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Tandon R, Nasrallah H, Akbarian S, Carpenter WT, DeLisi LE, Gaebel W, Green MF, Gur RE, Heckers S, Kane JM, Malaspina D, Meyer-Lindenberg A, Murray R, Owen M, Smoller JW, Yassin W, Keshavan M. The schizophrenia syndrome, circa 2024: What we know and how that informs its nature. Schizophr Res 2024; 264:1-28. [PMID: 38086109 DOI: 10.1016/j.schres.2023.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024]
Abstract
With new data about different aspects of schizophrenia being continually generated, it becomes necessary to periodically revisit exactly what we know. Along with a need to review what we currently know about schizophrenia, there is an equal imperative to evaluate the construct itself. With these objectives, we undertook an iterative, multi-phase process involving fifty international experts in the field, with each step building on learnings from the prior one. This review assembles currently established findings about schizophrenia (construct, etiology, pathophysiology, clinical expression, treatment) and posits what they reveal about its nature. Schizophrenia is a heritable, complex, multi-dimensional syndrome with varying degrees of psychotic, negative, cognitive, mood, and motor manifestations. The illness exhibits a remitting and relapsing course, with varying degrees of recovery among affected individuals with most experiencing significant social and functional impairment. Genetic risk factors likely include thousands of common genetic variants that each have a small impact on an individual's risk and a plethora of rare gene variants that have a larger individual impact on risk. Their biological effects are concentrated in the brain and many of the same variants also increase the risk of other psychiatric disorders such as bipolar disorder, autism, and other neurodevelopmental conditions. Environmental risk factors include but are not limited to urban residence in childhood, migration, older paternal age at birth, cannabis use, childhood trauma, antenatal maternal infection, and perinatal hypoxia. Structural, functional, and neurochemical brain alterations implicate multiple regions and functional circuits. Dopamine D-2 receptor antagonists and partial agonists improve psychotic symptoms and reduce risk of relapse. Certain psychological and psychosocial interventions are beneficial. Early intervention can reduce treatment delay and improve outcomes. Schizophrenia is increasingly considered to be a heterogeneous syndrome and not a singular disease entity. There is no necessary or sufficient etiology, pathology, set of clinical features, or treatment that fully circumscribes this syndrome. A single, common pathophysiological pathway appears unlikely. The boundaries of schizophrenia remain fuzzy, suggesting the absence of a categorical fit and need to reconceptualize it as a broader, multi-dimensional and/or spectrum construct.
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Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, WMU Homer Stryker School of Medicine, Kalamazoo, MI 49008, United States of America.
| | - Henry Nasrallah
- Department of Psychiatry, University of Cincinnati College of Medicine Cincinnati, OH 45267, United States of America
| | - Schahram Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, United States of America
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Dusseldorf, Heinrich-Heine University, Dusseldorf, Germany
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute of Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90024, United States of America; Greater Los Angeles Veterans' Administration Healthcare System, United States of America
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY 11004, United States of America
| | - Dolores Malaspina
- Department of Psychiatry, Neuroscience, Genetics, and Genomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannhein/Heidelberg University, Mannheim, Germany
| | - Robin Murray
- Institute of Psychiatry, Psychology, and Neuroscience, Kings College, London, UK
| | - Michael Owen
- Centre for Neuropsychiatric Genetics and Genomics, and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jordan W Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Psychiatric and Neurodevelopmental Unit, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Walid Yassin
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
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Schachar RJ. Fifty years of executive control research in attention-deficit/hyperactivity disorder:What we have learned and still need to know. Neurosci Biobehav Rev 2023; 155:105461. [PMID: 37949153 DOI: 10.1016/j.neubiorev.2023.105461] [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: 08/23/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
For 50 years, attention-deficit/hyperactivity disorder (ADHD) has been considered a disorder of executive control (EC), the higher-order, cognitive skills that support self-regulation, goal attainment and what we generally call "attention." This review surveys our current understanding of the nature of EC as it pertains to ADHD and considers the evidence in support of eight hypotheses that can be derived from the EC theory of ADHD. This paper provides a resource for practitioners to aid in clinical decision-making. To support theory building, I draw a parallel between the EC theory of ADHD and the common gene-common variant model of complex traits such as ADHD. The conclusion offers strategies for advancing collaborative research.
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Affiliation(s)
- Russell J Schachar
- Department of Psychiatry, The Hospital for Sick Children and University of Toronto, Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
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Del Re EC, Keshavan MS. Childhood trauma and psychosis-Searching for causes and mechanisms. Schizophr Res 2023; 262:146-148. [PMID: 37979417 DOI: 10.1016/j.schres.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
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Cattarinussi G, Gugliotta AA, Sambataro F. The Risk for Schizophrenia-Bipolar Spectrum: Does the Apple Fall Close to the Tree? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6540. [PMID: 37569080 PMCID: PMC10418911 DOI: 10.3390/ijerph20156540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) are severe psychiatric disorders that share clinical features and several risk genes. Important information about their genetic underpinnings arises from intermediate phenotypes (IPs), quantifiable biological traits that are more prevalent in unaffected relatives (RELs) of patients compared to the general population and co-segregate with the disorders. Within IPs, neuropsychological functions and neuroimaging measures have the potential to provide useful insight into the pathophysiology of SCZ and BD. In this context, the present narrative review provides a comprehensive overview of the available evidence on deficits in neuropsychological functions and neuroimaging alterations in unaffected relatives of SCZ (SCZ-RELs) and BD (BD-RELs). Overall, deficits in cognitive functions including intelligence, memory, attention, executive functions, and social cognition could be considered IPs for SCZ. Although the picture for cognitive alterations in BD-RELs is less defined, BD-RELs seem to present worse performances compared to controls in executive functioning, including adaptable thinking, planning, self-monitoring, self-control, and working memory. Among neuroimaging markers, SCZ-RELs appear to be characterized by structural and functional alterations in the cortico-striatal-thalamic network, while BD risk seems to be associated with abnormalities in the prefrontal, temporal, thalamic, and limbic regions. In conclusion, SCZ-RELs and BD-RELs present a pattern of cognitive and neuroimaging alterations that lie between patients and healthy individuals. Similar abnormalities in SCZ-RELs and BD-RELs may be the phenotypic expression of the shared genetic mechanisms underlying both disorders, while the specificities in neuropsychological and neuroimaging profiles may be associated with the differential symptom expression in the two disorders.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Alessio A. Gugliotta
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
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Veddum L, Greve AN, Gregersen M, Andreassen AK, Knudsen CB, Brandt JM, Krantz MF, Søndergaard A, Burton BK, Jepsen JRM, Hemager N, Werge T, Thorup AAE, Nordentoft M, Mors O, Nudel R. A study of the genetic architecture of social responsiveness in families with parental schizophrenia or bipolar disorder and population-based controls. Psychiatry Res 2023; 326:115280. [PMID: 37339530 DOI: 10.1016/j.psychres.2023.115280] [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: 02/27/2023] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/22/2023]
Abstract
Twin-studies of social responsiveness have reported moderate to high heritabilities, but studies using parent-child data are lacking. Additionally, social impairments have been suggested as a vulnerability marker for schizophrenia and bipolar disorder, but the heritability of social responsiveness in this context is unknown. This study is part of the Danish High Risk and Resilience Study - VIA, comprising families with one parent with schizophrenia (n = 202) or bipolar disorder (n = 120) and population-based controls (PBC, n = 200). Social responsiveness was assessed with The Social Responsiveness Scale, Second Edition (SRS-2). Heritability was estimated from variance components, and a polygenic risk score (PRS) for autism spectrum disorder (ASD) was calculated to assess the genetic relationship between ASD and SRS-2. SRS-2 heritability was moderate to high and significantly different from zero in all groups when the children were rated by the primary caregiver. With teacher ratings, the heritability was lower and only significant in the full cohort and PBC. We found no significant association between SRS-2 and PRS for ASD. Our study confirms that social responsiveness is heritable, but that heritability estimates are affected by the child-respondent relation and familial risk of mental illness. This has implications for clinical practice and research using SRS-2 and provides insight on the familial transmission of mental illness.
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Affiliation(s)
- Lotte Veddum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| | - Aja Neergaard Greve
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Maja Gregersen
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Anna Krogh Andreassen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Christina Bruun Knudsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Julie Marie Brandt
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Mette Falkenberg Krantz
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark
| | - Anne Søndergaard
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark; Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Denmark
| | - Jens Richardt Møllegaard Jepsen
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, Copenhagen University Hospital, Mental Health Services Copenhagen, Denmark
| | - Nicoline Hemager
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark
| | - Thomas Werge
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Mental Health Services Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Merete Nordentoft
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Ole Mors
- The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Ron Nudel
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark.
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Ben-Azu B, del Re EC, VanderZwaag J, Carrier M, Keshavan M, Khakpour M, Tremblay MÈ. Emerging epigenetic dynamics in gut-microglia brain axis: experimental and clinical implications for accelerated brain aging in schizophrenia. Front Cell Neurosci 2023; 17:1139357. [PMID: 37256150 PMCID: PMC10225712 DOI: 10.3389/fncel.2023.1139357] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Brain aging, which involves a progressive loss of neuronal functions, has been reported to be premature in probands affected by schizophrenia (SCZ). Evidence shows that SCZ and accelerated aging are linked to changes in epigenetic clocks. Recent cross-sectional magnetic resonance imaging analyses have uncovered reduced brain reserves and connectivity in patients with SCZ compared to typically aging individuals. These data may indicate early abnormalities of neuronal function following cyto-architectural alterations in SCZ. The current mechanistic knowledge on brain aging, epigenetic changes, and their neuropsychiatric disease association remains incomplete. With this review, we explore and summarize evidence that the dynamics of gut-resident bacteria can modulate molecular brain function and contribute to age-related neurodegenerative disorders. It is known that environmental factors such as mode of birth, dietary habits, stress, pollution, and infections can modulate the microbiota system to regulate intrinsic neuronal activity and brain reserves through the vagus nerve and enteric nervous system. Microbiota-derived molecules can trigger continuous activation of the microglial sensome, groups of receptors and proteins that permit microglia to remodel the brain neurochemistry based on complex environmental activities. This remodeling causes aberrant brain plasticity as early as fetal developmental stages, and after the onset of first-episode psychosis. In the central nervous system, microglia, the resident immune surveillance cells, are involved in neurogenesis, phagocytosis of synapses and neurological dysfunction. Here, we review recent emerging experimental and clinical evidence regarding the gut-brain microglia axis involvement in SCZ pathology and etiology, the hypothesis of brain reserve and accelerated aging induced by dietary habits, stress, pollution, infections, and other factors. We also include in our review the possibilities and consequences of gut dysbiosis activities on microglial function and dysfunction, together with the effects of antipsychotics on the gut microbiome: therapeutic and adverse effects, role of fecal microbiota transplant and psychobiotics on microglial sensomes, brain reserves and SCZ-derived accelerated aging. We end the review with suggestions that may be applicable to the clinical setting. For example, we propose that psychobiotics might contribute to antipsychotic-induced therapeutic benefits or adverse effects, as well as reduce the aging process through the gut-brain microglia axis. Overall, we hope that this review will help increase the understanding of SCZ pathogenesis as related to chronobiology and the gut microbiome, as well as reveal new concepts that will serve as novel treatment targets for SCZ.
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Affiliation(s)
- Benneth Ben-Azu
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Nigeria
| | - Elisabetta C. del Re
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Jared VanderZwaag
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Micaël Carrier
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | | | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Department of Biochemistry and Molecular Biology, The University of British Columbia, Vancouver, BC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Department of Molecular Medicine, Université Laval, Québec City, QC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), Institute on Aging and Lifelong Health (IALH), University of Victoria, Victoria, BC, Canada
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7
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Del Re EC, Yassin W, Zeng V, Keedy S, Alliey-Rodriguez N, Ivleva E, Hill S, Rychagov N, McDowell JE, Bishop JR, Mesholam-Gately R, Merola G, Lizano P, Gershon E, Pearlson G, Sweeney JA, Clementz B, Tamminga C, Keshavan M. Characterization of childhood trauma, hippocampal mediation and Cannabis use in a large dataset of psychosis and non-psychosis individuals. Schizophr Res 2023; 255:102-109. [PMID: 36989667 DOI: 10.1016/j.schres.2023.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Cannabis use (CA) and childhood trauma (CT) independently increase the risk of earlier psychosis onset; but their interaction in relation to psychosis risk and association with endocannabinoid-receptor rich brain regions, i.e. the hippocampus (HP), remains unclear. The objective was to determine whether lower age of psychosis onset (AgePsyOnset) is associated with CA and CT through mediation by the HP volumes, and genetic risk, as measured by schizophrenia polygene scores (SZ-PGRS). METHODS Cross-sectional, case-control, multicenter sample from 5 metropolitan US regions. Participants (n = 1185) included 397 controls not affected by psychosis (HC); 209 participants with bipolar disorder type-1; 279 with schizoaffective disorder; and 300 with schizophrenia (DSM IV-TR). CT was assessed using the Childhood Trauma Questionnaire (CTQ); CA was assessed by self-reports and trained clinical interviewers. Assessment included neuroimaging, symptomatology, cognition and calculation of the SZ polygenic risk score (SZ-PGRS). RESULTS In survival analysis, CT and CA exposure interact to be associated with lower AgePsyOnset. At high CT or CA, CT or CA are individually sufficient to affect AgePsyOnset. CT relation with AgePsyOnset is mediated in part by the HP in CA users before AgePsyOnset. CA before AgePsyOnset is associated with higher SZ-PGRS and correlated with younger age at CA usage. DISCUSSION CA and CT interact to increase risk when moderate; while severe CT and/or CA abuse/dependence are each sufficient to affect AgePsyOnset, indicating a ceiling effect. Probands with/out CA before AgePsyOnset differ on biological variables, suggesting divergent pathways to psychosis. FUNDING MH077945; MH096942; MH096913; MH077862; MH103368; MH096900; MH122759.
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McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry 2023; 28:1902-1918. [PMID: 36690793 PMCID: PMC10575791 DOI: 10.1038/s41380-023-01949-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
Cognitive deficits are a core feature of schizophrenia, account for much of the impaired functioning associated with the disorder and are not responsive to existing treatments. In this review, we first describe the clinical presentation and natural history of these deficits. We then consider aetiological factors, highlighting how a range of similar genetic and environmental factors are associated with both cognitive function and schizophrenia. We then review the pathophysiological mechanisms thought to underlie cognitive symptoms, including the role of dopamine, cholinergic signalling and the balance between GABAergic interneurons and glutamatergic pyramidal cells. Finally, we review the clinical management of cognitive impairments and candidate novel treatments.
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Affiliation(s)
- Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
- Oxford health NHS Foundation Trust, Oxford health NHS Foundation Trust, Oxford, UK.
| | - Richard S E Keefe
- Departments of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Philip K McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford health NHS Foundation Trust, Oxford health NHS Foundation Trust, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
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9
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Fitzallen GC, Taylor HG, Liley HG, Bora S. Within- and between-twin comparisons of risk for childhood behavioral difficulties after preterm birth. Pediatr Res 2023:10.1038/s41390-023-02579-1. [PMID: 37041209 DOI: 10.1038/s41390-023-02579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Preterm birth and multiple gestation are independently associated with adverse neurodevelopmental outcomes. The objective of this study was to describe risks of screening positive for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and anxiety in preterm-born twin children by zygosity (monozygotic, dizygotic) and birth order (first-born, second-born). METHODS Caregivers of 349 preterm-born twin pairs (42% monozygotic) aged 3-18 years reported child behavioral outcomes on Strengths and Weaknesses of ADHD Symptoms and Normal Behavior; Social Responsiveness Scale, Second Edition; and Preschool Anxiety Scale or Screen for Child Anxiety and Related Emotional Disorders. RESULTS Concordance for behavioral outcomes in twin pairs ranged from 80.06 to 89.31% for ADHD, 61.01 to 84.23% for ASD, and 64.76 to 73.35% for anxiety. Monozygotic twins had a greater risk than dizygotic of screening positive for inattention (risk ratio = 2.91, 95% CI = 1.48-5.72) and social anxiety (1.79, 1.23-2.61). Relative to first-born, second-born twins had a greater risk of screening positive for hyperactivity/impulsivity (1.51, 1.06-2.16); overall ASD (2.38, 1.62-3.49); difficulties with social awareness (2.68, 1.94-3.71), social cognition (4.45, 3.06-6.46), and social communication (2.36, 1.56-3.57); restricted/repetitive behavior (1.91, 1.30-2.81); overall anxiety (1.34, 1.10-1.64); generalized anxiety (1.34, 1.11-1.60); and social anxiety (1.32, 1.06-1.64). CONCLUSION The current findings emphasize considering zygosity and birth order in preterm and multiple birth outcomes research, and highlight clinical implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support. IMPACT Zygosity and birth order are important determinants of behavioral and socioemotional outcomes in preterm-born twins. Among 349 preterm-born twin pairs aged 3-18 years (42% monozygotic), 61-89% demonstrated concordance for behavioral and socioemotional outcomes. Monozygosity had greater risks than dizygosity for positive screening of inattention and social anxiety. Second-born twins had greater risks than first-born for hyperactivity/impulsivity, social difficulties (awareness, cognition, communication), restricted/repetitive behavior, and anxiety (generalized, social). These findings have implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support.
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Affiliation(s)
- Grace C Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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10
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Sánchez-Torres AM, Amoretti S, Enguita-Germán M, Mezquida G, Moreno-Izco L, Panadero-Gómez R, Rementería L, Toll A, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez Á, Usall J, Contreras F, Vieta E, López-Ilundain JM, Merchán-Naranjo J, González-Pinto A, Berrocoso E, Bernardo M, Cuesta MJ. Relapse, cognitive reserve, and their relationship with cognition in first episode schizophrenia: a 3-year follow-up study. Eur Neuropsychopharmacol 2023; 67:53-65. [PMID: 36495858 DOI: 10.1016/j.euroneuro.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Schizophrenia is frequently characterized by the presence of multiple relapses. Cognitive impairments are core features of schizophrenia. Cognitive reserve (CR) is the ability of the brain to compensate for damage caused by pathologies such as psychotic illness. As cognition is related to CR, the study of the relationship between relapse, cognition and CR may broaden our understanding of the course of the disease. We aimed to determine whether relapse was associated with cognitive impairment, controlling for the effects of CR. Ninety-nine patients with a remitted first episode of schizophrenia or schizophreniform disorder were administered a set of neuropsychological tests to assess premorbid IQ, attention, processing speed, working memory, verbal and visual memory, executive functions and social cognition. They were followed up for 3 years (n=53) or until they relapsed (n=46). Personal and familial CR was estimated from a principal component analysis of the premorbid information gathered. Linear mixed-effects models were applied to analyse the effect of time and relapse on cognitive function, with CR as covariate. Patients who relapsed and had higher personal CR showed less deterioration in attention, whereas those with higher CR (personal and familial CR) who did not relapse showed better performance in processing speed and visual memory. Taken together, CR seems to ameliorate the negative effects of relapse on attention performance and shows a positive effect on processing speed and visual memory in those patients who did not relapse. Our results add evidence for the protective effect of CR over the course of the illness.
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Affiliation(s)
- Ana M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mónica Enguita-Germán
- Navarra Institute of Health Research (IdiSNA), Pamplona, Spain; Unidad de Metodología. Navarrabiomed-CHN -UPNA. Pamplona
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Rocío Panadero-Gómez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Lide Rementería
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM)
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat
| | - Fernando Contreras
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatric Department. Bellvitge Universitary Hospital. IDIBELL
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jose M López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychology, University of Cadiz, Spain, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain.
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11
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Lemvigh CK, Glenthøj BY, Fagerlund B. A nation-wide twin study of social cognition in schizophrenia spectrum disorders. SCHIZOPHRENIA 2022; 8:12. [PMID: 35236855 PMCID: PMC8891357 DOI: 10.1038/s41537-022-00223-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022]
Abstract
We examined social cognition in 32 monozygotic (MZ) and 21 dizygotic (DZ) twin pairs concordant or discordant for a schizophrenia spectrum diagnosis and healthy control (HC) twin pairs (29 MZ/20 DZ). All participants were recruited through the Danish registers. Patients showed several deficits in the ability to detect sarcasm. Impairments were also observed in the unaffected MZ co-twins, indicating that social cognitive deficits could be a genetic vulnerability indicator of the disease. Worse social cognition was associated with lower intelligence and higher levels of psychopathology in patients.
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12
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A family-based study of genetic and epigenetic effects across multiple neurocognitive, motor, social-cognitive and social-behavioral functions. Behav Brain Funct 2022; 18:14. [PMID: 36457050 PMCID: PMC9714039 DOI: 10.1186/s12993-022-00198-0] [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: 02/24/2022] [Accepted: 09/09/2022] [Indexed: 12/03/2022] Open
Abstract
Many psychiatric and neurodevelopmental disorders are known to be heritable, but studies trying to elucidate the genetic architecture of such traits often lag behind studies of somatic traits and diseases. The reasons as to why relatively few genome-wide significant associations have been reported for such traits have to do with the sample sizes needed for the detection of small effects, the difficulty in defining and characterizing the phenotypes, partially due to overlaps in affected underlying domains (which is especially true for cognitive phenotypes), and the complex genetic architectures of the phenotypes, which are not wholly captured in traditional case-control GWAS designs. We aimed to tackle the last two issues by performing GWASs of eight quantitative neurocognitive, motor, social-cognitive and social-behavioral traits, which may be considered endophenotypes for a variety of psychiatric and neurodevelopmental conditions, and for which we employed models capturing both general genetic association and parent-of-origin effects, in a family-based sample comprising 402 children and their parents (mostly family trios). We identified 48 genome-wide significant associations across several traits, of which 3 also survived our strict study-wide quality criteria. We additionally performed a functional annotation of implicated genes, as most of the 48 associations were with variants within protein-coding genes. In total, our study highlighted associations with five genes (TGM3, CACNB4, ANKS1B, CSMD1 and SYNE1) associated with measures of working memory, processing speed and social behavior. Our results thus identify novel associations, including previously unreported parent-of-origin associations with relevant genes, and our top results illustrate new potential gene → endophenotype → disorder pathways.
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13
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Martinez ME, Stohn JP, Mutina EM, Whitten RJ, Hernandez A. Thyroid hormone elicits intergenerational epigenetic effects on adult social behavior and fetal brain expression of autism susceptibility genes. Front Neurosci 2022; 16:1055116. [PMID: 36419462 PMCID: PMC9676973 DOI: 10.3389/fnins.2022.1055116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
Genetic mutations identified in genome-wide association studies can only explain a small percentage of the cases of complex, highly heritable human conditions, including neurological and neurodevelopmental disorders. This suggests that intergenerational epigenetic effects, possibly triggered by environmental circumstances, may contribute to their etiology. We previously described altered DNA methylation signatures in the sperm of mice that experienced developmental overexposure to thyroid hormones as a result of a genetic defect in hormone clearance (DIO3 deficiency). Here we studied fetal brain gene expression and adult social behavior in genetically normal F2 generation descendants of overexposed mice. The brain of F2 generation E13.5 fetuses exhibited abnormal expression of genes associated with autism in humans, including Auts2, Disc1, Ldlr, Per2, Shank3, Oxtr, Igf1, Foxg1, Cd38, Grid2, Nrxn3, and Reln. These abnormal gene expression profiles differed depending on the sex of the exposed ancestor. In the three-chamber social box test, adult F2 generation males manifested significantly decreased interest in social interaction and social novelty, as revealed by decrease total time, distance traveled and time immobile in the area of interaction with novel strangers. F1 generation mice, compared to appropriate controls also exhibited altered profiles in fetal brain gene expression, although these profiles were substantially different to those in the F2 generation. Likewise adult F1 generation mice showed some abnormalities in social behavior that were sexually dimorphic and milder than those in F2 generation mice. Our results indicate that developmental overexposure to thyroid hormone causes intergenerational epigenetic effects impacting social behavior and the expression of autism-related genes during early brain development. Our results open the possibility that altered thyroid hormone states, by eliciting changes in the epigenetic information of the germ line, contribute to the susceptibility and the missing-but heriTables-etiology of complex neurodevelopmental conditions characterized by social deficits, including autism and schizophrenia.
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Affiliation(s)
- Maria Elena Martinez
- Center for Molecular Medicine, MaineHealth Institute for Research, MaineHealth, Scarborough, ME, United States
| | - Julia Patrizia Stohn
- Center for Molecular Medicine, MaineHealth Institute for Research, MaineHealth, Scarborough, ME, United States
| | - Elizabeth M. Mutina
- Center for Molecular Medicine, MaineHealth Institute for Research, MaineHealth, Scarborough, ME, United States
| | - Rayne J. Whitten
- Center for Molecular Medicine, MaineHealth Institute for Research, MaineHealth, Scarborough, ME, United States
| | - Arturo Hernandez
- Center for Molecular Medicine, MaineHealth Institute for Research, MaineHealth, Scarborough, ME, United States
- Graduate School for Biomedical Sciences and Engineering, University of Maine, Orono, ME, United States
- Department of Medicine, Tufts University School of Medicine, Boston, MA, United States
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14
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Berretz G, Packheiser J. Altered hemispheric asymmetries as an endophenotype in psychological and developmental disorders: A theory on the influence of stress on brain lateralization. Front Behav Neurosci 2022; 16:1054114. [PMID: 36408453 PMCID: PMC9672314 DOI: 10.3389/fnbeh.2022.1054114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 02/18/2024] Open
Affiliation(s)
- Gesa Berretz
- Department of Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Julian Packheiser
- Social Brain Lab, Netherlands Institute for Neuroscience, Amsterdam, Netherlands
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15
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Transmission of intelligence, working memory, and processing speed from parents to their seven-year-old offspring is function specific in families with schizophrenia or bipolar disorder. Schizophr Res 2022; 246:195-201. [PMID: 35802954 DOI: 10.1016/j.schres.2022.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 06/15/2022] [Accepted: 06/26/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Prior studies have shown high heritability estimates regarding within-function transmission of neurocognition, both in healthy families and in families with schizophrenia but it remains an open question whether transmission from parents to offspring is function specific and whether the pattern is the same in healthy families and families with schizophrenia or bipolar disorder. We aimed to characterize the transmission of intelligence, processing speed, and verbal working memory functions from both biological parents to their 7-year-old offspring in families with parental schizophrenia, bipolar disorder, and population-based control parents. METHODS The population-based cohort consists of 7-year-old children with one parent diagnosed with schizophrenia (n = 186), bipolar disorder (n = 114), and of parents without schizophrenia or bipolar disorder (n = 192). Children and both parents were assessed using identical, age-relevant neurocognitive tests of intelligence, verbal working memory, and processing speed. RESULTS In multiple regression analyses children's intelligence, verbal working memory, and processing speed scores were significantly associated with the corresponding parental cognitive function score. All associations from parents to offspring across functions were non-significant. No significant parental cognitive function by group interaction was observed. CONCLUSION Transmissions of intelligence, processing speed, and verbal working memory from parents to offspring are function specific. The structure of transmission is comparable between families with schizophrenia, families with bipolar disorder and families without these disorders.
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16
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Sun J, Wang W, Zhang R, Duan H, Tian X, Xu C, Li X, Zhang D. Multivariate genome-wide association study of depression, cognition, and memory phenotypes and validation analysis identify 12 cross-ethnic variants. Transl Psychiatry 2022; 12:304. [PMID: 35907915 PMCID: PMC9338946 DOI: 10.1038/s41398-022-02074-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
To date, little is known about the pleiotropic genetic variants among depression, cognition, and memory. The current research aimed to identify the potential pleiotropic single nucleotide polymorphisms (SNPs), genes, and pathways of the three phenotypes by conducting a multivariate genome-wide association study and an additional pleiotropy analysis among Chinese individuals and further validate the top variants in the UK Biobank (UKB). In the discovery phase, the participants were 139 pairs of dizygotic twins from the Qingdao Twins Registry. The genome-wide efficient mixed-model analysis identified 164 SNPs reaching suggestive significance (P < 1 × 10-5). Among them, rs3967317 (P = 1.21 × 10-8) exceeded the genome-wide significance level (P < 5 × 10-8) and was also demonstrated to be associated with depression and memory in pleiotropy analysis, followed by rs9863698, rs3967316, and rs9261381 (P = 7.80 × 10-8-5.68 × 10-7), which were associated with all three phenotypes. After imputation, a total of 457 SNPs reached suggestive significance. The top SNP chr6:24597173 was located in the KIAA0319 gene, which had biased expression in brain tissues. Genes and pathways related to metabolism, immunity, and neuronal systems demonstrated nominal significance (P < 0.05) in gene-based and pathway enrichment analyses. In the validation phase, 12 of the abovementioned SNPs reached the nominal significance level (P < 0.05) in the UKB. Among them, three SNPs were located in the KIAA0319 gene, and four SNPs were identified as significant expression quantitative trait loci in brain tissues. These findings may provide evidence for pleiotropic variants among depression, cognition, and memory and clues for further exploring the shared genetic pathogenesis of depression with Alzheimer's disease.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Ronghui Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Haiping Duan
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xiaocao Tian
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Chunsheng Xu
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China.
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17
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Lemvigh CK, Brouwer RM, Pantelis C, Jensen MH, Hilker RW, Legind CS, Anhøj SJ, Robbins TW, Sahakian BJ, Glenthøj BY, Fagerlund B. Heritability of specific cognitive functions and associations with schizophrenia spectrum disorders using CANTAB: a nation-wide twin study. Psychol Med 2022; 52:1101-1114. [PMID: 32779562 DOI: 10.1017/s0033291720002858] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many cognitive functions are under strong genetic control and twin studies have demonstrated genetic overlap between some aspects of cognition and schizophrenia. How the genetic relationship between specific cognitive functions and schizophrenia is influenced by IQ is currently unknown. METHODS We applied selected tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) to examine the heritability of specific cognitive functions and associations with schizophrenia liability. Verbal and performance IQ were estimated using The Wechsler Adult Intelligence Scale-III and the Danish Adult Reading Test. In total, 214 twins including monozygotic (MZ = 32) and dizygotic (DZ = 22) pairs concordant or discordant for a schizophrenia spectrum disorder, and healthy control pairs (MZ = 29, DZ = 20) were recruited through the Danish national registers. Additionally, eight twins from affected pairs participated without their sibling. RESULTS Significant heritability was observed for planning/spatial span (h2 = 25%), self-ordered spatial working memory (h2 = 64%), sustained attention (h2 = 56%), and movement time (h2 = 47%), whereas only unique environmental factors contributed to set-shifting, reflection impulsivity, and thinking time. Schizophrenia liability was associated with planning/spatial span (rph = -0.34), self-ordered spatial working memory (rph = -0.24), sustained attention (rph = -0.23), and set-shifting (rph = -0.21). The association with planning/spatial span was not driven by either performance or verbal IQ. The remaining associations were shared with performance, but not verbal IQ. CONCLUSIONS This study provides further evidence that some cognitive functions are heritable and associated with schizophrenia, suggesting a partially shared genetic etiology. These functions may constitute endophenotypes for the disorder and provide a basis to explore genes common to cognition and schizophrenia.
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Affiliation(s)
- Cecilie K Lemvigh
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rachel M Brouwer
- Department of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Christos Pantelis
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Maria H Jensen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark
| | - Rikke W Hilker
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian S Legind
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Mental Health Center North Zealand, Hilleroed, Denmark
| | - Simon J Anhøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychiatry Svendborg, Baagoes Alle 25, 5700 Svendborg, Denmark
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Birte Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
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18
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Tölli P, Keltikangas‐Järvinen L, Lehtimäki T, Ravaja N, Hintsanen M, Ahola‐Olli A, Pahkala K, Kähönen M, Hutri‐Kähönen N, Laitinen TT, Tossavainen P, Taittonen L, Dobewall H, Jokinen E, Raitakari O, Cloninger CR, Rovio S, Saarinen A. The relationship between temperament, polygenic score for intelligence and cognition: A population-based study of middle-aged adults. GENES, BRAIN, AND BEHAVIOR 2022; 21:e12798. [PMID: 35170850 PMCID: PMC9744494 DOI: 10.1111/gbb.12798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/30/2022]
Abstract
We investigated whether temperament modifies an association between polygenic intelligence potential and cognitive test performance in midlife. The participants (n = 1647, born between 1962 and 1977) were derived from the Young Finns Study. Temperament was assessed with Temperament and Character Inventory over a 15-year follow-up (1997, 2001, 2007, 2012). Polygenic intelligence potential was assessed with a polygenic score for intelligence. Cognitive performance (visual memory, reaction time, sustained attention, spatial working memory) was assessed with CANTAB in midlife. The PGSI was significantly associated with the overall cognitive performance and performance in visual memory, sustained attention and working memory tests but not reaction time test. Temperament did not correlate with polygenic score for intelligence and did not modify an association between the polygenic score and cognitive performance, either. High persistence was associated with higher visual memory (B = 0.092; FDR-adj. p = 0.007) and low harm avoidance with higher overall cognitive performance, specifically better reaction time (B = -0.102; FDR-adj; p = 0.007). The subscales of harm avoidance had different associations with cognitive performance: higher "anticipatory worry," higher "fatigability," and lower "shyness with strangers" were associated with lower cognitive performance, while the role of "fear of uncertainty" was subtest-related. In conclusion, temperament does not help or hinder one from realizing their genetic potential for intelligence. The overall modest relationships between temperament and cognitive performance advise caution if utilizing temperament-related information e.g. in working-life recruitments. Cognitive abilities may be influenced by temperament variables, such as the drive for achievement and anxiety about test performance, but they involve distinct systems of learning and memory.
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Affiliation(s)
- Pekka Tölli
- Department of Psychology and Logopedics, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Terho Lehtimäki
- Department of Clinical ChemistryFimlab Laboratories, and Finnish Cardiovascular Research CenterTampereFinland,Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Niklas Ravaja
- Department of Psychology and Logopedics, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Mirka Hintsanen
- Research Unit of Psychology, Faculty of EducationUniversity of OuluOuluFinland
| | - Ari Ahola‐Olli
- Department of Internal MedicineSatasairaala Central HospitalPoriFinland,Psychiatric and Neurodevelopmental Genetics UnitDepartment of Psychiatry, Massachusetts General HospitalBostonMassachusettsUSA,Institute for Molecular Medicine Finland (FIMM)University of HelsinkiHelsinkiFinland
| | - Katja Pahkala
- Research Centre for Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland,Sports Exercise Medicine Unit, Department of Physical Activity and HealthPaavo Nurmi CentreTurkuFinland
| | - Mika Kähönen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland,Department of Clinical PhysiologyTampere University HospitalTampereFinland
| | - Nina Hutri‐Kähönen
- Tampere Centre for Skills Training and SimulationTampere UniversityTampereFinland
| | - Tomi T. Laitinen
- Research Centre for Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland,Sports Exercise Medicine Unit, Department of Physical Activity and HealthPaavo Nurmi CentreTurkuFinland
| | - Päivi Tossavainen
- Department of Pediatrics and AdolescentsOulu University HospitalOuluFinland,PEDEGO Research Unit and Medical Research Center OuluUniversity of OuluOuluFinland
| | - Leena Taittonen
- Vaasa Central HospitalVaasaFinland,Department of PediatricsUniversity of OuluOuluFinland
| | - Henrik Dobewall
- Research Unit of Psychology, Faculty of EducationUniversity of OuluOuluFinland
| | - Eero Jokinen
- Department of PediatricsUniversity of HelsinkiHelsinkiFinland,Hospital for Children and AdolescentsHelsinki University HospitalHelsinkiFinland
| | - Olli Raitakari
- Department of Internal MedicineSatasairaala Central HospitalPoriFinland,Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland,Department of Clinical Physiology and Nuclear MedicineTurku University HospitalTurkuFinland
| | | | - Suvi Rovio
- Research Centre for Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
| | - Aino Saarinen
- Department of Psychology and Logopedics, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
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19
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Quinn PD, López Pérez D, Kennedy DP, Bölte S, D'Onofrio B, Lichtenstein P, Falck‐Ytter T. Visual search: Heritability and association with general intelligence. GENES, BRAIN, AND BEHAVIOR 2022; 21:e12779. [PMID: 35044053 PMCID: PMC9744476 DOI: 10.1111/gbb.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 10/01/2021] [Accepted: 11/09/2021] [Indexed: 02/03/2023]
Abstract
Visual search guides goal-directed action in humans and many other species, and it has been studied extensively in the past. Yet, no study has investigated the relative contributions of genes and environments to individual differences in visual search performance, or to which extent etiologies are shared with broader cognitive phenotypes. To address this gap, we studied visual search and general intelligence in 156 monozygotic (MZ) and 158 same-sex dizygotic (DZ) twin pairs. We found that different indexes of visual search performance (response latency and visual search efficiency) were moderately heritable. Phenotypic correlations between visual search and intelligence were small-to-moderate, and only a small proportion of the genetic variance in visual search was shared with genetic variance in intelligence. We discuss these findings in the context of the "generalist genes hypothesis" stating that different cognitive functions have a common genetic basis.
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Affiliation(s)
- Patrick D. Quinn
- Department of Applied Health Science, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - David López Pérez
- Neurocognitive Development UnitInstitute of Psychology, Polish Academy of SciencesWarsawPoland
| | - Daniel P. Kennedy
- Deparment of Psychological and Brain Sciences, Cognitive Science Program, Program in NeuroscienceIndiana UniversityBloomingtonIndianaUSA
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent PsychiatryStockholm Health Care Services, Region StockholmStockholmSweden,Curtin Autism Research Group, Curtin School of Allied HealthCurtin UniversityPerthWestern AustraliaAustralia
| | - Brian D'Onofrio
- Department of Applied Health Science, School of Public HealthIndiana UniversityBloomingtonIndianaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Terje Falck‐Ytter
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent PsychiatryStockholm Health Care Services, Region StockholmStockholmSweden,Development and Neurodiversity Lab, Department of PsychologyUppsala UniversityUppsalaSweden,Swedish Collegium for Advanced StudyUppsalaSweden
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20
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Tang R, Etzel JA, Kizhner A, Braver TS. Frontoparietal pattern similarity analyses of cognitive control in monozygotic twins. Neuroimage 2021; 241:118415. [PMID: 34298081 PMCID: PMC8958982 DOI: 10.1016/j.neuroimage.2021.118415] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
The ability to flexibly adapt thoughts and actions in a goal-directed manner appears to rely on cognitive control mechanisms that are strongly impacted by individual differences. A powerful research strategy for investigating the nature of individual variation is to study monozygotic (identical) twins. Evidence of twin effects have been observed in prior behavioral and neuroimaging studies, yet within the domain of cognitive control, it remains to be demonstrated that the neural underpinnings of such effects are specific and reliable. Here, we utilize a multi-task, within-subjects event-related neuroimaging design with functional magnetic resonance imaging to investigate twin effects through multivariate pattern similarity analyses. We focus on fronto-parietal brain regions exhibiting consistently increased activation associated with cognitive control demands across four task domains: selective attention, context processing, multi-tasking, and working memory. Healthy young adult monozygotic twin pairs exhibited increased similarity of within- and cross-task activation patterns in these fronto-parietal regions, relative to unrelated pairs. Twin activation pattern similarity effects were clearest under high control demands, were not present in a set of task-unrelated parcels or due to anatomic similarity, and were primarily observed during the within-trial timepoints in which the control demands peaked. Together, these results indicate that twin similarity in the neural representation of cognitive control may be domain-general but also functionally and temporally specific in relation to the level of control demand. The findings suggest a genetic and/or environmental basis for individual variation in cognitive control function, and highlight the potential of twin-based neuroimaging designs for exploring heritability questions within this domain.
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Affiliation(s)
- Rongxiang Tang
- Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Campus Box 1125, Saint Louis, Missouri 63130, USA.
| | - Joset A Etzel
- Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Campus Box 1125, Saint Louis, Missouri 63130, USA
| | - Alexander Kizhner
- Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Campus Box 1125, Saint Louis, Missouri 63130, USA
| | - Todd S Braver
- Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Campus Box 1125, Saint Louis, Missouri 63130, USA; Department of Radiology, Washington University in St. Louis, USA; Department of Neuroscience, Washington University in St. Louis, Saint Louis 63130, Missouri, USA
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21
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Genetic Overlap Profiles of Cognitive Ability in Psychotic and Affective Illnesses: A Multisite Study of Multiplex Pedigrees. Biol Psychiatry 2021; 90:373-384. [PMID: 33975707 PMCID: PMC8403107 DOI: 10.1016/j.biopsych.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/08/2021] [Accepted: 03/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cognitive impairment is a key feature of psychiatric illness, making cognition an important tool for exploring of the genetics of illness risk. It remains unclear which measures should be prioritized in pleiotropy-guided research. Here, we generate profiles of genetic overlap between psychotic and affective disorders and cognitive measures in Caucasian and Hispanic groups. METHODS Data were from 4 samples of extended pedigrees (N = 3046). Coefficient of relationship analyses were used to estimate genetic overlap between illness risk and cognitive ability. Results were meta-analyzed. RESULTS Psychosis was characterized by cognitive impairments on all measures with a generalized profile of genetic overlap. General cognitive ability shared greatest genetic overlap with psychosis risk (average endophenotype ranking value [ERV] across samples from a random-effects meta-analysis = 0.32), followed by verbal memory (ERV = 0.24), executive function (ERV = 0.22), and working memory (ERV = 0.21). For bipolar disorder, there was genetic overlap with processing speed (ERV = 0.05) and verbal memory (ERV = 0.11), but these were confined to select samples. Major depressive disorder was characterized by enhanced working and face memory performance, as reflected in significant genetic overlap in 2 samples. CONCLUSIONS There is substantial genetic overlap between risk for psychosis and a range of cognitive abilities (including general intelligence). Most of these effects are largely stable across of ascertainment strategy and ethnicity. Genetic overlap between affective disorders and cognition, on the other hand, tends to be specific to ascertainment strategy, ethnicity, and cognitive test battery.
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22
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West ML, Guest RM, Carmel A. Comorbid early psychosis and borderline personality disorder: Conceptualizing clinical overlap, etiology, and treatment. Personal Ment Health 2021; 15:208-222. [PMID: 33955194 DOI: 10.1002/pmh.1509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Despite substantial efforts aimed at the detection and intervention for early symptoms of mental illness, there is relatively limited research on the clinical overlap between borderline personality disorder (BPD) and early psychosis, for example, clinical high risk (CHR) for psychosis, in young people. We present a narrative review of the clinical overlap between BPD and psychosis spectrum symptoms. Both conditions have unstable temporal course, and both are marked by functional impairment, increased suicide risk, and higher rates of psychiatric inpatient services. We then review evidence-based treatments for psychosis and BPD, emphasizing treatments for early presentations of these symptoms and initial research considering treatments for the overlap. Psychotherapies with the strongest empirical support include cognitive behavioral models, with BPD showing limited response to adjunctive pharmacotherapy. We end by discussing specific recommendations for future research, including longitudinal studies to determine the predictors of the course of illness and the development of treatments to target comorbid BPD and CHR symptoms.
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Affiliation(s)
- Michelle L West
- CEDAR Clinic and Research Program, Massachusetts Mental Health Center, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, University of Colorado School of Medicine (CUSOM), Aurora, Colorado, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Adam Carmel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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23
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Burger TJ, Schirmbeck F, Vermeulen JM, Quee PJ, de Koning MB, Bruggeman R, de Haan L. Association between cognitive phenotype in unaffected siblings and prospective 3- and 6-year clinical outcome in their proband affected by psychosis. Psychol Med 2021; 51:1916-1926. [PMID: 32290874 DOI: 10.1017/s0033291720000719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. METHODS In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes ('normal', 'mixed' and 'impaired') in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. RESULTS Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. CONCLUSIONS Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.
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Affiliation(s)
- Thijs J Burger
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Piotr J Quee
- Department of Neurorehabilitation, Rijndam Revalidatie, Rotterdam, the Netherlands
| | - Mariken B de Koning
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Lieuwe de Haan
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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24
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Greve AN, Uher R, Als TD, Jepsen JRM, Mortensen EL, Gantriis DL, Ohland J, Burton BK, Ellersgaard D, Christiani CJ, Spang KS, Hemager N, Plessen KJ, Thorup AAE, Bliksted V, Nordentoft M, Mors O. A Nationwide Cohort Study of Nonrandom Mating in Schizophrenia and Bipolar Disorder. Schizophr Bull 2021; 47:1342-1350. [PMID: 33772315 PMCID: PMC8379547 DOI: 10.1093/schbul/sbab021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Nonrandom mating in parents with schizophrenia or bipolar disorder increases the population-level genetic variance among the offspring generation and creates familial (risk) environments likely to be shaped by specific conditions. The objective of this study was to investigate the occurrence of mental disorder and levels of cognitive and social functioning in individuals who have children by partners with schizophrenia or bipolar disorder compared to controls. The Danish High Risk and Resilience Study VIA 7 is a population-based cohort study conducted in Denmark between 2013 and 2016. This study focus on parents diagnosed with schizophrenia (n = 150) or bipolar disorder (n = 100) and control parents (n = 182), as well as their partners without schizophrenia or bipolar disorder (n = 440). We used linear mixed-effect models, and main outcomes were mental disorders, intelligence, processing speed, verbal working memory, and social functioning. We found that parents having children by a partner with schizophrenia or bipolar disorder more often fulfilled the criteria for a mental disorder and had poorer social functioning compared to parents having children by a partner without schizophrenia or bipolar disorder. Furthermore, parents having children by a partner with schizophrenia performed poorer on processing speed compared to parents in the control group. The presence of nonrandom mating found in this study has implications for our understanding of familial transmission of these disorders and our findings should be considered in future investigations of potential risk factors for children with a parent with schizophrenia or bipolar disorder.
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Affiliation(s)
- Aja Neergaard Greve
- Psychosis Research Unit, Aarhus University Hospital—Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,To whom correspondence should be addressed; tel: +45 6179 7035, e-mail:
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Halifax, NS, Canada
| | - Thomas Damm Als
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Department of Biomedicine, Aarhus University, Høegh-Guldbergs Gade 10, 8000 Aarhus C, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Ndr. Ringvej 29–67, 2600 Glostrup, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Oester Farimagsgade 5, 1014 Copenhagen K, Denmark
| | - Ditte Lou Gantriis
- Psychosis Research Unit, Aarhus University Hospital—Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark
| | - Ditte Ellersgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark
| | - Camilla Jerlang Christiani
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark
| | - Katrine S Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark
| | - Kerstin J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne, Switzerland
| | - Anne A E Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Gentofte Hospitalsvej nr 3A, 2900 Hellerup, Denmark
| | - Vibeke Bliksted
- Psychosis Research Unit, Aarhus University Hospital—Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark,Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, Building 15, 4th, 2900 Hellerup, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital—Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
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25
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Del Re EC, Stone WS, Bouix S, Seitz J, Zeng V, Guliano A, Somes N, Zhang T, Reid B, Lyall A, Lyons M, Li H, Whitfield-Gabrieli S, Keshavan M, Seidman LJ, McCarley RW, Wang J, Tang Y, Shenton ME, Niznikiewicz MA. Baseline Cortical Thickness Reductions in Clinical High Risk for Psychosis: Brain Regions Associated with Conversion to Psychosis Versus Non-Conversion as Assessed at One-Year Follow-Up in the Shanghai-At-Risk-for-Psychosis (SHARP) Study. Schizophr Bull 2021; 47:562-574. [PMID: 32926141 PMCID: PMC8480195 DOI: 10.1093/schbul/sbaa127] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess cortical thickness (CT) and surface area (SA) of frontal, temporal, and parietal brain regions in a large clinical high risk for psychosis (CHR) sample, and to identify cortical brain abnormalities in CHR who convert to psychosis and in the whole CHR sample, compared with the healthy controls (HC). METHODS Magnetic resonance imaging, clinical, and cognitive data were acquired at baseline in 92 HC, 130 non-converters, and 22 converters (conversion assessed at 1-year follow-up). CT and SA at baseline were calculated for frontal, temporal, and parietal subregions. Correlations between regions showing group differences and clinical scores and age were also obtained. RESULTS CT but not SA was significantly reduced in CHR compared with HC. Two patterns of findings emerged: (1) In converters, CT was significantly reduced relative to non-converters and controls in the banks of superior temporal sulcus, Heschl's gyrus, and pars triangularis and (2) CT in the inferior parietal and supramarginal gyrus, and at trend level in the pars opercularis, fusiform, and middle temporal gyri was significantly reduced in all high-risk individuals compared with HC. Additionally, reduced CT correlated significantly with older age in HC and in non-converters but not in converters. CONCLUSIONS These results show for the first time that fronto-temporo-parietal abnormalities characterized all CHR, that is, both converters and non-converters, relative to HC, while CT abnormalities in converters relative to CHR-NC and HC were found in core auditory and language processing regions.
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Affiliation(s)
- Elisabetta C Del Re
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Johanna Seitz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Anthony Guliano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Nathaniel Somes
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Benjamin Reid
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Monica Lyons
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Huijun Li
- Florida A&M University, Department of Psychology,
Tallahassee, FL
| | | | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Robert W McCarley
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
- Department of Radiology, Brigham and Women’s Hospital, and
Harvard Medical School, Boston, MA
- Research and Development, VA Boston Healthcare System,
Boston, MA
| | - Margaret A Niznikiewicz
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
- To whom correspondence should be addressed; e-mail:
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26
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Sreeraj VS, Holla B, Ithal D, Nadella RK, Mahadevan J, Balachander S, Ali F, Sheth S, Narayanaswamy JC, Venkatasubramanian G, John JP, Varghese M, Benegal V, Jain S, Reddy YJ, Viswanath B. Psychiatric symptoms and syndromes transcending diagnostic boundaries in Indian multiplex families: The cohort of ADBS study. Psychiatry Res 2021; 296:113647. [PMID: 33429328 DOI: 10.1016/j.psychres.2020.113647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023]
Abstract
Syndromes of schizophrenia, bipolar disorder, obsessive-compulsive disorder, substance use disorders and Alzheimer's dementia are highly heritable. About 10-20% of subjects have another affected first degree relative (FDR), and thus represent a 'greater' genetic susceptibility. We screened 3583 families to identify 481 families with multiple affected members, assessed 1406 individuals in person, and collected information systematically about other relatives. Within the selected families, a third of all FDRs were affected with serious mental illness. Although similar diagnoses aggregated within families, 62% of the families also had members with other syndromes. Moreover, 15% of affected individuals met criteria for co-occurrence of two or more syndromes, across their lifetime. Using dimensional assessments, we detected a range of symptom clusters in both affected and unaffected individuals, and across diagnostic categories. Our findings suggest that in multiplex families, there is considerable heterogeneity of clinical syndromes, as well as sub-threshold symptoms. These families would help provide an opportunity for further research using both genetic analyses and biomarkers.
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Affiliation(s)
- Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Dhruva Ithal
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Ravi Kumar Nadella
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Furkhan Ali
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Sweta Sheth
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - John P John
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Yc Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
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- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
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Genetic influence on cognitive development between childhood and adulthood. Mol Psychiatry 2021; 26:656-665. [PMID: 30644433 PMCID: PMC6570578 DOI: 10.1038/s41380-018-0277-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/15/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022]
Abstract
Successful cognitive development between childhood and adulthood has important consequences for future mental and physical wellbeing, as well as occupational and financial success. Therefore, delineating the genetic influences underlying changes in cognitive abilities during this developmental period will provide important insights into the biological mechanisms that govern both typical and atypical maturation. Using data from the Philadelphia Neurodevelopmental Cohort (PNC), a large population-based sample of individuals aged 8 to 21 years old (n = 6634), we used an empirical relatedness matrix to establish the heritability of general and specific cognitive functions and determine if genetic factors influence cognitive maturation (i.e., Gene × Age interactions) between childhood and early adulthood. We found that neurocognitive measures across childhood and early adulthood were significantly heritable. Moreover, genetic variance on general cognitive ability, or g, increased significantly between childhood and early adulthood. Finally, we did not find evidence for decay in genetic correlation on neurocognition throughout childhood and adulthood, suggesting that the same genetic factors underlie cognition at different ages throughout this developmental period. Establishing significant Gene × Age interactions in neurocognitive functions across childhood and early adulthood is a necessary first step in identifying genes that influence cognitive development, rather than genes that influence cognition per se. Moreover, since aberrant cognitive development confers risk for several psychiatric disorders, further examination of these Gene × Age interactions may provide important insights into their etiology.
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Soler J, Lera-Miguel S, Lázaro L, Calvo R, Ferentinos P, Fañanás L, Fatjó-Vilas M. Familial aggregation analysis of cognitive performance in early-onset bipolar disorder. Eur Child Adolesc Psychiatry 2020; 29:1705-1716. [PMID: 32052174 DOI: 10.1007/s00787-020-01486-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/27/2020] [Indexed: 01/03/2023]
Abstract
We analysed the familial aggregation (familiality) of cognitive dimensions and explored their role as liability markers for early-onset bipolar disorder (EOBD). The sample comprised 99 subjects from 26 families, each with an offspring diagnosed with EOBD. Four cognitive dimensions were assessed: reasoning skills; attention and working memory; memory; and executive functions. Their familiality was investigated in the total sample and in a subset of healthy relatives. The intra-family resemblance score (IRS), a family-based index of the similarity of cognitive performance among family members, was calculated. Familiality was detected for the attention and working memory (AW) dimension in the total sample (ICC = 0.37, p = 0.0004) and in the subsample of healthy relatives (ICC = 0.37, p = 0.016). The IRS reflected that there are families with similar AW mean scores (either high or low) and families with heterogeneous scores. Families with the most common background for the AW dimension (IRS > 0) were selected and dichotomized in two groups according to the mean family AW score. This allowed differentiating families whose members had similar high scores than those with similar low scores: both patients (t = - 4.82, p = 0.0005) and relatives (t = - 5.04, p < 0.0001) of the two groups differed in their AW scores. AW dimension showed familial aggregation, suggesting its putative role as a familial vulnerability marker for EOBD. The IRS estimation allowed the identification of families with homogeneous scores for this dimension. This represents a first step towards the investigation of the underlying mechanisms of AW dimension and the identification of etiological subgroups.
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Affiliation(s)
- Jordi Soler
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Lera-Miguel
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
- Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Rosa Calvo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Lourdes Fañanás
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Fatjó-Vilas
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain.
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
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29
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Jiang HY, Zhang X, Pan LY, Ma YC. Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis. Asian J Psychiatr 2020; 54:102275. [PMID: 32663796 DOI: 10.1016/j.ajp.2020.102275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The effects of childhood infection exposure on the risk of subsequent psychosis are unclear and no overview is available. We conducted a meta-analysis to assess the link between childhood infection and the risk of psychosis in later life. METHODS We performed systematic searches of the PubMed and Embase databases to identify relevant articles published up to March 1, 2020. Random-effects models were used to pool the odds ratios [OR] of childhood infection and later psychosis. RESULTS Thirteen observational studies (seven on hospital exposure to infection and six on central nervous system (CNS) infection) were included in the meta-analysis. Hospital contact with any infection during childhood was associated with an increased risk of psychosis (OR, 1.27; 95 % confidence interval (CI), 1.13-1.44; p < 0.001; I2 = 84 %) or schizophrenia (OR, 1.44; 95 % CI, 1.19-1.73; p < 0.001; I2 = 54.2 %) later in life. In further analysis, the association also existed for children exposed to CNS infection (OR, 1.68; 95 % CI, 1.08-2.62; p = 0.021; I2 = 68.7 %). However, the risk was modulated by the timing and frequency of infection. CONCLUSIONS Our results suggest an increased risk of psychosis later in life with infection exposure in childhood. However, non-causal explanations for the association cannot be ruled out.
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Affiliation(s)
- Hai-Yin Jiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Xue Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Li-Ya Pan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Yong-Chun Ma
- Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, China.
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Evermann U, Gaser C, Besteher B, Langbein K, Nenadić I. Cortical Gyrification, Psychotic-Like Experiences, and Cognitive Performance in Nonclinical Subjects. Schizophr Bull 2020; 46:1524-1534. [PMID: 32691058 PMCID: PMC7707080 DOI: 10.1093/schbul/sbaa068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Psychotic-like experiences (PLE) are present in nonclinical populations, yet their association with brain structural variation, especially markers of early neurodevelopment, is poorly understood. We tested the hypothesis that cortical surface gyrification, a putative marker of early brain development, is associated with PLE in healthy subjects. METHODS We analyzed gyrification from 3 Tesla MRI scans (using CAT12 software) and PLE (positive, negative, and depressive symptom dimensions derived from the Community Assessment of Psychic Experiences, CAPE) in 103 healthy participants (49 females, mean age 29.13 ± 9.37 years). A subsample of 63 individuals completed tasks from the Wechsler Adult Intelligence Scale and Controlled Oral Word Association Test. Estimated IQ and a composite neuropsychological score were used to explore mediation pathways via cognition. RESULTS Positive PLE distress was negatively associated with gyrification of the left precuneus. PLE depression dimension showed a negative association with gyrification in the right supramarginal and temporal region. There was no significant mediating effect of cognition on these associations. CONCLUSION Our results support a neurobiological psychosis spectrum, for the first time linking an early developmental imaging marker (rather than volume) to dimensional subclinical psychotic symptoms. While schizophrenia risk, neurodevelopment, and cognitive function might share genetic risk factors, additional mediation analyses did not confirm a mediating effect of cognition on the gyrification-psychopathology correlation.
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Affiliation(s)
- Ulrika Evermann
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
- Marburg University Hospital – UKGM, Marburg, Germany
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31
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Musket CW, Kuo SS, Rupert PE, Almasy L, Gur RC, Prasad K, Wood J, Roalf DR, Gur RE, Nimgaonkar VL, Pogue-Geile MF. Why does age of onset predict clinical severity in schizophrenia? A multiplex extended pedigree study. Am J Med Genet B Neuropsychiatr Genet 2020; 183:403-411. [PMID: 32812349 PMCID: PMC8728945 DOI: 10.1002/ajmg.b.32814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 05/30/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
Schizophrenia has substantial variation in symptom severity, course of illness, and overall functioning. Earlier age of onset (AOO) is consistently associated with negative outcomes and yet the causes of this association are still unknown. We used a multiplex, extended pedigree design (total N = 771; 636 relatives from 43 multigenerational families with at least 2 relatives diagnosed with schizophrenia and 135 matched controls) to examine among the schizophrenia relatives (N = 103) the relationship between AOO and negative and positive symptom severity, cognition, and community functioning. Most importantly, we assessed whether there are shared genetic effects between AOO and negative symptoms, positive symptoms, cognition, and community functioning. As expected, earlier AOO was significantly correlated with increased severity of negative and positive symptoms and poorer cognition and community functioning among schizophrenia patients. Notably, the genetic correlation between AOO of schizophrenia and negative symptoms was significant (Rg = -1.00, p = .007). Although the genetic correlations between AOO and positive symptoms, cognition, and community functioning were estimated at maximum and in the predicted direction, they were not statistically significant. AOO of schizophrenia itself was modestly heritable, although not significant and negative symptoms, positive symptoms, and cognition were all strongly and significantly heritable. In sum, we replicated prior findings indicating that earlier AOO is associated with increased symptom severity and extended the literature by detecting shared genetic effects between AOO and negative symptoms, suggestive of pleiotropy.
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Affiliation(s)
- Christie W. Musket
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Susan S. Kuo
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Petra E. Rupert
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C. Gur
- Neuropsychiatry Division, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Konasale Prasad
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David R. Roalf
- Neuropsychiatry Division, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E. Gur
- Neuropsychiatry Division, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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Dickerson F, Schroeder JR, Nimgaonkar V, Gold J, Yolken R. The association between exposure to herpes simplex virus type 1 (HSV-1) and cognitive functioning in schizophrenia: A meta-analysis. Psychiatry Res 2020; 291:113157. [PMID: 32593064 DOI: 10.1016/j.psychres.2020.113157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022]
Abstract
Cognitive deficits are characteristic of schizophrenia but their etiology is not understood. Previous studies show an association between viral exposures and cognitive impairment. This meta-analysis was undertaken to determine the relationship of herpes simplex virus type 1 (HSV-1) exposure and cognitive functioning in schizophrenia. A systematic search was performed for studies comparing the cognitive functioning of HSV-1 seropositive vs. seronegative persons with schizophrenia. The primary outcome was the standardized mean difference (SMD) in composite cognitive score using Hedges' g. Secondary outcomes were SMDs in 9cognitive domains. Study heterogeneity was estimated using the I2 index and formal tests of heterogeneity using Cochran's Q. In a sample of 3516 individuals from 9 studies the SMD was negative for the composite score and all 9 domains indicating a significant deficit for seropositive individuals in 8 domains. The SMDs ranged from -0.11 (Working Memory) to -0.36 (Visual Spatial). Cochran's Q test indicated heterogeneity for one domain. The I2 index of heterogeneity was in the low -moderate range for all but one domain. Exposure to HSV-1 is associated with decreased cognitive functioning in schizophrenia. An increased understanding of HSV-1 exposure might lead to improved methods for the prevention and treatment of cognitive deficits in schizophrenia.
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Affiliation(s)
- Faith Dickerson
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204.
| | | | - Viswajit Nimgaonkar
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St., Pittsburgh, PA 15213
| | - James Gold
- Maryland Psychiatric Research Center, 55 Wade Ave, Catonsville, MD 21228
| | - Robert Yolken
- Johns Hopkins School of Medicine, 600 North Wolfe St., Baltimore, MD 21287
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33
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Fatjó-Vilas M, Soler J, Ibáñez MI, Moya-Higueras J, Ortet G, Guardiola-Ripoll M, Fañanás L, Arias B. The effect of the AKT1 gene and cannabis use on cognitive performance in healthy subjects. J Psychopharmacol 2020; 34:990-998. [PMID: 32536252 DOI: 10.1177/0269881120928179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Evidence suggests that the AKT1 gene may modulate the degree to which cannabis use induces cognitive alterations in patients with a psychotic disorder. AIM To examine the interplay between AKT1 and cannabis use in terms of the cognitive performance of the general population. METHODS Our sample consisted of 389 Spanish university students. Sustained attention was measured via the Continuous Performance Test-Identical Pairs, immediate and delayed verbal memory with the Logical Memory subtest of the Wechsler Memory Scale, and working memory with the Wisconsin Card Sorting Test. Lifetime cannabis use frequency was assessed and individuals were classified as cannabis users or non-users. Two single nucleotide polymorphisms of the AKT1 gene were genotyped and, according to previous studies, each subject was defined as a carrier of two, one or no copies of the haplotype (rs2494732(C)-rs1130233(A)). Multiple linear regressions were conducted to test the effect of the genetic variability and cannabis use (and their interaction) on cognitive performance. RESULTS An effect of the AKT1 haplotype was found on attention scores: individuals with two copies of the haplotype performed better (β=0.18, p<0.001 (adjusted for false discovery rate)), while neither cannabis nor the AKT1-cannabis interaction was associated with attention. No effect of AKT1, cannabis or the AKT1-cannabis interaction was found on verbal memory or working memory. CONCLUSIONS Our study provides additional evidence that AKT1 modulates cognitive performance. However, in our non-clinical sample, the previously reported interaction between cannabis use and the AKT1 gene was not replicated.
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Affiliation(s)
- M Fatjó-Vilas
- FIDMAG Sisters Hospitallers Research Foundation, Barcelona, Spain.,Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Spain.,Biomedicine Institute of the University of Barcelona (IBUB), Spain.,Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - J Soler
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Spain.,Biomedicine Institute of the University of Barcelona (IBUB), Spain
| | - M I Ibáñez
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, University Jaume I, Castelló, Spain
| | - J Moya-Higueras
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
| | - G Ortet
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, University Jaume I, Castelló, Spain
| | - M Guardiola-Ripoll
- FIDMAG Sisters Hospitallers Research Foundation, Barcelona, Spain.,Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - L Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Spain.,Biomedicine Institute of the University of Barcelona (IBUB), Spain.,Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - B Arias
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Spain.,Biomedicine Institute of the University of Barcelona (IBUB), Spain.,Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Shared polygenic risk for ADHD, executive dysfunction and other psychiatric disorders. Transl Psychiatry 2020; 10:182. [PMID: 32518222 PMCID: PMC7283259 DOI: 10.1038/s41398-020-00872-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/15/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Many psychiatric disorders are associated with impaired executive functioning (EF). The associated EF component varies by psychiatric disorders, and this variation might be due to genetic liability. We explored the genetic association between five psychiatric disorders and EF in clinically-recruited attention deficit hyperactivity disorder (ADHD) children using polygenic risk score (PRS) methodology. Genome-wide association study (GWAS) summary data for ADHD, major depressive disorder (MDD), schizophrenia (SZ), bipolar disorder (BIP) and autism were used to calculate the PRSs. EF was evaluated by the Stroop test for inhibitory control, the trail-making test for cognitive flexibility, and the digital span test for working memory in a Chinese ADHD cohort (n = 1147). Exploratory factor analysis of the three measures identified one principal component for EF (EF-PC). Linear regression models were used to analyze the association between each PRS and the EF measures. The role of EF measures in mediating the effects of the PRSs on ADHD symptoms was also analyzed. The result showed the PRSs for MDD, ADHD and BIP were all significantly associated with the EF-PC. For each EF component, the association results were different for the PRSs of the five psychiatric disorders: the PRSs for ADHD and MDD were associated with inhibitory control (adjusted P = 0.0183 and 0.0313, respectively), the PRS for BIP was associated with working memory (adjusted P = 0.0416), and the PRS for SZ was associated with cognitive flexibility (adjusted P = 0.0335). All three EF measures were significantly correlated with ADHD symptoms. In mediation analyses, the ADHD and MDD PRSs, which were associated with inhibitory control, had significant indirect effects on ADHD symptoms through the mediation of inhibitory control. These findings indicate that the polygenic risks for several psychiatric disorders influence specific executive dysfunction in children with ADHD. The results helped to clarify the relationship between risk genes of each mental disorder and the intermediate cognitive domain, which may further help elucidate the risk genes and motivate efforts to develop EF measures as a diagnostic marker and future treatment target.
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35
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Mallet J, Le Strat Y, Dubertret C, Gorwood P. Polygenic Risk Scores Shed Light on the Relationship between Schizophrenia and Cognitive Functioning: Review and Meta-Analysis. J Clin Med 2020; 9:E341. [PMID: 31991840 PMCID: PMC7074036 DOI: 10.3390/jcm9020341] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/14/2020] [Accepted: 01/23/2020] [Indexed: 12/26/2022] Open
Abstract
Schizophrenia is a multifactorial disease associated with widespread cognitive impairment. Although cognitive deficits are one of the factors most strongly associated with functional impairment in schizophrenia (SZ), current treatment strategies hardly tackle these impairments. To develop more efficient treatment strategies in patients, a better understanding of their pathogenesis is needed. Recent progress in genetics, driven by large genome-wide association studies (GWAS) and the use of polygenic risk scores (PRS), has provided new insights about the genetic architecture of complex human traits, including cognition and SZ. Here, we review the recent findings examining the genetic links between SZ and cognitive functions in population-based samples as well as in participants with SZ. The performed meta-analysis showed a negative correlation between the polygenetic risk score of schizophrenia and global cognition (p < 0.001) when the samples rely on general and healthy participants, while no significant correlation was detected when the three studies devoted to schizophrenia patients were meta-analysed (p > 0.05). Our review and meta-analysis therefore argues against universal pleiotropy for schizophrenia alleles and cognition, since cognition in SZ patients would be underpinned by the same genetic factors than in the general population, and substantially independent of common variant liability to the disorder.
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Affiliation(s)
- Jasmina Mallet
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Yann Le Strat
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Caroline Dubertret
- APHP; Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; (Y.L.S.); (C.D.)
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Philip Gorwood
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, F-75014 Paris, France
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36
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Cook JR, Platek SM, Espinoza CN. Proposed symptom-based model of the origins of schizophrenia. Med Hypotheses 2019; 134:109428. [PMID: 31678901 DOI: 10.1016/j.mehy.2019.109428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
Schizophrenia is considered a severe mental illness and effects an estimated 1% of the world population. The evidence suggests that incidence rate has been and will continue to be stable over time. Here we adopt a symptomatology-focused evolutionary informed approach to discuss the possible biological adaptations of various presentations of schizophrenia. It is our contention that rather than thinking about schizophrenia as a single disorder, or even a spectrum of disorders, marked by social maladaptation and personal subjective distress, that an evolutionary interpretation based on adaptive nature of individual, or small clusters of, symptoms could prove to be more useful in better understanding the pathophysiology of schizophrenia and its relationship with other psychiatric diagnoses.
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37
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Christiani CJ, Jepsen JRM, Thorup A, Hemager N, Ellersgaard D, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve AN, Gantriis DL, Poulsen G, Uddin MJ, Seidman LJ, Mors O, Plessen KJ, Nordentoft M. Social Cognition, Language, and Social Behavior in 7-Year-Old Children at Familial High-Risk of Developing Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7-A Population-Based Cohort Study. Schizophr Bull 2019; 45:1218-1230. [PMID: 30852621 PMCID: PMC6811824 DOI: 10.1093/schbul/sbz001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To characterize social cognition, language, and social behavior as potentially shared vulnerability markers in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP). METHODS The Danish High-Risk and Resilience Study VIA7 is a multisite population-based cohort of 522 7-year-old children extracted from the Danish registries. The population-based controls were matched to the FHR-SZ children on age, sex, and municipality. The FHR-BP group followed same inclusion criteria. Data were collected blinded to familial high-risk status. Outcomes were social cognition, language, and social behavior. RESULTS The analysis included 202 FHR-SZ children (girls: 46%), 120 FHR-BP children (girls: 46.7%), and 200 controls (girls: 46.5%). FHR-SZ children displayed significant deficits in language (receptive: d = -0.27, P = .006; pragmatic: d = -0.51, P < .001), social responsiveness (d = -0.54, P < .001), and adaptive social functioning (d = -0.47, P < .001) compared to controls after Bonferroni correction. Compared to FHR-BP children, FHR-SZ children performed significantly poorer on adaptive social functioning (d = -0.29, P = .007) after Bonferroni correction. FHR-BP and FHR-SZ children showed no significant social cognitive impairments compared to controls after Bonferroni correction. CONCLUSION Language, social responsiveness, and adaptive social functioning deficits seem associated with FHR-SZ but not FHR-BP in this developmental phase. The pattern of results suggests adaptive social functioning impairments may not be shared between FHR-BP and FHR-SZ in this developmental phase and thus not reflective of the shared risk factors for schizophrenia and bipolar disorder.
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Affiliation(s)
- Camilla Jerlang Christiani
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,To whom correspondence should be addressed; Mental Health Centre Copenhagen, Research Unit, The Danish High Risk and Resilience Study VIA 7; Kildegaardsvej 28, 15., 1., 2900 Hellerup, Denmark; tel: +4520220285; e-mail:
| | - Jens R M Jepsen
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Thorup
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Nicoline Hemager
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ditte Ellersgaard
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Katrine S Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Birgitte K Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Maja Gregersen
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Anne Søndergaard
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Aja N Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte L Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Gry Poulsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Md Jamal Uddin
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,Services of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Merete Nordentoft
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Cognitive impairment in patients with treatment resistant schizophrenia: Associations with DRD2, DRD3, HTR2A, BDNF and CYP2D6 genetic polymorphisms. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.npbr.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Luperdi SC, Tabarés-Seisdedos R, Livianos L, Vieta E, Cuesta MJ, Balanzá-Martínez V. Neurocognitive endophenotypes in schizophrenia and bipolar disorder: A systematic review of longitudinal family studies. Schizophr Res 2019; 210:21-29. [PMID: 31272906 DOI: 10.1016/j.schres.2019.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/16/2019] [Accepted: 06/17/2019] [Indexed: 01/28/2023]
Abstract
Although there is substantial evidence supporting the existence of neurocognitive impairment in patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD), few studies have explored the field from an endophenotypic perspective. The present systematic review sought to identify longitudinal family studies exploring suitable neurocognitive endophenotypes in unaffected relatives of patients with SZ and/or BD. Following the PRISMA statement, only five follow-up studies met the inclusion criteria, comprising 79 SZ patients, 159 SZ unaffected relatives of SZ, 131 BD patients, 77 unaffected relatives of BD, and 248 controls. Verbal memory, auditory attention, face memory and emotion processing were found as putative endophenotypic candidates for SZ, whereas this strategy identified none for BD. Substantial heterogeneity and lack of standardization in global neurocognitive assessment within this area should be pointed out; nevertheless, several candidate endophenotypes were identified for SZ, except for executive impairment.
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Affiliation(s)
- Sussy C Luperdi
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; PhD Program in Medicine. University of Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Public Health (CIBERESP-Grupo 17), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Vicent Balanzá-Martínez
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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40
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Chu AOK, Chang WC, Chan SKW, Lee EHM, Hui CLM, Chen EYH. Comparison of cognitive functions between first-episode schizophrenia patients, their unaffected siblings and individuals at clinical high-risk for psychosis. Psychol Med 2019; 49:1929-1936. [PMID: 30226125 DOI: 10.1017/s0033291718002726] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia and has been observed in both familial (FHR) and clinical high-risk (CHR) samples. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in these two high-risk states and first-episode schizophrenia. This study aimed to compare cognitive functions in patients with first-episode schizophrenia-spectrum disorder (FES), their unaffected siblings (FHR), CHR individuals and healthy controls. METHOD A standardized battery of cognitive assessments was administered to 69 FES patients, 71 help-seeking CHR individuals without family history of psychotic disorder, 50 FHR participants and 68 controls. FES and CHR participants were recruited from territory-wide early intervention service for psychosis in Hong Kong. CHR status was ascertained using Comprehensive Assessment of At-Risk Mental State. RESULTS Among four groups, FES patients displayed the largest global cognitive impairment and had medium-to-large deficits across all cognitive tests relative to controls. CHR and FHR participants significantly underperformed in most cognitive tests than controls. Among various cognitive tests, digit symbol coding demonstrated the greatest magnitude of impairment in FES and CHR groups compared with controls. No significant difference between two high-risk groups was observed in global cognition and all individual cognitive tests except digit symbol coding which showed greater deficits in CHR than in FHR participants. CONCLUSION Clinical and familial risk groups experienced largely comparable cognitive impairment that was intermediate between FES and controls. Digit symbol coding may have the greatest discriminant capacity in distinguishing FES and CHR from healthy controls, and between two high-risk samples.
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41
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Cortisol stress response in psychosis from the high-risk to the chronic stage: a systematic review. Ir J Psychol Med 2019; 36:305-315. [PMID: 31317845 DOI: 10.1017/ipm.2019.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We review studies of whether cortisol levels following psychosocial stress exposure differ between patients with psychosis and healthy control subjects. METHODS Original research published between 1993 and February 2019 was included in the literature search. Studies that used experimentally induced psychosocial stress and reported stress response measures of plasma or saliva cortisol levels in patients at any stage of illness (i.e. high risk, first episode and chronic phase) were included. RESULTS A total of 17 studies were included. Although there was evidence of inconsistencies in measures, we observed moderate evidence of an association with stress-induced cortisol blunting response across studies. CONCLUSIONS This review highlights recent evidence of blunting of cortisol response following experimentally induced psychosocial stress. While there was some evidence of this blunted response across illness types and stages, the strongest evidence was observed for those with chronic schizophrenia. Due to the low number of studies, in particular in bipolar disorder, much work is still needed to accurately characterise the biological effects of stress in psychosis.
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42
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Taporoski TP, Duarte NE, Pompéia S, Sterr A, Gómez LM, Alvim RO, Horimoto ARVR, Krieger JE, Vallada H, Pereira AC, von Schantz M, Negrão AB. Heritability of semantic verbal fluency task using time-interval analysis. PLoS One 2019; 14:e0217814. [PMID: 31185027 PMCID: PMC6559646 DOI: 10.1371/journal.pone.0217814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/20/2019] [Indexed: 01/27/2023] Open
Abstract
Individual variability in word generation is a product of genetic and environmental influences. The genetic effects on semantic verbal fluency were estimated in 1,735 participants from the Brazilian Baependi Heart Study. The numbers of exemplars produced in 60 s were broken down into time quartiles because of the involvement of different cognitive processes—predominantly automatic at the beginning, controlled/executive at the end. Heritability in the unadjusted model for the 60-s measure was 0.32. The best-fit model contained age, sex, years of schooling, and time of day as covariates, giving a heritability of 0.21. Schooling had the highest moderating effect. The highest heritability (0.17) was observed in the first quartile, decreasing to 0.09, 0.12, and 0.0003 in the following ones. Heritability for average production starting point (intercept) was 0.18, indicating genetic influences for automatic cognitive processes. Production decay (slope), indicative of controlled processes, was not significant. The genetic influence on different quartiles of the semantic verbal fluency test could potentially be exploited in clinical practice and genome-wide association studies.
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Affiliation(s)
- T. P. Taporoski
- Institute of Psychiatry (LIM-23), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - N. E. Duarte
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Departmento de Matemáticas, Universidad Nacional de Colombia, Manizales, Colombia
| | - S. Pompéia
- Department of Psychobiology, Universidade Federal de São Paulo–Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - A. Sterr
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - L. M. Gómez
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - R. O. Alvim
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - A. R. V. R. Horimoto
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - J. E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - H. Vallada
- Institute of Psychiatry (LIM-23), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - A. C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - M. von Schantz
- Institute of Psychiatry (LIM-23), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
- * E-mail:
| | - A. B. Negrão
- Institute of Psychiatry (LIM-23), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
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43
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Kaskie RE, Graziano B, Ferrarelli F. Topographic deficits in sleep spindle density and duration point to frontal thalamo-cortical dysfunctions in first-episode psychosis. J Psychiatr Res 2019; 113:39-44. [PMID: 30878791 DOI: 10.1016/j.jpsychires.2019.03.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
Sleep spindles are NREM sleep EEG oscillations, which are initiated within the thalamus and are regulated by thalamo-cortical circuits. Previous work from our and other research groups has shown marked spindle deficits in patients with schizophrenia (SCZ). However, the presence of spindle impairments at illness onset, including which parameters are most affected, their topographic characteristics, and their relationships with clinical symptoms have yet to be characterized. In this study we performed sleep high density (hd)-EEG recordings in twenty-seven first-episode psychosis (FEP) patients and twenty-three healthy controls (HC). Several spindle parameters-amplitude, duration, and density-were calculated and compared across groups. FEP patients showed reduced spindle duration and density, but not in spindle amplitude relative to HC. These spindles reductions were localized in a frontal area and predicted the severity of FEP patients' negative symptoms. Altogether, these findings indicate that spindle deficits are present at the beginning of psychosis, contribute to clinical symptomatology, and point to frontal thalamo-cortical dysfunctions, thus providing a potential treatment target for early interventions in SCZ and related psychotic disorders.
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Konishi J, Del Re EC, Bouix S, Blokland GAM, Mesholam-Gately R, Woodberry K, Niznikiewicz M, Goldstein J, Hirayasu Y, Petryshen TL, Seidman LJ, Shenton ME, McCarley RW. Abnormal relationships between local and global brain measures in subjects at clinical high risk for psychosis: a pilot study. Brain Imaging Behav 2019; 12:974-988. [PMID: 28815390 DOI: 10.1007/s11682-017-9758-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We examined whether abnormal volumes of several brain regions as well as their mutual associations that have been observed in patients with schizophrenia, are also present in individuals at clinical high-risk (CHR) for developing psychosis. 3T magnetic resonance imaging was acquired in 19 CHR and 20 age- and handedness-matched controls. Volumes were measured for the body and temporal horns of the lateral ventricles, hippocampus and amygdala as well as total brain, cortical gray matter, white matter, and subcortical gray matter volumes. Relationships between volumes as well as correlations between volumes and cognitive and clinical measures were explored. Ratios of lateral ventricular volume to total brain volume and temporal horn volume to total brain volume were calculated. Volumetric abnormalities were lateralized to the left hemisphere. Volumes of the left temporal horn, and marginally, of the body of the left lateral ventricle were larger, while left amygdala but not hippocampal volume was significantly smaller in CHR participants compared to controls. Total brain volume was also significantly smaller and the ratio of the temporal horn/total brain volume was significantly higher in CHR than in controls. White matter volume correlated positively with higher verbal fluency score while temporal horn volume correlated positively with a greater number of perseverative errors. Together with the finding of larger temporal horns and smaller amygdala volumes in the left hemisphere, these results indicate that the ratio of temporal horns volume to brain volume is abnormal in CHR compared to controls. These abnormalities present in CHR individuals may constitute the biological basis for at least some of the CHR syndrome.
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Affiliation(s)
- Jun Konishi
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, and Harvard Medical School, Boston, MA, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Elisabetta C Del Re
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, and Harvard Medical School, Boston, MA, USA. .,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Gabriëlla A M Blokland
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | - Kristen Woodberry
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | - Margaret Niznikiewicz
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, and Harvard Medical School, Boston, MA, USA
| | - Jill Goldstein
- Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology, Boston, MA, USA.,Health and Gender Biology, Boston, MA, USA.,Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA
| | - Yoshio Hirayasu
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Research and Development, VA Boston Healthcare System, Boston, MA, USA
| | - Robert W McCarley
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, and Harvard Medical School, Boston, MA, USA
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Dauvermann MR, Donohoe G. The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder - A systematic review. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 16:1-11. [PMID: 30581765 PMCID: PMC6293032 DOI: 10.1016/j.scog.2018.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/09/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022]
Abstract
Childhood trauma (CT) has repeatedly been associated with cognitive deficits in patients with psychosis but many inconsistencies have been reported so that the nature of the relationship remains unclear. The purpose of this review was to better characterize the contribution of CT to cognitive deficits by considering the type, severity and frequency of childhood traumatic events and their relationships with psychosis at all stages. Relevant studies were identified via electronic and manual literature searches and included original studies that investigated the relationship between CT and higher cognitive performance or social cognitive performance in patients with schizophrenia, bipolar disorder and psychosis at all stages of the illness stages (i.e. ultra-high risk, first episode or chronic phase). Overall, a majority of studies reported that patients who experienced CT displayed deficits in general cognitive ability compared to patients with psychosis without such a history. Associations between CT and other cognitive function were more mixed. When comparing patient groups, the association between CT and cognitive function was more inconsistent in patients with chronic schizophrenia than in healthy participants, ultra-high risk individuals, first-episode patients and patients with chronic bipolar disorder. In understanding the variability in the reported relationships between CT and cognition across study populations, we highlight the variety of questionnaires used and discuss the likelihood of there being differences in cognitive function based on specific stressors, severity and frequency. Finally, we consider future research steps that may shed light on psychobiological mechanisms underlying CT and cognitive performance in patients with psychosis.
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Nakahara S, Medland S, Turner JA, Calhoun VD, Lim KO, Mueller BA, Bustillo JR, O’Leary DS, Vaidya JG, McEwen S, Voyvodic J, Belger A, Mathalon DH, Ford JM, Guffanti G, Macciardi F, Potkin SG, van Erp TG. Polygenic risk score, genome-wide association, and gene set analyses of cognitive domain deficits in schizophrenia. Schizophr Res 2018; 201:393-399. [PMID: 29907492 PMCID: PMC6252137 DOI: 10.1016/j.schres.2018.05.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/25/2018] [Accepted: 05/27/2018] [Indexed: 12/12/2022]
Abstract
This study assessed genetic contributions to six cognitive domains, identified by the MATRICS Cognitive Consensus Battery as relevant for schizophrenia, cognition-enhancing, clinical trials. Psychiatric Genomics Consortium Schizophrenia polygenic risk scores showed significant negative correlations with each cognitive domain. Genome-wide association analyses identified loci associated with attention/vigilance (rs830786 within HNF4G), verbal memory (rs67017972 near NDUFS4), and reasoning/problem solving (rs76872642 within HDAC9). Gene set analysis identified unique and shared genes across cognitive domains. These findings suggest involvement of common and unique mechanisms across cognitive domains and may contribute to the discovery of new therapeutic targets to treat cognitive deficits in schizophrenia.
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Affiliation(s)
- Soichiro Nakahara
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92617, United States,Unit 2, Candidate Discovery Science Labs, Drug Discovery Research, Astellas Pharma Inc, 21, Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Sarah Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston QLD 4006, Australia
| | - Jessica A. Turner
- Departments of Psychology and Neuroscience, Georgia State University, Atlanta, GA, USA,Mind Research Network, Albuquerque, NM, 87106, United States
| | - Vince D. Calhoun
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM,Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM, 87131, United States,Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55454, United States
| | - Kelvin O. Lim
- Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM, 87131, United States
| | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55454, United States
| | - Juan R. Bustillo
- Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM, 87131, United States
| | - Daniel S. O’Leary
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242, USA
| | - Jatin G. Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242, USA
| | - Sarah McEwen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, 92093, United States
| | - James Voyvodic
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, United States
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, United States
| | - Daniel H. Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, 94143, United States, and Veterans Affairs San Francisco Healthcare System, San Francisco, CA, 94121, United States
| | - Judith M. Ford
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, 94143, United States, and Veterans Affairs San Francisco Healthcare System, San Francisco, CA, 94121, United States,San Francisco VA Medical Center, San Francisco, CA 94121
| | - Guia Guffanti
- Department of Psychiatry at Harvard Medical School and Computational Genomics Lab at McLean Hospital, Boston, United States
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92617, United States
| | - Steven G. Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92617, United States
| | - Theo G.M. van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92617, United States,Corresponding Author: Theo G.M. van Erp, Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, 5251 California Avenue, Suite 240, Irvine, CA 92617, voice: (949) 824-3331, fax: (949) 924-3324,
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Yamamoto M, Kushima I, Suzuki R, Branko A, Kawano N, Inada T, Iidaka T, Ozaki N. Aberrant functional connectivity between the thalamus and visual cortex is related to attentional impairment in schizophrenia. Psychiatry Res Neuroimaging 2018; 278:35-41. [PMID: 29981940 DOI: 10.1016/j.pscychresns.2018.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/20/2022]
Abstract
Resting-state (rs) functional magnetic resonance imaging (fMRI) studies have revealed dysfunctional thalamocortical functional connectivity (FC) in schizophrenia. However, the relationship between thalamocortical FC and cognitive impairment has not been thoroughly investigated. We hypothesized that aberrant thalamocortical FC is related to attention deficits in schizophrenia. Thirty-eight patients with schizophrenia and 38 matched healthy controls underwent rs-fMRI and task fMRI while performing a Flanker task. We observed decreased left thalamic activation in patients with schizophrenia using task fMRI to determine the thalamic seed. A seed-based analysis using this seed was performed in the whole brain to assess differences in thalamocortical FC between the groups. Significantly worse performance was observed in the patient group. The rs-fMRI analysis revealed significantly increased FC between the left thalamus seed and the occipital cortices/postcentral gyri in patients when compared to controls. In the patient group, significant positive correlations were observed between the degree of FC from the left thalamus to the bilateral occipital gyri, which correspond to the visual cortex, and the Flanker effect. No significant correlation was detected in the control group. These results indicate that aberrant FC between the left thalamus and the visual cortex is related to attention deficits in schizophrenia.
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Affiliation(s)
- Maeri Yamamoto
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan
| | - Itaru Kushima
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan; Institute for Advanced Research, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, Japan
| | - Ryohei Suzuki
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan
| | - Aleksic Branko
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan
| | - Naoko Kawano
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan; Institutes of Innovation for Future Society, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, Japan
| | - Toshiya Inada
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan
| | - Tetsuya Iidaka
- Department of Physical and Occupational Therapy, Nagoya University, Graduate School of Medicine, 1-1-20, Daiko-minami, Higashi, Nagoya, Aichi 461-8673, Japan.
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan
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48
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Hemager N, Plessen KJ, Thorup A, Christiani C, Ellersgaard D, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve AN, Gantriis DL, Poulsen G, Seidman LJ, Mors O, Nordentoft M, Jepsen JRM. Assessment of Neurocognitive Functions in 7-Year-Old Children at Familial High Risk for Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7. JAMA Psychiatry 2018; 75:844-852. [PMID: 29926086 PMCID: PMC6143091 DOI: 10.1001/jamapsychiatry.2018.1415] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
IMPORTANCE Children at familial high risk of schizophrenia spectrum disorders (FHR-SZ) or bipolar disorder (FHR-BP) exhibit neurocognitive impairments. Large studies of neurocognition in young children at familial high risk at the same age are important to differentiate the pathophysiology and developmental trajectory of these 2 groups. OBJECTIVE To characterize neurocognitive functions in 7-year-old children with FHR-SZ or FHR-BP and a control population. DESIGN, SETTING, AND PARTICIPANTS This multisite population-based cohort study collected data from January 1, 2013, to January 31, 2016, in the first wave of the Danish High Risk and Resilience Study VIA 7 at 2 university hospital research sites in Copenhagen and Aarhus using Danish registries. Participants (n = 514) included 197 children with FHR-SZ, 118 with FHR-BP, and 199 controls matched with the FHR-SZ group for age, sex, and municipality. Assessors were blinded to risk status. EXPOSURES Parents with schizophrenia, bipolar disorder, or neither diagnosis. MAIN OUTCOMES AND MEASURES Neurocognitive functions were measured across 23 tests. Four neurocognitive domains were derived by principal component analysis, including processing speed and working memory, verbal functions, executive and visuospatial functions, and declarative memory and attention. RESULTS A total of 514 children aged 7 years were included in the analysis (46.3% girls), consisting of 197 children with FHR-SZ (46.2% girls), 118 with FHR-BP (46.6% girls), and 199 controls (46.2% girls). Children with FHR-SZ were significantly impaired compared with controls on processing speed and working memory (Cohen d = 0.50; P < .001), executive and visuospatial functions (Cohen d = 0.28; P = .03), and declarative memory and attention (Cohen d = 0.29; P = .02). Compared with children with FHR-BP, children with FHR-SZ performed significantly poorer in processing speed and working memory (Cohen d = 0.40; P = .002), executive and visuospatial functions (Cohen d = 0.35; P = .008), and declarative memory and attention (Cohen d = 0.31; P = .03). Children with FHR-BP and controls did not differ. CONCLUSIONS AND RELEVANCE Children with FHR-SZ had widespread neurocognitive impairments, supporting the hypothesis of neurocognitive functions as endophenotypes of schizophrenia. The absence of neurocognitive deficits in children with FHR-BP suggests distinct neurodevelopmental manifestations in these familial high-risk groups at this age. Early detection of children with FHR-SZ and cognitive impairments is warranted to investigate associations of neurocognition with transition to psychosis, add to the knowledge of their developmental pathophysiology, and inform early intervention programs.
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Affiliation(s)
- Nicoline Hemager
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Kerstin J. Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Anne Thorup
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Camilla Christiani
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Ditte Ellersgaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Anne Søndergaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Gry Poulsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Larry J. Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Center for Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen
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49
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Mucci A, Galderisi S, Green MF, Nuechterlein K, Rucci P, Gibertoni D, Rossi A, Rocca P, Bertolino A, Bucci P, Hellemann G, Spisto M, Palumbo D, Aguglia E, Amodeo G, Amore M, Bellomo A, Brugnoli R, Carpiniello B, Dell'Osso L, Di Fabio F, di Giannantonio M, Di Lorenzo G, Marchesi C, Monteleone P, Montemagni C, Oldani L, Romano R, Roncone R, Stratta P, Tenconi E, Vita A, Zeppegno P, Maj M. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives. Psychol Med 2018; 48:1359-1366. [PMID: 29017620 DOI: 10.1017/s0033291717002902] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative-control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands' scores. METHODS Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands' MCCB scores predicted REL neurocognitive performance. RESULTS SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. CONCLUSIONS In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.
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Affiliation(s)
- A Mucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - S Galderisi
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - M F Green
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - K Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Rocca
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - P Bucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - G Hellemann
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - M Spisto
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - D Palumbo
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine,Psychiatry Unit,University of Catania,Catania,Italy
| | - G Amodeo
- Department of Molecular Medicine and Clinical Department of Mental Health,University of Siena,Siena,Italy
| | - M Amore
- Department of Neurosciences,Rehabilitation,Ophthalmology,Genetics and Maternal and Child Health,Section of Psychiatry,University of Genoa,Genoa,Italy
| | - A Bellomo
- Department of Medical Sciences,Psychiatry Unit,University of Foggia,Foggia,Italy
| | - R Brugnoli
- Department of Neurosciences,Mental Health and Sensory Organs,S. Andrea Hospital,Sapienza University of Rome,Rome,Italy
| | - B Carpiniello
- Department of Public Health,Clinical and Molecular Medicine,Section of Psychiatry,University of Cagliari,Cagliari,Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine,Section of Psychiatry,University of Pisa,Pisa,Italy
| | - F Di Fabio
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M di Giannantonio
- Department of Neuroscience and Imaging,Chair of Psychiatry,G. d'Annunzio University,Chieti,Italy
| | - G Di Lorenzo
- Department of Systems Medicine,Chair of Psychiatry,Tor Vergata University of Rome,Rome,Italy
| | - C Marchesi
- Department of Neuroscience,Psychiatry Unit,University of Parma,Parma,Italy
| | - P Monteleone
- Department of Medicine and Surgery,Chair of Psychiatry,University of Salerno,Salerno,Italy
| | - C Montemagni
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - L Oldani
- Department of Psychiatry,University of Milan,Milan,Italy
| | - R Romano
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - R Roncone
- Department of Life,Health and Environmental Sciences,Unit of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Stratta
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - E Tenconi
- Psychiatric Clinic,Department of Neurosciences,University of Padua,Padua,Italy
| | - A Vita
- Department of Mental Health,Psychiatric Unit,School of Medicine,University of Brescia,Spedali Civili Hospital,Brescia,Italy
| | - P Zeppegno
- Department of Translational Medicine,Psychiatric Unit,University of Eastern Piedmont,Novara,Italy
| | - M Maj
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
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50
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Blokland GAM, del Re EC, Mesholam-Gately RI, Jovicich J, Trampush JW, Keshavan MS, DeLisi LE, Walters JTR, Turner JA, Malhotra AK, Lencz T, Shenton ME, Voineskos AN, Rujescu D, Giegling I, Kahn RS, Roffman JL, Holt DJ, Ehrlich S, Kikinis Z, Dazzan P, Murray RM, Di Forti M, Lee J, Sim K, Lam M, Wolthusen RPF, de Zwarte SMC, Walton E, Cosgrove D, Kelly S, Maleki N, Osiecki L, Picchioni MM, Bramon E, Russo M, David AS, Mondelli V, Reinders AATS, Falcone MA, Hartmann AM, Konte B, Morris DW, Gill M, Corvin AP, Cahn W, Ho NF, Liu JJ, Keefe RSE, Gollub RL, Manoach DS, Calhoun VD, Schulz SC, Sponheim SR, Goff DC, Buka SL, Cherkerzian S, Thermenos HW, Kubicki M, Nestor PG, Dickie EW, Vassos E, Ciufolini S, Marques TR, Crossley NA, Purcell SM, Smoller JW, van Haren NEM, Toulopoulou T, Donohoe G, Goldstein JM, Seidman LJ, McCarley RW, Petryshen TL. The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) consortium: A collaborative cognitive and neuroimaging genetics project. Schizophr Res 2018; 195:306-317. [PMID: 28982554 PMCID: PMC5882601 DOI: 10.1016/j.schres.2017.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/15/2017] [Accepted: 09/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Schizophrenia has a large genetic component, and the pathways from genes to illness manifestation are beginning to be identified. The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) Consortium aims to clarify the role of genetic variation in brain abnormalities underlying schizophrenia. This article describes the GENUS Consortium sample collection. METHODS We identified existing samples collected for schizophrenia studies consisting of patients, controls, and/or individuals at familial high-risk (FHR) for schizophrenia. Samples had single nucleotide polymorphism (SNP) array data or genomic DNA, clinical and demographic data, and neuropsychological and/or brain magnetic resonance imaging (MRI) data. Data were subjected to quality control procedures at a central site. RESULTS Sixteen research groups contributed data from 5199 psychosis patients, 4877 controls, and 725 FHR individuals. All participants have relevant demographic data and all patients have relevant clinical data. The sex ratio is 56.5% male and 43.5% female. Significant differences exist between diagnostic groups for premorbid and current IQ (both p<1×10-10). Data from a diversity of neuropsychological tests are available for 92% of participants, and 30% have structural MRI scans (half also have diffusion-weighted MRI scans). SNP data are available for 76% of participants. The ancestry composition is 70% European, 20% East Asian, 7% African, and 3% other. CONCLUSIONS The Consortium is investigating the genetic contribution to brain phenotypes in a schizophrenia sample collection of >10,000 participants. The breadth of data across clinical, genetic, neuropsychological, and MRI modalities provides an important opportunity for elucidating the genetic basis of neural processes underlying schizophrenia.
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Affiliation(s)
- Gabriëlla A. M. Blokland
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
| | - Elisabetta C. del Re
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Jorge Jovicich
- Center for Mind/Brain Sciences (CiMEC), University of Trento,
Trento, Italy
| | - Joey W. Trampush
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States,BrainWorkup, LLC, Los Angeles, CA, United States
| | - Matcheri S. Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States,University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
| | - Lynn E. DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States
| | - James T. R. Walters
- Department of Psychological Medicine, Cardiff University, Cardiff,
United Kingdom
| | - Jessica A. Turner
- The Mind Research Network, Albuquerque, NM, United States,Department of Psychology and Neuroscience Institute, Georgia State
University, GA, United States
| | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States
| | - Todd Lencz
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States
| | - Martha E. Shenton
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital,
Harvard Medical School, Boston, MA, United States
| | - Aristotle N. Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Research
Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and
Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada,Department of Psychiatry and Institute of Medical Science,
University of Toronto, Toronto, ON, Canada
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany,Department of Psychiatry, Ludwig Maximilians University, Munich,
Germany
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - René S. Kahn
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Daphne J. Holt
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Stefan Ehrlich
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States,Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Zora Kikinis
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States
| | - Paola Dazzan
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Robin M. Murray
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Marta Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Jimmy Lee
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Kang Sim
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Max Lam
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Rick P. F. Wolthusen
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States,Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Sonja M. C. de Zwarte
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Esther Walton
- Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Donna Cosgrove
- The Cognitive Genetics and Cognitive Therapy Group, Department of
Psychology, National University of Ireland, Galway, Ireland
| | - Sinead Kelly
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Laboratory of NeuroImaging, Keck School of Medicine, University of
Southern California, Los Angeles, CA, United States
| | - Nasim Maleki
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Marco M. Picchioni
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Elvira Bramon
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom,Mental Health Neuroscience Research Department, UCL Division of
Psychiatry, University College London, United Kingdom
| | - Manuela Russo
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Anthony S. David
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Antje A. T. S. Reinders
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - M. Aurora Falcone
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Annette M. Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - Bettina Konte
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - Derek W. Morris
- Cognitive Genetics and Cognitive Therapy Group, Neuroimaging and
Cognitive Genomics (NICOG) Centre and NCBES Galway Neuroscience Centre, School of
Psychology and Discipline of Biochemistry, National University of Ireland, Galway,
Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Aiden P. Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Wiepke Cahn
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - New Fei Ho
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | | | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, United States
| | - Randy L. Gollub
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Dara S. Manoach
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Vince D. Calhoun
- The Mind Research Network, Albuquerque, NM, United States,Department of Electrical and Computer Engineering, University of
New Mexico, Albuquerque, NM, United States
| | - S. Charles Schulz
- Department of Psychiatry, University of Minnesota, Minneapolis, MN,
United States
| | - Scott R. Sponheim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN,
United States
| | - Donald C. Goff
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Nathan S. Kline Institute for Psychiatric Research, Department of
Psychiatry, New York University Langone Medical Center, New York, NY, United
States
| | - Stephen L. Buka
- Department of Epidemiology, Brown University, Providence, RI,
United States
| | - Sara Cherkerzian
- Department of Medicine, Division of Women’s Health, Brigham
and Women’s Hospital, Harvard Medical School, Boston, MA, United
States
| | - Heidi W. Thermenos
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Marek Kubicki
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital,
Harvard Medical School, Boston, MA, United States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Paul G. Nestor
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Laboratory of Applied Neuropsychology, University of Massachusetts,
Boston, MA, United States
| | - Erin W. Dickie
- Kimel Family Translational Imaging Genetics Laboratory, Research
Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and
Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
| | - Evangelos Vassos
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Simone Ciufolini
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Tiago Reis Marques
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Nicolas A. Crossley
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Shaun M. Purcell
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States,Department of Psychiatry, Brigham and Women’s Hospital,
Boston, MA, United States,Division of Psychiatric Genomics, Departments of Psychiatry and
Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York,
NY, United States
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
| | - Neeltje E. M. van Haren
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Timothea Toulopoulou
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,Department of Psychology, Bilkent University, Bilkent, Ankara,
Turkey,Department of Psychology, The University of Hong Kong, Pokfulam,
Hong Kong, SAR, China
| | - Gary Donohoe
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Cognitive Genetics and Cognitive Therapy Group, Neuroimaging and
Cognitive Genomics (NICOG) Centre and NCBES Galway Neuroscience Centre, School of
Psychology and Discipline of Biochemistry, National University of Ireland, Galway,
Ireland
| | - Jill M. Goldstein
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Medicine, Division of Women’s Health, Brigham
and Women’s Hospital, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Brigham and Women’s Hospital,
Boston, MA, United States
| | - Larry J. Seidman
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Robert W. McCarley
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States
| | - Tracey L. Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
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