L, King RA, Fernandez TV, Brown LW, Cheon KA, Coffey BJ, Garcia-Delgar B, Gilbert DL, Grice DE, Hagstrøm J, Hedderly T, Heyman I, Hong HJ, Huyser C, Ibanez-Gomez L, Kim YK, Kim YS, Koh YJ, Kook S, Kuperman S, Leventhal B, Madruga-Garrido M, Maras A, Mir P, Morer A, Münchau A, Plessen KJ, Roessner V, Shin EY, Song DH, Song J, Visscher F, Zinner SH, Mathews CA, Scharf JM, Tischfield JA, Heiman GA, Dietrich A, Hoekstra PJ. Investigation of gene-environment interactions in relation to tic severity. J Neural Transm (Vienna) 2021; 128:1757-1765. [PMID: 34389898 PMCID: PMC8536549 DOI: 10.1007/s00702-021-02396-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/28/2021] [Indexed: 12/27/2022]
Abstract
Tourette syndrome (TS) is a neuropsychiatric disorder with involvement of genetic and environmental factors. We investigated genetic loci previously implicated in Tourette syndrome and associated disorders in interaction with pre- and perinatal adversity in relation to tic severity using a case-only (N = 518) design. We assessed 98 single-nucleotide polymorphisms (SNPs) selected from (I) top SNPs from genome-wide association studies (GWASs) of TS; (II) top SNPs from GWASs of obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD); (III) SNPs previously implicated in candidate-gene studies of TS; (IV) SNPs previously implicated in OCD or ASD; and (V) tagging SNPs in neurotransmitter-related candidate genes. Linear regression models were used to examine the main effects of the SNPs on tic severity, and the interaction effect of these SNPs with a cumulative pre- and perinatal adversity score. Replication was sought for SNPs that met the threshold of significance (after correcting for multiple testing) in a replication sample (N = 678). One SNP (rs7123010), previously implicated in a TS meta-analysis, was significantly related to higher tic severity. We found a gene-environment interaction for rs6539267, another top TS GWAS SNP. These findings were not independently replicated. Our study highlights the future potential of TS GWAS top hits in gene-environment studies.
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Affiliation(s)
- Mohamed Abdulkadir
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA.
| | - Dongmei Yu
- Department of Neurology, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Lisa Osiecki
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Robert A King
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Thomas V Fernandez
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Lawrence W Brown
- Pediatric Neuropsychiatry Program, Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Keun-Ah Cheon
- Yonsei University College of Medicine, Severance Hospital, Seoul, 120-752, South Korea
| | - Barbara J Coffey
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- University of Miami Miller School of Medicine, Miami, FL, 33146, USA
| | - Blanca Garcia-Delgar
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain
| | - Donald L Gilbert
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Julie Hagstrøm
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tammy Hedderly
- Evelina London Children's Hospital GSTT, Kings Health Partners AHSC, London, UK
| | - Isobel Heyman
- Psychological Medicine, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi, 14068, South Korea
| | - Chaim Huyser
- Academic Center for Child and Adolescent Psychiatry De Bascule, 1105 AZ, Amsterdam, The Netherlands
| | | | - Young Key Kim
- Department of Psychiatry, Yonsei Bom Clinic, Seoul, 03330, South Korea
| | - Young-Shin Kim
- University of California San Francisco Medical Center, San Francisco, CA, 94143, USA
| | - Yun-Joo Koh
- Korea Institute for Children's Social Development, Seoul, South Korea
| | - Sodahm Kook
- Yonsei-Nuri Mental Health Clinic, Seoul, 08005, South Korea
| | - Samuel Kuperman
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, IA, 52242, USA
| | - Bennett Leventhal
- University of California San Francisco Medical Center, San Francisco, CA, 94143, USA
| | - Marcos Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, 3311 JG, Dordrecht, The Netherlands
| | - Pablo Mir
- Unidad de Trastornos del MovimientoInstituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/CSICUniversidad de Sevilla, Seville, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIPABS) and Centro de Investigacion en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Alexander Münchau
- Institute of Systems of Motor Science, University of Lübeck, 23562, Lübeck, Germany
| | - Kerstin J Plessen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Eun-Young Shin
- Yonsei University College of Medicine, Severance Hospital, Seoul, 120-752, South Korea
| | - Dong-Ho Song
- Yonsei University Severance Hospital, Seoul, 03722, South Korea
| | - Jungeun Song
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi, 10444, South Korea
| | - Frank Visscher
- Admiraal De Ruyter Ziekenhuis, Department of Neurology, Goes, The Netherlands
| | - Samuel H Zinner
- Department of Pediatrics, Division of Developmental Medicine, University of Washington School of Medicine, 1925 NE Pacific Street, Box 356524, Seattle, WA, 98195, USA
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, and Genetics Institute, University of Florida College of Medicine, Gainesville, FL, 32611, USA
| | - Jeremiah M Scharf
- Department of Neurology, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Abstract
Tourette syndrome (TS) is a severe neuropsychiatric disorder characterized by recurrent, involuntary physical and verbal tics. With a prevalence as high as 1% in children, a deeper understanding of the etiology of the disorder and contributions to risk is critical. Here, we cover the current body of knowledge in scientific literature regarding the genetics of TS. We first review the history and diagnostic criteria for TS cases. We then cover the prevalence, and begin to address the etiology of the disorder. We highlight long-standing evidence for a genetic contribution to TS risk from epidemiology studies focused on twins, families, and population-scale data. Finally, we summarize current large-scale genetic studies of TS along specific classes of genetic variation, including common variation, rare copy number variation, and de novo variation that impact protein-coding sequence. Although these variants do not account for the entirety of TS genetic risk, current evidence is clear that each class of variation is a factor in the overall risk architecture across TS cases.
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Affiliation(s)
- Laura Domènech
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Boston, MA, USA
| | - Carolina Cappi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Matt Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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29
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Levy AM, Paschou P, Tümer Z. Candidate Genes and Pathways Associated with Gilles de la Tourette Syndrome-Where Are We? Genes (Basel) 2021; 12:1321. [PMID: 34573303 PMCID: PMC8468358 DOI: 10.3390/genes12091321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/05/2021] [Accepted: 08/25/2021] [Indexed: 12/21/2022] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a childhood-onset neurodevelopmental and -psychiatric tic-disorder of complex etiology which is often comorbid with obsessive-compulsive disorder (OCD) and/or attention deficit hyperactivity disorder (ADHD). Twin and family studies of GTS individuals have shown a high level of heritability suggesting, that genetic risk factors play an important role in disease etiology. However, the identification of major GTS susceptibility genes has been challenging, presumably due to the complex interplay between several genetic factors and environmental influences, low penetrance of each individual factor, genetic diversity in populations, and the presence of comorbid disorders. To understand the genetic components of GTS etiopathology, we conducted an extensive review of the literature, compiling the candidate susceptibility genes identified through various genetic approaches. Even though several strong candidate genes have hitherto been identified, none of these have turned out to be major susceptibility genes yet.
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Affiliation(s)
- Amanda M. Levy
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark;
| | - Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Zeynep Tümer
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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30
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Contextualizing genetic risk score for disease screening and rare variant discovery. Nat Commun 2021; 12:4418. [PMID: 34285202 PMCID: PMC8292385 DOI: 10.1038/s41467-021-24387-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 06/07/2021] [Indexed: 11/08/2022] Open
Abstract
Studies of the genetic basis of complex traits have demonstrated a substantial role for common, small-effect variant polygenic burden (PB) as well as large-effect variants (LEV, primarily rare). We identify sufficient conditions in which GWAS-derived PB may be used for well-powered rare pathogenic variant discovery or as a sample prioritization tool for whole-genome or exome sequencing. Through extensive simulations of genetic architectures and generative models of disease liability with parameters informed by empirical data, we quantify the power to detect, among cases, a lower PB in LEV carriers than in non-carriers. Furthermore, we uncover clinically useful conditions wherein the risk derived from the PB is comparable to the LEV-derived risk. The resulting summary-statistics-based methodology (with publicly available software, PB-LEV-SCAN) makes predictions on PB-based LEV screening for 36 complex traits, which we confirm in several disease datasets with available LEV information in the UK Biobank, with important implications on clinical decision-making.
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31
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Lamothe H, Tamouza R, Hartmann A, Mallet L. Immunity and Gilles de la Tourette syndrome: A systematic review and meta-analysis of evidence for immune implications in Tourette syndrome. Eur J Neurol 2021; 28:3187-3200. [PMID: 34133837 DOI: 10.1111/ene.14983] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/30/2021] [Accepted: 06/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE The neurobiology of Gilles de la Tourette syndrome (GTS) is known to involve corticostriatal loops possibly under genetic control. Less is known about possible environmental triggers of GTS. Specifically, immune-related events following possible environmental inducers have been evoked, but important controversies still exist. In this systematic review and meta-analysis, we looked for evidence in favor of such possibilities. METHODS We performed a systematic review and meta-analysis of all immunological data in PubMed. RESULTS We found large discrepancies concerning immune dysfunctions in GTS, and meta-analyzing cytokines data did not allow us to conclude there is an involvement of specific cytokines in GTS neurobiology. When looking specifically at pediatric autoimmune neuropsychiatric disorder associated with streptococcus/pediatric acute onset neuropsychiatric syndrome, we found some important evidence of a possible infectious involvement but in a limited number of studies. Our meta-analysis found an increased level of anti-streptolysin O antibodies in GTS patients, but the level of anti-DNase B antibodies was not increased. CONCLUSIONS Too many questions still exist to allow us to definitively reach the conclusion that there is an infectious and immunological etiology in GTS. Much work is still needed to elucidate the possible role of immunology in GTS neurobiology and to favor immunological treatment rather than classical treatment.
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Affiliation(s)
- Hugues Lamothe
- Assistance Publique-Hôpitaux de Paris, Pôle de Psychiatrie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Paris-East Créteil University, Créteil, France.,Institut du Cerveau et de la Moelle Épinière, INSERM U1127, CNRS UMR 7225, Sorbonne University, Paris, France
| | - Ryad Tamouza
- Assistance Publique-Hôpitaux de Paris, Pôle de Psychiatrie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Paris-East Créteil University, Créteil, France.,Institut Mondor de Recherche Biomédical, Paris-East Créteil University, Team "Psychiatrie Translationnelle, INSERM U955, Créteil, France
| | - Andreas Hartmann
- Institut du Cerveau et de la Moelle Épinière, INSERM U1127, CNRS UMR 7225, Sorbonne University, Paris, France.,Centre Hospitalo-Universitaire de la Pitié Salpétrière, Paris, France
| | - Luc Mallet
- Assistance Publique-Hôpitaux de Paris, Pôle de Psychiatrie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Paris-East Créteil University, Créteil, France.,Institut du Cerveau et de la Moelle Épinière, INSERM U1127, CNRS UMR 7225, Sorbonne University, Paris, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
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32
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Ueda K, Black KJ. A Comprehensive Review of Tic Disorders in Children. J Clin Med 2021; 10:2479. [PMID: 34204991 PMCID: PMC8199885 DOI: 10.3390/jcm10112479] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/13/2023] Open
Abstract
Tics are characterized by sudden, rapid, recurrent, nonrhythmic movement or vocalization, and are the most common movement disorders in children. Their onset is usually in childhood and tics often will diminish within one year. However, some of the tics can persist and cause various problems such as social embarrassment, physical discomfort, or emotional impairments, which could interfere with daily activities and school performance. Furthermore, tic disorders are frequently associated with comorbid neuropsychiatric symptoms, which can become more problematic than tic symptoms. Unfortunately, misunderstanding and misconceptions of tic disorders still exist among the general population. Understanding tic disorders and their comorbidities is important to deliver appropriate care to patients with tics. Several studies have been conducted to elucidate the clinical course, epidemiology, and pathophysiology of tics, but they are still not well understood. This article aims to provide an overview about tics and tic disorders, and recent findings on tic disorders including history, definition, diagnosis, epidemiology, etiology, diagnostic approach, comorbidities, treatment and management, and differential diagnosis.
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Affiliation(s)
- Keisuke Ueda
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kevin J. Black
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA
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33
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Tsetsos F, Yu D, Sul JH, Huang AY, Illmann C, Osiecki L, Darrow SM, Hirschtritt ME, Greenberg E, Muller-Vahl KR, Stuhrmann M, Dion Y, Rouleau GA, Aschauer H, Stamenkovic M, Schlögelhofer M, Sandor P, Barr CL, Grados MA, Singer HS, Nöthen MM, Hebebrand J, Hinney A, King RA, Fernandez TV, Barta C, Tarnok Z, Nagy P, Depienne C, Worbe Y, Hartmann A, Budman CL, Rizzo R, Lyon GJ, McMahon WM, Batterson JR, Cath DC, Malaty IA, Okun MS, Berlin C, Woods DW, Lee PC, Jankovic J, Robertson MM, Gilbert DL, Brown LW, Coffey BJ, Dietrich A, Hoekstra PJ, Kuperman S, Zinner SH, Wagner M, Knowles JA, Jeremy Willsey A, Tischfield JA, Heiman GA, Cox NJ, Freimer NB, Neale BM, Davis LK, Coppola G, Mathews CA, Scharf JM, Paschou P, Barr CL, Batterson JR, Berlin C, Budman CL, Cath DC, Coppola G, Cox NJ, Darrow S, Davis LK, Dion Y, Freimer NB, Grados MA, Greenberg E, Hirschtritt ME, Huang AY, Illmann C, King RA, Kurlan R, Leckman JF, Lyon GJ, Malaty IA, Mathews CA, McMahon WM, Neale BM, Okun MS, Osiecki L, Robertson MM, Rouleau GA, Sandor P, Scharf JM, Singer HS, Smit JH, Sul JH, Yu D, Aschauer HAH, Barta C, Budman CL, Cath DC, Depienne C, Hartmann A, Hebebrand J, Konstantinidis A, Mathews CA, Müller-Vahl K, Nagy P, Nöthen MM, Paschou P, Rizzo R, Rouleau GA, Sandor P, Scharf JM, Schlögelhofer M, Stamenkovic M, Stuhrmann M, Tsetsos F, Tarnok Z, Wolanczyk T, Worbe Y, Brown L, Cheon KA, Coffey BJ, Dietrich A, Fernandez TV, Garcia-Delgar B, Gilbert D, Grice DE, Hagstrøm J, Hedderly T, Heiman GA, Heyman I, Hoekstra PJ, Huyser C, Kim YK, Kim YS, King RA, Koh YJ, Kook S, Kuperman S, Leventhal BL, Madruga-Garrido M, Mir P, Morer A, Münchau A, Plessen KJ, Roessner V, Shin EY, Song DH, Song J, Tischfield JA, Willsey AJ, Zinner S, Aschauer H, Barr CL, Barta C, Batterson JR, Berlin C, Brown L, Budman CL, Cath DC, Coffey BJ, Coppola G, Cox NJ, Darrow S, Davis LK, Depienne C, Dietrich A, Dion Y, Fernandez T, Freimer NB, Gilbert D, Grados MA, Greenberg E, Hartmann A, Hebebrand J, Heiman G, Hirschtritt ME, Hoekstra P, Huang AY, Illmann C, Jankovic J, King RA, Kuperman S, Lee PC, Lyon GJ, Malaty IA, Mathews CA, McMahon WM, Müller-Vahl K, Nagy P, Neale BM, Nöthen MM, Okun MS, Osiecki L, Paschou P, Rizzo R, Robertson MM, Rouleau GA, Sandor P, Scharf JM, Schlögelhofer M, Singer HS, Stamenkovic M, Stuhrmann M, Sul JH, Tarnok Z, Tischfield J, Tsetsos F, Willsey AJ, Woods D, Worbe Y, Yu D, Zinner S. Synaptic processes and immune-related pathways implicated in Tourette syndrome. Transl Psychiatry 2021; 11:56. [PMID: 33462189 PMCID: PMC7814139 DOI: 10.1038/s41398-020-01082-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/18/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022] Open
Abstract
Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS.
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Grants
- R01 NS102371 NINDS NIH HHS
- R01 NS096207 NINDS NIH HHS
- R01 NS096008 NINDS NIH HHS
- R01 MH115958 NIMH NIH HHS
- K08 MH099424 NIMH NIH HHS
- U24 NS095914 NINDS NIH HHS
- K02 NS085048 NINDS NIH HHS
- R01 MH115963 NIMH NIH HHS
- U01 HG009086 NHGRI NIH HHS
- R56 MH120736 NIMH NIH HHS
- U54 MD010722 NIMHD NIH HHS
- UL1 TR001863 NCATS NIH HHS
- R01 DC016977 NIDCD NIH HHS
- R01 NS105746 NINDS NIH HHS
- R01 MH118233 NIMH NIH HHS
- DP2 HD098859 NICHD NIH HHS
- R01 MH115961 NIMH NIH HHS
- U24 MH068457 NIMH NIH HHS
- R25 NS108939 NINDS NIH HHS
- R01 MH114927 NIMH NIH HHS
- R01 NR014852 NINR NIH HHS
- R21 HG010652 NHGRI NIH HHS
- R01 MH113362 NIMH NIH HHS
- RM1 HG009034 NHGRI NIH HHS
- FT is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning» in the context of the project “Reinforcement of Postdoctoral Researchers - 2nd Cycle” (MIS-5033021), implemented by the State Scholarships Foundation (IKY)
- KMV has received financial or material research support from the EU (FP7-HEALTH-2011 No. 278367, FP7-PEOPLE-2012-ITN No. 316978), the German Research Foundation (DFG: GZ MU 1527/3-1), the German Ministry of Education and Research (BMBF: 01KG1421), the National Institute of Mental Health (NIMH), the Tourette Gesellschaft Deutschland e.V., the Else-Kroner-Fresenius-Stiftung, and GW, Almirall, Abide Therapeutics, and Therapix Biosiences and has received consultant’s honoraria from Abide Therapeutics, Tilray, Resalo Vertrieb GmbH, and Wayland Group, speaker’s fees from Tilray and Cogitando GmbH, and royalties from Medizinisch Wissenschaftliche Verlagsgesellschaft Berlin, Elsevier, and Kohlhammer; and is a consultant for Nuvelution TS Pharma Inc., Zynerba Pharmaceuticals, Resalo Vertrieb GmbH, CannaXan GmbH, Therapix Biosiences, Syqe, Nomovo Pharma, and Columbia Care.
- MMN has received fees for memberships in Scientific Advisory Boards from the Lundbeck Foundation and the Robert-Bosch-Stiftung, and for membership in the Medical-Scientific Editorial Office of the Deutsches Ärzteblatt. MMN was reimbursed travel expenses for a conference participation by Shire Deutschland GmbH. MMN receives salary payments from Life & Brain GmbH and holds shares in Life & Brain GmbH. All this concerned activities outside the submitted work.
- IM has participated in research funded by the Parkinson Foundation, Tourette Association, Dystonia Coalition, AbbVie, Biogen, Boston Scientific, Eli Lilly, Impax, Neuroderm, Prilenia, Revance, Teva but has no owner interest in any pharmaceutical company. She has received travel compensation or honoraria from the Tourette Association of America, Parkinson Foundation, International Association of Parkinsonism and Related Disorders, Medscape, and Cleveland Clinic, and royalties for writing a book with Robert rose publishers.
- MSO serves as a consultant for the Parkinson’s Foundation, and has received research grants from NIH, Parkinson’s Foundation, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association, and the UF Foundation. MSO’s DBS research is supported by: NIH R01 NR014852 and R01NS096008. MSO is PI of the NIH R25NS108939 Training Grant. MSO has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, Perseus, Robert Rose, Oxford and Cambridge (movement disorders books). MSO is an associate editor for New England Journal of Medicine Journal Watch Neurology. MSO has participated in CME and educational activities on movement disorders sponsored by the Academy for Healthcare Learning, PeerView, Prime, QuantiaMD, WebMD/Medscape, Medicus, MedNet, Einstein, MedNet, Henry Stewart, American Academy of Neurology, Movement Disorders Society and by Vanderbilt University. The institution and not MSO receives grants from Medtronic, Abbvie, Boston Scientific, Abbott and Allergan and the PI has no financial interest in these grants. MSO has participated as a site PI and/or co-I for several NIH, foundation, and industry sponsored trials over the years but has not received honoraria. Research projects at the University of Florida receive device and drug donations.
- DW receives royalties for books on Tourette Syndrome with Guilford Press, Oxford University Press, and Springer Press.
- BMN is a member of the scientific advisory board at Deep Genomics and consultant for Camp4 Therapeutics, Takeda Pharmaceutical and Biogen.
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Affiliation(s)
- Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sabrina M Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kirsten R Muller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | | | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Thomas V Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | | | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Douglas W Woods
- Marquette University and University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Paul C Lee
- Tripler Army Medical Center and University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Donald L Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | | | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Samuel H Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA.
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | | | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sabrina Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA
| | - James F Leckman
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jan H Smit
- Department of Psychiatry, VU UniversityMedical Center, Amsterdam, The Netherlands
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Harald Aschauer Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anastasios Konstantinidis
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Center for Mental Health Muldenstrasse, BBRZMed, Linz, Austria
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, 00-001, Warsaw, Poland
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Lawrence Brown
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Keun-Ah Cheon
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Thomas V Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Blanca Garcia-Delgar
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain
| | - Donald Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | - Dorothy E Grice
- Department of Psychiatry, Friedman Brain Institute, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie Hagstrøm
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark
| | - Tammy Hedderly
- Tic and Neurodevelopmental Movements Service (TANDeM), Evelina Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
- Paediatric Neurosciences, Kings College London, London, UK
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chaim Huyser
- De Bascule, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | | | - Young-Shin Kim
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yun-Joo Koh
- The Korea Institute for Children's Social Development, Rudolph Child Research Center, Seoul, South Korea
| | - Sodahm Kook
- Kangbuk Samsung Hospital, Seoul, South Korea
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bennett L Leventhal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Marcos Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Pablo Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Kerstin J Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital Carl Gustav CarusTU Dresden, Dresden, Germany
| | - Eun-Young Shin
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Dong-Ho Song
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Jungeun Song
- National Health Insurance Service Ilsan Hospital, Goyang-Si, South Korea
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Samuel Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | | | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Lawrence Brown
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sabrina Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Thomas Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Donald Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gary Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Pieter Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Paul C Lee
- Tripler Army Medical Center and University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Douglas Woods
- Marquette University and University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Samuel Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Hildonen M, Levy AM, Dahl C, Bjerregaard VA, Birk Møller L, Guldberg P, Debes NM, Tümer Z. Elevated Expression of SLC6A4 Encoding the Serotonin Transporter (SERT) in Gilles de la Tourette Syndrome. Genes (Basel) 2021; 12:86. [PMID: 33445578 PMCID: PMC7827645 DOI: 10.3390/genes12010086] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 01/02/2023] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a complex neurodevelopmental disorder characterized by motor and vocal tics. Most of the GTS individuals have comorbid diagnoses, of which obsessive-compulsive disorder (OCD) and attention deficit-hyperactivity disorder (ADHD) are the most common. Several neurotransmitter systems have been implicated in disease pathogenesis, and amongst these, the dopaminergic and the serotonergic pathways are the most widely studied. In this study, we aimed to investigate whether the serotonin transporter (SERT) gene (SLC6A4) was differentially expressed among GTS individuals compared to healthy controls, and whether DNA variants (the SERT-linked polymorphic region 5-HTTLPR, together with the associated rs25531 and rs25532 variants, and the rare Ile425Val variant) or promoter methylation of SLC6A4 were associated with gene expression levels or with the presence of OCD as comorbidity. We observed that SLC6A4 expression is upregulated in GTS individuals compared to controls. Although no specific genotype, allele or haplotype was overrepresented in GTS individuals compared to controls, we observed that the LAC/LAC genotype of the 5-HTTLPR/rs25531/rs25532 three-locus haplotype was associated with higher SLC6A4 mRNA expression levels in GTS individuals, but not in the control group.
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Affiliation(s)
- Mathis Hildonen
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark; (M.H.); (A.M.L.); (V.A.B.); (L.B.M.)
| | - Amanda M. Levy
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark; (M.H.); (A.M.L.); (V.A.B.); (L.B.M.)
| | - Christina Dahl
- Danish Cancer Society Research Center, 2100 Copenhagen, Denmark; (C.D.); (P.G.)
| | - Victoria A. Bjerregaard
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark; (M.H.); (A.M.L.); (V.A.B.); (L.B.M.)
| | - Lisbeth Birk Møller
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark; (M.H.); (A.M.L.); (V.A.B.); (L.B.M.)
- Institute for Nature, Systems and Models, Roskilde University Center, 4000 Roskilde, Denmark
| | - Per Guldberg
- Danish Cancer Society Research Center, 2100 Copenhagen, Denmark; (C.D.); (P.G.)
- Department of Cancer and Inflammation Research, Institute for Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Nanette M. Debes
- Tourette Clinics, Department of Paediatrics, Copenhagen University Hospital, 2730 Herlev, Denmark;
| | - Zeynep Tümer
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark; (M.H.); (A.M.L.); (V.A.B.); (L.B.M.)
- Deparment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2020 Copenhagen, Denmark
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Heiman GA, Rispoli J, Seymour C, Leckman JF, King RA, Fernandez TV. Empiric Recurrence Risk Estimates for Chronic Tic Disorders: Implications for Genetic Counseling. Front Neurol 2020; 11:770. [PMID: 32849224 PMCID: PMC7432137 DOI: 10.3389/fneur.2020.00770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/22/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Tourette disorder (TD) and other chronic tic disorders are neurodevelopmental/neuropsychiatric disorders characterized by motor and/or vocal tics. Family studies indicate that TD strongly aggregates within families and that other chronic tic disorders are biologically related such that studies typically combine them into any chronic tic disorder (CTD). Because of stigma, bullying, and comorbidity with other neuropsychiatric disorders, CTDs can severely impact the quality of life of individuals with these disorders. Objectives: The genetic architecture of CTDs is complex and heterogeneous, involving a myriad of genetic variants. Thus, providing familial recurrence risks is based on empirical recurrence risk estimates rather than genetic testing. Because empiric recurrence risks for CTDs have not been published, the purpose of this study is to calculate and report these recurrence risks estimates. Methods: Based on population prevalence and increased risk to different relatives from a large population-based family study, we calculated the empiric recurrent risk estimate for each relative type (full sibling, parents, offspring, all first-degree, and all second-degree). Results: The recurrence risk estimate for CTDs in first-degree relatives is 29.9% [95% confidence interval (CI) = 23.2-38.5%]. The risk is higher in males, 33.7% (95% CI = 26.2-43.3%), than females, 24.3% (95% CI = 18.9-31.3%). Conclusions: Given the complex, heterogeneous genetic architecture of CTDs, individuals concerned about recurrence risk should be referred to genetic counseling. Such counseling should include discussion of the derivation and limitations of these empiric recurrence risk estimates, including the upper and lower limits of the range of risk.
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Affiliation(s)
- Gary A. Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Jessica Rispoli
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Christine Seymour
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - James F. Leckman
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Robert A. King
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Thomas V. Fernandez
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Liu W, Zhang X, Deng Z, Li G, Zhang R, Yang Z, Che F, Liu S, Li H. The role of SLITRK6 in the pathogenesis of Tourette syndrome: From the conclusion of a family-based study in the Chinese Han population. J Gene Med 2020; 22:e3173. [PMID: 32037697 DOI: 10.1002/jgm.3173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/12/2020] [Accepted: 02/04/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Tourette syndrome (TS) is a complex neuropsychiatric disorder coupled with obvious genetic heterogeneity. Studies in recent years have confirmed the association of SLITRK genes with sensory and neuropsychiatric diseases. To detect whether SLITRK6 is involved in the progress of TS, a family-based association study was performed to explore the possible genetic association between SLITRK6 and TS in the Chinese Han population. METHODS We genotyped 399 TS nuclear families trios, and then analyzed three tag SLITRK6 single nucleotide polymorphisms using the transmission disequilibrium test (TDT) haplotype relative risk (HRR) and haplotype-based haplotype relative risk (HHRR) methods. RESULTS The TDT showed no statistically significant allele transfer for the three polymorphisms. The HRR and HHRR also showed a negative association. CONCLUSIONS Despite the results suggesting that these polymorphisms may not be associated with susceptibility to TS in the Chinese Han population, we are still unable to determine the potential role of SLITRK6 in the pathogenesis of TS. Furthermore, the results still need to be confirmed in a larger sample size and in different populations.
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Affiliation(s)
- Wenmiao Liu
- Medical Genetics Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,The Prenatal diagnosis center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xuzhan Zhang
- Department of Clinical Laboratory, Heze Municipal Hospital, Heze, Shandong, China
| | - Ziwen Deng
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Guixia Li
- Department of Clinical Laboratory, Heze Municipal Hospital, Heze, Shandong, China
| | - Ru Zhang
- Medical Genetics Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,The Prenatal diagnosis center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zongjun Yang
- Department of Clinical Laboratory, The women and children's Hospital of Qingdao, Qingdao, Shandong, China
| | - Fengyuan Che
- Department of Neurology, the Affiliated Linyi People's Hospital of Shandong University, Linyi, Shandong, China
| | - Shiguo Liu
- Medical Genetics Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,The Prenatal diagnosis center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hui Li
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Pourfar MH, Mogilner AY. Gilles de la Tourette Syndrome: Deep Brain Stimulation. Stereotact Funct Neurosurg 2020. [DOI: 10.1007/978-3-030-34906-6_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Depienne C, Ciura S, Trouillard O, Bouteiller D, Leitão E, Nava C, Keren B, Marie Y, Guegan J, Forlani S, Brice A, Anheim M, Agid Y, Krack P, Damier P, Viallet F, Houeto JL, Durif F, Vidailhet M, Worbe Y, Roze E, Kabashi E, Hartmann A. Association of Rare Genetic Variants in Opioid Receptors with Tourette Syndrome. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2019; 9:tre-09-693. [PMID: 31824749 PMCID: PMC6878848 DOI: 10.7916/tohm.v0.693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/15/2019] [Indexed: 01/07/2023]
Abstract
Background Genes involved in Tourette syndrome (TS) remain largely unknown. We aimed to identify genetic factors contributing to TS in a French cohort of 120 individuals using a combination of hypothesis-driven and exome-sequencing approaches. Methods We first sequenced exons of SLITRK1-6 and HDC in the TS cohort and subsequently sequenced the exome of 12 individuals harboring rare variants in these genes to find additional rare variants contributing to the disorder under the hypothesis of oligogenic inheritance. We further screened three candidate genes (OPRK1, PCDH10, and NTSR2) preferentially expressed in the basal ganglia, and three additional genes involved in neurotensin and opioid signaling (OPRM1, NTS, and NTSR1), and compared variant frequencies in TS patients and 788 matched control individuals. We also investigated the impact of altering the expression of Oprk1 in zebrafish. Results Thirteen ultrarare missense variants of SLITRK1-6 and HDC were identified in 12 patients. Exome sequencing in these patients revealed rare possibly deleterious variants in 3,041 genes, 54 of which were preferentially expressed in the basal ganglia. Comparison of variant frequencies altering selected candidate genes in TS and control individuals revealed an excess of potentially disrupting variants in OPRK1, encoding the opioid kappa receptor, in TS patients. Accordingly, we show that downregulation of the Oprk1 orthologue in zebrafish induces a hyperkinetic phenotype in early development. Discussion These results support a heterogeneous and complex genetic etiology of TS, possibly involving rare variants altering the opioid pathway in some individuals, which could represent a novel therapeutic target in this disorder.
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Affiliation(s)
- Christel Depienne
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, DE
| | - Sorana Ciura
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Oriane Trouillard
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Delphine Bouteiller
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Elsa Leitão
- Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, DE
| | - Caroline Nava
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Génétique, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Boris Keren
- Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Génétique, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Yannick Marie
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Justine Guegan
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Sylvie Forlani
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Alexis Brice
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Mathieu Anheim
- Service de neurologie, CHU de Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67200 Strasbourg Strasbourg, FR
| | - Yves Agid
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Paul Krack
- Service de Neurologie, CHU de Grenoble, Avenue Maquis du Grésivaudan, 38700 La Tronche, FR.,Center for Movement Disorders, Inselspital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
| | - Philippe Damier
- Service de Neurologie, CHU de Nantes, 5 Allée de l'Île Gloriette, 44093 Nantes, FR
| | - François Viallet
- Service de Neurologie, CRHU d'Aix-en-Provence, Avenue des Tamaris, 13100 Aix-en-Provence, FR
| | - Jean-Luc Houeto
- Service de Neurologie, CHU de Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, FR
| | - Franck Durif
- Service de Neurologie, CHU de Clermont-Ferrand, CHU de Clermont-Ferrand, Hôpital Gabriel Montpied, 58 rue Montalembert, 63003 Clermont-Ferrand, FR
| | - Marie Vidailhet
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Yulia Worbe
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,AP-HP, Centre de Référence National Maladie Rare 'Syndrome Gilles de la Tourette', Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Emmanuel Roze
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,AP-HP, Centre de Référence National Maladie Rare 'Syndrome Gilles de la Tourette', Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Edor Kabashi
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
| | - Andreas Hartmann
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR.,AP-HP, Centre de Référence National Maladie Rare 'Syndrome Gilles de la Tourette', Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, FR
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Khramtsova EA, Heldman R, Derks EM, Yu D, Davis LK, Stranger BE. Sex differences in the genetic architecture of obsessive-compulsive disorder. Am J Med Genet B Neuropsychiatr Genet 2019; 180:351-364. [PMID: 30456828 PMCID: PMC6527502 DOI: 10.1002/ajmg.b.32687] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a highly heritable complex phenotype that demonstrates sex differences in age of onset and clinical presentation, suggesting a possible sex difference in underlying genetic architecture. We present the first genome-wide characterization of the sex-specific genetic architecture of OCD, utilizing the largest set of OCD cases and controls available from the Psychiatric Genomics Consortium. We assessed evidence for several mechanisms that may contribute to sex differences including a sex-dependent liability threshold, the presence of individual sex-specific risk variants on the autosomes and the X chromosome, and sex-specific pleiotropic effects. Furthermore, we tested the hypothesis that genetic heterogeneity between the sexes may obscure associations in a sex-combined genome-wide association study. We observed a strong genetic correlation between male and female OCD and no evidence for a sex-dependent liability threshold model, suggesting that sex-combined analysis does not suffer from widespread loss of power because of genetic heterogeneity between the sexes. While we did not detect any significant sex-specific genome-wide single nucleotide polymorphisms (SNP) associations, we did identify two significant gene-based associations in females: GRID2 and GRP135, which showed no association in males. We observed that the SNPs with sexually differentiated effects showed an enrichment of regulatory variants influencing expression of genes in brain and immune tissues. These findings suggest that future studies with larger sample sizes hold great promise for the identification of sex-specific genetic risk factors for OCD.
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Affiliation(s)
- Ekaterina A Khramtsova
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois
- Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois
| | | | - Eske M Derks
- Queensland Institute of Medical Research, Brisbane, Australia
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Lea K Davis
- Vanderbilt Genetics Institute; Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Medical Genetics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Barbara E Stranger
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois
- Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois
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Baumgaertel C, Skripuletz T, Kronenberg J, Stangel M, Schwenkenbecher P, Sinke C, Müller-Vahl KR, Sühs KW. Immunity in Gilles de la Tourette-Syndrome: Results From a Cerebrospinal Fluid Study. Front Neurol 2019; 10:732. [PMID: 31333575 PMCID: PMC6621640 DOI: 10.3389/fneur.2019.00732] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Several lines of evidence support the hypothesis of an autoimmune origin of Gilles de la Tourette-Syndrome (GTS). Accordingly, in a recent study we detected positive oligoclonal bands (OCB) in cerebrospinal fluid (CSF) in >30% of adult patients indicating an intrathecal antibody synthesis. However, until today no corresponding antibodies could be identified. The aims of this study were to replicate our findings of positive OCB in an independent sample and to detect CSF autoantibodies. Methods: In this prospective study, 20 adult patients with GTS (male: female = 18:2, median age 36.1 years ± 14.34 SD) were included. All patients were thoroughly clinically characterized. Magnetic Resonance Imaging (MRI) and CSF standard measurements were performed. Isoelectric focusing on polyacrylamide gels with silver staining was used to detect OCB. To examine specific and unspecified autoantibodies, we used transfected Human Embryonic Kidney (HEK) cells expressing different surface antigens (NMDA-, CASPR2-, LGI1-, AMPA-, or GABAB1/B), indirect immunofluorescence on different brain tissue sections, and enzyme-linked visualization. Additionally, we differentiated Glioma stem cells SY5Y (human neuroblastoma) using retinoic acid and astrocytes (rat). Results: CSF analyses showed positive OCB (type 2) in 4/20 patients (20%). Using transfected HEK cells we did not find specific surface-autoantibodies. Immunohistochemistry on tissue-sections, SY5Y Glioma stem-cells, and astrocytes showed no specific binding patterns either. Conclusions: Our results corroborate previous findings and demonstrate positive OCB in a substantial number of patients with GTS (prevalence in healthy controls: 5%). Although this is the largest study investigating CSF autoantibodies in GTS using several techniques, we failed to detect any specific or unspecified autoantibodies.
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Affiliation(s)
- Charlotte Baumgaertel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | | | - Jessica Kronenberg
- Department of Neurology, Hannover Medical School, Hanover, Germany.,Center for Systems Neuroscience, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Martin Stangel
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | | | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Kirsten R Müller-Vahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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Pittenger C. The histidine decarboxylase model of tic pathophysiology: a new focus on the histamine H 3 receptor. Br J Pharmacol 2019; 177:570-579. [PMID: 30714121 DOI: 10.1111/bph.14606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/12/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022] Open
Abstract
Histamine dysregulation was implicated as a rare cause of Tourette syndrome and other tic disorders a decade ago by a landmark genetic study in a high density family pedigree, which implicated a hypomorphic mutation in the histidine decarboxylase (Hdc) gene as a rare but high penetrance genetic cause. Studies in Hdc knockout (KO) mice have confirmed that this mutation causes tic-relevant behavioural and neurochemical abnormalities that parallel what is seen in patients and thus validate the KO as a potentially informative model of tic pathophysiology. Recent studies have focused on the potential role of the histamine H3 receptor in this model, and by association in tic disorders and related neuropsychiatric conditions. The H3 receptor is up-regulated in the striatum in Hdc KO mice. As the H3 receptor has constitutive activity in the absence of ligand, this receptor up-regulation may have significant cellular effects despite the absence of neurotransmitter histamine in these mice. Activation in vivo of H3 receptors in wild type mice regulates signalling in striatal medium spiny neurons (MSNs) that interacts non-linearly with dopamine receptor signalling. Baseline signalling alterations in MSNs in Hdc KO mice resemble those seen after H3 receptor agonist treatment in wild type animals. H3 receptor agonist treatment in the KOs further accentuates most of these signalling abnormalities and produces behavioural stereotypy. Together, these data suggest the intriguing hypothesis that constitutive signalling by up-regulated H3 receptors explains many of the molecular and behavioural abnormalities seen in these animals. LINKED ARTICLES: This article is part of a themed section on New Uses for 21st Century. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.3/issuetoc.
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Mufford M, Cheung J, Jahanshad N, van der Merwe C, Ding L, Groenewold N, Koen N, Chimusa ER, Dalvie S, Ramesar R, Knowles JA, Lochner C, Hibar DP, Paschou P, van den Heuvel OA, Medland SE, Scharf JM, Mathews CA, Thompson PM, Stein DJ. Concordance of genetic variation that increases risk for tourette syndrome and that influences its underlying neurocircuitry. Transl Psychiatry 2019; 9:120. [PMID: 30902966 PMCID: PMC6430767 DOI: 10.1038/s41398-019-0452-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 02/13/2019] [Accepted: 02/16/2019] [Indexed: 01/18/2023] Open
Abstract
There have been considerable recent advances in understanding the genetic architecture of Tourette syndrome (TS) as well as its underlying neurocircuitry. However, the mechanisms by which genetic variation that increases risk for TS-and its main symptom dimensions-influence relevant brain regions are poorly understood. Here we undertook a genome-wide investigation of the overlap between TS genetic risk and genetic influences on the volume of specific subcortical brain structures that have been implicated in TS. We obtained summary statistics for the most recent TS genome-wide association study (GWAS) from the TS Psychiatric Genomics Consortium Working Group (4644 cases and 8695 controls) and GWAS of subcortical volumes from the ENIGMA consortium (30,717 individuals). We also undertook analyses using GWAS summary statistics of key symptom factors in TS, namely social disinhibition and symmetry behaviour. SNP effect concordance analysis (SECA) was used to examine genetic pleiotropy-the same SNP affecting two traits-and concordance-the agreement in single nucelotide polymorphism (SNP) effect directions across these two traits. In addition, a conditional false discovery rate (FDR) analysis was performed, conditioning the TS risk variants on each of the seven subcortical and the intracranial brain volume GWAS. Linkage disequilibrium score regression (LDSR) was used as validation of the SECA method. SECA revealed significant pleiotropy between TS and putamen (p = 2 × 10-4) and caudate (p = 4 × 10-4) volumes, independent of direction of effect, and significant concordance between TS and lower thalamic volume (p = 1 × 10-3). LDSR lent additional support for the association between TS and thalamus volume (p = 5.85 × 10-2). Furthermore, SECA revealed significant evidence of concordance between the social disinhibition symptom dimension and lower thalamus volume (p = 1 × 10-3), as well as concordance between symmetry behaviour and greater putamen volume (p = 7 × 10-4). Conditional FDR analysis further revealed novel variants significantly associated with TS (p < 8 × 10-7) when conditioning on intracranial (rs2708146, q = 0.046; and rs72853320, q = 0.035) and hippocampal (rs1922786, q = 0.001) volumes, respectively. These data indicate concordance for genetic variation involved in disorder risk and subcortical brain volumes in TS. Further work with larger samples is needed to fully delineate the genetic architecture of these disorders and their underlying neurocircuitry.
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Affiliation(s)
- Mary Mufford
- 0000 0004 1937 1151grid.7836.aHuman Genetics Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Josh Cheung
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA USA
| | - Neda Jahanshad
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA USA
| | - Celia van der Merwe
- 0000 0004 1937 1151grid.7836.aHuman Genetics Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Linda Ding
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA USA
| | - Nynke Groenewold
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and MRC Unit on Risk & Resilience, University of Cape Town, Cape Town, South Africa
| | - Nastassja Koen
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and MRC Unit on Risk & Resilience, University of Cape Town, Cape Town, South Africa ,0000 0004 0635 1506grid.413335.3Groote Schuur Hospital and Neuroscience Institute, Cape Town, South Africa
| | - Emile R. Chimusa
- 0000 0004 1937 1151grid.7836.aHuman Genetics Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Shareefa Dalvie
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and MRC Unit on Risk & Resilience, University of Cape Town, Cape Town, South Africa ,0000 0004 0635 1506grid.413335.3Groote Schuur Hospital and Neuroscience Institute, Cape Town, South Africa
| | - Raj Ramesar
- 0000 0004 1937 1151grid.7836.aHuman Genetics Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - James A. Knowles
- 0000 0001 2156 6853grid.42505.36Department of Psychiatry and the Behavioural Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Christine Lochner
- 0000 0001 2214 904Xgrid.11956.3aDepartment of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Derrek P. Hibar
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA USA
| | - Peristera Paschou
- 0000 0004 1937 2197grid.169077.eDepartment of Biological Sciences, Purdue University, West Lafayette, IN USA
| | - Odile A. van den Heuvel
- grid.484519.5Department of Psychiatry, Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Sarah E. Medland
- 0000 0001 2294 1395grid.1049.cQIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Jeremiah M. Scharf
- 000000041936754Xgrid.38142.3cPsychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Harvard Medical School, Boston, MA USA ,0000 0004 0386 9924grid.32224.35Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA ,0000 0004 0386 9924grid.32224.35Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Carol A. Mathews
- 0000 0004 1936 8091grid.15276.37Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL USA
| | - Paul M. Thompson
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA USA
| | - Dan J. Stein
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and MRC Unit on Risk & Resilience, University of Cape Town, Cape Town, South Africa ,0000 0004 0635 1506grid.413335.3Groote Schuur Hospital and Neuroscience Institute, Cape Town, South Africa
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Yu D, Sul JH, Tsetsos F, Nawaz MS, Huang AY, Zelaya I, Illmann C, Osiecki L, Darrow SM, Hirschtritt ME, Greenberg E, Muller-Vahl KR, Stuhrmann M, Dion Y, Rouleau G, Aschauer H, Stamenkovic M, Schlögelhofer M, Sandor P, Barr CL, Grados M, Singer HS, Nöthen MM, Hebebrand J, Hinney A, King RA, Fernandez TV, Barta C, Tarnok Z, Nagy P, Depienne C, Worbe Y, Hartmann A, Budman CL, Rizzo R, Lyon GJ, McMahon WM, Batterson JR, Cath DC, Malaty IA, Okun MS, Berlin C, Woods DW, Lee PC, Jankovic J, Robertson MM, Gilbert DL, Brown LW, Coffey BJ, Dietrich A, Hoekstra PJ, Kuperman S, Zinner SH, Luðvigsson P, Sæmundsen E, Thorarensen Ó, Atzmon G, Barzilai N, Wagner M, Moessner R, Ophoff R, Pato CN, Pato MT, Knowles JA, Roffman JL, Smoller JW, Buckner RL, Willsey JA, Tischfield JA, Heiman GA, Stefansson H, Stefansson K, Posthuma D, Cox NJ, Pauls DL, Freimer NB, Neale BM, Davis LK, Paschou P, Coppola G, Mathews CA, Scharf JM. Interrogating the Genetic Determinants of Tourette's Syndrome and Other Tic Disorders Through Genome-Wide Association Studies. Am J Psychiatry 2019; 176:217-227. [PMID: 30818990 PMCID: PMC6677250 DOI: 10.1176/appi.ajp.2018.18070857] [Citation(s) in RCA: 200] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Tourette's syndrome is polygenic and highly heritable. Genome-wide association study (GWAS) approaches are useful for interrogating the genetic architecture and determinants of Tourette's syndrome and other tic disorders. The authors conducted a GWAS meta-analysis and probed aggregated Tourette's syndrome polygenic risk to test whether Tourette's and related tic disorders have an underlying shared genetic etiology and whether Tourette's polygenic risk scores correlate with worst-ever tic severity and may represent a potential predictor of disease severity. METHODS GWAS meta-analysis, gene-based association, and genetic enrichment analyses were conducted in 4,819 Tourette's syndrome case subjects and 9,488 control subjects. Replication of top loci was conducted in an independent population-based sample (706 case subjects, 6,068 control subjects). Relationships between Tourette's polygenic risk scores (PRSs), other tic disorders, ascertainment, and tic severity were examined. RESULTS GWAS and gene-based analyses identified one genome-wide significant locus within FLT3 on chromosome 13, rs2504235, although this association was not replicated in the population-based sample. Genetic variants spanning evolutionarily conserved regions significantly explained 92.4% of Tourette's syndrome heritability. Tourette's-associated genes were significantly preferentially expressed in dorsolateral prefrontal cortex. Tourette's PRS significantly predicted both Tourette's syndrome and tic spectrum disorders status in the population-based sample. Tourette's PRS also significantly correlated with worst-ever tic severity and was higher in case subjects with a family history of tics than in simplex case subjects. CONCLUSIONS Modulation of gene expression through noncoding variants, particularly within cortico-striatal circuits, is implicated as a fundamental mechanism in Tourette's syndrome pathogenesis. At a genetic level, tic disorders represent a continuous spectrum of disease, supporting the unification of Tourette's syndrome and other tic disorders in future diagnostic schemata. Tourette's PRSs derived from sufficiently large samples may be useful in the future for predicting conversion of transient tics to chronic tic disorders, as well as tic persistence and lifetime tic severity.
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Affiliation(s)
- Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus
University of Thrace, Xanthi, Greece
- Department of Biological Sciences, Purdue University, West
Lafayette, Indiana, USA
| | | | - Alden Y. Huang
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
- Bioinformatics Interdepartmental Program, University of
California, Los Angeles, Los Angeles, California, USA
| | - Ivette Zelaya
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
- Bioinformatics Interdepartmental Program, University of
California, Los Angeles, Los Angeles, California, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Sabrina M. Darrow
- Department of Psychiatry, University of California, San
Francisco, San Francisco, California, USA
| | - Matthew E. Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for
Neurosciences, University of California, San Francisco, San Francisco, California,
USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Kirsten R. Muller-Vahl
- Clinic of Psychiatry, Social Psychiatry and
Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School,
Hannover, Germany
| | - Yves Dion
- McGill University Health Center (MUHC), University of
Montréal, Centre Universitaire de Santé de Montréal (CHUM),
Montreal, Quebec, Canada
| | - Guy Rouleau
- Montreal Neurological Institute, Department of Neurology
and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical
University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical
University Vienna, Vienna, Austria
| | | | - Paul Sandor
- University Health Network and Youthdale Treatment Centres
University of Toronto, Toronto, Ontario, Canada
| | - Cathy L. Barr
- Krembil Research Institute, University Health Network,
Hospital for Sick Children, and The University of Toronto, Toronto, Ontario,
Canada
| | - Marco Grados
- Johns Hopkins University School of Medicine, Baltimore,
Maryland, USA
| | - Harvey S. Singer
- Johns Hopkins University School of Medicine, Baltimore,
Maryland, USA
| | - Markus M. Nöthen
- Institute of Human Genetics, University Hospital Bonn,
University of Bonn Medical School, Bonn, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry,
Psychosomatics and Psychotherapy, University Hospital Essen, University of
Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry,
Psychosomatics and Psychotherapy, University Hospital Essen, University of
Duisburg-Essen, Essen, Germany
| | - Robert A. King
- Yale Child Study Center, Yale University School of
Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut, USA
| | - Thomas V. Fernandez
- Yale Child Study Center, Yale University School of
Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut, USA
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and
Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital,
Budapest, Hungary
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital,
Budapest, Hungary
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen,
University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette
Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
- Assistance Publique-Hôpitaux de Paris, Department
of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette
Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
- Assistance Publique-Hôpitaux de Paris, Department
of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
| | - Cathy L. Budman
- Zucker School of Medicine at Hofstra/Northwell,
Hempstead, New York, USA
| | - Renata Rizzo
- Neuropsichiatria Infantile. Dipartimento di Medicina
Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring
Harbor Laboratory, Cold Spring Harbor, New York, USA
| | | | | | - Danielle C. Cath
- Department of Psychiatry, University Medical Center
Groningen & Rijksuniversity Groningen, Groningen, the Netherlands
- Drenthe Mental Health Center, Groningen, the
Netherlands
| | - Irene A. Malaty
- Department of Neurology, Fixel Center for Neurological
Diseases, McKnight Brain Institute, University of Florida, Gainesville, Florida,
USA
| | - Michael S. Okun
- Department of Neurology, Fixel Center for Neurological
Diseases, McKnight Brain Institute, University of Florida, Gainesville, Florida,
USA
| | - Cheston Berlin
- Pennsylvania State University College of Medicine,
Hershey, Pennsylvania, USA
| | - Douglas W. Woods
- Marquette University, Milwaukee, Wisconsin, USA
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin,
USA
| | - Paul C. Lee
- Tripler Army Medical Center, University of Hawai’i
John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders
Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas,
USA
| | - Mary M. Robertson
- Division of Psychiatry, Department of Neuropsychiatry,
University College London, London, UK
| | - Donald L. Gilbert
- Department of Pediatrics, Cincinnati Children’s
Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lawrence W. Brown
- Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania, USA
| | - Barbara J. Coffey
- Department of Psychiatry and Behavioral Sciences,
University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrea Dietrich
- University of Groningen, University Medical Center
Groningen, Department of Child and Adolescent Psychiatry, Groningen, The
Netherlands
| | - Pieter J. Hoekstra
- University of Groningen, University Medical Center
Groningen, Department of Child and Adolescent Psychiatry, Groningen, The
Netherlands
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City,
Iowa, USA
| | - Samuel H Zinner
- Department of Pediatrics, University of Washington,
Seattle, Washington, USA
| | - Pétur Luðvigsson
- Department of Pediatrics, Landspitalinn University
Hospital, Reykjavik, Iceland
| | - Evald Sæmundsen
- Faculty of Medicine, University of Iceland,
Reykjavík, Iceland
- The State Diagnostic and Counselling Centre,
Kópavogur, Iceland
| | - Ólafur Thorarensen
- Department of Pediatrics, Landspitalinn University
Hospital, Reykjavik, Iceland
| | - Gil Atzmon
- Department of Genetics, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Human Biology, Haifa University, Haifa,
Israel
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of
Medicine, Bronx, New York, USA
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of
Bonn, Bonn, Germany
| | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of
Tuebingen, Tuebingen, Germany
| | - Roel Ophoff
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
| | | | | | | | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Research,
Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts,
USA
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of
Public Health, Boston, Massachusetts, USA
| | - Randy L. Buckner
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Research,
Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts,
USA
- Center for Brain Science, Harvard University, Cambridge,
Massachusetts, USA
- Department of Psychology, Harvard University, Cambridge,
Massachusetts, USA
| | - Jeremy A. Willsey
- Department of Psychiatry, UCSF Weill Institute for
Neurosciences, University of California, San Francisco, San Francisco, California,
USA
- Institute for Neurodegenerative Diseases, UCSF Weill
Institute for Neurosciences, University of California San Francisco, San Francisco,
California, USA
| | - Jay A. Tischfield
- Department of Genetics and the Human Genetics Institute
of New Jersey, Rutgers, the State University of New Jersey, Piscataway, New Jersey,
USA
| | - Gary A. Heiman
- Department of Genetics and the Human Genetics Institute
of New Jersey, Rutgers, the State University of New Jersey, Piscataway, New Jersey,
USA
| | | | - Kári Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland,
Reykjavík, Iceland
| | - Danielle Posthuma
- Department of Complex Trait Genetics Center for
Neurogenomics and Cognitive Research, VU University Amsterdam, Amsterdam, the
Netherlands
| | - Nancy J. Cox
- Division of Genetic Medicine, Vanderbilt Genetics
Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Nelson B. Freimer
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Benjamin M. Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
- Analytic and Translational Genetics Unit, Department of
Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lea K. Davis
- Division of Genetic Medicine, Vanderbilt Genetics
Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West
Lafayette, Indiana, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Carol A. Mathews
- Department of Psychiatry, Genetics Institute, University
of Florida, Gainesville, Florida, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Brigham and Women’s
Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital,
Boston, Massachusetts, USA
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44
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Abstract
Anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) are heritable conditions that are influenced by both genetic and environmental factors. Recent genome-wide association studies (GWAS) of AN have identified specific genetic loci implicated in AN, and genetic correlations have implicated both psychiatric and metabolic factors in its origin. No GWAS have been performed for BN or BED. Genetic counseling is an important tool and can aid families and patients in understanding risk for these illnesses.
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Affiliation(s)
- Cynthia M Bulik
- Department of Psychiatry, UNC Chapel Hill, University of North Carolina, CB 7160, Chapel Hill, NC 27599, USA; Department of Nutrition, University of North Carolina, CB 7400, Chapel Hill, NC 27599, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, SE-171 77, Stockholm, Sweden.
| | - Lauren Blake
- Department of Human Genetics, University of Chicago, Cummings Life Science Center, 920 East 58th Street, Chicago, IL 60637, USA
| | - Jehannine Austin
- Department of Psychiatry, University of British Columbia, Translational Lab Building Room a3-112 - 3rd Floor, 938 West 28th Avenue, Vancouver, British Columbia V5Z 4H4, Canada; Department of Medical Genetics, University of British Columbia, Translational Lab Building Room a3-112 - 3rd Floor, 938 West 28th Avenue, Vancouver, British Columbia V5Z 4H4, Canada
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45
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Abdulkadir M, Mathews CA, Scharf JM, Yu D, Tischfield JA, Heiman GA, Hoekstra PJ, Dietrich A. Polygenic Risk Scores Derived From a Tourette Syndrome Genome-wide Association Study Predict Presence of Tics in the Avon Longitudinal Study of Parents and Children Cohort. Biol Psychiatry 2019; 85:298-304. [PMID: 30424865 PMCID: PMC6342633 DOI: 10.1016/j.biopsych.2018.09.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/27/2018] [Accepted: 09/11/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Tourette syndrome (TS) has a well-established genetic background, but its genetic architecture remains largely unknown. The authors investigated the role of polygenic risk scores (PRSs) derived from a TS genome-wide association study in relation to the occurrence of tics and associated traits in a general population cohort. METHODS Using the most recent TS genome-wide association study (n = 4819 cases; n = 9488 controls) as the discovery sample, PRSs were calculated in Avon Longitudinal Study of Parents and Children participants (n = 8941). Regression analyses were used to assess whether PRS predicted the presence and chronicity of tics, and symptom severity of obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, and autism spectrum disorder in Avon Longitudinal Study of Parents and Children participants. RESULTS Following correction for multiple testing, the PRS significantly predicted the presence (R2 = .48%, p empirical = .01, Q = .04) but not the chronicity (R2 = .16%, p empirical = .07, Q = .14) of tics in the Avon Longitudinal Study of Parents and Children cohort; it did not predict the severity of obsessive-compulsive disorder (R2 = .11%, p empirical = .11, Q = .15), attention-deficit/hyperactivity disorder (R2 = .09%, p empirical = .19, Q = .21), or autism spectrum disorder (R2 = .12%, p empirical = .09, Q = .14). CONCLUSIONS The authors found a significant polygenic component of tics occurring in a general population cohort based on PRS derived from a genome-wide association study of individuals with a TS diagnosis. This finding supports the notion that tics along a spectrum from nonclinical to clinical symptom levels share a similar genetic background.
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Affiliation(s)
- Mohamed Abdulkadir
- Department of Genetics, Rutgers, the State University of New Jersey, and the Human Genetics Institute of New Jersey, Piscataway, New Jersey; Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, and Genetics Institute, University of Florida College of Medicine, Gainesville, Florida
| | - Jeremiah M Scharf
- Center for Genomic Medicine and Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dongmei Yu
- Center for Genomic Medicine and Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jay A Tischfield
- Department of Genetics, Rutgers, the State University of New Jersey, and the Human Genetics Institute of New Jersey, Piscataway, New Jersey
| | - Gary A Heiman
- Department of Genetics, Rutgers, the State University of New Jersey, and the Human Genetics Institute of New Jersey, Piscataway, New Jersey
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Schrag A, Martino D, Apter A, Ball J, Bartolini E, Benaroya-Milshtein N, Buttiglione M, Cardona F, Creti R, Efstratiou A, Gariup M, Georgitsi M, Hedderly T, Heyman I, Margarit I, Mir P, Moll N, Morer A, Müller N, Müller-Vahl K, Münchau A, Orefici G, Plessen KJ, Porcelli C, Paschou P, Rizzo R, Roessner V, Schwarz MJ, Steinberg T, Tagwerker Gloor F, Tarnok Z, Walitza S, Dietrich A, Hoekstra PJ. European Multicentre Tics in Children Studies (EMTICS): protocol for two cohort studies to assess risk factors for tic onset and exacerbation in children and adolescents. Eur Child Adolesc Psychiatry 2019; 28:91-109. [PMID: 29982875 PMCID: PMC6349795 DOI: 10.1007/s00787-018-1190-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 06/28/2018] [Indexed: 12/22/2022]
Abstract
Genetic predisposition, autoimmunity and environmental factors [e.g. pre- and perinatal difficulties, Group A Streptococcal (GAS) and other infections, stress-inducing events] might interact to create a neurobiological vulnerability to the development of tics and associated behaviours. However, the existing evidence for this relies primarily on small prospective or larger retrospective population-based studies, and is therefore still inconclusive. This article describes the design and methodology of the EMTICS study, a longitudinal observational European multicentre study involving 16 clinical centres, with the following objectives: (1) to investigate the association of environmental factors (GAS exposure and psychosocial stress, primarily) with the onset and course of tics and/or obsessive-compulsive symptoms through the prospective observation of at-risk individuals (ONSET cohort: 260 children aged 3-10 years who are tic-free at study entry and have a first-degree relative with a chronic tic disorder) and affected individuals (COURSE cohort: 715 youth aged 3-16 years with a tic disorder); (2) to characterise the immune response to microbial antigens and the host's immune response regulation in association with onset and exacerbations of tics; (3) to increase knowledge of the human gene pathways influencing the pathogenesis of tic disorders; and (4) to develop prediction models for the risk of onset and exacerbations of tic disorders. The EMTICS study is, to our knowledge, the largest prospective cohort assessment of the contribution of different genetic and environmental factors to the risk of developing tics in putatively predisposed individuals and to the risk of exacerbating tics in young individuals with chronic tic disorders.
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Affiliation(s)
- Anette Schrag
- 0000000121901201grid.83440.3bDepartment of Clinical Neurosciences, UCL Institute of Neurology, University College London, London, UK
| | - Davide Martino
- 0000 0004 1936 7697grid.22072.35Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Alan Apter
- 0000 0004 1937 0546grid.12136.37Child and Adolescent Psychiatry Department, Schneider Children’s Medical Center of Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Petah-Tikva, Israel
| | - Juliane Ball
- 0000 0004 1937 0650grid.7400.3Clinic of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | | | - Noa Benaroya-Milshtein
- 0000 0004 1937 0546grid.12136.37Child and Adolescent Psychiatry Department, Schneider Children’s Medical Center of Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Petah-Tikva, Israel
| | - Maura Buttiglione
- 0000 0001 0120 3326grid.7644.1Department of Biological Sciences and Human Oncology, Medical School, University of Bari “Aldo Moro”, Bari, Italy
| | - Francesco Cardona
- grid.7841.aDepartment of Human Neurosciences, University La Sapienza of Rome, Rome, Italy
| | - Roberta Creti
- 0000 0000 9120 6856grid.416651.1Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Androulla Efstratiou
- 0000 0004 5909 016Xgrid.271308.fWHO Global Collaborating Centre for Reference and Research on Diphtheria and Streptococcal Infections, Reference Microbiology, Directorate National Infection Service, Public Health England, London, UK
| | - Maria Gariup
- 0000 0004 1937 0247grid.5841.8University of Barcelona, Barcelona, Spain ,Intensive Inpatient Unit, Copenhagen Psychiatric Center, Copenhagen, Denmark
| | - Marianthi Georgitsi
- 0000 0001 2170 8022grid.12284.3dDepartment of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece ,0000000109457005grid.4793.9Department of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Tammy Hedderly
- 0000 0004 5345 7223grid.483570.dEvelina London Children’s Hospital GSTT, Kings Health Partners AHSC, London, UK
| | - Isobel Heyman
- 0000000121901201grid.83440.3bGreat Ormond Street Hospital for Children, UCL Institute of Child Health, London, UK
| | | | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clinica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Seville, Spain
| | - Natalie Moll
- 0000 0004 1936 973Xgrid.5252.0Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Astrid Morer
- 0000 0000 9635 9413grid.410458.cDepartment of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain ,grid.10403.36Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCentro de Investigacion en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Norbert Müller
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,Marion von Tessin Memory-Zentrum gGmbH, Munich, Germany
| | - Kirsten Müller-Vahl
- 0000 0000 9529 9877grid.10423.34Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Alexander Münchau
- 0000 0001 0057 2672grid.4562.5Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Graziella Orefici
- 0000 0000 9120 6856grid.416651.1Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Kerstin J. Plessen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark ,0000 0001 2165 4204grid.9851.5Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Cesare Porcelli
- Azienda Sanitaria Locale di Bari, Mental Health Department, Child and Adolescent Neuropsychiatry Service of Bari Metropolitan Area, Bari, Italy
| | - Peristera Paschou
- 0000 0004 1937 2197grid.169077.eDepartment of Biological Sciences, Purdue University, West Lafayette, USA
| | - Renata Rizzo
- 0000 0004 1757 1969grid.8158.4Child Neuropsychiatry Section, Department of Clinical and Experimental Medicine, School of Medicine, Catania University, Catania, Italy
| | - Veit Roessner
- 0000 0001 2111 7257grid.4488.0Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Markus J. Schwarz
- 0000 0004 1936 973Xgrid.5252.0Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Tamar Steinberg
- 0000 0004 1937 0546grid.12136.37Child and Adolescent Psychiatry Department, Schneider Children’s Medical Center of Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Petah-Tikva, Israel
| | - Friederike Tagwerker Gloor
- 0000 0004 1937 0650grid.7400.3Clinic of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Susanne Walitza
- 0000 0004 1937 0650grid.7400.3Clinic of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Andrea Dietrich
- 0000 0004 0407 1981grid.4830.fDepartment of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Pieter J. Hoekstra
- 0000 0004 0407 1981grid.4830.fDepartment of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Abstract
Tourette syndrome (TS) is a complex disorder characterized by repetitive, sudden, and involuntary movements or vocalizations, called tics. Tics usually appear in childhood, and their severity varies over time. In addition to frequent tics, people with TS are at risk for associated problems including attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, depression, and problems with sleep. TS occurs in most populations and ethnic groups worldwide, and it is more common in males than in females. Previous family and twin studies have shown that the majority of cases of TS are inherited. TS was previously thought to have an autosomal dominant pattern of inheritance. However, several decades of research have shown that this is unlikely the case. Instead, TS most likely results from a variety of genetic and environmental factors, not changes in a single gene. In the past decade, there has been a rapid development of innovative genetic technologies and methodologies, as well as significant progress in genetic studies of psychiatric disorders. In this review, we will briefly summarize previous genetic epidemiological studies of TS and related disorders. We will also review previous genetic studies based on genome-wide linkage analyses and candidate gene association studies to comment on problems of previous methodological and strategic issues. Our main purpose for this review will be to summarize the new genetic discoveries of TS based on novel genetic methods and strategies, such as genome-wide association studies (GWASs), whole exome sequencing (WES), and whole genome sequencing (WGS). We will also compare the new genetic discoveries of TS with other major psychiatric disorders in order to understand the current status of TS genetics and its relationship with other psychiatric disorders.
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Yang X, Liu W, Yi M, Zhang R, Xu Y, Huang Z, Liu S, Li T. Choline acetyltransferase may contribute to the risk of Tourette syndrome: Combination of family-based analysis and case-control study. World J Biol Psychiatry 2018; 19:521-526. [PMID: 28090804 DOI: 10.1080/15622975.2017.1282176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Twin and family analyses have revealed a genetic contribution to Tourette syndrome (TS) and post-mortem studies have raised the intriguing possibility of a reduction in cholinergic interneuronsin TS patients. METHODS We selected five tag SNPs (rs100824791, rs12264845, rs1880676, rs3793790 and rs3793798) of choline acetyltransferase (CHAT) from the Han Chinese population Hapmap database. Genotyping was conducted on 401 TS nuclear family trios and 405 control subjects. Transmission disequilibrium test (TDT) and haplotype relative risk (HRR) analyses were used to analyse the family-based study and a case-control study was also used to assess the genetic susceptibility to TS. RESULTS The results revealed a significant over-transmission of rs3793790 (TDT, χ2 = 9.121, P = 0.003; HRR, χ2 = 6.579, P = 0.01), while case-control analysis found no differences between the two groups (genotype, χ2 = 0.436, P = 0.804; allele, χ2 = 0.149, P = 0.700). Also, rs3793798 also indicated a positive association associated with TS (TDT, χ2 = 5.025, P = 0.028; HRR, χ2 = 0.250, P = 0.617). However, the other three SNPs investigated were found not to be associated with TS in both in the family-based and case-control studies. CONCLUSIONS Our association analysis demonstrates that CHAT may contribute to TS susceptibility in the Han Chinese population. This gives strong support to the involvement of cholinergic interneurons in the aetiology of TS and reveals a potential therapeutic target.
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Affiliation(s)
- Xiuling Yang
- a Department of Pediatrics , The Affiliated Hospital of Qingdao University , Qingdao , China.,b Department of Nursing , Medical College of Qingdao University , Qingdao , China
| | - Wenmiao Liu
- c Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University , Qingdao , China.,d Genetic Laboratory , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Mingji Yi
- e Child Health Care Department , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Ru Zhang
- c Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University , Qingdao , China.,d Genetic Laboratory , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Yinglei Xu
- c Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University , Qingdao , China.,d Genetic Laboratory , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Zuzhou Huang
- c Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University , Qingdao , China.,d Genetic Laboratory , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Shiguo Liu
- c Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University , Qingdao , China.,d Genetic Laboratory , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Tang Li
- a Department of Pediatrics , The Affiliated Hospital of Qingdao University , Qingdao , China
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49
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Wang S, Mandell JD, Kumar Y, Sun N, Morris MT, Arbelaez J, Nasello C, Dong S, Duhn C, Zhao X, Yang Z, Padmanabhuni SS, Yu D, King RA, Dietrich A, Khalifa N, Dahl N, Huang AY, Neale BM, Coppola G, Mathews CA, Scharf JM, Fernandez TV, Buxbaum JD, De Rubeis S, Grice DE, Xing J, Heiman GA, Tischfield JA, Paschou P, Willsey AJ, State MW. De Novo Sequence and Copy Number Variants Are Strongly Associated with Tourette Disorder and Implicate Cell Polarity in Pathogenesis. Cell Rep 2018; 24:3441-3454.e12. [PMID: 30257206 PMCID: PMC6475626 DOI: 10.1016/j.celrep.2018.08.082] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/13/2018] [Accepted: 08/27/2018] [Indexed: 12/30/2022] Open
Abstract
We previously established the contribution of de novo damaging sequence variants to Tourette disorder (TD) through whole-exome sequencing of 511 trios. Here, we sequence an additional 291 TD trios and analyze the combined set of 802 trios. We observe an overrepresentation of de novo damaging variants in simplex, but not multiplex, families; we identify a high-confidence TD risk gene, CELSR3 (cadherin EGF LAG seven-pass G-type receptor 3); we find that the genes mutated in TD patients are enriched for those related to cell polarity, suggesting a common pathway underlying pathobiology; and we confirm a statistically significant excess of de novo copy number variants in TD. Finally, we identify significant overlap of de novo sequence variants between TD and obsessive-compulsive disorder and de novo copy number variants between TD and autism spectrum disorder, consistent with shared genetic risk.
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Affiliation(s)
- Sheng Wang
- College of Biological Sciences, China Agricultural University, Beijing, China; National Institute of Biological Sciences, Beijing, China; Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jeffrey D Mandell
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Yogesh Kumar
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Nawei Sun
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Montana T Morris
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Arbelaez
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Cara Nasello
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Shan Dong
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Clif Duhn
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Xin Zhao
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiatong University School of Medicine, Shanghai, China
| | - Zhiyu Yang
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | | | - Dongmei Yu
- Center for Genomic Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert A King
- Yale Child Study Center and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Najah Khalifa
- Department of Neuroscience, Child and Adolescent Psychiatry Uppsala University, Uppsala, Sweden; Centre for Research and Development, Region Gävleborg, Gävle, Sweden
| | - Niklas Dahl
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Alden Y Huang
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Benjamin M Neale
- Center for Genomic Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Center for Genomic Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Thomas V Fernandez
- Yale Child Study Center and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Silvia De Rubeis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jinchuan Xing
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA.
| | - A Jeremy Willsey
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Quantitative Biosciences Institute (QBI), University of California, San Francisco, San Francisco, CA, USA.
| | - Matthew W State
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Quantitative Biosciences Institute (QBI), University of California, San Francisco, San Francisco, CA, USA.
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50
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Gagné JP. The psychology of Tourette disorder: Revisiting the past and moving toward a cognitively-oriented future. Clin Psychol Rev 2018; 67:11-21. [PMID: 30292438 DOI: 10.1016/j.cpr.2018.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/15/2018] [Accepted: 09/21/2018] [Indexed: 01/04/2023]
Abstract
Tourette syndrome is a neurodevelopmental disorder characterized by chronic tics (i.e., repetitive and stereotyped movements and vocalizations) and premonitory urges (i.e., aversive sensations preceding tics that are alleviated once a tic is performed). Research supports that dysfunctional neurobiological and psychological processes interact and contribute to the development and maintenance of tics. However, psychological theories of Tourette syndrome and accompanying research have mainly focused on the emotional states (e.g., anxiety and frustration) and behavioural principles (i.e., operant conditioning) that play a role in tic exacerbation. This selective review summarizes key discoveries pertaining to the emotional and behavioural aspects of Tourette syndrome but also proposes a more comprehensive, cognitively-oriented conceptualization of the disorder. Specifically, it is proposed that maladaptive beliefs about discomfort and about one's ability to cope with discomfort underlie negative appraisals of unpleasant sensory experiences in individuals with Tourette syndrome. It is further suggested that these beliefs lead individuals to perceive premonitory urges in a catastrophic manner and thereby enhance tic frequency. Concrete research avenues to empirically examine these hypotheses are outlined and clinical implications for the field of cognitive-behaviour therapy are discussed.
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Affiliation(s)
- Jean-Philippe Gagné
- Department of Psychology, Concordia University, 7141 Sherbrooke St. West, Montreal, QC H4B 1R6, Canada.
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