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Ernst J, Ehrenreich H, Weissenborn K, Grosse GM. Unraveling Mechanisms of Cryptogenic Stroke at the Genetic Level: A Systematic Literature Review. J Am Heart Assoc 2023; 12:e029843. [PMID: 37489722 PMCID: PMC10492995 DOI: 10.1161/jaha.123.029843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023]
Abstract
Background A substantial proportion of ischemic strokes remain cryptogenic, which has important implications for secondary prevention. Identifying genetic variants related to mechanisms of stroke causes may provide a chance to clarify the actual causes of cryptogenic strokes. Methods and Results In a 2-step process, 2 investigators independently and systematically screened studies that reported genetic variants in regard to stroke causes that were published between January 1991 and April 2021. Studies on monogenetic disorders, investigation of vascular risk factors as the primary end point, reviews, meta-analyses, and studies not written in English were excluded. We extracted information on study types, ancestries, corresponding single nucleotide polymorphisms, and sample and effect sizes. There were 937 studies screened, and 233 were eligible. We identified 35 single nucleotide polymorphisms and allele variants that were associated with an overlap between cryptogenic strokes and another defined cause. Conclusions Associations of single variants with an overlap between cryptogenic stroke and another defined cause were limited to a few polymorphisms. A limitation of all studies is a low granularity of clinical data, which is of major importance in a complex disease such as stroke. Deep phenotyping is in supposed contradiction with large sample sizes but needed for genome-wide analyses. Future studies should attempt to address this restriction to advance the promising approach of elucidating the cause of stroke at the genetic level. Especially in a highly heterogenous disease such as ischemic stroke, genetics are promising to establish a personalized approach in diagnostics and treatment in the sense of precision medicine.
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Affiliation(s)
- Johanna Ernst
- Department of NeurologyHannover Medical SchoolHannoverGermany
| | - Hannelore Ehrenreich
- Clinical NeuroscienceMax Planck Institute for Multidisciplinary SciencesGöttingenGermany
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2
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Xavier RM, Dungan JR, Keefe RS, Vorderstrasse A. Polygenic signal for symptom dimensions and cognitive performance in patients with chronic schizophrenia. Schizophr Res Cogn 2018; 12:11-19. [PMID: 29552508 PMCID: PMC5852279 DOI: 10.1016/j.scog.2018.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 01/13/2018] [Accepted: 01/18/2018] [Indexed: 01/04/2023]
Abstract
Genetic etiology of psychopathology symptoms and cognitive performance in schizophrenia is supported by candidate gene and polygenic risk score (PRS) association studies. Such associations are reported to be dependent on several factors - sample characteristics, illness phase, illness severity etc. We aimed to examine if schizophrenia PRS predicted psychopathology symptoms and cognitive performance in patients with chronic schizophrenia. We also examined if schizophrenia associated autosomal loci were associated with specific symptoms or cognitive domains. Case-only analysis using data from the Clinical Antipsychotics Trials of Intervention Effectiveness-Schizophrenia trials (n = 730). PRS was constructed using Psychiatric Genomics Consortium (PGC) leave one out genome wide association analysis as the discovery data set. For candidate region analysis, we selected 105-schizophrenia associated autosomal loci from the PGC study. We found a significant effect of PRS on positive symptoms at p-threshold (PT ) of 0.5 (R2 = 0.007, p = 0.029, empirical p = 0.029) and negative symptoms at PT of 1e-07 (R2 = 0.005, p = 0.047, empirical p = 0.048). For models that additionally controlled for neurocognition, best fit PRS predicted positive (p-threshold 0.01, R2 = 0.007, p = 0.013, empirical p = 0.167) and negative symptoms (p-threshold 0.1, R2 = 0.012, p = 0.004, empirical p = 0.329). No associations were seen for overall neurocognitive and social cognitive performance tests. Post-hoc analyses revealed that PRS predicted working memory and vigilance performance but did not survive correction. No candidate regions that survived multiple testing corrections were associated with either symptoms or cognitive performance. Our findings point to potentially distinct pathogenic mechanisms for schizophrenia symptoms.
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Affiliation(s)
- Rose Mary Xavier
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 1034 Gates Pavilion, HUP, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | | | - Richard S.E. Keefe
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States
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3
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Leonenko G, Di Florio A, Allardyce J, Forty L, Knott S, Jones L, Gordon‐Smith K, Owen MJ, Jones I, Walters J, Craddock N, O'Donovan MC, Escott‐Price V. A data-driven investigation of relationships between bipolar psychotic symptoms and schizophrenia genome-wide significant genetic loci. Am J Med Genet B Neuropsychiatr Genet 2018; 177:468-475. [PMID: 29671935 PMCID: PMC6001555 DOI: 10.1002/ajmg.b.32635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/16/2018] [Accepted: 03/27/2018] [Indexed: 11/11/2022]
Abstract
The etiologies of bipolar disorder (BD) and schizophrenia include a large number of common risk alleles, many of which are shared across the disorders. BD is clinically heterogeneous and it has been postulated that the pattern of symptoms is in part determined by the particular risk alleles carried, and in particular, that risk alleles also confer liability to schizophrenia influence psychotic symptoms in those with BD. To investigate links between psychotic symptoms in BD and schizophrenia risk alleles we employed a data-driven approach in a genotyped and deeply phenotyped sample of subjects with BD. We used sparse canonical correlation analysis (sCCA) (Witten, Tibshirani, & Hastie, ) to analyze 30 psychotic symptoms, assessed with the OPerational CRITeria checklist, and 82 independent genome-wide significant single nucleotide polymorphisms (SNPs) identified by the Schizophrenia Working group of the Psychiatric Genomics Consortium for which we had data in our BD sample (3,903 subjects). As a secondary analysis, we applied sCCA to larger groups of SNPs, and also to groups of symptoms defined according to a published factor analyses of schizophrenia. sCCA analysis based on individual psychotic symptoms revealed a significant association (p = .033), with the largest weights attributed to a variant on chromosome 3 (rs11411529), chr3:180594593, build 37) and delusions of influence, bizarre behavior and grandiose delusions. sCCA analysis using the same set of SNPs supported association with the same SNP and the group of symptoms defined "factor 3" (p = .012). A significant association was also observed to the "factor 3" phenotype group when we included a greater number of SNPs that were less stringently associated with schizophrenia; although other SNPs contributed to the significant multivariate association result, the greatest weight remained assigned to rs11411529. Our results suggest that the canonical correlation is a useful tool to explore phenotype-genotype relationships. To the best of our knowledge, this is the first study to apply this approach to complex, polygenic psychiatric traits. The sparse canonical correlation approach offers the potential to include a larger number of fine-grained systematic descriptors, and to include genetic markers associated with other disorders that are genetically correlated with BD.
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Affiliation(s)
- Ganna Leonenko
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Arianna Di Florio
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Judith Allardyce
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Liz Forty
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Sarah Knott
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Lisa Jones
- Department of Psychological MedicineUniversity of WorcesterWorcesterUnited Kingdom
| | | | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Ian Jones
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Michael C. O'Donovan
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
| | - Valentina Escott‐Price
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff University Institute of Psychological Medicine and Clinical NeurosciencesCardiffUnited Kingdom
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4
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OTTO: a new strategy to extract mental disease-relevant combinations of GWAS hits from individuals. Mol Psychiatry 2018; 23:476-486. [PMID: 27922606 PMCID: PMC5794905 DOI: 10.1038/mp.2016.208] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 09/08/2016] [Accepted: 10/07/2016] [Indexed: 12/27/2022]
Abstract
Despite high heritability of schizophrenia, genome-wide association studies (GWAS) have not yet revealed distinct combinations of single-nucleotide polymorphisms (SNPs), relevant for mental disease-related, quantifiable behavioral phenotypes. Here we propose an individual-based model to use genome-wide significant markers for extracting first genetic signatures of such behavioral continua. 'OTTO' (old Germanic=heritage) marks an individual characterized by a prominent phenotype and a particular load of phenotype-associated risk SNPs derived from GWAS that likely contributed to the development of his personal mental illness. This load of risk SNPs is shared by a small squad of 'similars' scattered under the genetically and phenotypically extremely heterogeneous umbrella of a schizophrenia end point diagnosis and to a variable degree also by healthy subjects. In a discovery sample of >1000 deeply phenotyped schizophrenia patients and several independent replication samples, including the general population, a gradual increase in the severity of 'OTTO's phenotype' expression is observed with an increasing share of 'OTTO's risk SNPs', as exemplified here by autistic and affective phenotypes. These data suggest a model in which the genetic contribution to dimensional behavioral traits can be extracted from combinations of GWAS SNPs derived from individuals with prominent phenotypes. Even though still in the 'model phase' owing to a world-wide lack of sufficiently powered, deeply phenotyped replication samples, the OTTO approach constitutes a conceptually novel strategy to delineate biological subcategories of mental diseases starting from GWAS findings and individual subjects.
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5
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Mitjans M, Begemann M, Ju A, Dere E, Wüstefeld L, Hofer S, Hassouna I, Balkenhol J, Oliveira B, van der Auwera S, Tammer R, Hammerschmidt K, Völzke H, Homuth G, Cecconi F, Chowdhury K, Grabe H, Frahm J, Boretius S, Dandekar T, Ehrenreich H. Sexual dimorphism of AMBRA1-related autistic features in human and mouse. Transl Psychiatry 2017; 7:e1247. [PMID: 28994820 PMCID: PMC5682605 DOI: 10.1038/tp.2017.213] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/01/2017] [Accepted: 08/17/2017] [Indexed: 12/18/2022] Open
Abstract
Ambra1 is linked to autophagy and neurodevelopment. Heterozygous Ambra1 deficiency induces autism-like behavior in a sexually dimorphic manner. Extraordinarily, autistic features are seen in female mice only, combined with stronger Ambra1 protein reduction in brain compared to males. However, significance of AMBRA1 for autistic phenotypes in humans and, apart from behavior, for other autism-typical features, namely early brain enlargement or increased seizure propensity, has remained unexplored. Here we show in two independent human samples that a single normal AMBRA1 genotype, the intronic SNP rs3802890-AA, is associated with autistic features in women, who also display lower AMBRA1 mRNA expression in peripheral blood mononuclear cells relative to female GG carriers. Located within a non-coding RNA, likely relevant for mRNA and protein interaction, rs3802890 (A versus G allele) may affect its stability through modification of folding, as predicted by in silico analysis. Searching for further autism-relevant characteristics in Ambra1+/- mice, we observe reduced interest of female but not male mutants regarding pheromone signals of the respective other gender in the social intellicage set-up. Moreover, altered pentylentetrazol-induced seizure propensity, an in vivo readout of neuronal excitation-inhibition dysbalance, becomes obvious exclusively in female mutants. Magnetic resonance imaging reveals mild prepubertal brain enlargement in both genders, uncoupling enhanced brain dimensions from the primarily female expression of all other autistic phenotypes investigated here. These data support a role of AMBRA1/Ambra1 partial loss-of-function genotypes for female autistic traits. Moreover, they suggest Ambra1 heterozygous mice as a novel multifaceted and construct-valid genetic mouse model for female autism.
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Affiliation(s)
- M Mitjans
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - M Begemann
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany,Department of Psychiatry and Psychotherapy, UMG, Georg-August-University, Göttingen, Germany
| | - A Ju
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - E Dere
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - L Wüstefeld
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - S Hofer
- Biomedizinische NMR Forschungs GmbH, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - I Hassouna
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - J Balkenhol
- Department of Bioinformatics, Biocenter, University of Würzburg, Würzburg, Germany
| | - B Oliveira
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - S van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine, and German Center for Neurodegenerative Diseases (DZNE) Greifswald, Greifswald, Germany
| | - R Tammer
- Biomedizinische NMR Forschungs GmbH, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - K Hammerschmidt
- Cognitive Ethology Laboratory, German Primate Center, Göttingen, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - G Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - F Cecconi
- IRCCS Fondazione Santa Lucia and Department of Biology, University of Rome Tor Vergata, Rome, Italy,Unit of Cell Stress and Survival, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Chowdhury
- Department of Molecular Cell Biology, Max Planck Institute of Biophysical Chemistry, Göttingen, Germany
| | - H Grabe
- Department of Psychiatry and Psychotherapy, University Medicine, and German Center for Neurodegenerative Diseases (DZNE) Greifswald, Greifswald, Germany
| | - J Frahm
- Biomedizinische NMR Forschungs GmbH, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - S Boretius
- Department of Functional Imaging, German Primate Center, Leibniz Institute of Primate Research, Göttingen, Germany
| | - T Dandekar
- Department of Bioinformatics, Biocenter, University of Würzburg, Würzburg, Germany
| | - H Ehrenreich
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany,Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str. 3, Göttingen 37075, Germany. E-mail:
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Abstract
The development of drugs to treat psychosis is a fascinating nexus for understanding mechanisms underlying disorders of mind and movement. Although the risk of drug-induced extrapyramidal syndromes has been mitigated by the acceptance of less potent dopamine antagonists, expansive marketing and off-label use has increased the number of susceptible people who may be at risk for these neurologic effects. Clinicians need to be familiar with advances in diagnosis and management, which are reviewed herein. A better understanding of drug-induced effects on the motor circuit may improve patient safety, enhance antipsychotic effectiveness, and provide insights into mechanisms underlying antipsychotic activity in parallel brain circuits.
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Affiliation(s)
- Stanley N Caroff
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 300 Blockley Hall, Philadelphia, PA 19104, USA.
| | - E Cabrina Campbell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center-116A, University & Woodland Avenues, Philadelphia, PA 19104, USA
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8
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Stepniak B, Kästner A, Poggi G, Mitjans M, Begemann M, Hartmann A, Van der Auwera S, Sananbenesi F, Krueger-Burg D, Matuszko G, Brosi C, Homuth G, Völzke H, Benseler F, Bagni C, Fischer U, Dityatev A, Grabe HJ, Rujescu D, Fischer A, Ehrenreich H. Accumulated common variants in the broader fragile X gene family modulate autistic phenotypes. EMBO Mol Med 2016; 7:1565-79. [PMID: 26612855 PMCID: PMC4693501 DOI: 10.15252/emmm.201505696] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Fragile X syndrome (FXS) is mostly caused by a CGG triplet expansion in the fragile X mental retardation 1 gene (FMR1). Up to 60% of affected males fulfill criteria for autism spectrum disorder (ASD), making FXS the most frequent monogenetic cause of syndromic ASD. It is unknown, however, whether normal variants (independent of mutations) in the fragile X gene family (FMR1, FXR1, FXR2) and in FMR2 modulate autistic features. Here, we report an accumulation model of 8 SNPs in these genes, associated with autistic traits in a discovery sample of male patients with schizophrenia (N = 692) and three independent replicate samples: patients with schizophrenia (N = 626), patients with other psychiatric diagnoses (N = 111) and a general population sample (N = 2005). For first mechanistic insight, we contrasted microRNA expression in peripheral blood mononuclear cells of selected extreme group subjects with high‐ versus low‐risk constellation regarding the accumulation model. Thereby, the brain‐expressed miR‐181 species emerged as potential “umbrella regulator”, with several seed matches across the fragile X gene family and FMR2. To conclude, normal variation in these genes contributes to the continuum of autistic phenotypes.
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Affiliation(s)
- Beata Stepniak
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Anne Kästner
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - Giulia Poggi
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Marina Mitjans
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Annette Hartmann
- Department of Psychiatry and Psychotherapy, University of Halle, Halle, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Farahnaz Sananbenesi
- Epigenetics in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Dilja Krueger-Burg
- Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Gabriela Matuszko
- Molecular Neuroplasticity, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Cornelia Brosi
- Department of Biochemistry, University of Würzburg, Würzburg, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Fritz Benseler
- Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Claudia Bagni
- KU Leuven, Center for Human Genetics and Leuven Institute for Neurodegenerative Diseases, Leuven, Belgium Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Utz Fischer
- Department of Biochemistry, University of Würzburg, Würzburg, Germany
| | - Alexander Dityatev
- Molecular Neuroplasticity, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, University of Halle, Halle, Germany
| | - Andre Fischer
- Epigenetics in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany Department of Psychiatry & Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
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Abstract
IBS is the most prevalent functional gastrointestinal disorder and phenotypically characterized by chronic abdominal discomfort, pain and altered defecation patterns. The pathophysiology of IBS is multifactorial, albeit with a substantial genetic component. To date, studies using various methodologies, ranging from family and twin studies to candidate gene approaches and genome-wide association studies, have identified several genetic variants in the context of IBS. Yet, despite enlarged sample sizes, increased statistical power and meta-analyses in the past 7 years, positive associations are still scarce and/or have not been reproduced. In addition, epigenetic and pharmacogenetic approaches remain in their infancy. A major hurdle is the lack of large homogenized case-control cohorts recruited according to standardized and harmonized criteria. The COST Action BM1106 GENIEUR (GENes in Irritable Bowel Syndrome Research Network EURope) has been established to address these obstacles. In this Review, the (epi)genetic working group of GENIEUR reports on the current state-of-the-art in the field, highlights fundamental flaws and pitfalls in current IBS (epi)genetic research and provides a vision on how to address and improve (epi)genetic approaches in this complex disorder in the future.
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Kästner A, Begemann M, Michel TM, Everts S, Stepniak B, Bach C, Poustka L, Becker J, Banaschewski T, Dose M, Ehrenreich H. Autism beyond diagnostic categories: characterization of autistic phenotypes in schizophrenia. BMC Psychiatry 2015; 15:115. [PMID: 25968177 PMCID: PMC4436160 DOI: 10.1186/s12888-015-0494-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/29/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Behavioral phenotypical continua from health to disease suggest common underlying mechanisms with quantitative rather than qualitative differences. Until recently, autism spectrum disorders and schizophrenia were considered distinct nosologic entities. However, emerging evidence contributes to the blurring of symptomatic and genetic boundaries between these conditions. The present study aimed at quantifying behavioral phenotypes shared by autism spectrum disorders and schizophrenia to prepare the ground for biological pathway analyses. METHODS Specific items of the Positive and Negative Syndrome Scale were employed and summed up to form a dimensional autism severity score (PAUSS). The score was created in a schizophrenia sample (N = 1156) and validated in adult high-functioning autism spectrum disorder (ASD) patients (N = 165). To this end, the Autism Diagnostic Observation Schedule (ADOS), the Autism (AQ) and Empathy Quotient (EQ) self-rating questionnaires were applied back to back with the newly developed PAUSS. RESULTS PAUSS differentiated between ASD, schizophrenia and a disease-control sample and substantially correlated with the Autism Diagnostic Observation Schedule. Patients with ADOS scores ≥12 obtained highest, those with scores <7 lowest PAUSS values. AQ and EQ were not found to vary dependent on ADOS diagnosis. ROC curves for ADOS and PAUSS resulted in AuC values of 0.9 and 0.8, whereas AQ and EQ performed at chance level in the prediction of ASD. CONCLUSIONS This work underscores the convergence of schizophrenia negative symptoms and autistic phenotypes. PAUSS evolved as a measure capturing the continuous nature of autistic behaviors. The definition of extreme-groups based on the dimensional PAUSS may permit future investigations of genetic constellations modulating autistic phenotypes.
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Affiliation(s)
- Anne Kästner
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany. .,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.
| | - Tanja Maria Michel
- Department of Psychiatry, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Sarah Everts
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Beata Stepniak
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Christiane Bach
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Joachim Becker
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany.
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
| | - Matthias Dose
- kbo-Isar-Amper-Klinikum Taufkirchen, Taufkirchen (Vils), Germany.
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075, Göttingen, Germany. .,DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.
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12
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Pouget JG, Gonçalves VF, Nurmi EL, P Laughlin C, Mallya KS, McCracken JT, Aman MG, McDougle CJ, Scahill L, Misener VL, Tiwari AK, Zai CC, Brandl EJ, Felsky D, Leung AQ, Lieberman JA, Meltzer HY, Potkin SG, Niedling C, Steimer W, Leucht S, Knight J, Müller DJ, Kennedy JL. Investigation of TSPO variants in schizophrenia and antipsychotic treatment outcomes. Pharmacogenomics 2015; 16:5-22. [DOI: 10.2217/pgs.14.158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: TSPO is a neuroinflammatory biomarker and emerging therapeutic target in psychiatric disorders. We evaluated whether TSPO polymorphisms contribute to interindividual variability in schizophrenia, antipsychotic efficacy and antipsychotic-induced weight gain. Patients & methods: We analyzed TSPO polymorphisms in 670 schizophrenia cases and 775 healthy controls. Gene–gene interactions between TSPO and other mitochondrial membrane protein-encoding genes (VDAC1 and ANT1) were explored. Positive findings were evaluated in two independent samples (Munich, n = 300; RUPP, n = 119). Results: TSPO rs6971 was independently associated with antipsychotic-induced weight gain in the discovery (puncor = 0.04) and RUPP samples (p = 3.00 × 10-3), and interacted with ANT1 rs10024068 in the discovery (p = 1.15 × 10-3) and RUPP samples (p = 2.76 × 10-4). Conclusion: Our findings highlight TSPO as a candidate for future investigations of antipsychotic-induced weight gain, and support the involvement of mitochondrial membrane components in this serious treatment side effect. Original submitted 20 August 2014; Revision submitted 3 November 2014
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Affiliation(s)
- Jennie G Pouget
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vanessa F Gonçalves
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erika L Nurmi
- • Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, CA, USA
| | - Christopher P Laughlin
- • Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, CA, USA
| | - Karyn S Mallya
- • Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, CA, USA
| | - James T McCracken
- • Department of Psychiatry & Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, CA, USA
| | - Michael G Aman
- • Department of Psychiatry, Ohio State University, OH, USA
| | | | | | - Virginia L Misener
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Arun K Tiwari
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Clement C Zai
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Eva J Brandl
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Department of Psychiatry & Psychotherapy, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Felsky
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Amy Q Leung
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Jeffrey A Lieberman
- • Department of Psychiatry, College of Physicians & Surgeons, Columbia University, NY, USA
- • New York State Psychiatric Institute, New York, NY, USA
| | - Herbert Y Meltzer
- • Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven G Potkin
- • Brain Imaging Centre, Irvine Hall, University of California, Irvine, CA, USA
| | - Charlotte Niedling
- • Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar, TU-München, Germany
| | - Werner Steimer
- • Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar, TU-München, Germany
| | - Stefan Leucht
- • Psychiatrische Klinik und Poliklinik, Klinikum rechts der Isar, TU-München, Germany
| | - Jo Knight
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- • Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Daniel J Müller
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- • Pharmacogenetics Research Clinic, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - James L Kennedy
- • Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
- • Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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13
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Stepniak B, Papiol S, Hammer C, Ramin A, Everts S, Hennig L, Begemann M, Ehrenreich H. Accumulated environmental risk determining age at schizophrenia onset: a deep phenotyping-based study. Lancet Psychiatry 2014; 1:444-53. [PMID: 26361199 DOI: 10.1016/s2215-0366(14)70379-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Schizophrenia is caused by a combination of genetic and environmental factors, as first evidenced by twin studies. Extensive efforts have been made to identify the genetic roots of schizophrenia, including large genome-wide association studies, but these yielded very small effect sizes for individual markers. In this study, we aimed to assess the relative contribution of genome-wide association study-derived genetic versus environmental risk factors to crucial determinants of schizophrenia severity: disease onset, disease severity, and socioeconomic measures. METHODS In this parallel analysis, we studied 750 male patients from the Göttingen Research Association for Schizophrenia (GRAS) dataset (Germany) with schizophrenia for whom both genome-wide coverage of single-nucleotide polymorphisms and deep clinical phenotyping data were available. Specifically, we investigated the potential effect of schizophrenia risk alleles as identified in the most recent large genome-wide association study versus the effects of environmental hazards (ie, perinatal brain insults, cannabis use, neurotrauma, psychotrauma, urbanicity, and migration), alone and upon accumulation, on age at disease onset, age at prodrome, symptom expression, and socioeconomic parameters. FINDINGS In this study, we could show that frequent environmental factors become a major risk for early schizophrenia onset when accumulated (prodrome begins up to 9 years earlier; p=2·9×10(-10)). In particular, cannabis use-an avoidable environmental risk factor-is highly significantly associated with earlier age at prodrome (p=3·8×10(-20)). By contrast, polygenic genome-wide association study risk scores did not have any detectable effects on schizophrenia phenotypes. INTERPRETATION These findings should be translated to preventive measures to reduce environmental risk factors, since age at onset of schizophrenia is a crucial determinant of an affected individual's fate and the total socioeconomic cost of the illness. FUNDING German Research Foundation (Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain), Max Planck Society, Max Planck Förderstiftung, EXTRABRAIN EU-FP7, ERA-NET NEURON.
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Affiliation(s)
- Beata Stepniak
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Sergi Papiol
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany; DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
| | - Christian Hammer
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Anna Ramin
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Sarah Everts
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Lena Hennig
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany; DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.
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14
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Mei L, Nave KA. Neuregulin-ERBB signaling in the nervous system and neuropsychiatric diseases. Neuron 2014; 83:27-49. [PMID: 24991953 DOI: 10.1016/j.neuron.2014.06.007] [Citation(s) in RCA: 413] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Neuregulins (NRGs) comprise a large family of growth factors that stimulate ERBB receptor tyrosine kinases. NRGs and their receptors, ERBBs, have been identified as susceptibility genes for diseases such as schizophrenia (SZ) and bipolar disorder. Recent studies have revealed complex Nrg/Erbb signaling networks that regulate the assembly of neural circuitry, myelination, neurotransmission, and synaptic plasticity. Evidence indicates there is an optimal level of NRG/ERBB signaling in the brain and deviation from it impairs brain functions. NRGs/ERBBs and downstream signaling pathways may provide therapeutic targets for specific neuropsychiatric symptoms.
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Affiliation(s)
- Lin Mei
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA; Department of Neurology, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA; Charlie Norwood VA Medical Center, Augusta, GA 30904, USA.
| | - Klaus-Armin Nave
- Department of Neurogenetics, Max Planck Institute of Experimental Medicine, 37075 Goettingen, Germany.
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