1
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Akköprü H, Alnak A, Karadoğan ZN, Çağlayan AO, Özçetin M, Coşkun M. Peripheral Expression of ADORA2A Is Increased and Is Correlated with Autism Spectrum Disorder Severity in a Sample of Turkish Children. PSYCHIAT CLIN PSYCH 2023; 33:14-19. [PMID: 38764528 PMCID: PMC11082569 DOI: 10.5152/pcp.2023.22509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/06/2022] [Indexed: 05/21/2024] Open
Abstract
Background The aim of this study was to evaluate the peripheral expression of ADORA2A (Adenosine A2A receptor gene) in young subjects with autism spectrum disorder compared with healthy controls and its relationship with clinical characteristics. Method This study included 93 children and adolescents with a diagnosis of autism spectrum disorder as the study group and 105 healthy age- and gender-matched controls. Blood samples were obtained from all participants, and a real-time quantitative polymerase chain reaction was performed. Parent- and clinician-rated assessment instruments were used to assess and rate the severity of autism spectrum disorder and other emotional/behavioral problems. Results The mean age of the study group was 9.06 ± 3.57 and 86% were male (n = 83), whereas the mean age of the control group was 9.22 ± 3.86 and 86.7% were male (n = 91). We have found a higher level of peripheral expression of ADORA2A in children and adolescents with autism spectrum disorder compared with healthy controls (fold change = 1.33, P = .001). We also found a weak negative correlation with autism spectrum disorder severity (r = -0.216; P = .038) and stereotyped behaviors (r = -0.207, P = .046). Conclusion ADORA2A genes may have a role in the pathophysiology of autism spectrum disorder. Further studies are needed to evaluate whether peripheral expression of ADORA2A genes may be among the biomarkers for diagnosing or measuring the severity of autism spectrum disorder.
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Affiliation(s)
- Hilal Akköprü
- Bingöl Maternity and Child Health Hospital Bingöl, Turkey
| | - Alper Alnak
- Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | | | | - Mustafa Özçetin
- Department of Child Health and Diseases, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Murat Coşkun
- Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
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2
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Gudbrandsen M, Mann C, Bletsch A, Daly E, Murphy CM, Stoencheva V, Blackmore CE, Rogdaki M, Kushan L, Bearden CE, Murphy DGM, Craig MC, Ecker C. Patterns of Cortical Folding Associated with Autistic Symptoms in Carriers and Noncarriers of the 22q11.2 Microdeletion. Cereb Cortex 2020; 30:5281-5292. [PMID: 32420595 PMCID: PMC7566689 DOI: 10.1093/cercor/bhaa108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022] Open
Abstract
22q11.2 deletion syndrome (22q11.2DS) is a genetic condition accompanied by a range of psychiatric manifestations, including autism spectrum disorder (ASD). It remains unknown, however, whether these symptoms are mediated by the same or distinct neural mechanisms as in idiopathic ASD. Here, we examined differences in lGI associated with ASD in 50 individuals with 22q11.2DS (n = 25 with ASD, n = 25 without ASD) and 81 individuals without 22q11.2DS (n = 40 with ASD, n = 41 typically developing controls). We initially utilized a factorial design to identify the set of brain regions where lGI is associated with the main effect of 22q11.2DS, ASD, and with the 22q11.2DS-by-ASD interaction term. Subsequently, we employed canonical correlation analysis (CCA) to compare the multivariate association between variability in lGI and the complex clinical phenotype of ASD between 22q11.2DS carriers and noncarriers. Across approaches, we established that even though there is a high degree of clinical similarity across groups, the associated patterns of lGI significantly differed between carriers and noncarriers of the 22q11.2 microdeletion. Our results suggest that ASD symptomatology recruits different neuroanatomical underpinnings across disorders and that 22q11.2DS individuals with ASD represent a neuroanatomically distinct subgroup that differs from 22q11.2DS individuals without ASD and from individuals with idiopathic ASD.
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Affiliation(s)
- Maria Gudbrandsen
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | - Caroline Mann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Anke Bletsch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Eileen Daly
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | - Clodagh M Murphy
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Behavioural Genetics Clinic, Adult Autism and ADHD Services, Behavioural and Developmental Clinical Academic Group, South London and Maudsley Foundation, NHS, UK
| | - Vladimira Stoencheva
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Behavioural Genetics Clinic, Adult Autism and ADHD Services, Behavioural and Developmental Clinical Academic Group, South London and Maudsley Foundation, NHS, UK
| | - Charlotte E Blackmore
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Behavioural Genetics Clinic, Adult Autism and ADHD Services, Behavioural and Developmental Clinical Academic Group, South London and Maudsley Foundation, NHS, UK
| | - Maria Rogdaki
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Imperial College, London, UK
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Behavioural Genetics Clinic, Adult Autism and ADHD Services, Behavioural and Developmental Clinical Academic Group, South London and Maudsley Foundation, NHS, UK
| | - Michael C Craig
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- National Autism Unit, Bethlem Royal Hospital, London, UK
| | - Christine Ecker
- Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
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3
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Quinlan MA, Robson MJ, Ye R, Rose KL, Schey KL, Blakely RD. Ex vivo Quantitative Proteomic Analysis of Serotonin Transporter Interactome: Network Impact of the SERT Ala56 Coding Variant. Front Mol Neurosci 2020; 13:89. [PMID: 32581705 PMCID: PMC7295033 DOI: 10.3389/fnmol.2020.00089] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022] Open
Abstract
Altered serotonin (5-HT) signaling is associated with multiple brain disorders, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and autism spectrum disorder (ASD). The presynaptic, high-affinity 5-HT transporter (SERT) tightly regulates 5-HT clearance after release from serotonergic neurons in the brain and enteric nervous systems, among other sites. Accumulating evidence suggests that SERT is dynamically regulated in distinct activity states as a result of environmental and intracellular stimuli, with regulation perturbed by disease-associated coding variants. Our lab identified a rare, hypermorphic SERT coding substitution, Gly56Ala, in subjects with ASD, finding that the Ala56 variant stabilizes a high-affinity outward-facing conformation (SERT∗) that leads to elevated 5-HT uptake in vitro and in vivo. Hyperactive SERT Ala56 appears to preclude further activity enhancements by p38α mitogen-activated protein kinase (MAPK) and can be normalized by pharmacological p38α MAPK inhibition, consistent with SERT Ala56 mimicking, constitutively, a high-activity conformation entered into transiently by p38α MAPK activation. We hypothesize that changes in SERT-interacting proteins (SIPs) support the shift of SERT into the SERT∗ state which may be captured by comparing the composition of SERT Ala56 protein complexes with those of wildtype (WT) SERT, defining specific interactions through comparisons of protein complexes recovered using preparations from SERT–/– (knockout; KO) mice. Using quantitative proteomic-based approaches, we identify a total of 459 SIPs, that demonstrate both SERT specificity and sensitivity to the Gly56Ala substitution, with a striking bias being a loss of SIP interactions with SERT Ala56 compared to WT SERT. Among this group are previously validated SIPs, such as flotillin-1 (FLOT1) and protein phosphatase 2A (PP2A), whose functions are believed to contribute to SERT microdomain localization and regulation. Interestingly, our studies nominate a number of novel SIPs implicated in ASD, including fragile X mental retardation 1 protein (FMR1) and SH3 and multiple ankyrin repeat domains protein 3 (SHANK3), of potential relevance to long-standing evidence of serotonergic contributions to ASD. Further investigation of these SIPs, and the broader networks they engage, may afford a greater understanding of ASD as well as other brain and peripheral disorders associated with perturbed 5-HT signaling.
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Affiliation(s)
- Meagan A Quinlan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Department of Pharmacology, Vanderbilt University, Nashville, TN, United States.,Department of Biomedical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Jupiter, FL, United States
| | - Matthew J Robson
- Division of Pharmaceutical Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, United States
| | - Ran Ye
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - Kristie L Rose
- Department of Biochemistry, Vanderbilt University, Nashville, TN, United States
| | - Kevin L Schey
- Department of Biochemistry, Vanderbilt University, Nashville, TN, United States
| | - Randy D Blakely
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States.,Brain Institute, Florida Atlantic University, Jupiter, FL, United States
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4
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Baba M, Yokoyama K, Seiriki K, Naka Y, Matsumura K, Kondo M, Yamamoto K, Hayashida M, Kasai A, Ago Y, Nagayasu K, Hayata-Takano A, Takahashi A, Yamaguchi S, Mori D, Ozaki N, Yamamoto T, Takuma K, Hashimoto R, Hashimoto H, Nakazawa T. Psychiatric-disorder-related behavioral phenotypes and cortical hyperactivity in a mouse model of 3q29 deletion syndrome. Neuropsychopharmacology 2019; 44:2125-2135. [PMID: 31216562 PMCID: PMC6887869 DOI: 10.1038/s41386-019-0441-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 01/23/2023]
Abstract
3q29 microdeletion, a rare recurrent copy number variant (CNV), greatly confers an increased risk of psychiatric disorders, such as schizophrenia and autism spectrum disorder (ASD), as well as intellectual disability. However, disease-relevant cellular phenotypes of 3q29 deletion syndrome remain to be identified. To reveal the molecular and cellular etiology of 3q29 deletion syndrome, we generated a mouse model of human 3q29 deletion syndrome by chromosome engineering, which achieved construct validity. 3q29 deletion (Df/+) mice showed reduced body weight and brain volume and, more importantly, impaired social interaction and prepulse inhibition. Importantly, the schizophrenia-related impaired prepulse inhibition was reversed by administration of antipsychotics. These findings are reminiscent of the growth defects and neuropsychiatric behavioral phenotypes in patients with 3q29 deletion syndrome and exemplify that the mouse model achieves some part of face validity and predictive validity. Unbiased whole-brain imaging revealed that neuronal hyperactivation after a behavioral task was strikingly exaggerated in a restricted region of the cortex of Df/+ mice. We further elucidated the cellular phenotypes of neuronal hyperactivation and the reduction of parvalbumin expression in the cortex of Df/+ mice. Thus, the 3q29 mouse model provides invaluable insight into the disease-causative molecular and cellular pathology of psychiatric disorders.
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Affiliation(s)
- Masayuki Baba
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Kazumasa Yokoyama
- 0000 0001 0673 6017grid.419841.1Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Kanagawa Fujisawa, 251-8555 Japan
| | - Kaoru Seiriki
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0373 3971grid.136593.bInterdisciplinary Program for Biomedical Sciences, Institute for Transdisciplinary Graduate Degree Programs, Osaka University, Suita, Osaka 565-0871 Japan
| | - Yuichiro Naka
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Kensuke Matsumura
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0373 3971grid.136593.bInterdisciplinary Program for Biomedical Sciences, Institute for Transdisciplinary Graduate Degree Programs, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0614 710Xgrid.54432.34Research Fellowships for Young Scientists of the Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, 102-0083 Japan
| | - Momoka Kondo
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Kana Yamamoto
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Misuzu Hayashida
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Atsushi Kasai
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Yukio Ago
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0373 3971grid.136593.bLaboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Kazuki Nagayasu
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan
| | - Atsuko Hayata-Takano
- 0000 0004 0373 3971grid.136593.bLaboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0373 3971grid.136593.bMolecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka 565-0871 Japan
| | - Akinori Takahashi
- 0000 0000 9805 2626grid.250464.1Cell Signal Unit, Okinawa Institute of Science and Technology Graduate University, Onna-son, Okinawa, 904-0495 Japan
| | - Shun Yamaguchi
- 0000 0004 0370 4927grid.256342.4Department of Morphological Neuroscience, Gifu University Graduate School of Medicine, Gifu, 501-1194 Japan ,0000 0004 0370 4927grid.256342.4Center for Highly Advanced Integration of Nano and Life Sciences, Gifu University, Gifu, 501-1194 Japan
| | - Daisuke Mori
- 0000 0001 0943 978Xgrid.27476.30Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Nagoya, 466-8550 Japan ,0000 0001 0943 978Xgrid.27476.30Brain and Mind Research Center, Nagoya University, Aichi, Nagoya, 466-8550 Japan
| | - Norio Ozaki
- 0000 0001 0943 978Xgrid.27476.30Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Nagoya, 466-8550 Japan
| | - Tadashi Yamamoto
- 0000 0000 9805 2626grid.250464.1Cell Signal Unit, Okinawa Institute of Science and Technology Graduate University, Onna-son, Okinawa, 904-0495 Japan ,0000000094465255grid.7597.cLaboratory for Immunogenetics, Center for Integrative Medical Sciences, RIKEN, Kanagawa Yokohama, 230-0045 Japan
| | - Kazuhiro Takuma
- 0000 0004 0373 3971grid.136593.bMolecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka 565-0871 Japan ,0000 0004 0373 3971grid.136593.bDepartment of Pharmacology, Graduate School of Dentistry, Osaka University, Suita, Osaka 565-0871 Japan
| | - Ryota Hashimoto
- 0000 0004 1763 8916grid.419280.6Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8553 Japan ,0000 0004 0373 3971grid.136593.bOsaka University, Suita, Osaka 565-0871 Japan
| | - Hitoshi Hashimoto
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, 565-0871, Japan. .,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, 565-0871, Japan. .,Division of Bioscience, Institute for Datability Science, Osaka University, Suita, Osaka, 565-0871, Japan. .,Transdimensional Life Imaging Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, 565-0871, Japan.
| | - Takanobu Nakazawa
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, 565-0871, Japan. .,Department of Pharmacology, Graduate School of Dentistry, Osaka University, Suita, Osaka, 565-0871, Japan.
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5
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Hiroi N, Yamauchi T. Modeling and Predicting Developmental Trajectories of Neuropsychiatric Dimensions Associated With Copy Number Variations. Int J Neuropsychopharmacol 2019; 22:488-500. [PMID: 31135887 PMCID: PMC6672556 DOI: 10.1093/ijnp/pyz026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 01/23/2023] Open
Abstract
Copy number variants, such as duplications and hemizygous deletions at chromosomal loci of up to a few million base pairs, are highly associated with psychiatric disorders. Hemizygous deletions at human chromosome 22q11.2 were found to be associated with elevated instances of schizophrenia and autism spectrum disorder in 1992 and 2002, respectively. Following these discoveries, many mouse models have been developed and tested to analyze the effects of gene dose alterations in small chromosomal segments and single genes of 22q11.2. Despite several limitations to modeling mental illness in mice, mouse models have identified several genes on 22q11.2-Tbx1, Dgcr8, Comt, Sept5, and Prodh-that contribute to dimensions of autism spectrum disorder and schizophrenia, including working memory, social communication and interaction, and sensorimotor gating. Mouse studies have identified that heterozygous deletion of Tbx1 results in defective social communication during the neonatal period and social interaction deficits during adolescence/adulthood. Overexpression of Tbx1 or Comt in adult neural progenitor cells in the hippocampus delays the developmental maturation of working memory capacity. Collectively, mouse models of variants of these 4 genes have revealed several potential neuronal mechanisms underlying various aspects of psychiatric disorders, including adult neurogenesis, microRNA processing, catecholamine metabolism, and synaptic transmission. The validity of the mouse data would be ultimately tested when therapies or drugs based on such potential mechanisms are applied to humans.
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Affiliation(s)
- Noboru Hiroi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York
| | - Takahira Yamauchi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York
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6
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Suzuki R, Warita T, Nakamura Y, Kitamura Y, Aoyama Y, Ogawa Y, Kawada H, Ando K. A case of double-refractory multiple myeloma with both the IgH-MMSET fusion protein and the congenital abnormality t(11;22). Int J Hematol 2019; 109:731-736. [PMID: 30680670 DOI: 10.1007/s12185-019-02603-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
Abstract
A 67-year-old female was referred to our hospital with a sternal fracture in March 2008. She received a diagnosis of multiple myeloma (MM) BJP-κ type (ISS stage III). G-banding karyotype revealed 46, XX, t(11;22)(q23.3;q11.2) (Hubacek, Gene 592:193-9, 2016), which was later confirmed to be congenital. After repeated rounds of chemotherapy with bortezomib and lenalidomide, she obtained a very good partial response in August 2014, and she was followed up with no treatment. However, she relapsed in February 2016. At that time, fluorescence in situ hybridization identified del(13q) and t(4;14)(p16;q32), which are associated with a poor prognosis. Furthermore, PCR analysis showed that the chromosome 11 breakpoint was at the APOA5/APOA4 locus at 11q23.3, which is associated with malignancy, and that the chromosome 22 breakpoint was at the SEPT5 intron 1 locus, which also plays a role in leukemogenesis through formation of a fusion gene with MLL. Although she was treated with three further lines of therapy, she died from disease progression in August 2017. Synergism between t(11;22) and t(4;14) may have induced the double-refractory phenotype to proteasome inhibitor and lenalidomide, at least during the chemorefractory phase. We present a biological analysis of this case and a review of the literature.
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Affiliation(s)
- Rikio Suzuki
- Department of Hematology/Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan.
| | - Takayuki Warita
- Center for Regenerative Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yoshihiko Nakamura
- Center for Regenerative Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yuka Kitamura
- Center for Regenerative Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yasuyuki Aoyama
- Department of Hematology/Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Yoshiaki Ogawa
- Department of Hematology/Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Hiroshi Kawada
- Department of Hematology/Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Kiyoshi Ando
- Department of Hematology/Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan. .,Center for Regenerative Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
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7
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Zhao Y, Guo T, Fiksinski A, Breetvelt E, McDonald-McGinn DM, Crowley TB, Diacou A, Schneider M, Eliez S, Swillen A, Breckpot J, Vermeesch J, Chow EWC, Gothelf D, Duijff S, Evers R, van Amelsvoort TA, van den Bree M, Owen M, Niarchou M, Bearden CE, Ornstein C, Pontillo M, Buzzanca A, Vicari S, Armando M, Murphy KC, Murphy C, Garcia-Minaur S, Philip N, Campbell L, Morey-Cañellas J, Raventos J, Rosell J, Heine-Suner D, Shprintzen RJ, Gur RE, Zackai E, Emanuel BS, Wang T, Kates WR, Bassett AS, Vorstman JAS, Morrow BE. Variance of IQ is partially dependent on deletion type among 1,427 22q11.2 deletion syndrome subjects. Am J Med Genet A 2018; 176:2172-2181. [PMID: 30289625 PMCID: PMC6209529 DOI: 10.1002/ajmg.a.40359] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/02/2018] [Accepted: 05/23/2018] [Indexed: 12/28/2022]
Abstract
The 22q11.2 deletion syndrome is caused by non-allelic homologous recombination events during meiosis between low copy repeats (LCR22) termed A, B, C, and D. Most patients have a typical LCR22A-D (AD) deletion of 3 million base pairs (Mb). In this report, we evaluated IQ scores in 1,478 subjects with 22q11.2DS. The mean of full scale IQ, verbal IQ, and performance IQ scores in our cohort were 72.41 (standard deviation-SD of 13.72), 75.91(SD of 14.46), and 73.01(SD of 13.71), respectively. To investigate whether IQ scores are associated with deletion size, we examined individuals with the 3 Mb, AD (n = 1,353) and nested 1.5 Mb, AB (n = 74) deletions, since they comprised the largest subgroups. We found that full scale IQ was decreased by 6.25 points (p = .002), verbal IQ was decreased by 8.17 points (p = .0002) and performance IQ was decreased by 4.03 points (p = .028) in subjects with the AD versus AB deletion. Thus, individuals with the smaller, 1.5 Mb AB deletion have modestly higher IQ scores than those with the larger, 3 Mb AD deletion. Overall, the deletion of genes in the AB region largely explains the observed low IQ in the 22q11.2DS population. However, our results also indicate that haploinsufficiency of genes in the LCR22B-D region (BD) exert an additional negative impact on IQ. Furthermore, we did not find evidence of a confounding effect of severe congenital heart disease on IQ scores in our cohort.
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Affiliation(s)
- Yingjie Zhao
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tingwei Guo
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ania Fiksinski
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Addiction and Mental Health and the University of Toronto, Toronto, Canada
| | - Elemi Breetvelt
- Center for Addiction and Mental Health and the University of Toronto, Toronto, Canada
| | - Donna M. McDonald-McGinn
- Division of Human Genetics, Children’s Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Terrence B. Crowley
- Division of Human Genetics, Children’s Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Alexander Diacou
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, University of Geneva School of Medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, University of Geneva School of Medicine, Geneva, Switzerland
| | - Ann Swillen
- Center for Human Genetics, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium
| | - Jeroen Breckpot
- Center for Human Genetics, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium
| | - Joris Vermeesch
- Center for Human Genetics, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium
| | - Eva W. C. Chow
- Center for Addiction and Mental Health and the University of Toronto, Toronto, Canada
| | - Doron Gothelf
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- The Child Psychiatry Division, Edmond and Lily Sapfra Children’s Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Sasja Duijff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rens Evers
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | | | - Marianne van den Bree
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, Wales
| | - Michael Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, Wales
| | - Maria Niarchou
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, Wales
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Claudia Ornstein
- Department of Psychiatry, Hospital Clinico Universidad de Chile,, Santiago, Chile
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesu, Rome, Italy
| | - Antonino Buzzanca
- Department of Human Neuroscience, University Sapienza of Rome, Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesu, Rome, Italy
| | - Marco Armando
- Developmental Imaging and Psychopathology Lab, University of Geneva School of Medicine, Geneva, Switzerland
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesu, Rome, Italy
| | - Kieran C. Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Clodagh Murphy
- Department of Psychiatry, King’s College London, London, England
| | - Sixto Garcia-Minaur
- Section of Clinical Genetics and Dismorphology, Instituto de Genética Médica y Molecular, INGEMM, Hospital Universitario La Paz, Madrid, Spain
| | - Nicole Philip
- Department of Medical Genetics, APHM, MMG, INSERM, Aix-Marseille University, Marseille, France
| | - Linda Campbell
- School of Psychology, University of Newcastle, Newcastle, Australia
| | | | | | - Jordi Rosell
- Section of Genetics, Hospital Son Espases, Palma, Spain
| | | | - Robert J. Shprintzen
- The Virtual Center for Velo-Cardio-Facial Syndrome and Related Disorders, Syracuse, NY, USA
| | - Raquel E. Gur
- Department of Psychiatry and the Lifespan Brain Institute, Perelman School of Medicine and Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
| | - Elaine Zackai
- Division of Human Genetics, Children’s Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Beverly S. Emanuel
- Division of Human Genetics, Children’s Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Tao Wang
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Wendy R. Kates
- Department of Psychiatry and Behavioral Sciences, and Program in Neuroscience, SUNY Upstate Medical University, Syracuse, USA
| | - Anne S. Bassett
- Center for Addiction and Mental Health and the University of Toronto, Toronto, Canada
- The Dalglish 22q Clinic for Adults, Toronto General Hospital, University Health Network, Toronto, Canada
| | | | - Bernice E. Morrow
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
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8
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Broin PÓ, Beckert MV, Takahashi T, Izumi T, Ye K, Kang G, Pouso P, Topolski M, Pena JL, Hiroi N. Computational Analysis of Neonatal Mouse Ultrasonic Vocalization. CURRENT PROTOCOLS IN MOUSE BIOLOGY 2018; 8:e46. [PMID: 29927553 PMCID: PMC6055925 DOI: 10.1002/cpmo.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Neonatal vocalization is structurally altered in mouse models of autism spectrum disorder (ASD). Our published data showed that pup vocalization, under conditions of maternal separation, contains sequences whose alterations in a genetic mouse model of ASD impair social communication between pups and mothers. We describe details of a method which reveals the statistical structure of call sequences that are functionally critical for optimal maternal care. Entropy analysis determines the degree of non-random call sequencing. A Markov model determines the actual call sequences used by pups. Sparse partial least squares discriminant analysis (sPLS-DA) identifies call sequences that differentiate groups and reveals the degrees of individual variability in call sequences between groups. These three sets of analyses can be used to identify the otherwise hidden call structure that is altered in mouse models of developmental neuropsychiatric disorders, including not only autism but also schizophrenia. © 2018 by John Wiley & Sons, Inc.
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Affiliation(s)
- Pilib Ó Broin
- School of Mathematics, Statistics & Applied Mathematics,
National University of Ireland Galway, Galway, Ireland
| | - Michael V. Beckert
- Department of Neuroscience, Albert Einstein College of Medicine,
Bronx, NY, USA
| | - Tomohisa Takahashi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
| | - Takeshi Izumi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
| | - Kenny Ye
- Department of Epidemiology & Population Health, Albert
Einstein College of Medicine, Bronx, NY, USA
| | - Gina Kang
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
| | - Patricia Pouso
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
| | - Mackenzie Topolski
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
| | - Jose L. Pena
- Department of Neuroscience, Albert Einstein College of Medicine,
Bronx, NY, USA
| | - Noboru Hiroi
- Department of Neuroscience, Albert Einstein College of Medicine,
Bronx, NY, USA
- Department of Psychiatry and Behavioral Sciences, Albert Einstein
College of Medicine, Bronx, NY, USA
- Department of Genetics, Albert Einstein College of Medicine, Bronx,
NY, USA
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9
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Hiroi N. Critical reappraisal of mechanistic links of copy number variants to dimensional constructs of neuropsychiatric disorders in mouse models. Psychiatry Clin Neurosci 2018; 72:301-321. [PMID: 29369447 PMCID: PMC5935536 DOI: 10.1111/pcn.12641] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/27/2017] [Accepted: 01/19/2018] [Indexed: 12/17/2022]
Abstract
Copy number variants are deletions and duplications of a few thousand to million base pairs and are associated with extraordinarily high levels of autism spectrum disorder, schizophrenia, intellectual disability, or attention-deficit hyperactivity disorder. The unprecedented levels of robust and reproducible penetrance of copy number variants make them one of the most promising and reliable entry points to delve into the mechanistic bases of many mental disorders. However, the precise mechanistic bases of these associations still remain elusive in humans due to the many genes encoded in each copy number variant and the diverse associated phenotypic features. Genetically engineered mice have provided a technical means to ascertain precise genetic mechanisms of association between copy number variants and dimensional aspects of mental illnesses. Molecular, cellular, and neuronal phenotypes can be detected as potential mechanistic substrates for various behavioral constructs of mental illnesses. However, mouse models come with many technical pitfalls. Genetic background is not well controlled in many mouse models, leading to rather obvious interpretative issues. Dose alterations of many copy number variants and single genes within copy number variants result in some molecular, cellular, and neuronal phenotypes without a behavioral phenotype or with a behavioral phenotype opposite to what is seen in humans. In this review, I discuss technical and interpretative pitfalls of mouse models of copy number variants and highlight well-controlled studies to suggest potential neuronal mechanisms of dimensional aspects of mental illnesses. Mouse models of copy number variants represent toeholds to achieve a better understanding of the mechanistic bases of dimensions of neuropsychiatric disorders and thus for development of mechanism-based therapeutic options in humans.
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Affiliation(s)
- Noboru Hiroi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, USA.,Department of Neuroscience, Albert Einstein College of Medicine, New York, USA.,Department of Genetics, Albert Einstein College of Medicine, New York, USA
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10
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Evers LJM, Engelen JJM, Houben LMH, Curfs LMG, van Amelsvoort TAMJ. The use of two different MLPA kits in 22q11.2 deletion syndrome. Eur J Med Genet 2016; 59:183-8. [PMID: 26921528 DOI: 10.1016/j.ejmg.2016.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 02/15/2016] [Accepted: 02/21/2016] [Indexed: 11/30/2022]
Abstract
22q11.2 deletion syndrome (22q11DS) is one of the most common recurrent copy-number variant disorder, caused by a microdeletion in chromosome band 22q11.2 and occurring with a population prevalence of 1 in 2000. Until today there has been no evidence that the size of the deletion has an influence on the clinical phenotype. Most studies report that 22q11DS is associated with mild or borderline intellectual disability. There are a limited number of reports on 22q11DS subjects with moderate or severe intellectual disability. In this study we describe 63 adult patients with 22q11DS, including 22q11DS patients functioning at a moderate to severe intellectual disabled level. Deletion size was established with an experimental Multiplex ligation-dependent probe amplification (MLPA) mixture (P324) in addition to the commonly used MLPA kit (P250). We compared deletion size with intellectual functioning and presence of psychotic symptoms during life. The use of the experimental MLPA kit gives extra information on deletion size, only when combined with the common MLPA kit. We were able to detect eleven atypical deletions and in two cases the deletion size was shorter than all other "typical ones". We conclude that the use of the experimental kit P324 gives extra information about the deletion size, but only when used together with the standard P250 kit. We did not found any relation of deletion size with intelligence or presence of psychosis.
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Affiliation(s)
- L J M Evers
- Koraalgroup, MFCG, Heel, The Netherlands; Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - J J M Engelen
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L M H Houben
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L M G Curfs
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands; CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - T A M J van Amelsvoort
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands; Mondriaan Mental Healthcare, Heerlen, The Netherlands; Virenze Mental Healthcare, Gronsveld, The Netherlands
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11
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Gur RE, Yi JJ, McDonald-McGinn DM, Tang SX, Calkins ME, Whinna D, Souders MC, Savitt A, Zackai EH, Moberg PJ, Emanuel BS, Gur RC. Neurocognitive development in 22q11.2 deletion syndrome: comparison with youth having developmental delay and medical comorbidities. Mol Psychiatry 2014; 19:1205-11. [PMID: 24445907 PMCID: PMC4450860 DOI: 10.1038/mp.2013.189] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/28/2013] [Accepted: 12/03/2013] [Indexed: 11/09/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) presents with medical and neuropsychiatric manifestations including neurocognitive deficits. Quantitative neurobehavioral measures linked to brain circuitry can help elucidate genetic mechanisms contributing to deficits. To establish the neurocognitive profile and neurocognitive 'growth charts', we compared cross-sectionally 137 individuals with 22q11DS ages 8-21 to 439 demographically matched non-deleted individuals with developmental delay (DD) and medical comorbidities and 443 typically developing (TD) participants. We administered a computerized neurocognitive battery that measures performance accuracy and speed in executive, episodic memory, complex cognition, social cognition and sensorimotor domains. The accuracy performance profile of 22q11DS showed greater impairment than DD, who were impaired relative to TD. Deficits in 22q11DS were most pronounced for face memory and social cognition, followed by complex cognition. Performance speed was similar for 22q11DS and DD, but 22q11DS individuals were differentially slower in face memory and emotion identification. The growth chart, comparing neurocognitive age based on performance relative to chronological age, indicated that 22q11DS participants lagged behind both groups from the earliest age assessed. The lag ranged from less than 1 year to over 3 years depending on chronological age and neurocognitive domain. The greatest developmental lag across the age range was for social cognition and complex cognition, with the smallest for episodic memory and sensorimotor speed, where lags were similar to DD. The results suggest that 22q11.2 microdeletion confers specific vulnerability that may underlie brain circuitry associated with deficits in several neuropsychiatric disorders, and therefore help identify potential targets and developmental epochs optimal for intervention.
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Affiliation(s)
- Raquel E. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - James J. Yi
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
- Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry
| | - Donna M. McDonald-McGinn
- The Children’s Hospital of Philadelphia, Division of Human Genetics
- University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Sunny X. Tang
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Monica E. Calkins
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Daneen Whinna
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | | | - Adam Savitt
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Elaine H. Zackai
- The Children’s Hospital of Philadelphia, Division of Human Genetics
- University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Paul J. Moberg
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Beverly S. Emanuel
- The Children’s Hospital of Philadelphia, Division of Human Genetics
- University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Ruben C. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
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12
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Copy number variation at 22q11.2: from rare variants to common mechanisms of developmental neuropsychiatric disorders. Mol Psychiatry 2013; 18:1153-65. [PMID: 23917946 PMCID: PMC3852900 DOI: 10.1038/mp.2013.92] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 05/13/2013] [Accepted: 06/24/2013] [Indexed: 11/08/2022]
Abstract
Recently discovered genome-wide rare copy number variants (CNVs) have unprecedented levels of statistical association with many developmental neuropsychiatric disorders, including schizophrenia, autism spectrum disorders, intellectual disability and attention deficit hyperactivity disorder. However, as CNVs often include multiple genes, causal genes responsible for CNV-associated diagnoses and traits are still poorly understood. Mouse models of CNVs are in use to delve into the precise mechanisms through which CNVs contribute to disorders and associated traits. Based on human and mouse model studies on rare CNVs within human chromosome 22q11.2, we propose that alterations of a distinct set of multiple, noncontiguous genes encoded in this chromosomal region, in concert with modulatory impacts of genetic background and environmental factors, variably shift the probabilities of phenotypes along a predetermined developmental trajectory. This model can be further extended to the study of other CNVs and may serve as a guide to help characterize the impact of genes in developmental neuropsychiatric disorders.
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