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Secara MT, Oliver LD, Gallucci J, Dickie EW, Foussias G, Gold J, Malhotra AK, Buchanan RW, Voineskos AN, Hawco C. Heterogeneity in functional connectivity: Dimensional predictors of individual variability during rest and task fMRI in psychosis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110991. [PMID: 38484928 PMCID: PMC11034852 DOI: 10.1016/j.pnpbp.2024.110991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Individuals with schizophrenia spectrum disorders (SSD) often demonstrate cognitive impairments, associated with poor functional outcomes. While neurobiological heterogeneity has posed challenges when examining social cognition in SSD, it provides a unique opportunity to explore brain-behavior relationships. The aim of this study was to investigate the relationship between individual variability in functional connectivity during resting state and the performance of a social task and social and non-social cognition in a large sample of controls and individuals diagnosed with SSD. METHODS Neuroimaging and behavioral data were analyzed for 193 individuals with SSD and 155 controls (total n = 348). Individual variability was quantified through mean correlational distance (MCD) of functional connectivity between participants; MCD was defined as a global 'variability score'. Pairwise correlational distance was calculated as 1 - the correlation coefficient between a given pair of participants, and averaging distance from one participant to all other participants provided the mean correlational distance metric. Hierarchical regressions were performed on variability scores derived from resting state and Empathic Accuracy (EA) task functional connectivity data to determine potential predictors (e.g., age, sex, neurocognitive and social cognitive scores) of individual variability. RESULTS Group comparison between SSD and controls showed greater SSD MCD during rest (p = 0.00038), while no diagnostic differences were observed during task (p = 0.063). Hierarchical regression analyses demonstrated the persistence of a significant diagnostic effect during rest (p = 0.008), contrasting with its non-significance during the task (p = 0.50), after social cognition was added to the model. Notably, social cognition exhibited significance in both resting state and task conditions (both p = 0.01). CONCLUSIONS Diagnostic differences were more prevalent during unconstrained resting scans, whereas the task pushed participants into a more common pattern which better emphasized transdiagnostic differences in cognitive abilities. Focusing on variability may provide new opportunities for interventions targeting specific cognitive impairments to improve functional outcomes.
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Affiliation(s)
- Maria T Secara
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anil K Malhotra
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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2
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Gallego JA, McNamara RK, Blanco EA, Castaneda S, Jimenez LD, Alvarez-Lesmes S, Lencz T, Malhotra AK. Evidence for cytokine dysregulation in schizophrenia spectrum disorders: A comparison of cerebrospinal fluid and blood samples. Psychiatry Res 2024; 335:115871. [PMID: 38547600 PMCID: PMC11036713 DOI: 10.1016/j.psychres.2024.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/26/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024]
Abstract
Abnormalities in immune function have been described in schizophrenia but few studies have investigated cytokines in cerebrospinal fluid (CSF) and their correlation with blood levels. In this cross-sectional study, cytokines were measured in CSF and plasma of 30 subjects with schizophrenia spectrum disorder (SSD) diagnosis and 23 healthy volunteers (HV). Results showed that CSF TNFα was increased in SSD subjects compared to HV and there were no correlations between CSF and plasma cytokine levels. The present findings provide evidence of dysregulation of TNFα in CSF of schizophrenia. These results identify elevated CSF TNFα levels as a potential biomarker in schizophrenia.
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Affiliation(s)
- Juan A Gallego
- The Feinstein Institute for Medical Research, Manhasset, NY, USA; The Zucker Hillside Hospital, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA; Weill Cornell Medical College, New York, NY, USA.
| | | | | | | | - Laura D Jimenez
- Fundacion Universitaria de Ciencias de la Salud, FUCS, Bogotá, Colombia
| | | | - Todd Lencz
- The Feinstein Institute for Medical Research, Manhasset, NY, USA; The Zucker Hillside Hospital, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Anil K Malhotra
- The Feinstein Institute for Medical Research, Manhasset, NY, USA; The Zucker Hillside Hospital, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Hempstead, NY, USA
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3
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Oliver LD, Jeyachandra J, Dickie EW, Hawco C, Mansour S, Hare SM, Buchanan RW, Malhotra AK, Blumberger DM, Deng ZD, Voineskos AN. Bayesian Optimization of Neurostimulation (BOONStim). bioRxiv 2024:2024.03.08.584169. [PMID: 38559269 PMCID: PMC10979934 DOI: 10.1101/2024.03.08.584169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) treatment response is influenced by individual variability in brain structure and function. Sophisticated, user-friendly approaches, incorporating both established functional magnetic resonance imaging (fMRI) and TMS simulation tools, to identify TMS targets are needed. OBJECTIVE The current study presents the development and validation of the Bayesian Optimization of Neuro-Stimulation (BOONStim) pipeline. METHODS BOONStim uses Bayesian optimization for individualized TMS targeting, automating interoperability between surface-based fMRI analytic tools and TMS electric field modeling. Bayesian optimization performance was evaluated in a sample dataset (N=10) using standard circular and functional connectivity-defined targets, and compared to grid optimization. RESULTS Bayesian optimization converged to similar levels of total electric field stimulation across targets in under 30 iterations, converging within a 5% error of the maxima detected by grid optimization, and requiring less time. CONCLUSIONS BOONStim is a scalable and configurable user-friendly pipeline for individualized TMS targeting with quick turnaround.
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4
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Bigdeli TB, Barr PB, Rajeevan N, Graham DP, Li Y, Meyers JL, Gorman BR, Peterson RE, Sayward F, Radhakrishnan K, Natarajan S, Nielsen DA, Wilkinson AV, Malhotra AK, Zhao H, Brophy M, Shi Y, O'Leary TJ, Gleason T, Przygodzki R, Pyarajan S, Muralidhar S, Gaziano JM, Huang GD, Concato J, Siever LJ, DeLisi LE, Kimbrel NA, Beckham JC, Swann AC, Kosten TR, Fanous AH, Aslan M, Harvey PD. Correlates of suicidal behaviors and genetic risk among United States veterans with schizophrenia or bipolar I disorder. Mol Psychiatry 2024:10.1038/s41380-024-02472-1. [PMID: 38491344 DOI: 10.1038/s41380-024-02472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 03/18/2024]
Abstract
Persons diagnosed with schizophrenia (SCZ) or bipolar I disorder (BPI) are at high risk for self-injurious behavior, suicidal ideation, and suicidal behaviors (SB). Characterizing associations between diagnosed health problems, prior pharmacological treatments, and polygenic scores (PGS) has potential to inform risk stratification. We examined self-reported SB and ideation using the Columbia Suicide Severity Rating Scale (C-SSRS) among 3,942 SCZ and 5,414 BPI patients receiving care within the Veterans Health Administration (VHA). These cross-sectional data were integrated with electronic health records (EHRs), and compared across lifetime diagnoses, treatment histories, follow-up screenings, and mortality data. PGS were constructed using available genomic data for related traits. Genome-wide association studies were performed to identify and prioritize specific loci. Only 20% of the veterans who reported SB had a corroborating ICD-9/10 EHR code. Among those without prior SB, more than 20% reported new-onset SB at follow-up. SB were associated with a range of additional clinical diagnoses, and with treatment with specific classes of psychotropic medications (e.g., antidepressants, antipsychotics, etc.). PGS for externalizing behaviors, smoking initiation, suicide attempt, and major depressive disorder were associated with SB. The GWAS for SB yielded no significant loci. Among individuals with a diagnosed mental illness, self-reported SB were strongly associated with clinical variables across several EHR domains. Analyses point to sequelae of substance-related and psychiatric comorbidities as strong correlates of prior and subsequent SB. Nonetheless, past SB was frequently not documented in health records, underscoring the value of regular screening with direct, in-person assessments, especially among high-risk individuals.
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Affiliation(s)
- Tim B Bigdeli
- VA New York Harbor Healthcare System, Brooklyn, NY, US.
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US.
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US.
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US.
| | - Peter B Barr
- VA New York Harbor Healthcare System, Brooklyn, NY, US
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
| | - Nallakkandi Rajeevan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - David P Graham
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Yuli Li
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
| | - Bryan R Gorman
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA
| | - Roseann E Peterson
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US
| | - Frederick Sayward
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Krishnan Radhakrishnan
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | | | - David A Nielsen
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Anna V Wilkinson
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Science, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Anil K Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Hongyu Zhao
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Mary Brophy
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Yunling Shi
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA
| | - Timothy J O'Leary
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Ronald Przygodzki
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA
| | | | - J Michael Gaziano
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA
- Harvard University, Boston, MA, USA
| | - Grant D Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - John Concato
- Yale University School of Medicine, New Haven, CT, USA
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA
| | - Nathan A Kimbrel
- Durham VA Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C Beckham
- Durham VA Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Alan C Swann
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Thomas R Kosten
- Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ayman H Fanous
- VA New York Harbor Healthcare System, Brooklyn, NY, US
- Department of Psychiatry, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - Mihaela Aslan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Philip D Harvey
- Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA
- University of Miami School of Medicine, Miami, FL, USA
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5
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Voineskos AN, Hawco C, Neufeld NH, Turner JA, Ameis SH, Anticevic A, Buchanan RW, Cadenhead K, Dazzan P, Dickie EW, Gallucci J, Lahti AC, Malhotra AK, Öngür D, Lencz T, Sarpal DK, Oliver LD. Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions. World Psychiatry 2024; 23:26-51. [PMID: 38214624 PMCID: PMC10786022 DOI: 10.1002/wps.21159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicholas H Neufeld
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anil K Malhotra
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Todd Lencz
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Rubio JM, Lencz T, Cao H, Kraguljac N, Dhamala E, Homan P, Horga G, Sarpal DK, Argyelan M, Gallego J, Cholewa J, Barber A, Kane JM, Malhotra AK. Replication of a neuroimaging biomarker for striatal dysfunction in psychosis. Mol Psychiatry 2024:10.1038/s41380-023-02381-9. [PMID: 38177349 DOI: 10.1038/s41380-023-02381-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024]
Abstract
To bring biomarkers closer to clinical application, they should be generalizable, reliable, and maintain performance within the constraints of routine clinical conditions. The functional striatal abnormalities (FSA), is among the most advanced neuroimaging biomarkers in schizophrenia, trained to discriminate diagnosis, with post-hoc analyses indicating prognostic properties. Here, we attempt to replicate its diagnostic capabilities measured by the area under the curve (AUC) in receiver operator characteristic curves discriminating individuals with psychosis (n = 101) from healthy controls (n = 51) in the Human Connectome Project for Early Psychosis. We also measured the test-retest (run 1 vs 2) and phase encoding direction (i.e., AP vs PA) reliability with intraclass correlation coefficients (ICC). Additionally, we measured effects of scan length on classification accuracy (i.e., AUCs) and reliability (i.e., ICCs). Finally, we tested the prognostic capability of the FSA by the correlation between baseline scores and symptom improvement over 12 weeks of antipsychotic treatment in a separate cohort (n = 97). Similar analyses were conducted for the Yeo networks intrinsic connectivity as a reference. The FSA had good/excellent diagnostic discrimination (AUC = 75.4%, 95% CI = 67.0-83.3%; in non-affective psychosis AUC = 80.5%, 95% CI = 72.1-88.0%, and in affective psychosis AUC = 58.7%, 95% CI = 44.2-72.0%). Test-retest reliability ranged between ICC = 0.48 (95% CI = 0.35-0.59) and ICC = 0.22 (95% CI = 0.06-0.36), which was comparable to that of networks intrinsic connectivity. Phase encoding direction reliability for the FSA was ICC = 0.51 (95% CI = 0.42-0.59), generally lower than for networks intrinsic connectivity. By increasing scan length from 2 to 10 min, diagnostic classification of the FSA increased from AUC = 71.7% (95% CI = 63.1-80.3%) to 75.4% (95% CI = 67.0-83.3%) and phase encoding direction reliability from ICC = 0.29 (95% CI = 0.14-0.43) to ICC = 0.51 (95% CI = 0.42-0.59). FSA scores did not correlate with symptom improvement. These results reassure that the FSA is a generalizable diagnostic - but not prognostic - biomarker. Given the replicable results of the FSA as a diagnostic biomarker trained on case-control datasets, next the development of prognostic biomarkers should be on treatment-response data.
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Affiliation(s)
- Jose M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA.
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA.
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA.
| | - Todd Lencz
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Hengyi Cao
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Nina Kraguljac
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Elvisha Dhamala
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, 8057, Zurich, Switzerland
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Miklos Argyelan
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Juan Gallego
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - John Cholewa
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Anita Barber
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - John M Kane
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Anil K Malhotra
- Donald and Barbara Zucker School of Medicine at Hofstra University - Northwell Health, New York, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA
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7
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Argyelan M, Deng ZD, Ousdal OT, Oltedal L, Angulo B, Baradits M, Spitzberg AJ, Kessler U, Sartorius A, Dols A, Narr KL, Espinoza R, van Waarde JA, Tendolkar I, van Eijndhoven P, van Wingen GA, Takamiya A, Kishimoto T, Jorgensen MB, Jorgensen A, Paulson OB, Yrondi A, Péran P, Soriano-Mas C, Cardoner N, Cano M, van Diermen L, Schrijvers D, Belge JB, Emsell L, Bouckaert F, Vandenbulcke M, Kiebs M, Hurlemann R, Mulders PC, Redlich R, Dannlowski U, Kavakbasi E, Kritzer MD, Ellard KK, Camprodon JA, Petrides G, Malhotra AK, Abbott CC. Correction: Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression. Mol Psychiatry 2023:10.1038/s41380-023-02358-8. [PMID: 38052984 DOI: 10.1038/s41380-023-02358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Miklos Argyelan
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA.
- The Zucker Hillside Hospital, Glen Oaks, NY, USA.
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Olga Therese Ousdal
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Brian Angulo
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA
| | - Mate Baradits
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Ute Kessler
- Department of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Hungary
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Annemiek Dols
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Psychiatry, Neuroscience, Amsterdam, The Netherlands
| | - Katherine L Narr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Philip van Eijndhoven
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Akihiro Takamiya
- Department of Neuropsychiatry Keio University School of Medicine, Tokyo, Japan
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - Martin B Jorgensen
- Psychiatric Center Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Jorgensen
- Psychiatric Center Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Olaf B Paulson
- Neurobiological Research Unit Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Antoine Yrondi
- Service de Psychiatrie et Psychologie Médicale, Centre Expert Dépression Résistante, Fondation Fondamental, CHU Toulouse, ToNIC, Toulouse NeuroImaging Center, Univerité de Toulouse, Inserm, UPS, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Univeristé de Toulouse, Inserm, UPS, Toulouse, France
| | - Carles Soriano-Mas
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - Narcis Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Cano
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Linda van Diermen
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Psychiatric Center Bethanie, Andreas Vesaliuslaan 39, 2980, Zoersel, Belgium
| | - Didier Schrijvers
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Psychiatric Center Duffel, Stationstraat 22, Duffel, 2570, Belgium
| | - Jean-Baptiste Belge
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Louise Emsell
- Geriatric Psychiatry, University Psychiatric Center-KU Leuven, Leuven, Belgium
| | - Filip Bouckaert
- Geriatric Psychiatry, University Psychiatric Center-KU Leuven, Leuven, Belgium
| | | | - Maximilian Kiebs
- School of Medicine & Health Sciences University Hospital Oldenburg, Oldenburg, Germany
- Department of Psychiatry and Psychotherapy University Hospital Bonn, Bonn, Germany
| | - René Hurlemann
- School of Medicine & Health Sciences University Hospital Oldenburg, Oldenburg, Germany
| | - Peter Cr Mulders
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Ronny Redlich
- Department of Psychology, University of Halle, Halle, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Halle, Germany
| | - Udo Dannlowski
- Department of Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Erhan Kavakbasi
- Department of Mental Health, University of Muenster, Muenster, Germany
| | - Michael D Kritzer
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristen K Ellard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joan A Camprodon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Anil K Malhotra
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA
- The Zucker Hillside Hospital, Glen Oaks, NY, USA
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Calarco N, Oliver LD, Joseph M, Hawco C, Dickie EW, DeRosse P, Gold JM, Foussias G, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. Multivariate Associations Among White Matter, Neurocognition, and Social Cognition Across Individuals With Schizophrenia Spectrum Disorders and Healthy Controls. Schizophr Bull 2023; 49:1518-1529. [PMID: 36869812 PMCID: PMC10686342 DOI: 10.1093/schbul/sbac216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND AND HYPOTHESIS Neurocognitive and social cognitive abilities are important contributors to functional outcomes in schizophrenia spectrum disorders (SSDs). An unanswered question of considerable interest is whether neurocognitive and social cognitive deficits arise from overlapping or distinct white matter impairment(s). STUDY DESIGN We sought to fill this gap, by harnessing a large sample of individuals from the multi-center Social Processes Initiative in the Neurobiology of the Schizophrenia(s) (SPINS) dataset, unique in its collection of advanced diffusion imaging and an extensive battery of cognitive assessments. We applied canonical correlation analysis to estimates of white matter microstructure, and cognitive performance, across people with and without an SSD. STUDY RESULTS Our results established that white matter circuitry is dimensionally and strongly related to both neurocognition and social cognition, and that microstructure of the uncinate fasciculus and the rostral body of the corpus callosum may assume a "privileged role" subserving both. Further, we found that participant-wise estimates of white matter microstructure, weighted by cognitive performance, were largely consistent with participants' categorical diagnosis, and predictive of (cross-sectional) functional outcomes. CONCLUSIONS The demonstrated strength of the relationship between white matter circuitry and neurocognition and social cognition underscores the potential for using relationships among these variables to identify biomarkers of functioning, with potential prognostic and therapeutic implications.
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Affiliation(s)
- Navona Calarco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Michael Joseph
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pamela DeRosse
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Miklos Argyelan
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Robert W Buchanan
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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9
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Argyelan M, Deng ZD, Ousdal OT, Oltedal L, Angulo B, Baradits M, Spitzberg AJ, Kessler U, Sartorius A, Dols A, Narr KL, Espinoza R, van Waarde JA, Tendolkar I, van Eijndhoven P, van Wingen GA, Takamiya A, Kishimoto T, Jorgensen MB, Jorgensen A, Paulson OB, Yrondi A, Péran P, Soriano-Mas C, Cardoner N, Cano M, van Diermen L, Schrijvers D, Belge JB, Emsell L, Bouckaert F, Vandenbulcke M, Kiebs M, Hurlemann R, Mulders PC, Redlich R, Dannlowski U, Kavakbasi E, Kritzer MD, Ellard KK, Camprodon JA, Petrides G, Malhotra AK, Abbott CC. Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression. Mol Psychiatry 2023:10.1038/s41380-023-02318-2. [PMID: 37985787 DOI: 10.1038/s41380-023-02318-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Neurostimulation is a mainstream treatment option for major depression. Neuromodulation techniques apply repetitive magnetic or electrical stimulation to some neural target but significantly differ in their invasiveness, spatial selectivity, mechanism of action, and efficacy. Despite these differences, recent analyses of transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)-treated individuals converged on a common neural network that might have a causal role in treatment response. We set out to investigate if the neuronal underpinnings of electroconvulsive therapy (ECT) are similarly associated with this causal depression network (CDN). Our aim here is to provide a comprehensive analysis in three cohorts of patients segregated by electrode placement (N = 246 with right unilateral, 79 with bitemporal, and 61 with mixed) who underwent ECT. We conducted a data-driven, unsupervised multivariate neuroimaging analysis Principal Component Analysis (PCA) of the cortical and subcortical volume changes and electric field (EF) distribution to explore changes within the CDN associated with antidepressant outcomes. Despite the different treatment modalities (ECT vs TMS and DBS) and methodological approaches (structural vs functional networks), we found a highly similar pattern of change within the CDN in the three cohorts of patients (spatial similarity across 85 regions: r = 0.65, 0.58, 0.40, df = 83). Most importantly, the expression of this pattern correlated with clinical outcomes (t = -2.35, p = 0.019). This evidence further supports that treatment interventions converge on a CDN in depression. Optimizing modulation of this network could serve to improve the outcome of neurostimulation in depression.
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Affiliation(s)
- Miklos Argyelan
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA.
- The Zucker Hillside Hospital, Glen Oaks, NY, USA.
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Olga Therese Ousdal
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Brian Angulo
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA
| | - Mate Baradits
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Ute Kessler
- Department of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Hungary
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Annemiek Dols
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Psychiatry, Neuroscience, Amsterdam, The Netherlands
| | - Katherine L Narr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Philip van Eijndhoven
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Akihiro Takamiya
- Department of Neuropsychiatry Keio University School of Medicine, Tokyo, Japan
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - Martin B Jorgensen
- Psychiatric Center Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Jorgensen
- Psychiatric Center Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Olaf B Paulson
- Neurobiological Research Unit Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Antoine Yrondi
- Service de Psychiatrie et Psychologie Médicale, Centre Expert Dépression Résistante, Fondation Fondamental, CHU Toulouse, ToNIC, Toulouse NeuroImaging Center, Univerité de Toulouse, Inserm, UPS, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Univeristé de Toulouse, Inserm, UPS, Toulouse, France
| | - Carles Soriano-Mas
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - Narcis Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Cano
- CIBERSAM, Carlos III Health Institute, Madrid, Spain
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Linda van Diermen
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Psychiatric Center Bethanie, Andreas Vesaliuslaan 39, 2980, Zoersel, Belgium
| | - Didier Schrijvers
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Psychiatric Center Duffel, Stationstraat 22, Duffel, 2570, Belgium
| | - Jean-Baptiste Belge
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Louise Emsell
- Geriatric Psychiatry, University Psychiatric Center-KU Leuven, Leuven, Belgium
| | - Filip Bouckaert
- Geriatric Psychiatry, University Psychiatric Center-KU Leuven, Leuven, Belgium
| | | | - Maximilian Kiebs
- School of Medicine & Health Sciences University Hospital Oldenburg, Oldenburg, Germany
- Department of Psychiatry and Psychotherapy University Hospital Bonn, Bonn, Germany
| | - René Hurlemann
- School of Medicine & Health Sciences University Hospital Oldenburg, Oldenburg, Germany
| | - Peter Cr Mulders
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Ronny Redlich
- Department of Psychology, University of Halle, Halle, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Halle, Germany
| | - Udo Dannlowski
- Department of Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Erhan Kavakbasi
- Department of Mental Health, University of Muenster, Muenster, Germany
| | - Michael D Kritzer
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristen K Ellard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joan A Camprodon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Anil K Malhotra
- Feinstein Institutes for Medical Research, Institute of Behavioral Science, Manhasset, NY, USA
- The Zucker Hillside Hospital, Glen Oaks, NY, USA
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10
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Cao H, Lencz T, Gallego JA, Rubio JM, John M, Barber AD, Birnbaum ML, Robinson DG, Malhotra AK. A Functional Connectome-Based Neural Signature for Individualized Prediction of Antipsychotic Response in First-Episode Psychosis. Am J Psychiatry 2023; 180:827-835. [PMID: 37644811 DOI: 10.1176/appi.ajp.20220719] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Identification of robust biomarkers that predict individualized response to antipsychotic treatment at the early stage of psychotic disorders remains a challenge in precision psychiatry. The aim of this study was to investigate whether any functional connectome-based neural traits could serve as such a biomarker. METHODS In a discovery sample, 49 patients with first-episode psychosis received multi-paradigm fMRI scans at baseline and were clinically followed up for 12 weeks under antipsychotic monotherapies. Treatment response was evaluated at the individual level based on the psychosis score of the Brief Psychiatric Rating Scale. Cross-paradigm connectivity and connectome-based predictive modeling were employed to train a predictive model that uses baseline connectomic measures to predict individualized change rates of psychosis scores, with model performance evaluated as the Pearson correlations between the predicted change rates and the observed change rates, based on cross-validation. The model generalizability was further examined in an independent validation sample of 24 patients in a similar design. RESULTS The results revealed a paradigm-independent connectomic trait that significantly predicted individualized treatment outcome in both the discovery sample (predicted-versus-observed r=0.41) and the validation sample (predicted-versus-observed r=0.47, mean squared error=0.019). Features that positively predicted psychosis change rates primarily involved connections related to the cerebellar-cortical circuitry, and features that negatively predicted psychosis change rates were chiefly connections within the cortical cognitive systems. CONCLUSIONS This study discovers and validates a connectome-based functional signature as a promising early predictor for individualized response to antipsychotic treatment in first-episode psychosis, thus highlighting the potential clinical value of this biomarker in precision psychiatry.
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Affiliation(s)
- Hengyi Cao
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Todd Lencz
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Juan A Gallego
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Jose M Rubio
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Majnu John
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Anita D Barber
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Michael L Birnbaum
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Delbert G Robinson
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
| | - Anil K Malhotra
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, N.Y. (all authors); Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, N.Y. (all authors); Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, N.Y. (all authors)
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11
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Dickie EW, Shahab S, Hawco C, Miranda D, Herman G, Argyelan M, Ji JL, Jeyachandra J, Anticevic A, Malhotra AK, Voineskos AN. Robust hierarchically organized whole-brain patterns of dysconnectivity in schizophrenia spectrum disorders observed after personalized intrinsic network topography. Hum Brain Mapp 2023; 44:5153-5166. [PMID: 37605827 PMCID: PMC10502662 DOI: 10.1002/hbm.26453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/05/2023] [Accepted: 08/01/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Spatial patterns of brain functional connectivity can vary substantially at the individual level. Applying cortical surface-based approaches with individualized rather than group templates may accelerate the discovery of biological markers related to psychiatric disorders. We investigated cortico-subcortical networks from multi-cohort data in people with schizophrenia spectrum disorders (SSDs) and healthy controls (HC) using individualized connectivity profiles. METHODS We utilized resting-state and anatomical MRI data from n = 406 participants (n = 203 SSD, n = 203 HC) from four cohorts. Functional timeseries were extracted from previously defined intrinsic network subregions of the striatum, thalamus, and cerebellum as well as 80 cortical regions of interest, representing six intrinsic networks using (1) volume-based approaches, (2) a surface-based group atlas approaches, and (3) Personalized Intrinsic Network Topography (PINT). RESULTS The correlations between all cortical networks and the expected subregions of the striatum, cerebellum, and thalamus were increased using a surface-based approach (Cohen's D volume vs. surface 0.27-1.00, all p < 10-6 ) and further increased after PINT (Cohen's D surface vs. PINT 0.18-0.96, all p < 10-4 ). In SSD versus HC comparisons, we observed robust patterns of dysconnectivity that were strengthened using a surface-based approach and PINT (Number of differing pairwise-correlations: volume: 404, surface: 570, PINT: 628, FDR corrected). CONCLUSION Surface-based and individualized approaches can more sensitively delineate cortical network dysconnectivity differences in people with SSDs. These robust patterns of dysconnectivity were visibly organized in accordance with the cortical hierarchy, as predicted by computational models.
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Affiliation(s)
- Erin W. Dickie
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
| | - Saba Shahab
- Department of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Colin Hawco
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
| | - Dayton Miranda
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Gabrielle Herman
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Miklos Argyelan
- Psychiatry Research, The Zucker Hillside HospitalGlen CoveNew YorkUSA
- Institute of Behavioral Science, Feinstein Institutes for Medical ResearchManhassetNew YorkUSA
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Jie Lisa Ji
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
| | - Jerrold Jeyachandra
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
| | - Alan Anticevic
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
| | - Anil K. Malhotra
- Psychiatry Research, The Zucker Hillside HospitalGlen CoveNew YorkUSA
- Institute of Behavioral Science, Feinstein Institutes for Medical ResearchManhassetNew YorkUSA
- Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Aristotle N. Voineskos
- Center for Addiction and Mental HealthCampbell Family Mental Health ResearchTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioUSA
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12
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Tang SX, Cong Y, Nikzad AH, Mehta A, Cho S, Hänsel K, Berretta S, Dhar AA, Kane JM, Malhotra AK. Clinical and computational speech measures are associated with social cognition in schizophrenia spectrum disorders. Schizophr Res 2023; 259:28-37. [PMID: 35835710 DOI: 10.1016/j.schres.2022.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/15/2022]
Abstract
In this study, we compared three domains of social cognition (emotion processing, mentalizing, and attribution bias) to clinical and computational language measures in 63 participants with schizophrenia spectrum disorders. Based on the active inference model for discourse, we hypothesized that emotion processing and mentalizing, but not attribution bias, would be related to language disturbances. Clinical ratings for speech disturbance assessed disorganized and underproductive dimensions. Computational features included speech graph metrics, use of modal verbs, use of first-person pronouns, cosine similarity of adjacent utterances, and measures of sentiment; these were represented by four principal components. We found that higher clinical ratings for disorganized speech were predicted by greater impairments in both emotion processing and mentalizing, and that these relationships remained significant when accounting for demographic variables, overall psychosis symptoms, and verbal ability. Similarly, a computational speech component reflecting insular speech was consistently predicted by impairment in emotion processing. There were notable trends for computational speech components reflecting underproductive speech and decreased content-rich speech predicting mentalizing ability. Exploratory longitudinal analyses in a small subset of participants (n = 17) found that improvements in both emotion processing and mentalizing predicted improvements in disorganized speech. Attribution bias did not demonstrate strong relationships with language measures. Altogether, our findings are consistent with the active inference model of discourse and suggest greater emphasis on treatments that target social cognitive and language systems.
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Affiliation(s)
- Sunny X Tang
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Yan Cong
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Amir H Nikzad
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Aarush Mehta
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Sunghye Cho
- University of Pennsylvania, Linguistic Data Consortium, 3600 Market St., Suite 810, Philadelphia, PA 19104, United States of America.
| | - Katrin Hänsel
- Yale University, Department of Laboratory Medicine, 195 Church Street, New Haven, CT 06510, United States of America.
| | - Sarah Berretta
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Aamina A Dhar
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America
| | - John M Kane
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
| | - Anil K Malhotra
- Zucker Hillside Hospital, Department of Psychiatry, Feinstein Institutes for Medical Research, 75-59 263rd St., Glen Oaks, NY 11004, United States of America.
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13
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Cao H, Barber AD, Rubio JM, Argyelan M, Gallego JA, Lencz T, Malhotra AK. Effects of phase encoding direction on test-retest reliability of human functional connectome. Neuroimage 2023; 277:120238. [PMID: 37364743 PMCID: PMC10529794 DOI: 10.1016/j.neuroimage.2023.120238] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/23/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023] Open
Abstract
The majority of human connectome studies in the literature based on functional magnetic resonance imaging (fMRI) data use either an anterior-to-posterior (AP) or a posterior-to-anterior (PA) phase encoding direction (PED). However, whether and how PED would affect test-retest reliability of functional connectome is unclear. Here, in a sample of healthy subjects with two sessions of fMRI scans separated by 12 weeks (two runs per session, one with AP, the other with PA), we tested the influence of PED on global, nodal, and edge connectivity in the constructed brain networks. All data underwent the state-of-the-art Human Connectome Project (HCP) pipeline to correct for phase-encoding-related distortions before entering analysis. We found that at the global level, the PA scans showed significantly higher intraclass correlation coefficients (ICCs) for global connectivity compared with AP scans, which was particularly prominent when using the Seitzman-300 atlas (versus the CAB-NP-718 atlas). At the nodal level, regions most strongly affected by PED were consistently mapped to the cingulate cortex, temporal lobe, sensorimotor areas, and visual areas, with significantly higher ICCs during PA scans compared with AP scans, regardless of atlas. Better ICCs were also observed during PA scans at the edge level, in particular when global signal regression (GSR) was not performed. Further, we demonstrated that the observed reliability differences between PEDs may relate to a similar effect on the reliability of temporal signal-to-noise ratio (tSNR) in the same regions (that PA scans were associated with higher reliability of tSNR than AP scans). Averaging the connectivity outcome from the AP and PA scans could increase median ICCs, especially at the nodal and edge levels. Similar results at the global and nodal levels were replicated in an independent, public dataset from the HCP-Early Psychosis (HCP-EP) study with a similar design but a much shorter scan session interval. Our findings suggest that PED has significant effects on the reliability of connectomic estimates in fMRI studies. We urge that these effects need to be carefully considered in future neuroimaging designs, especially in longitudinal studies such as those related to neurodevelopment or clinical intervention.
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Affiliation(s)
- Hengyi Cao
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
| | - Anita D Barber
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Jose M Rubio
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Miklos Argyelan
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Juan A Gallego
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Todd Lencz
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Anil K Malhotra
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Division of Psychiatry Research, Zucker Hillside Hospital, 265-16 74th Avenue, Glen Oaks, NY 11004, United States; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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14
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Cetin-Karayumak S, Lyall AE, Di Biase MA, Seitz-Holland J, Zhang F, Kelly S, Elad D, Pearlson G, Tamminga CA, Sweeney JA, Clementz BA, Schretlen D, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Keshavan M, Shenton ME, Rathi Y, Pasternak O, Kubicki M. Characterization of the extracellular free water signal in schizophrenia using multi-site diffusion MRI harmonization. Mol Psychiatry 2023; 28:2030-2038. [PMID: 37095352 DOI: 10.1038/s41380-023-02068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/06/2023] [Accepted: 04/05/2023] [Indexed: 04/26/2023]
Abstract
Studies applying Free Water Imaging have consistently reported significant global increases in extracellular free water (FW) in populations of individuals with early psychosis. However, these published studies focused on homogenous clinical participant groups (e.g., only first episode or chronic), thereby limiting our understanding of the time course of free water elevations across illness stages. Moreover, the relationship between FW and duration of illness has yet to be directly tested. Leveraging our multi-site diffusion magnetic resonance imaging(dMRI) harmonization approach, we analyzed dMRI scans collected by 12 international sites from 441 healthy controls and 434 individuals diagnosed with schizophrenia-spectrum disorders at different illness stages and ages (15-58 years). We characterized the pattern of age-related FW changes by assessing whole brain white matter in individuals with schizophrenia and healthy controls. In individuals with schizophrenia, average whole brain FW was higher than in controls across all ages, with the greatest FW values observed from 15 to 23 years (effect size range = [0.70-0.87]). Following this peak, FW exhibited a monotonic decrease until reaching a minima at the age of 39 years. After 39 years, an attenuated monotonic increase in FW was observed, but with markedly smaller effect sizes when compared to younger patients (effect size range = [0.32-0.43]). Importantly, FW was found to be negatively associated with duration of illness in schizophrenia (p = 0.006), independent of the effects of other clinical and demographic data. In summary, our study finds in a large, age-diverse sample that participants with schizophrenia with a shorter duration of illness showed higher FW values compared to participants with more prolonged illness. Our findings provide further evidence that elevations in the FW are present in individuals with schizophrenia, with the greatest differences in the FW being observed in those at the early stages of the disorder, which might suggest acute extracellular processes.
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Affiliation(s)
- Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Maria A Di Biase
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Doron Elad
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | | | - Robert W Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Anil K Malhotra
- The Feinstein Institutes for Medical Research and Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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15
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Bigdeli TB, Barr PB, Rajeevan N, Graham DP, Li Y, Meyers JL, Gorman BR, Peterson RE, Sayward F, Radhakrishnan K, Natarajan S, Nielsen DA, Wilkinson AV, Malhotra AK, Zhao H, Brophy M, Shi Y, O’Leary TJ, Gleason T, Przygodzki R, Pyarajan S, Muralidhar S, Gaziano JM, Huang GD, Concato J, Siever LJ, DeLisi LE, Kimbrel NA, Beckham JC, Swann AC, Kosten TR, Fanous AH, Aslan M, Harvey PD. Correlates of suicidal behaviors and genetic risk among United States veterans with schizophrenia or bipolar I disorder. medRxiv 2023:2023.03.06.23286866. [PMID: 36945597 PMCID: PMC10029042 DOI: 10.1101/2023.03.06.23286866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Objective Persons diagnosed with schizophrenia (SCZ) or bipolar I disorder (BPI) are at high risk for self-injurious behavior, suicidal ideation, and suicidal behaviors (SB). Characterizing associations between diagnosed mental and physical health problems, prior pharmacological treatments, and aggregate genetic factors has potential to inform risk stratification and mitigation strategies. Methods In this study of 3,942 SCZ and 5,414 BPI patients receiving VA care, self-reported SB and ideation were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS). These cross-sectional data were integrated with electronic health records (EHR), and compared by lifetime diagnoses, treatment histories, follow-up screenings, and mortality data. Polygenic scores (PGS) for traits related to psychiatric disorders, substance use, and cognition were constructed using available genomic data, and exploratory genome-wide association studies were performed to identify and prioritize specific loci. Results Only 20% of veterans who self-reported SB had a corroborating ICD-9/10 code in their EHR; and among those who denied prior behaviors, more than 20% reported new-onset SB at follow-up. SB were associated with a range of psychiatric and non-psychiatric diagnoses, and with treatment with specific classes of psychotropic medications (e.g., antidepressants, antipsychotics, etc.). PGS for externalizing behaviors, smoking, suicide attempt, and major depressive disorder were also associated with attempt and ideation. Conclusions Among individuals with a diagnosed mental illness, a GWAS for SB did not yield any significant loci. Self-reported SB were strongly associated with clinical variables across several EHR domains. Overall, clinical and polygenic analyses point to sequelae of substance-use related behaviors and other psychiatric comorbidities as strong correlates of prior and subsequent SB. Nonetheless, past SB was frequently not documented in clinical settings, underscoring the value of regular screening based on direct, in-person assessments, especially among high-risk individuals.
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Affiliation(s)
- Tim B. Bigdeli
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Peter B. Barr
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Nallakkandi Rajeevan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - David P. Graham
- Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Yuli Li
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Bryan R. Gorman
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA
| | - Roseann E. Peterson
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Frederick Sayward
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Krishnan Radhakrishnan
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, Rockville, MD
| | | | - David A. Nielsen
- Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Anna V. Wilkinson
- Michael E. DeBakey VA Medical Center, Houston, TX
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, Rockville, MD
| | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
- Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY
| | - Hongyu Zhao
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Mary Brophy
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA
- Boston University School of Medicine, Boston, MA
| | - Yunling Shi
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA
| | - Timothy J. O’Leary
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Ronald Przygodzki
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - J. Michael Gaziano
- Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA
- Harvard University, Boston, MA
| | | | | | - Grant D. Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - John Concato
- Yale University School of Medicine, New Haven, CT
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Larry J. Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY
- James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Lynn E. DeLisi
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA
| | - Nathan A. Kimbrel
- Durham VA Health Care System, Durham, NC
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Jean C. Beckham
- Durham VA Health Care System, Durham, NC
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Alan C. Swann
- Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Thomas R. Kosten
- Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
- Departments of Neuroscience, Pharmacology, and Immunology and Rheumatology, Baylor College of Medicine, Houston, TX
| | - Ayman H. Fanous
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry, University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - Mihaela Aslan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Philip D. Harvey
- Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, FL
- University of Miami School of Medicine, Miami, FL
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16
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Liu D, Meyer D, Fennessy B, Feng C, Cheng E, Johnson JS, Park YJ, Rieder MK, Ascolillo S, de Pins A, Dobbyn A, Lebovitch D, Moya E, Nguyen TH, Wilkins L, Hassan A, Burdick KE, Buxbaum JD, Domenici E, Frangou S, Hartmann AM, Laurent-Levinson C, Malhotra D, Pato CN, Pato MT, Ressler K, Roussos P, Rujescu D, Arango C, Bertolino A, Blasi G, Bocchio-Chiavetto L, Campion D, Carr V, Fullerton JM, Gennarelli M, González-Peñas J, Levinson DF, Mowry B, Nimgaokar VL, Pergola G, Rampino A, Cervilla JA, Rivera M, Schwab SG, Wildenauer DB, Daly M, Neale B, Singh T, O'Donovan MC, Owen MJ, Walters JT, Ayub M, Malhotra AK, Lencz T, Sullivan PF, Sklar P, Stahl EA, Huckins LM, Charney AW. Schizophrenia risk conferred by rare protein-truncating variants is conserved across diverse human populations. Nat Genet 2023; 55:369-376. [PMID: 36914870 PMCID: PMC10011128 DOI: 10.1038/s41588-023-01305-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/23/2023] [Indexed: 03/14/2023]
Abstract
Schizophrenia (SCZ) is a chronic mental illness and among the most debilitating conditions encountered in medical practice. A recent landmark SCZ study of the protein-coding regions of the genome identified a causal role for ten genes and a concentration of rare variant signals in evolutionarily constrained genes1. This recent study-and most other large-scale human genetics studies-was mainly composed of individuals of European (EUR) ancestry, and the generalizability of the findings in non-EUR populations remains unclear. To address this gap, we designed a custom sequencing panel of 161 genes selected based on the current knowledge of SCZ genetics and sequenced a new cohort of 11,580 SCZ cases and 10,555 controls of diverse ancestries. Replicating earlier work, we found that cases carried a significantly higher burden of rare protein-truncating variants (PTVs) among evolutionarily constrained genes (odds ratio = 1.48; P = 5.4 × 10-6). In meta-analyses with existing datasets totaling up to 35,828 cases and 107,877 controls, this excess burden was largely consistent across five ancestral populations. Two genes (SRRM2 and AKAP11) were newly implicated as SCZ risk genes, and one gene (PCLO) was identified as shared by individuals with SCZ and those with autism. Overall, our results lend robust support to the rare allelic spectrum of the genetic architecture of SCZ being conserved across diverse human populations.
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Affiliation(s)
- Dongjing Liu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Dara Meyer
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Fennessy
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claudia Feng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Wellcome Sanger Institute, Hinxton, UK
| | - Esther Cheng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica S Johnson
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - You Jeong Park
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marysia-Kolbe Rieder
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Ascolillo
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Agathe de Pins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amanda Dobbyn
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dannielle Lebovitch
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily Moya
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tan-Hoang Nguyen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Lillian Wilkins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Enrico Domenici
- Centre for Computational and Systems Biology, Fondazione The Microsoft Research - University of Trento, Rovereto, Italy
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annette M Hartmann
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Claudine Laurent-Levinson
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique n°15-Troubles Psychiatriques et Développement, Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Dheeraj Malhotra
- Department of Neuroscience and Rare Diseases, Roche Pharma Research and Early Development, F. Hoffmann-La Roche, Basel, Switzerland
| | - Carlos N Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate College of Medicine, New York, NY, USA
| | - Michele T Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate College of Medicine, New York, NY, USA
| | - Kerry Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Panos Roussos
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Blasi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Luisella Bocchio-Chiavetto
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Dominique Campion
- INSERM U1245, Rouen, France
- Centre Hospitalier du Rouvray, Rouen, France
| | - Vaughan Carr
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Massimo Gennarelli
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Javier González-Peñas
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | | | - Bryan Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Vishwajit L Nimgaokar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, Pittsburgh, PA, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Giulio Pergola
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Jorge A Cervilla
- Institute of Neurosciences, Biomedical Research Centre, University of Granada, Granada, Spain
- Department of Psychiatry, San Cecilio University Hospital, University of Granada, Granada, Spain
| | - Margarita Rivera
- Institute of Neurosciences, Biomedical Research Centre, University of Granada, Granada, Spain
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - Sibylle G Schwab
- Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Mark Daly
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Benjamin Neale
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Tarjinder Singh
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michael C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James T Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Muhammad Ayub
- University College London, London, UK
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Anil K Malhotra
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Todd Lencz
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, USA
| | - Patrick F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pamela Sklar
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eli A Stahl
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - Laura M Huckins
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Alexander W Charney
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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17
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Barber AD, Gallego JA, DeRosse P, Birnbaum ML, Lencz T, Ali SA, Moyett A, Malhotra AK. Contributions of Parasympathetic Arousal-Related Activity to Cognitive Performance in Patients With First-Episode Psychosis and Control Subjects. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:181-188. [PMID: 34728433 PMCID: PMC9054940 DOI: 10.1016/j.bpsc.2021.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cognitive impairment is integral to the pathophysiology of psychosis. Recent findings implicate autonomic arousal-related activity in both momentary fluctuations and individual differences in cognitive performance. Although altered autonomic arousal is common in patients with first-episode psychosis (FEP), its contribution to cognitive performance is unknown. METHODS A total of 24 patients with FEP (46% male, age = 24.31 [SD 4.27] years) and 24 control subjects (42% male, age = 27.06 [3.44] years) performed the Multi-Source Interference Task in-scanner with simultaneous pulse oximetry. First-level models included the cardiac-blood oxygen level-dependent regressor, in addition to task (congruent, interference, and error) and nuisance (motion and CompCor physiology) regressors. The cardiac-blood oxygen level-dependent regressor reflected parasympathetic arousal-related activity and was created by convolving the interbeat interval at each heartbeat with the hemodynamic response function. Group models examined the effect of group or cognitive performance (reaction times × error rate) on arousal-related and task activity, while controlling for sex, age, and framewise displacement. RESULTS Parasympathetic arousal-related activity was robust in both groups but localized to different regions for patients with FEP and healthy control subjects. Within both groups, arousal-related activity was significantly associated with cognitive performance across occipital and temporal cortical regions. Greater arousal-related activity in the bilateral prefrontal cortex (Brodmann area 9) was related to better performance in healthy control subjects but not patients with FEP. CONCLUSIONS Autonomic arousal circuits contribute to cognitive performance and the pathophysiology of FEP. Arousal-related functional activity is a novel indicator of cognitive ability and should be incorporated into neurobiological models of cognition in psychosis.
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Affiliation(s)
- Anita D Barber
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York.
| | - Juan A Gallego
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
| | - Pamela DeRosse
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
| | - Michael L Birnbaum
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
| | - Todd Lencz
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
| | - Sana A Ali
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Ashley Moyett
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Anil K Malhotra
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
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18
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Lencz T, Moyett A, Argyelan M, Barber AD, Cholewa J, Birnbaum ML, Gallego JA, John M, Szeszko PR, Robinson DG, Malhotra AK. Frontal lobe fALFF measured from resting-state fMRI as a prognostic biomarker in first-episode psychosis. Neuropsychopharmacology 2022; 47:2245-2251. [PMID: 36198875 PMCID: PMC9630308 DOI: 10.1038/s41386-022-01470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/09/2022]
Abstract
Clinical response to antipsychotic drug treatment is highly variable, yet prognostic biomarkers are lacking. The goal of the present study was to test whether the fractional amplitude of low-frequency fluctuations (fALFF), as measured from baseline resting-state fMRI data, can serve as a potential biomarker of treatment response to antipsychotics. Patients in the first episode of psychosis (n = 126) were enrolled in two prospective studies employing second-generation antipsychotics (risperidone or aripiprazole). Patients were scanned at the initiation of treatment on a 3T MRI scanner (Study 1, GE Signa HDx, n = 74; Study 2, Siemens Prisma, n = 52). Voxelwise fALFF derived from baseline resting-state fMRI scans served as the primary measure of interest, providing a hypothesis-free (as opposed to region-of-interest) search for regions of the brain that might be predictive of response. At baseline, patients who would later meet strict criteria for clinical response (defined as two consecutive ratings of much or very much improved on the CGI, as well as a rating of ≤3 on psychosis-related items of the BPRS-A) demonstrated significantly greater baseline fALFF in bilateral orbitofrontal cortex compared to non-responders. Thus, spontaneous activity in orbitofrontal cortex may serve as a prognostic biomarker of antipsychotic treatment.
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Affiliation(s)
- Todd Lencz
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA.
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA.
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA.
| | - Ashley Moyett
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
| | - Miklos Argyelan
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
| | - Anita D Barber
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
| | - John Cholewa
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
| | - Michael L Birnbaum
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
| | - Juan A Gallego
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
| | - Majnu John
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
- Department of Mathematics, Hofstra University, Hempstead, NY, 11549, USA
| | - Philip R Szeszko
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Delbert G Robinson
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
| | - Anil K Malhotra
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11550, USA
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, 11004, USA
- Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, 11030, USA
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19
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Lam M, Chen CY, Hill WD, Xia C, Tian R, Levey DF, Gelernter J, Stein MB, Hatoum AS, Huang H, Malhotra AK, Runz H, Ge T, Lencz T. Collective genomic segments with differential pleiotropic patterns between cognitive dimensions and psychopathology. Nat Commun 2022; 13:6868. [PMID: 36369282 PMCID: PMC9652380 DOI: 10.1038/s41467-022-34418-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/24/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits are known to be related to most forms of psychopathology. Here, we perform local genetic correlation analysis as a means of identifying independent segments of the genome that show biologically interpretable pleiotropic associations between cognitive dimensions and psychopathology. We identify collective segments of the genome, which we call "meta-loci", showing differential pleiotropic patterns for psychopathology relative to either cognitive task performance (CTP) or performance on a non-cognitive factor (NCF) derived from educational attainment. We observe that neurodevelopmental gene sets expressed during the prenatal-early childhood period predominate in CTP-relevant meta-loci, while post-natal gene sets are more involved in NCF-relevant meta-loci. Further, we demonstrate that neurodevelopmental gene sets are dissociable across CTP meta-loci with respect to their spatial distribution across the brain. Additionally, we find that GABA-ergic, cholinergic, and glutamatergic genes drive pleiotropic relationships within dissociable meta-loci.
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Affiliation(s)
- Max Lam
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Institute of Mental Health, Singapore, Singapore
| | - Chia-Yen Chen
- Translational Biology, Research and Development, Biogen Inc, Cambridge, MA, USA
| | - W David Hill
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Charley Xia
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ruoyu Tian
- Computational Biology and Human Genetics, Dewpoint Therapeutics, Boston, MA, USA
| | - Daniel F Levey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Murray B Stein
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Alexander S Hatoum
- Department of Psychiatry, Washington University in St. Louis Medical School, St. Louis, MO, USA
| | - Hailiang Huang
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Norwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Norwell, Hempstead, NY, USA
| | - Heiko Runz
- Translational Biology, Research and Development, Biogen Inc, Cambridge, MA, USA
| | - Tian Ge
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell, Glen Oaks, NY, USA.
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Norwell, Hempstead, NY, USA.
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Norwell, Hempstead, NY, USA.
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20
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Bigdeli TB, Voloudakis G, Barr PB, Gorman BR, Genovese G, Peterson RE, Burstein DE, Velicu VI, Li Y, Gupta R, Mattheisen M, Tomasi S, Rajeevan N, Sayward F, Radhakrishnan K, Natarajan S, Malhotra AK, Shi Y, Zhao H, Kosten TR, Concato J, O’Leary TJ, Przygodzki R, Gleason T, Pyarajan S, Brophy M, Huang GD, Muralidhar S, Gaziano JM, Aslan M, Fanous AH, Harvey PD, Roussos P. Penetrance and Pleiotropy of Polygenic Risk Scores for Schizophrenia, Bipolar Disorder, and Depression Among Adults in the US Veterans Affairs Health Care System. JAMA Psychiatry 2022; 79:2796413. [PMID: 36103194 PMCID: PMC9475441 DOI: 10.1001/jamapsychiatry.2022.2742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/20/2022] [Indexed: 12/21/2022]
Abstract
Importance Serious mental illnesses, including schizophrenia, bipolar disorder, and depression, are heritable, highly multifactorial disorders and major causes of disability worldwide. Objective To benchmark the penetrance of current neuropsychiatric polygenic risk scores (PRSs) in the Veterans Health Administration health care system and to explore associations between PRS and broad categories of human disease via phenome-wide association studies. Design, Setting, and Participants Extensive Veterans Health Administration's electronic health records were assessed from October 1999 to January 2021, and an embedded cohort of 9378 individuals with confirmed diagnoses of schizophrenia or bipolar 1 disorder were found. The performance of schizophrenia, bipolar disorder, and major depression PRSs were compared in participants of African or European ancestry in the Million Veteran Program (approximately 400 000 individuals), and associations between PRSs and 1650 disease categories based on ICD-9/10 billing codes were explored. Last, genomic structural equation modeling was applied to derive novel PRSs indexing common and disorder-specific genetic factors. Analysis took place from January 2021 to January 2022. Main Outcomes and Measures Diagnoses based on in-person structured clinical interviews were compared with ICD-9/10 billing codes. PRSs were constructed using summary statistics from genome-wide association studies of schizophrenia, bipolar disorder, and major depression. Results Of 707 299 enrolled study participants, 459 667 were genotyped at the time of writing; 84 806 were of broadly African ancestry (mean [SD] age, 58 [12.1] years) and 314 909 were of broadly European ancestry (mean [SD] age, 66.4 [13.5] years). Among 9378 individuals with confirmed diagnoses of schizophrenia or bipolar 1 disorder, 8962 (95.6%) were correctly identified using ICD-9/10 codes (2 or more). Among those of European ancestry, PRSs were robustly associated with having received a diagnosis of schizophrenia (odds ratio [OR], 1.81 [95% CI, 1.76-1.87]; P < 10-257) or bipolar disorder (OR, 1.42 [95% CI, 1.39-1.44]; P < 10-295). Corresponding effect sizes in participants of African ancestry were considerably smaller for schizophrenia (OR, 1.35 [95% CI, 1.29-1.42]; P < 10-38) and bipolar disorder (OR, 1.16 [95% CI, 1.11-1.12]; P < 10-10). Neuropsychiatric PRSs were associated with increased risk for a range of psychiatric and physical health problems. Conclusions and Relevance Using diagnoses confirmed by in-person structured clinical interviews and current neuropsychiatric PRSs, the validity of an electronic health records-based phenotyping approach in US veterans was demonstrated, highlighting the potential of PRSs for disentangling biological and mediated pleiotropy.
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Affiliation(s)
- Tim B. Bigdeli
- VA New York Harbor Healthcare System, Brooklyn
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, New York
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Georgios Voloudakis
- James J. Peters Veterans Affairs Medical Center, Bronx, New York
- Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Peter B. Barr
- VA New York Harbor Healthcare System, Brooklyn
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, New York
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Bryan R. Gorman
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Roseann E. Peterson
- VA New York Harbor Healthcare System, Brooklyn
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, New York
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York
- Department of Psychiatry, Virginia Commonwealth University, Richmond
| | - David E. Burstein
- James J. Peters Veterans Affairs Medical Center, Bronx, New York
- Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vlad I. Velicu
- James J. Peters Veterans Affairs Medical Center, Bronx, New York
- Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Yuli Li
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University School of Medicine, New Haven, Connecticut
| | - Rishab Gupta
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Manuel Mattheisen
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Community Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Simone Tomasi
- James J. Peters Veterans Affairs Medical Center, Bronx, New York
- Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nallakkandi Rajeevan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University School of Medicine, New Haven, Connecticut
| | - Frederick Sayward
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University School of Medicine, New Haven, Connecticut
| | - Krishnan Radhakrishnan
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | | | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York
- Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, New York
| | - Yunling Shi
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain
| | - Hongyu Zhao
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University School of Medicine, New Haven, Connecticut
| | - Thomas R. Kosten
- Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Psychiatry, Neuroscience, Pharmacology, and Immunology and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - John Concato
- Yale University School of Medicine, New Haven, Connecticut
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Timothy J. O’Leary
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Ronald Przygodzki
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain
| | - Mary Brophy
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain
- Boston University School of Medicine, Boston, Massachusetts
| | - Grant D. Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - J. Michael Gaziano
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain
- Harvard Medical School, Boston, Massachusetts
| | - Mihaela Aslan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University School of Medicine, New Haven, Connecticut
| | - Ayman H. Fanous
- Department of Psychiatry, University of Arizona College of Medicine-Phoenix, Phoenix
- Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona
| | - Philip D. Harvey
- Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, Florida
- University of Miami Miller School of Medicine, Miami, Florida
| | - Panos Roussos
- James J. Peters Veterans Affairs Medical Center, Bronx, New York
- Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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21
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Seitz-Holland J, Wojcik JD, Cetin-Karayumak S, Lyall AE, Pasternak O, Rathi Y, Vangel M, Pearlson G, Tamminga C, Sweeney JA, Clementz BA, Schretlen DA, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Kelly S, Shenton ME, Keshavan MS, Mesholam-Gately RI, Kubicki M. Cognitive deficits, clinical variables, and white matter microstructure in schizophrenia: a multisite harmonization study. Mol Psychiatry 2022; 27:3719-3730. [PMID: 35982257 PMCID: PMC10538303 DOI: 10.1038/s41380-022-01731-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 02/08/2023]
Abstract
Cognitive deficits are among the best predictors of real-world functioning in schizophrenia. However, our understanding of how cognitive deficits relate to neuropathology and clinical presentation over the disease lifespan is limited. Here, we combine multi-site, harmonized cognitive, imaging, demographic, and clinical data from over 900 individuals to characterize a) cognitive deficits across the schizophrenia lifespan and b) the association between cognitive deficits, clinical presentation, and white matter (WM) microstructure. Multimodal harmonization was accomplished using T-scores for cognitive data, previously reported standardization methods for demographic and clinical data, and an established harmonization method for imaging data. We applied t-tests and correlation analysis to describe cognitive deficits in individuals with schizophrenia. We then calculated whole-brain WM fractional anisotropy (FA) and utilized regression-mediation analyses to model the association between diagnosis, FA, and cognitive deficits. We observed pronounced cognitive deficits in individuals with schizophrenia (p < 0.006), associated with more positive symptoms and medication dosage. Regression-mediation analyses showed that WM microstructure mediated the association between schizophrenia and language/processing speed/working memory/non-verbal memory. In addition, processing speed mediated the influence of diagnosis and WM microstructure on the other cognitive domains. Our study highlights the critical role of cognitive deficits in schizophrenia. We further show that WM is crucial when trying to understand the role of cognitive deficits, given that it explains the association between schizophrenia and cognitive deficits (directly and via processing speed).
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Affiliation(s)
- Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Joanne D Wojcik
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Petra Verena Viher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY, USA
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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22
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Hawco C, Dickie EW, Herman G, Turner JA, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. A longitudinal multi-scanner multimodal human neuroimaging dataset. Sci Data 2022; 9:332. [PMID: 35701471 PMCID: PMC9198098 DOI: 10.1038/s41597-022-01386-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
Human neuroimaging has led to an overwhelming amount of research into brain function in healthy and clinical populations. However, a better appreciation of the limitations of small sample studies has led to an increased number of multi-site, multi-scanner protocols to understand human brain function. As part of a multi-site project examining social cognition in schizophrenia, a group of "travelling human phantoms" had structural T1, diffusion, and resting-state functional MRIs obtained annually at each of three sites. Scan protocols were carefully harmonized across sites prior to the study. Due to scanner upgrades at each site (all sites acquired PRISMA MRIs during the study) and one participant being replaced, the end result was 30 MRI scans across 4 people, 6 MRIs, and 4 years. This dataset includes multiple neuroimaging modalities and repeated scans across six MRIs. It can be used to evaluate differences across scanners, consistency of pipeline outputs, or test multi-scanner harmonization approaches.
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Affiliation(s)
- Colin Hawco
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Erin W Dickie
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gabrielle Herman
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychology & Neuroscience Institute, Georgia State University, Atlanta, GA, United States
| | - Miklos Argyelan
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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23
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Trubetskoy V, Pardiñas AF, Qi T, Panagiotaropoulou G, Awasthi S, Bigdeli TB, Bryois J, Chen CY, Dennison CA, Hall LS, Lam M, Watanabe K, Frei O, Ge T, Harwood JC, Koopmans F, Magnusson S, Richards AL, Sidorenko J, Wu Y, Zeng J, Grove J, Kim M, Li Z, Voloudakis G, Zhang W, Adams M, Agartz I, Atkinson EG, Agerbo E, Al Eissa M, Albus M, Alexander M, Alizadeh BZ, Alptekin K, Als TD, Amin F, Arolt V, Arrojo M, Athanasiu L, Azevedo MH, Bacanu SA, Bass NJ, Begemann M, Belliveau RA, Bene J, Benyamin B, Bergen SE, Blasi G, Bobes J, Bonassi S, Braun A, Bressan RA, Bromet EJ, Bruggeman R, Buckley PF, Buckner RL, Bybjerg-Grauholm J, Cahn W, Cairns MJ, Calkins ME, Carr VJ, Castle D, Catts SV, Chambert KD, Chan RCK, Chaumette B, Cheng W, Cheung EFC, Chong SA, Cohen D, Consoli A, Cordeiro Q, Costas J, Curtis C, Davidson M, Davis KL, de Haan L, Degenhardt F, DeLisi LE, Demontis D, Dickerson F, Dikeos D, Dinan T, Djurovic S, Duan J, Ducci G, Dudbridge F, Eriksson JG, Fañanás L, Faraone SV, Fiorentino A, Forstner A, Frank J, Freimer NB, Fromer M, Frustaci A, Gadelha A, Genovese G, Gershon ES, Giannitelli M, Giegling I, Giusti-Rodríguez P, Godard S, Goldstein JI, González Peñas J, González-Pinto A, Gopal S, Gratten J, Green MF, Greenwood TA, Guillin O, Gülöksüz S, Gur RE, Gur RC, Gutiérrez B, Hahn E, Hakonarson H, Haroutunian V, Hartmann AM, Harvey C, Hayward C, Henskens FA, Herms S, Hoffmann P, Howrigan DP, Ikeda M, Iyegbe C, Joa I, Julià A, Kähler AK, Kam-Thong T, Kamatani Y, Karachanak-Yankova S, Kebir O, Keller MC, Kelly BJ, Khrunin A, Kim SW, Klovins J, Kondratiev N, Konte B, Kraft J, Kubo M, Kučinskas V, Kučinskiene ZA, Kusumawardhani A, Kuzelova-Ptackova H, Landi S, Lazzeroni LC, Lee PH, Legge SE, Lehrer DS, Lencer R, Lerer B, Li M, Lieberman J, Light GA, Limborska S, Liu CM, Lönnqvist J, Loughland CM, Lubinski J, Luykx JJ, Lynham A, Macek M, Mackinnon A, Magnusson PKE, Maher BS, Maier W, Malaspina D, Mallet J, Marder SR, Marsal S, Martin AR, Martorell L, Mattheisen M, McCarley RW, McDonald C, McGrath JJ, Medeiros H, Meier S, Melegh B, Melle I, Mesholam-Gately RI, Metspalu A, Michie PT, Milani L, Milanova V, Mitjans M, Molden E, Molina E, Molto MD, Mondelli V, Moreno C, Morley CP, Muntané G, Murphy KC, Myin-Germeys I, Nenadić I, Nestadt G, Nikitina-Zake L, Noto C, Nuechterlein KH, O'Brien NL, O'Neill FA, Oh SY, Olincy A, Ota VK, Pantelis C, Papadimitriou GN, Parellada M, Paunio T, Pellegrino R, Periyasamy S, Perkins DO, Pfuhlmann B, Pietiläinen O, Pimm J, Porteous D, Powell J, Quattrone D, Quested D, Radant AD, Rampino A, Rapaport MH, Rautanen A, Reichenberg A, Roe C, Roffman JL, Roth J, Rothermundt M, Rutten BPF, Saker-Delye S, Salomaa V, Sanjuan J, Santoro ML, Savitz A, Schall U, Scott RJ, Seidman LJ, Sharp SI, Shi J, Siever LJ, Sigurdsson E, Sim K, Skarabis N, Slominsky P, So HC, Sobell JL, Söderman E, Stain HJ, Steen NE, Steixner-Kumar AA, Stögmann E, Stone WS, Straub RE, Streit F, Strengman E, Stroup TS, Subramaniam M, Sugar CA, Suvisaari J, Svrakic DM, Swerdlow NR, Szatkiewicz JP, Ta TMT, Takahashi A, Terao C, Thibaut F, Toncheva D, Tooney PA, Torretta S, Tosato S, Tura GB, Turetsky BI, Üçok A, Vaaler A, van Amelsvoort T, van Winkel R, Veijola J, Waddington J, Walter H, Waterreus A, Webb BT, Weiser M, Williams NM, Witt SH, Wormley BK, Wu JQ, Xu Z, Yolken R, Zai CC, Zhou W, Zhu F, Zimprich F, Atbaşoğlu EC, Ayub M, Benner C, Bertolino A, Black DW, Bray NJ, Breen G, Buccola NG, Byerley WF, Chen WJ, Cloninger CR, Crespo-Facorro B, Donohoe G, Freedman R, Galletly C, Gandal MJ, Gennarelli M, Hougaard DM, Hwu HG, Jablensky AV, McCarroll SA, Moran JL, Mors O, Mortensen PB, Müller-Myhsok B, Neil AL, Nordentoft M, Pato MT, Petryshen TL, Pirinen M, Pulver AE, Schulze TG, Silverman JM, Smoller JW, Stahl EA, Tsuang DW, Vilella E, Wang SH, Xu S, Adolfsson R, Arango C, Baune BT, Belangero SI, Børglum AD, Braff D, Bramon E, Buxbaum JD, Campion D, Cervilla JA, Cichon S, Collier DA, Corvin A, Curtis D, Forti MD, Domenici E, Ehrenreich H, Escott-Price V, Esko T, Fanous AH, Gareeva A, Gawlik M, Gejman PV, Gill M, Glatt SJ, Golimbet V, Hong KS, Hultman CM, Hyman SE, Iwata N, Jönsson EG, Kahn RS, Kennedy JL, Khusnutdinova E, Kirov G, Knowles JA, Krebs MO, Laurent-Levinson C, Lee J, Lencz T, Levinson DF, Li QS, Liu J, Malhotra AK, Malhotra D, McIntosh A, McQuillin A, Menezes PR, Morgan VA, Morris DW, Mowry BJ, Murray RM, Nimgaonkar V, Nöthen MM, Ophoff RA, Paciga SA, Palotie A, Pato CN, Qin S, Rietschel M, Riley BP, Rivera M, Rujescu D, Saka MC, Sanders AR, Schwab SG, Serretti A, Sham PC, Shi Y, St Clair D, Stefánsson H, Stefansson K, Tsuang MT, van Os J, Vawter MP, Weinberger DR, Werge T, Wildenauer DB, Yu X, Yue W, Holmans PA, Pocklington AJ, Roussos P, Vassos E, Verhage M, Visscher PM, Yang J, Posthuma D, Andreassen OA, Kendler KS, Owen MJ, Wray NR, Daly MJ, Huang H, Neale BM, Sullivan PF, Ripke S, Walters JTR, O'Donovan MC. Mapping genomic loci implicates genes and synaptic biology in schizophrenia. Nature 2022; 604:502-508. [PMID: 35396580 PMCID: PMC9392466 DOI: 10.1038/s41586-022-04434-5] [Citation(s) in RCA: 721] [Impact Index Per Article: 360.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/10/2022] [Indexed: 01/16/2023]
Abstract
Schizophrenia has a heritability of 60-80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies.
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Affiliation(s)
- Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Antonio F Pardiñas
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Ting Qi
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
| | | | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Tim B Bigdeli
- Department of Psychiatry and the Behavioral Sciences, SUNY Downstate Medical Center, New York, NY, USA
- Institute for Genomic Health, SUNY Downstate Medical Center, New York, NY, USA
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Chia-Yen Chen
- Biogen, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Charlotte A Dennison
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lynsey S Hall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Max Lam
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Kyoko Watanabe
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Oleksandr Frei
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Janet C Harwood
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Frank Koopmans
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Science, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Alexander L Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Julia Sidorenko
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Yang Wu
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Zeng
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Minsoo Kim
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Zhiqiang Li
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Georgios Voloudakis
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wen Zhang
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark Adams
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Elizabeth G Atkinson
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Mariam Al Eissa
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | | | - Madeline Alexander
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Behrooz Z Alizadeh
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey
- Department of Neuroscience, Dokuz Eylül University Graduate School of Health Sciences, Izmir, Turkey
| | - Thomas D Als
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Farooq Amin
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Manuel Arrojo
- Servizo de Psiquiatría, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Lavinia Athanasiu
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Maria Helena Azevedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Silviu A Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Richard A Belliveau
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Judit Bene
- Department of Medical Genetics, Medical School, University of Pécs, Pécs, Hungary
| | - Beben Benyamin
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Julio Bobes
- Área de Psiquiatría-Universidad de Oviedo, Hospital Universitario Central de Asturias (HUCA), Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Asturias, Spain
| | - Stefano Bonassi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma and San Raffaele University, Rome, Italy
| | - Alice Braun
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Rodrigo Affonseca Bressan
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Evelyn J Bromet
- Department of Psychiatry and Behavioural Health, Stony Brook University, Stony Brook, NY, USA
| | - Richard Bruggeman
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter F Buckley
- Health Science Center, University of Tennessee, Memphis, TN, USA
| | - Randy L Buckner
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Wiepke Cahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Altrecht, General Menthal Health Care, Utrecht, The Netherlands
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - David Castle
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Stanley V Catts
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Kimberley D Chambert
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raymond C K Chan
- Institute of Psychology, Chinese Academy of Science, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Boris Chaumette
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Wei Cheng
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - David Cohen
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Institut des Systèmes Intelligents et de Robotique (ISIR), CNRS UMR7222, Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France
| | - Angèle Consoli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Charles Curtis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Kenneth L Davis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Cambridge Health Alliance, Cambridge, MA, USA
| | - Ditte Demontis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Dimitris Dikeos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Timothy Dinan
- Department of Psychiatry and Neurobehavioural Sciences, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Srdjan Djurovic
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Jubao Duan
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | | | - Frank Dudbridge
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessia Fiorentino
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andreas Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nelson B Freimer
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Menachem Fromer
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Frustaci
- Barnet, Enfield and Haringey Mental Health NHS Trust, St Ann's Hospital, London, UK
| | - Ary Gadelha
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Elliot S Gershon
- Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, USA
| | - Marianna Giannitelli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Ina Giegling
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Stephanie Godard
- Departments of Psychiatry and Human and Molecular Genetics, INSERM, Institut de Myologie, Hôpital de la Pitiè-Salpêtrière, Paris, France
| | - Jacqueline I Goldstein
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Javier González Peñas
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Srihari Gopal
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jacob Gratten
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Olivier Guillin
- INSERM, Rouen, France
- Centre Hospitalier du Rouvray, Rouen, France
- UFR Santé, Université de Rouen Normandie, Rouen, France
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Blanca Gutiérrez
- Department of Psychiatry, Faculty of Medicine and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Eric Hahn
- Department of Psychiatry, Charité - Universitätsmedizin, Berlin, Germany
| | - Hakon Hakonarson
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Vahram Haroutunian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research Clinical and Education Center (MIRECC), JJ Peters VA Medical Center, New York, NY, USA
| | - Annette M Hartmann
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Melbourne, Victoria, Australia
| | - Caroline Hayward
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Edinburgh, UK
| | - Frans A Henskens
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Stefan Herms
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Per Hoffmann
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Daniel P Howrigan
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Masashi Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Inge Joa
- Regional Centre for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Anna K Kähler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tony Kam-Thong
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Department of Genetics, Faculty of Biology, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | - Oussama Kebir
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Matthew C Keller
- Institute for Behavioural Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Brian J Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Andrey Khrunin
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Bettina Konte
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Julia Kraft
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | | | - Agung Kusumawardhani
- Psychiatry Department, University of Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Hana Kuzelova-Ptackova
- Department of Psychiatry, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Stefano Landi
- Dipartimento di Biologia, Universita' di Pisa, Pisa, Italy
| | - Laura C Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sophie E Legge
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Douglas S Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Rebecca Lencer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Bernard Lerer
- Department of Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Miaoxin Li
- Zhongshan School of Medicine and Key Laboratory of Tropical Diseases Control (SYSU), Sun Yat-sen University, Guangzhou, China
| | | | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Svetlana Limborska
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Jouko Lönnqvist
- Mental Health Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Carmel M Loughland
- Hunter New England Health and University of Newcastle, Newcastle, New South Wales, Australia
| | - Jan Lubinski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jurjen J Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Second Opinion Outpatient Clinic, GGNet Mental Health, Warnsveld, The Netherlands
| | - Amy Lynham
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Milan Macek
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacques Mallet
- Asfalia Biologics, iPEPS-ICM, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Stephen R Marder
- Semel Institute for Neurosciene, University of California Los Angeles, Los Angeles, CA, USA
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Alicia R Martin
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Manuel Mattheisen
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | | | - Colm McDonald
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - Helena Medeiros
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- College of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Newcastle, New South Wales, Australia
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Vihra Milanova
- Psychiatric Clinic, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Marina Mitjans
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Espen Molden
- Department of Pharmacy, University of Oslo, Oslo, Norway
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
| | - Esther Molina
- Department of Nursing, Faculty of Health Sciences and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - María Dolores Molto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Genetics, Faculty of Biological Sciences, Universidad de Valencia, Valencia, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Christopher P Morley
- Departments of Public Health and Preventive Medicine, Family Medicine, and Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
- Institut de Biologia Evolutiva (UPF-CSIC), Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, PRBB, Barcelona, Spain
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Inez Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Igor Nenadić
- Cognitive Neuropsychiatry Laboratory, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Cristiano Noto
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Niamh Louise O'Brien
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - F Anthony O'Neill
- Centre for Public Health, Institute of Clinical Sciences, Queen's University Belfast, Belfast, UK
| | - Sang-Yun Oh
- Department of Statistics and Applied Probability, University of California at Santa Barbara, Santa Barbara, CA, USA
- Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Vanessa Kiyomi Ota
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Christos Pantelis
- NorthWestern Mental Health, Melbourne, Victoria, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - George N Papadimitriou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Mara Parellada
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Tiina Paunio
- Department of Public Health Solutions, Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Renata Pellegrino
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Sathish Periyasamy
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Bruno Pfuhlmann
- Clinic of Psychiatry and Psychotherapy, Weißer Hirsch, Dresden, Germany
| | - Olli Pietiläinen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jonathan Pimm
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - John Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Allen D Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Mark H Rapaport
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anna Rautanen
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheryl Roe
- SUNY Upstate Medical University, Syracuse, NY, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Julian Roth
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Veikko Salomaa
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Julio Sanjuan
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
- Department of Psychiatry, School of Medicine, University of Valencia, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Marcos Leite Santoro
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Adam Savitz
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Ulrich Schall
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Mater Hospital, McAuley Centre, Newcastle, New South Wales, Australia
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Division of Molecular Medicine, NSW Health Pathology North, Newcastle, New South Wales, Australia
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sally Isabel Sharp
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Engilbert Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yoo Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nora Skarabis
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Petr Slominsky
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Janet L Sobell
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Erik Söderman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Helen J Stain
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
- TIPS - Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Nils Eiel Steen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Agnes A Steixner-Kumar
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | | | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
- Massachusetts Mental Health Center, Boston, MA, USA
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eric Strengman
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - T Scott Stroup
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jaana Suvisaari
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Dragan M Svrakic
- Department of Psychiatry, Washington University, St Louis, MO, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jin P Szatkiewicz
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Thi Minh Tam Ta
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Atsushi Takahashi
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Florence Thibaut
- Université de Paris, Faculté de Médecine, Hôpital Cochin-Tarnier, Paris, France
- INSERM U1266, Institut de Psychiatrie et de Neurosciences, Paris, France
| | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Bulgarian Academy of Science, Sofia, Bulgaria
| | - Paul A Tooney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Silvia Torretta
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Sarah Tosato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gian Battista Tura
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Alp Üçok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arne Vaaler
- Division of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Therese van Amelsvoort
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - John Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Bradley T Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Nigel M Williams
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brandon K Wormley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jing Qin Wu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Zhida Xu
- Department of Psychiatry, GGz Centraal, Utrecht, The Netherlands
| | - Robert Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clement C Zai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wei Zhou
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Zhu
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Eşref Cem Atbaşoğlu
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Muhammad Ayub
- Department of Psychiatry, Queens University Kingston, Kingston, Ontario, Canada
| | - Christian Benner
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Donald W Black
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Nicholas J Bray
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nancy G Buccola
- School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - William F Byerley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Benedicto Crespo-Facorro
- University of Sevilla, CIBERSAM IBiS, Seville, Spain
- Hospital Universitario Virgen del Rocio, Department of Psychiatry, Universidad del Sevilla, Seville, Spain
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Cherrie Galletly
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Michael J Gandal
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Hai-Gwo Hwu
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Assen V Jablensky
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jennifer L Moran
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Michele T Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ann E Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy M Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eli A Stahl
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Regeneron Genetics Center, Orange, CA, USA
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Shi-Heng Wang
- College of Public Health, China Medical University, Taichung, Taiwan
| | - Shuhua Xu
- State Key Laboratory of Genetic Engineering and Ministry of Education (MOE) Key Laboratory of Contemporary Anthropology, Collaborative Innovation Center of Genetics and Development, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Celso Arango
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Sintia Iole Belangero
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - David Braff
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Elvira Bramon
- Division of Psychiatry, Department of Mental Health Neuroscience, University College London, London, UK
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jorge A Cervilla
- Department of Psychiatry, San Cecilio University Hospital, University of Granada, Granada, Spain
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
| | | | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - David Curtis
- UCL Genetics Institute, University College London, London, UK
- Centre for Psychiatry, Queen Mary University London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Enrico Domenici
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Valentina Escott-Price
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ayman H Fanous
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
- Department of Psychiatry, Phoenix VA Healthcare System, Phoenix, AZ, USA
- Banner-University Medical Center, Phoenix, AZ, USA
| | - Anna Gareeva
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - Micha Gawlik
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Pablo V Gejman
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Stephen J Glatt
- Psychiatric Genetic Epidemiology and Neurobiology Laboratory (PsychGENe lab), Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Vera Golimbet
- Mental Health Research Center, Moscow, Russian Federation
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Steven E Hyman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Erik G Jönsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - René S Kahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elza Khusnutdinova
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James A Knowles
- Department of Psychiatry and Zilkha Neurogenetics Institute, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Cell Biology, State University of New York, Downstate Health Sciences University, New York, NY, USA
| | - Marie-Odile Krebs
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Claudine Laurent-Levinson
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Qingqin S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Dheeraj Malhotra
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Paulo R Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Derek W Morris
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Bryan J Mowry
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Robin M Murray
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Roel A Ophoff
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sara A Paciga
- Early Clinical Development, Pfizer Worldwide Research and Development, Groton, CT, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Carlos N Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Shengying Qin
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brien P Riley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Neurosciences, Biomedical Research Center (CIBM), University of Granada, Granada, Spain
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Meram C Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alan R Sanders
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Sibylle G Schwab
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pak C Sham
- Centre for PanorOmic Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yongyong Shi
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - David St Clair
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | | | | | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute of Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, Irvine, CA, USA
| | | | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | - Dieter B Wildenauer
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
| | - Weihua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Peter A Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Andrew J Pocklington
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Panos Roussos
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Matthijs Verhage
- Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research, University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Peter M Visscher
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Danielle Posthuma
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Hailiang Huang
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Michael C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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Agarwal A, Malhotra AK. Effect of Body Position and Size of Pleural Effusion on Oxygenation Status in Spontaneously Breathing Patients with Unilateral Pleural Effusion. J Assoc Physicians India 2022; 70:11-12. [PMID: 35443451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
UNLABELLED Abvims and Dr Rml Hospital, Delhi In unilateral pleural effusion it is necessary to find the best position for unilateral pleural effusion so that recovery can be hastened. There is scarcity of literature on the effect of body positional variations on oxygenation, and current guidelines do not address the necessity. The objective of this study is to assess the effect of body position and size of pleural effusion on oxygenation status in spontaneously breathing patients with unilateral pleural effusion. MATERIAL This was a hospital based observational cross-sectional study having a sample size of 90 patients of unilateral pleural effusion and on the basis of severity, they were divided into 2 classes- small and large. Ipsilateral and Contralateral oxygenation were analysed separately in small and large effusions using Mann-Whitney and Wilcoxon signed rank test and final analysis was made using SPSS software. OBSERVATION It was observed that oxygenation was better when patient lies on contralateral side in small effusion (PaO2 82.4±8.83 vs 85.01±8.24 p value <0.0001) while in cases of large effusion, oxygenation was better on ipsilateral side of effusion (82.35±10.4 vs 78.06±9.92, p value<0.0001). No significant difference was noted in case of PaCO2 levels in small and large effusion in ipsilateral and contralateral position. It was also noted that there was a significant difference in oxygen saturation. CONCLUSION There is significant effect of body position and size of pleural effusion on oxygenation status in spontaneously breathing patient with unilateral pleural effusion.
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Blokland GAM, Grove J, Chen CY, Cotsapas C, Tobet S, Handa R, St Clair D, Lencz T, Mowry BJ, Periyasamy S, Cairns MJ, Tooney PA, Wu JQ, Kelly B, Kirov G, Sullivan PF, Corvin A, Riley BP, Esko T, Milani L, Jönsson EG, Palotie A, Ehrenreich H, Begemann M, Steixner-Kumar A, Sham PC, Iwata N, Weinberger DR, Gejman PV, Sanders AR, Buxbaum JD, Rujescu D, Giegling I, Konte B, Hartmann AM, Bramon E, Murray RM, Pato MT, Lee J, Melle I, Molden E, Ophoff RA, McQuillin A, Bass NJ, Adolfsson R, Malhotra AK, Martin NG, Fullerton JM, Mitchell PB, Schofield PR, Forstner AJ, Degenhardt F, Schaupp S, Comes AL, Kogevinas M, Guzman-Parra J, Reif A, Streit F, Sirignano L, Cichon S, Grigoroiu-Serbanescu M, Hauser J, Lissowska J, Mayoral F, Müller-Myhsok B, Świątkowska B, Schulze TG, Nöthen MM, Rietschel M, Kelsoe J, Leboyer M, Jamain S, Etain B, Bellivier F, Vincent JB, Alda M, O'Donovan C, Cervantes P, Biernacka JM, Frye M, McElroy SL, Scott LJ, Stahl EA, Landén M, Hamshere ML, Smeland OB, Djurovic S, Vaaler AE, Andreassen OA, Baune BT, Air T, Preisig M, Uher R, Levinson DF, Weissman MM, Potash JB, Shi J, Knowles JA, Perlis RH, Lucae S, Boomsma DI, Penninx BWJH, Hottenga JJ, de Geus EJC, Willemsen G, Milaneschi Y, Tiemeier H, Grabe HJ, Teumer A, Van der Auwera S, Völker U, Hamilton SP, Magnusson PKE, Viktorin A, Mehta D, Mullins N, Adams MJ, Breen G, McIntosh AM, Lewis CM, Hougaard DM, Nordentoft M, Mors O, Mortensen PB, Werge T, Als TD, Børglum AD, Petryshen TL, Smoller JW, Goldstein JM. Sex-Dependent Shared and Nonshared Genetic Architecture Across Mood and Psychotic Disorders. Biol Psychiatry 2022; 91:102-117. [PMID: 34099189 PMCID: PMC8458480 DOI: 10.1016/j.biopsych.2021.02.972] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sex differences in incidence and/or presentation of schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BIP) are pervasive. Previous evidence for shared genetic risk and sex differences in brain abnormalities across disorders suggest possible shared sex-dependent genetic risk. METHODS We conducted the largest to date genome-wide genotype-by-sex (G×S) interaction of risk for these disorders using 85,735 cases (33,403 SCZ, 19,924 BIP, and 32,408 MDD) and 109,946 controls from the PGC (Psychiatric Genomics Consortium) and iPSYCH. RESULTS Across disorders, genome-wide significant single nucleotide polymorphism-by-sex interaction was detected for a locus encompassing NKAIN2 (rs117780815, p = 3.2 × 10-8), which interacts with sodium/potassium-transporting ATPase (adenosine triphosphatase) enzymes, implicating neuronal excitability. Three additional loci showed evidence (p < 1 × 10-6) for cross-disorder G×S interaction (rs7302529, p = 1.6 × 10-7; rs73033497, p = 8.8 × 10-7; rs7914279, p = 6.4 × 10-7), implicating various functions. Gene-based analyses identified G×S interaction across disorders (p = 8.97 × 10-7) with transcriptional inhibitor SLTM. Most significant in SCZ was a MOCOS gene locus (rs11665282, p = 1.5 × 10-7), implicating vascular endothelial cells. Secondary analysis of the PGC-SCZ dataset detected an interaction (rs13265509, p = 1.1 × 10-7) in a locus containing IDO2, a kynurenine pathway enzyme with immunoregulatory functions implicated in SCZ, BIP, and MDD. Pathway enrichment analysis detected significant G×S interaction of genes regulating vascular endothelial growth factor receptor signaling in MDD (false discovery rate-corrected p < .05). CONCLUSIONS In the largest genome-wide G×S analysis of mood and psychotic disorders to date, there was substantial genetic overlap between the sexes. However, significant sex-dependent effects were enriched for genes related to neuronal development and immune and vascular functions across and within SCZ, BIP, and MDD at the variant, gene, and pathway levels.
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Affiliation(s)
- Gabriëlla A M Blokland
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
| | - Jakob Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark; Bioinformatics Research Centre (BiRC), Aarhus, Denmark
| | - Chia-Yen Chen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Biogen Inc., Cambridge, Massachusetts
| | - Chris Cotsapas
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Departments of Neurology and Genetics, Yale School of Medicine, New Haven, Connecticut
| | - Stuart Tobet
- Innovation Center on Sex Differences in Medicine (ICON), Massachusetts General Hospital, Boston, Massachusetts; Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Robert Handa
- Innovation Center on Sex Differences in Medicine (ICON), Massachusetts General Hospital, Boston, Massachusetts; Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - David St Clair
- University of Aberdeen, Institute of Medical Sciences, Aberdeen, United Kingdom
| | - Todd Lencz
- The Feinstein Institute for Medical Research, Manhasset, New York; The Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; The Zucker Hillside Hospital, Glen Oaks, New York
| | - Bryan J Mowry
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia; Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sathish Periyasamy
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia; Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Wacol, Queensland, Australia
| | - Murray J Cairns
- Schizophrenia Research Institute, Sydney, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia; Priority Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Paul A Tooney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia; Priority Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Brian Kelly
- Priority Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Patrick F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Brien P Riley
- Virginia Institute for Psychiatric and Behavioral Genetics, Departments of Psychiatry and Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Tõnu Esko
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Lili Milani
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Erik G Jönsson
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden; Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aarno Palotie
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Hannelore Ehrenreich
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin Begemann
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Agnes Steixner-Kumar
- Department of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Pak C Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China; State Key Laboratory for Brain and Cognitive Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China; Centre for Genomic Sciences, The University of Hong Kong, Hong Kong, SAR China
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Baltimore, Maryland; Departments of Psychiatry, Neurology, Neuroscience and Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pablo V Gejman
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, North Shore University Health System, Evanston, Illinois
| | - Alan R Sanders
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, North Shore University Health System, Evanston, Illinois
| | - Joseph D Buxbaum
- Departments of Human Genetics and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dan Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany; Department of Psychiatry, University of Munich, Munich, Germany
| | - Ina Giegling
- Department of Psychiatry, University of Halle, Halle, Germany; Department of Psychiatry, University of Munich, Munich, Germany
| | - Bettina Konte
- Department of Psychiatry, University of Halle, Halle, Germany
| | | | - Elvira Bramon
- Mental Health Neuroscience Research Department, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Robin M Murray
- Institute of Psychiatry, King's College London, London, United Kingdom
| | - Michele T Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York; Department of Psychiatry and Zilkha Neurogenetics Institute, Keck School of Medicine at University of Southern California, Los Angeles, California
| | - Jimmy Lee
- Research Division and Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Espen Molden
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway; Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Roel A Ophoff
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, the Netherlands; Department of Human Genetics, University of California, Los Angeles, California; David Geffen School of Medicine, and Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, United Kingdom
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, United Kingdom
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden
| | - Anil K Malhotra
- The Feinstein Institute for Medical Research, Manhasset, New York; The Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; The Zucker Hillside Hospital, Glen Oaks, New York
| | - Nicholas G Martin
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia; Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Andreas J Forstner
- Centre for Human Genetics, University of Marburg, Marburg, Germany; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Sabrina Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | | | - José Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Joanna Hauser
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Jolanta Lissowska
- Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Bertram Müller-Myhsok
- University of Liverpool, Liverpool, United Kingdom; Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Beata Świątkowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Thomas G Schulze
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - John Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Marion Leboyer
- Faculté de Médecine, Université Paris Est, Créteil, France; Department of Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, Paris, France; Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Stéphane Jamain
- Faculté de Médecine, Université Paris Est, Créteil, France; INSERM U955, Psychiatrie Translationnelle, Créteil, France
| | - Bruno Etain
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; Department of Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S1144 Team 1 Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France; Psychiatry, Université Paris Diderot, Paris, France
| | - Frank Bellivier
- Department of Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, Paris, France; UMR-S1144 Team 1 Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France; Psychiatry, Université Paris Diderot, Paris, France; Paris Bipolar and TRD Expert Centres, FondaMental Foundation, Paris, France
| | - John B Vincent
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pablo Cervantes
- Department of Psychiatry, Mood Disorders Program, McGill University Health Center, Montréal, Québec, Canada
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mark Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - Laura J Scott
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Eli A Stahl
- Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Marian L Hamshere
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Olav B Smeland
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia; Department of Psychiatry, University of Münster, Münster, Germany
| | - Tracy Air
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Austrlalia, Australia
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Douglas F Levinson
- Psychiatry & Behavioral Sciences, Stanford University, Stanford, California
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York
| | - James B Potash
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - James A Knowles
- Psychiatry & The Behavioral Sciences, University of Southern California, Los Angeles, California
| | - Roy H Perlis
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Susanne Lucae
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Dorret I Boomsma
- Department of Biological Psychology/Netherlands Twin Register, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology/Netherlands Twin Register, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology/Netherlands Twin Register, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology/Netherlands Twin Register, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Henning Tiemeier
- Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | | | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Divya Mehta
- School of Psychology and Counseling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Niamh Mullins
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Gerome Breen
- NIHR Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Cathryn M Lewis
- Department of Medical & Molecular Genetics, King's College London, London, United Kingdom
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Copenhagen Mental Health Center, Mental Health Services Capital Region of Denmark Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Preben B Mortensen
- Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research (NCCR), Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Thomas Werge
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
| | - Thomas D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark; Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Concert Pharmaceuticals, Inc., Lexington, Massachusetts
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Jill M Goldstein
- Innovation Center on Sex Differences in Medicine (ICON), Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry and Vincent Department of Obstetrics, Gynecology & Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts; MGH-MIT-HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts; Departments of Psychiatry and Medicine, Harvard Medical School, Boston, Massachusetts.
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Argyelan M, Lencz T, Kang S, Ali S, Masi PJ, Moyett E, Joanlanne A, Watson P, Sanghani S, Petrides G, Malhotra AK. ECT-induced cognitive side effects are associated with hippocampal enlargement. Transl Psychiatry 2021; 11:516. [PMID: 34625534 PMCID: PMC8501017 DOI: 10.1038/s41398-021-01641-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/16/2021] [Accepted: 09/09/2021] [Indexed: 02/08/2023] Open
Abstract
Electroconvulsive therapy (ECT) is of the most effective treatments available for treatment-resistant depression, yet it is underutilized in part due to its reputation of causing cognitive side effects in a significant number of patients. Despite intensive neuroimaging research on ECT in the past two decades, the underlying neurobiological correlates of cognitive side effects remain elusive. Because the primary ECT-related cognitive deficit is memory impairment, it has been suggested that the hippocampus may play a crucial role. In the current study, we investigated 29 subjects with longitudinal MRI and detailed neuropsychological testing in two independent cohorts (N = 15/14) to test if volume changes were associated with cognitive side effects. The two cohorts underwent somewhat different ECT study protocols reflected in electrode placements and the number of treatments. We used longitudinal freesurfer algorithms (6.0) to obtain a bias-free estimate of volume changes in the hippocampus and tested its relationship with neurocognitive score changes. As an exploratory analysis and to evaluate how specific the effects were to the hippocampus, we also calculated this relationship in 41 other areas. In addition, we also analyzed cognitive data from a group of healthy volunteers (N = 29) to assess practice effects. Our results supported the hypothesis that hippocampus enlargement was associated with worse cognitive outcomes, and this result was generalizable across two independent cohorts with different diagnoses, different electrode placements, and a different number of ECT sessions. We found, in both cohorts, that treatment robustly increased the volume size of the hippocampus (Cohort 1: t = 5.07, Cohort 2: t = 4.82; p < 0.001), and the volume increase correlated with the neurocognitive T-score change. (Cohort 1: r = -0.68, p = 0.005; Cohort 2: r = -0.58; p = 0.04). Overall, our research indicates that novel treatment methods serving to avoid hippocampal volume increase may result in a better side effect profile.
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Affiliation(s)
- Miklos Argyelan
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA.
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
| | - Todd Lencz
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Simran Kang
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Sana Ali
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Paul J Masi
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Emily Moyett
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Andrea Joanlanne
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Philip Watson
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
| | - Sohag Sanghani
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Georgios Petrides
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Anil K Malhotra
- Psychiatry Research, The Zucker Hillside Hospital, Glen Cove, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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27
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Elad D, Cetin‐Karayumak S, Zhang F, Cho KIK, Lyall AE, Seitz‐Holland J, Ben‐Ari R, Pearlson GD, Tamminga CA, Sweeney JA, Clementz BA, Schretlen DJ, Viher PV, Stegmayer K, Walther S, Lee J, Crow TJ, James A, Voineskos AN, Buchanan RW, Szeszko PR, Malhotra AK, Keshavan MS, Shenton ME, Rathi Y, Bouix S, Sochen N, Kubicki MR, Pasternak O. Improving the predictive potential of diffusion MRI in schizophrenia using normative models-Towards subject-level classification. Hum Brain Mapp 2021; 42:4658-4670. [PMID: 34322947 PMCID: PMC8410550 DOI: 10.1002/hbm.25574] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/04/2021] [Accepted: 05/27/2021] [Indexed: 12/11/2022] Open
Abstract
Diffusion MRI studies consistently report group differences in white matter between individuals diagnosed with schizophrenia and healthy controls. Nevertheless, the abnormalities found at the group-level are often not observed at the individual level. Among the different approaches aiming to study white matter abnormalities at the subject level, normative modeling analysis takes a step towards subject-level predictions by identifying affected brain locations in individual subjects based on extreme deviations from a normative range. Here, we leveraged a large harmonized diffusion MRI dataset from 512 healthy controls and 601 individuals diagnosed with schizophrenia, to study whether normative modeling can improve subject-level predictions from a binary classifier. To this aim, individual deviations from a normative model of standard (fractional anisotropy) and advanced (free-water) dMRI measures, were calculated by means of age and sex-adjusted z-scores relative to control data, in 18 white matter regions. Even though larger effect sizes are found when testing for group differences in z-scores than are found with raw values (p < .001), predictions based on summary z-score measures achieved low predictive power (AUC < 0.63). Instead, we find that combining information from the different white matter tracts, while using multiple imaging measures simultaneously, improves prediction performance (the best predictor achieved AUC = 0.726). Our findings suggest that extreme deviations from a normative model are not optimal features for prediction. However, including the complete distribution of deviations across multiple imaging measures improves prediction, and could aid in subject-level classification.
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Affiliation(s)
- Doron Elad
- Department of MathematicsTel‐Aviv UniversityTel‐AvivIsrael
| | - Suheyla Cetin‐Karayumak
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fan Zhang
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Kang Ik K. Cho
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Amanda E. Lyall
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Departments of Psychiatry and NeuroscienceMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Johanna Seitz‐Holland
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryUniversity Hospital, Ludwig Maximilian University of MunichMunichGermany
| | | | | | - Carol A. Tamminga
- Department of PsychiatryUT Southwestern Medical CenterDallasTexasUSA
| | - John A. Sweeney
- Department of Psychiatry and Behavioral NeuroscienceUniversity of CincinnatiCincinnatiOhioUSA
| | - Brett A. Clementz
- Departments of Psychology and NeuroscienceBio‐Imaging Research Center, University of GeorgiaAthensGeorgiaUSA
| | - David J. Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological ScienceJohns Hopkins Medical InstitutionsBaltimoreMarylandUSA
| | - Petra Verena Viher
- Translational Research CenterUniversity Hospital of Psychiatry, University of BernBernSwitzerland
| | - Katharina Stegmayer
- Translational Research CenterUniversity Hospital of Psychiatry, University of BernBernSwitzerland
| | - Sebastian Walther
- Translational Research CenterUniversity Hospital of Psychiatry, University of BernBernSwitzerland
| | - Jungsun Lee
- Department of PsychiatryUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea
| | - Tim J. Crow
- Department of Psychiatry, SANE POWICWarneford Hospital, University of OxfordOxfordUK
| | - Anthony James
- Department of Psychiatry, SANE POWICWarneford Hospital, University of OxfordOxfordUK
| | - Aristotle N. Voineskos
- Centre for Addiction and Mental Health, Department of PsychiatryUniversity of TorontoTorontoCanada
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Philip R. Szeszko
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Mental Illness Research, Education and Clinical CenterJames J. Peters VA Medical CenterNew YorkNew YorkUSA
| | - Anil K. Malhotra
- The Feinstein Institute for Medical Research and Zucker Hillside HospitalManhassetNew YorkUSA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical CentreHarvard Medical SchoolBostonMassachusettsUSA
| | - Martha E. Shenton
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Departments of Psychiatry and NeuroscienceMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Yogesh Rathi
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Sylvain Bouix
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Nir Sochen
- Department of MathematicsTel‐Aviv UniversityTel‐AvivIsrael
| | - Marek R. Kubicki
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Departments of Psychiatry and NeuroscienceMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Ofer Pasternak
- Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
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28
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Marzouk T, Winkelbeiner S, Azizi H, Malhotra AK, Homan P. Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review. Neuropsychobiology 2021; 79:384-396. [PMID: 31505508 DOI: 10.1159/000502148] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 07/16/2019] [Indexed: 11/19/2022]
Abstract
Transcranial magnetic stimulation (TMS) has been proposed as a potential treatment add-on for positive symptoms in schizophrenia. To summarize the current evidence for its efficacy, we reviewed clinical trials from the last 20 years that investigated TMS for positive symptoms. We performed a search on the PubMed database for clinical trials that used TMS for the treatment of positive symptoms published in peer-reviewed journals. We excluded reviews, case reports, and opinion papers. Of the 30 studies included, the majority (n = 25) investigated auditory verbal hallucinations. Twelve studies found evidence for a positive treatment effect of TMS on positive symptoms, while 18 did not find enough evidence to conclude that TMS is effective for positive symptoms. However, the small sample size of the majority of studies is a limiting factor for the reliability of previous findings. In conclusion, evidence for an effect of TMS on positive symptoms was mixed. Since most of the studies were performed in patients with auditory verbal hallucinations, further research of TMS for other positive symptoms including thought disorder and delusions is warranted.
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Affiliation(s)
- Taylor Marzouk
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, New York, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA
| | - Stephanie Winkelbeiner
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA, .,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, New York, USA, .,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA, .,Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,
| | - Heela Azizi
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, New York, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA
| | - Anil K Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, New York, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA
| | - Philipp Homan
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, New York, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA
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29
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Seitz-Holland J, Cetin-Karayumak S, Wojcik JD, Lyall A, Levitt J, Shenton ME, Pasternak O, Westin CF, Baxi M, Kelly S, Mesholam-Gately R, Vangel M, Pearlson G, Tamminga CA, Sweeney JA, Clementz BA, Schretlen D, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Rathi Y, Keshavan M, Kubicki M. Elucidating the relationship between white matter structure, demographic, and clinical variables in schizophrenia-a multicenter harmonized diffusion tensor imaging study. Mol Psychiatry 2021; 26:5357-5370. [PMID: 33483689 PMCID: PMC8329919 DOI: 10.1038/s41380-021-01018-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/24/2020] [Accepted: 01/05/2021] [Indexed: 01/30/2023]
Abstract
White matter (WM) abnormalities are repeatedly demonstrated across the schizophrenia time-course. However, our understanding of how demographic and clinical variables interact, influence, or are dependent on WM pathologies is limited. The most well-known barriers to progress are heterogeneous findings due to small sample sizes and the confounding influence of age on WM. The present study leverages access to the harmonized diffusion magnetic-resonance-imaging data and standardized clinical data from 13 international sites (597 schizophrenia patients (SCZ)). Fractional anisotropy (FA) values for all major WM structures in patients were predicted based on FA models estimated from a healthy population (n = 492). We utilized the deviations between predicted and real FA values to answer three essential questions. (1) "Which clinical variables explain WM abnormalities?". (2) "Does the degree of WM abnormalities predict symptom severity?". (3) "Does sex influence any of those relationships?". Regression and mediator analyses revealed that a longer duration-of-illness is associated with more severe WM abnormalities in several tracts. In addition, they demonstrated that a higher antipsychotic medication dose is related to more severe corpus callosum abnormalities. A structural equation model revealed that patients with more WM abnormalities display higher symptom severity. Last, the results exhibited sex-specificity. Males showed a stronger association between duration-of-illness and WM abnormalities. Females presented a stronger association between WM abnormalities and symptom severity, with IQ impacting this relationship. Our findings provide clear evidence for the interaction of demographic, clinical, and behavioral variables with WM pathology in SCZ. Our results also point to the need for longitudinal studies, directly investigating the casualty and sex-specificity of these relationships, as well as the impact of cognitive resiliency on structure-function relationships.
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Affiliation(s)
- Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joanne D Wojcik
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Amanda Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - James Levitt
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carl-Fredrik Westin
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Madhura Baxi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Graduate Program of Neuroscience, Boston University, Boston, MA, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Petra Verena Viher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY, USA
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Lam M, Chen CY, Ge T, Xia Y, Hill DW, Trampush JW, Yu J, Knowles E, Davies G, Stahl EA, Huckins L, Liewald DC, Djurovic S, Melle I, Christoforou A, Reinvang I, DeRosse P, Lundervold AJ, Steen VM, Espeseth T, Räikkönen K, Widen E, Palotie A, Eriksson JG, Giegling I, Konte B, Hartmann AM, Roussos P, Giakoumaki S, Burdick KE, Payton A, Ollier W, Chiba-Falek O, Koltai DC, Need AC, Cirulli ET, Voineskos AN, Stefanis NC, Avramopoulos D, Hatzimanolis A, Smyrnis N, Bilder RM, Freimer NB, Cannon TD, London E, Poldrack RA, Sabb FW, Congdon E, Conley ED, Scult MA, Dickinson D, Straub RE, Donohoe G, Morris D, Corvin A, Gill M, Hariri AR, Weinberger DR, Pendleton N, Bitsios P, Rujescu D, Lahti J, Le Hellard S, Keller MC, Andreassen OA, Deary IJ, Glahn DC, Huang H, Liu C, Malhotra AK, Lencz T. Identifying nootropic drug targets via large-scale cognitive GWAS and transcriptomics. Neuropsychopharmacology 2021; 46:1788-1801. [PMID: 34035472 PMCID: PMC8357785 DOI: 10.1038/s41386-021-01023-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/22/2021] [Accepted: 04/12/2021] [Indexed: 02/05/2023]
Abstract
Broad-based cognitive deficits are an enduring and disabling symptom for many patients with severe mental illness, and these impairments are inadequately addressed by current medications. While novel drug targets for schizophrenia and depression have emerged from recent large-scale genome-wide association studies (GWAS) of these psychiatric disorders, GWAS of general cognitive ability can suggest potential targets for nootropic drug repurposing. Here, we (1) meta-analyze results from two recent cognitive GWAS to further enhance power for locus discovery; (2) employ several complementary transcriptomic methods to identify genes in these loci that are credibly associated with cognition; and (3) further annotate the resulting genes using multiple chemoinformatic databases to identify "druggable" targets. Using our meta-analytic data set (N = 373,617), we identified 241 independent cognition-associated loci (29 novel), and 76 genes were identified by 2 or more methods of gene identification. Actin and chromatin binding gene sets were identified as novel pathways that could be targeted via drug repurposing. Leveraging our transcriptomic and chemoinformatic databases, we identified 16 putative genes targeted by existing drugs potentially available for cognitive repurposing.
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Affiliation(s)
- Max Lam
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Institute of Mental Health, Singapore, Singapore
| | - Chia-Yen Chen
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Biogen, Inc, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Tian Ge
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Yan Xia
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- Psychiatry Department, SUNY Upstate Medical University, Syracuse, NY, USA
| | - David W Hill
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, Scotland, UK
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joey W Trampush
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jin Yu
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Emma Knowles
- Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychic Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Gail Davies
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, Scotland, UK
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Eli A Stahl
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science and Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura Huckins
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science and Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Liewald
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ingrid Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Andrea Christoforou
- Spaulding Rehabilitation Hospital Boston, Charlestown, MA, USA
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Ivar Reinvang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Pamela DeRosse
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Vidar M Steen
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Thomas Espeseth
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | - Johan G Eriksson
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Folkhälsan Research Center, Helsinki, Finland
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Panos Roussos
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Science and Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA
| | | | - Katherine E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA
- Department of Psychiatry - Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Antony Payton
- Division of Informatics, Imaging & Data Sciences, School of Health Sciences, The University of Manchester, Manchester, UK
| | - William Ollier
- Centre for Epidemiology, Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ornit Chiba-Falek
- Division of Translational Brain Sciences, Department of Neurology, Bryan Alzheimer's Disease Research Center, and Center for Genomic and Computational Biology, Duke University Medical Center, Durham, NC, USA
| | - Deborah C Koltai
- Psychiatry and Behavioral Sciences, Division of Medical Psychology, and Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Anna C Need
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Nikos C Stefanis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, University General Hospital "ATTIKON", Athens, Greece
- University Mental Health Research Institute, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Dimitrios Avramopoulos
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alex Hatzimanolis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, University General Hospital "ATTIKON", Athens, Greece
- University Mental Health Research Institute, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, University General Hospital "ATTIKON", Athens, Greece
- University Mental Health Research Institute, Athens, Greece
| | - Robert M Bilder
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Nelson B Freimer
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Edythe London
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | | | - Fred W Sabb
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Eliza Congdon
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | | | - Matthew A Scult
- Weill Cornell Psychiatry at NewYork-Presbyterian, Weill Cornell Medical Center, New York, NY, USA
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, MD, USA
| | - Richard E Straub
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Gary Donohoe
- Neuroimaging, Cognition & Genomics (NICOG) Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Derek Morris
- Neuroimaging, Cognition & Genomics (NICOG) Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology/School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, GR, Greece
| | - Dan Rujescu
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Stephanie Le Hellard
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Matthew C Keller
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, USA
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ian J Deary
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, Scotland, UK
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - David C Glahn
- Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychic Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Hailiang Huang
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Chunyu Liu
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- Psychiatry Department, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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Van Meter AR, Perez-Rodriguez MM, Braga RJ, Shanahan M, Hanna L, Malhotra AK, Burdick KE. Pramipexole to Improve Cognition in Bipolar Disorder: A Randomized Controlled Trial. J Clin Psychopharmacol 2021; 41:421-427. [PMID: 33956703 PMCID: PMC8238822 DOI: 10.1097/jcp.0000000000001407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adults with bipolar disorder (BD) often experience neurocognitive impairment that negatively impacts functioning and quality of life. Previous trials have found that dopamine agonist agents improve cognition in healthy volunteers and that adults with BD who have stable mood and mild cognitive deficits may also benefit. We hypothesized that pramipexole, a dopamine agonist, would improve neurocognitive function in patients with BD. METHODS We recruited 60 adults (aged 18-65 years) with a diagnosis of BD I or II for an 8-week, double-blind, placebo-controlled trial (NCT02397837). All had stable mood and clinically significant neurocognitive impairment at baseline. Participants were randomized to receive pramipexole (n = 31) or a placebo (n = 29), dose was initiated at 0.125 mg 2 times a day and increased to a target of 4.5 mg/d. RESULTS At trial end, the primary outcome, MATRICS Consensus Cognitive Battery composite score, had not improved more in the pramipexole group (mean [SD] = 1.15 [5.4]) than in the placebo group (mean [SD] = 4.12 [5.2], Cohen's d = 0.56, P = 0.049), and mixed models, controlling for symptoms, showed no association between treatment group and MATRICS Consensus Cognitive Battery scores. No serious adverse events were reported. CONCLUSIONS These results suggest that pramipexole is not an efficacious cognitive enhancement agent in BD, even in a sample enriched for characteristics that were associated with a beneficial response in prior work. There are distinct cognitive subgroups among adults with BD and may be related differences in neurobiology that affect response to pramipexole. Additional research to better understand the onset and nature of the cognitive deficits in people with BD will be an important step toward a more personalized approach to treatment.
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Affiliation(s)
- Anna R. Van Meter
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | | | - Raphael J. Braga
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Megan Shanahan
- Brigham and Women's Hospital, Mood and Psychosis Research Program, Boston
| | - Lauren Hanna
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Anil K. Malhotra
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Katherine E. Burdick
- Brigham and Women's Hospital, Mood and Psychosis Research Program, Boston
- Department of Psychiatry, Harvard Medical School, Cambridge, MA
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Lencz T, Yu J, Khan RR, Flaherty E, Carmi S, Lam M, Ben-Avraham D, Barzilai N, Bressman S, Darvasi A, Cho JH, Clark LN, Gümüş ZH, Vijai J, Klein RJ, Lipkin S, Offit K, Ostrer H, Ozelius LJ, Peter I, Malhotra AK, Maniatis T, Atzmon G, Pe'er I. Novel ultra-rare exonic variants identified in a founder population implicate cadherins in schizophrenia. Neuron 2021; 109:1465-1478.e4. [PMID: 33756103 DOI: 10.1016/j.neuron.2021.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/16/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022]
Abstract
The identification of rare variants associated with schizophrenia has proven challenging due to genetic heterogeneity, which is reduced in founder populations. In samples from the Ashkenazi Jewish population, we report that schizophrenia cases had a greater frequency of novel missense or loss of function (MisLoF) ultra-rare variants (URVs) compared to controls, and the MisLoF URV burden was inversely correlated with polygenic risk scores in cases. Characterizing 141 "case-only" genes (MisLoF URVs in ≥3 cases with none in controls), the cadherin gene set was associated with schizophrenia. We report a recurrent case mutation in PCDHA3 that results in the formation of cytoplasmic aggregates and failure to engage in homophilic interactions on the plasma membrane in cultured cells. Modeling purifying selection, we demonstrate that deleterious URVs are greatly overrepresented in the Ashkenazi population, yielding enhanced power for association studies. Identification of the cadherin/protocadherin family as risk genes helps specify the synaptic abnormalities central to schizophrenia.
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Affiliation(s)
- Todd Lencz
- Departments of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11550, USA; Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY 11004, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA.
| | - Jin Yu
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY 11004, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Raiyan Rashid Khan
- Department of Computer Science, Columbia University, New York, NY 10027, USA
| | - Erin Flaherty
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, NY 10032, USA; Mortimer B. Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, NY 10027, USA
| | - Shai Carmi
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Ein Kerem, Jerusalem 9112102, Israel
| | - Max Lam
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY 11004, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Danny Ben-Avraham
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Susan Bressman
- Department of Neurology, Beth Israel Medical Center, New York, NY 10003, USA
| | - Ariel Darvasi
- Department of Genetics, The Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel
| | - Judy H Cho
- Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Lorraine N Clark
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10032, USA; Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA
| | - Zeynep H Gümüş
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Joseph Vijai
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Robert J Klein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA
| | - Steven Lipkin
- Departments of Medicine, Genetic Medicine and Surgery, Weill Cornell Medical College, New York, NY 10065, USA
| | - Kenneth Offit
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Harry Ostrer
- Departments of Pathology and Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Laurie J Ozelius
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Inga Peter
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Anil K Malhotra
- Departments of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11550, USA; Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY 11004, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Tom Maniatis
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, NY 10032, USA; Mortimer B. Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, NY 10027, USA; New York Genome Center, New York, NY 10013, USA
| | - Gil Atzmon
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Human Biology, Haifa University, Haifa, Israel
| | - Itsik Pe'er
- Department of Computer Science, Columbia University, New York, NY 10027, USA; Center for Computational Biology and Bioinformatics, Columbia University, New York, NY 10032, USA.
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33
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Lyall AE, Nägele FL, Pasternak O, Gallego JA, Malhotra AK, McNamara RK, Kubicki M, Peters BD, Robinson DG, Szeszko PR. A 16-week randomized placebo-controlled trial investigating the effects of omega-3 polyunsaturated fatty acid treatment on white matter microstructure in recent-onset psychosis patients concurrently treated with risperidone. Psychiatry Res Neuroimaging 2021; 307:111219. [PMID: 33221631 PMCID: PMC8127861 DOI: 10.1016/j.pscychresns.2020.111219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/21/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022]
Abstract
We examined the impact of treatment with fish oil (FO), a rich source of omega-3 polyunsaturated fatty acids (n-3 PUFA), on white matter in 37 recent-onset psychosis patients receiving risperidone in a double-blind placebo-controlled randomized clinical trial. Patients were scanned at baseline and randomly assigned to receive 16-weeks of treatment with risperidone + FO or risperidone + placebo. Eighteen patients received follow-up MRIs (FO, n = 10/Placebo, n = 8). Erythrocyte levels of n-3 PUFAs eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA) were obtained at both time points. We employed Free Water Imaging metrics representing the extracellular free water fraction (FW) and fractional anisotropy of the tissue (FA-t). Analyses were conducted using Tract-Based-Spatial-Statistics and nonparametric permutation-based tests with family-wise error correction. There were significant positive correlations of FA-t with DHA and DPA among all patients at baseline. Patients treated with risperidone + placebo demonstrated reductions in FA-t and increases in FW, whereas patients treated with risperidone + FO exhibited no significant changes in FW and FA-t reductions were largely attenuated. The correlations of DPA and DHA with baseline FA-t support the hypothesis that n-3 PUFA intake or biosynthesis are associated with white matter abnormalities in psychosis. Adjuvant FO treatment may partially mitigate against white matter alterations observed in recent-onset psychosis patients following risperidone treatment.
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Affiliation(s)
- Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| | - Felix L Nägele
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Juan A Gallego
- Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Anil K Malhotra
- Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Robert K McNamara
- Department of Psychiatry and Behavioral Neuroscience, Lipidomics Research Program, University of Cincinnati, United States
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Bart D Peters
- Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Delbert G Robinson
- Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, United States
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Rubio JM, Malhotra AK, Kane JM. Towards a framework to develop neuroimaging biomarkers of relapse in schizophrenia. Behav Brain Res 2021; 402:113099. [PMID: 33417996 DOI: 10.1016/j.bbr.2020.113099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 12/31/2022]
Abstract
Schizophrenia is a chronic disorder that often requires long-term relapse-prevention treatment. This treatment is effective for most individuals, yet approximately 20-30 % of them may still relapse despite confirmed adherence. Alternatively, for about 15 % it may be safe to discontinue medications over the long term, but since there are no means to identify who those individuals will be, the recommendation is that all individuals receive long-term relapse-prevention treatment with antipsychotic maintenance. Thus, the current approach to prevent relapse in schizophrenia may be suboptimal for over one third of individuals, either by being insufficient to protect against relapse, or by unnecessarily exposing them to medication side effects. There is great need to identify biomarkers of relapse in schizophrenia to stratify treatment according to the risk and develop therapeutics targeting its pathophysiology. In order to develop a line of research that meets those needs, it is necessary to create a framework by identifying the challenges to this type of study as well as potential areas for biomarker identification and development. In this manuscript we review the literature to create such a framework.
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Affiliation(s)
- Jose M Rubio
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.
| | - Anil K Malhotra
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA
| | - John M Kane
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA
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DeRosse P, Ikuta T, Karlsgodt KH, Szeszko PR, Malhotra AK. History of childhood maltreatment is associated with reduced fractional anisotropy of the accumbofrontal 'reward' tract in healthy adults. Brain Imaging Behav 2021; 14:353-361. [PMID: 32125612 DOI: 10.1007/s11682-020-00265-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The deleterious outcomes associated with exposure to childhood maltreatment (CM) are well known and may be at least partially mediated by self-harm behaviors. It has been suggested that these self-harm behaviors serve as a means of decreasing negative mood states but the effects of CM on health outcomes may be much more sinister. A wealth of data suggest that CM may lead to experience-dependent changes in neural circuits underlying reward processes; processes associated with many harmful behaviors. The present study examined the relationship between a history of CM and the microstructure of a white matter tract that may be central to reward processes. Healthy adults (N = 122) were assessed with a diffusion tensor imaging (DTI) exam and the Childhood Trauma Questionnaire (CTQ). Probabilistic tractography was used to delineate the accumbofrontal "reward" tract, connecting the orbitofrontal cortex and nucleus accumbens, and measures of white matter microstructure were extracted. We then examined whether variation in CTQ scores were associated with variation in the microstructure of this tract as measured by fractional anisotropy (FA). After accounting for the effects of age and sex, the CTQ total score accounted for approximately 6% of the variance of FA in the accumbofrontal tract (F(3, 121) = 5.74; p = .001). Post hoc analyses indicated that the overall severity of CM, rather than a specific type of maltreatment, drove this result. These findings indicate that CM influences white matter microstructure in a fiber tract that is likely central to reward processes and adds to a growing literature implicating CM in long-term health-related outcomes.
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Affiliation(s)
- Pamela DeRosse
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, 11549, USA. .,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA. .,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA.
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, University, MS, USA
| | - Katherine H Karlsgodt
- Department of Psychology, University of California, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,James J. Peters VA Medical Center, Bronx, NY, USA
| | - Anil K Malhotra
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, 11549, USA.,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
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Oliver LD, Hawco C, Homan P, Lee J, Green MF, Gold JM, DeRosse P, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. Social Cognitive Networks and Social Cognitive Performance Across Individuals With Schizophrenia Spectrum Disorders and Healthy Control Participants. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 6:1202-1214. [PMID: 33579663 DOI: 10.1016/j.bpsc.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSDs) feature social cognitive deficits, although their neural basis remains unclear. Social cognitive performance may relate to neural circuit activation patterns more than to diagnosis, which would have important prognostic and therapeutic implications. The current study aimed to determine how functional connectivity within and between social cognitive networks relates to social cognitive performance across individuals with SSDs and healthy control participants. METHODS Participants with SSDs (n = 164) and healthy control participants (n = 117) completed the Empathic Accuracy task during functional magnetic resonance imaging as well as lower-level (e.g., emotion recognition) and higher-level (e.g., theory of mind) social cognitive measures outside the scanner. Functional connectivity during the Empathic Accuracy task was analyzed using background connectivity and graph theory. Data-driven social cognitive networks were identified across participants. Regression analyses were used to examine network connectivity-performance relationships across individuals. Positive and negative within- and between-network connectivity strengths were also compared in poor versus good social cognitive performers and in SSD versus control groups. RESULTS Three social cognitive networks were identified: motor resonance, affect sharing, and mentalizing. Regression and group-based analyses demonstrated reduced between-network negative connectivity, or segregation, and greater within- and between-network positive connectivity in worse social cognitive performers. There were no significant effects of diagnostic group on within- or between-network connectivity. CONCLUSIONS These findings suggest that the neural circuitry of social cognitive performance may exist dimensionally. Across participants, better social cognitive performance was associated with greater segregation between social cognitive networks, whereas poor versus good performers may compensate via hyperconnectivity within and between social cognitive networks.
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Affiliation(s)
- Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Philipp Homan
- University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland; Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California; Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Miklos Argyelan
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Cetin-Karayumak S, Di Biase MA, Chunga N, Reid B, Somes N, Lyall AE, Kelly S, Solgun B, Pasternak O, Vangel M, Pearlson G, Tamminga C, Sweeney JA, Clementz B, Schretlen D, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Hegde R, McCarley R, Keshavan M, Shenton M, Rathi Y, Kubicki M. White matter abnormalities across the lifespan of schizophrenia: a harmonized multi-site diffusion MRI study. Mol Psychiatry 2020; 25:3208-3219. [PMID: 31511636 PMCID: PMC7147982 DOI: 10.1038/s41380-019-0509-y] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/05/2019] [Accepted: 06/10/2019] [Indexed: 02/07/2023]
Abstract
Several prominent theories of schizophrenia suggest that structural white matter pathologies may follow a developmental, maturational, and/or degenerative process. However, a lack of lifespan studies has precluded verification of these theories. Here, we analyze the largest sample of carefully harmonized diffusion MRI data to comprehensively characterize age-related white matter trajectories, as measured by fractional anisotropy (FA), across the course of schizophrenia. Our analysis comprises diffusion scans of 600 schizophrenia patients and 492 healthy controls at different illness stages and ages (14-65 years), which were gathered from 13 sites. We determined the pattern of age-related FA changes by cross-sectionally assessing the timing of the structural neuropathology associated with schizophrenia. Quadratic curves were used to model between-group FA differences across whole-brain white matter and fiber tracts at each age; fiber tracts were then clustered according to both the effect-sizes and pattern of lifespan white matter FA differences. In whole-brain white matter, FA was significantly lower across the lifespan (up to 7%; p < 0.0033) and reached peak maturation younger in patients (27 years) compared to controls (33 years). Additionally, three distinct patterns of neuropathology emerged when investigating white matter fiber tracts in patients: (1) developmental abnormalities in limbic fibers, (2) accelerated aging and abnormal maturation in long-range association fibers, (3) severe developmental abnormalities and accelerated aging in callosal fibers. Our findings strongly suggest that white matter in schizophrenia is affected across entire stages of the disease. Perhaps most strikingly, we show that white matter changes in schizophrenia involve dynamic interactions between neuropathological processes in a tract-specific manner.
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Affiliation(s)
- Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA.
| | - Maria A Di Biase
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
| | - Natalia Chunga
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Neurology, University of Rochester Medical Center, NY, Rochester, USA
| | - Benjamin Reid
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
| | - Nathaniel Somes
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- MGH Institute of Health Professions, MA, Charlestown, USA
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | | | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, USA
| | - David Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, USA
| | - Petra Verena Viher
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | | | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, New York, USA
| | - Anil K Malhotra
- The Feinstein Institute for Medical Research and Zucker Hillside Hospital, Manhasset, USA
| | - Rachal Hegde
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | | | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Martha Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Harvard Medical School, Boston, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Bigdeli TB, Fanous AH, Li Y, Rajeevan N, Sayward F, Genovese G, Gupta R, Radhakrishnan K, Malhotra AK, Sun N, Lu Q, Hu Y, Li B, Chen Q, Mane S, Miller P, Cheung KH, Gur RE, Greenwood TA, Braff DL, Achtyes ED, Buckley PF, Escamilla MA, Lehrer D, Malaspina DP, McCarroll SA, Rapaport MH, Vawter MP, Pato MT, Pato CN, Zhao H, Kosten TR, Brophy M, Pyarajan S, Shi Y, O’Leary TJ, Gleason T, Przygodzki R, Muralidhar S, Gaziano JM, Huang GD, Concato J, Siever LJ, Aslan M, Harvey PD. Genome-Wide Association Studies of Schizophrenia and Bipolar Disorder in a Diverse Cohort of US Veterans. Schizophr Bull 2020; 47:517-529. [PMID: 33169155 PMCID: PMC7965063 DOI: 10.1093/schbul/sbaa133] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Schizophrenia (SCZ) and bipolar disorder (BIP) are debilitating neuropsychiatric disorders, collectively affecting 2% of the world's population. Recognizing the major impact of these psychiatric disorders on the psychosocial function of more than 200 000 US Veterans, the Department of Veterans Affairs (VA) recently completed genotyping of more than 8000 veterans with SCZ and BIP in the Cooperative Studies Program (CSP) #572. METHODS We performed genome-wide association studies (GWAS) in CSP #572 and benchmarked the predictive value of polygenic risk scores (PRS) constructed from published findings. We combined our results with available summary statistics from several recent GWAS, realizing the largest and most diverse studies of these disorders to date. RESULTS Our primary GWAS uncovered new associations between CHD7 variants and SCZ, and novel BIP associations with variants in Sortilin Related VPS10 Domain Containing Receptor 3 (SORCS3) and downstream of PCDH11X. Combining our results with published summary statistics for SCZ yielded 39 novel susceptibility loci including CRHR1, and we identified 10 additional findings for BIP (28 326 cases and 90 570 controls). PRS trained on published GWAS were significantly associated with case-control status among European American (P < 10-30) and African American (P < .0005) participants in CSP #572. CONCLUSIONS We have demonstrated that published findings for SCZ and BIP are robustly generalizable to a diverse cohort of US veterans. Leveraging available summary statistics from GWAS of global populations, we report 52 new susceptibility loci and improved fine-mapping resolution for dozens of previously reported associations.
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Affiliation(s)
- Tim B Bigdeli
- VA New York Harbor Healthcare System, Brooklyn, NY,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Ayman H Fanous
- VA New York Harbor Healthcare System, Brooklyn, NY,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Yuli Li
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Nallakkandi Rajeevan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Frederick Sayward
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA,Department of Genetics, Harvard Medical School, Boston, MA
| | - Rishab Gupta
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Krishnan Radhakrishnan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,College of Medicine, University of Kentucky, Lexington, KY
| | - Anil K Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY,Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY
| | - Ning Sun
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Qiongshi Lu
- Department of Medicine, Yale School of Medicine, New Haven, CT,Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Yiming Hu
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Boyang Li
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Quan Chen
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Shrikant Mane
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Perry Miller
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Kei-Hoi Cheung
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Raquel E Gur
- Departments of Psychiatry and Child & Adolescent Psychiatry and Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - David L Braff
- Department of Psychiatry, University of California, La Jolla, San Diego, CA,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA
| | | | - Eric D Achtyes
- Cherry Health and Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Michael A Escamilla
- Department of Psychiatry, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX
| | - Douglas Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH
| | - Dolores P Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA,Department of Genetics, Harvard Medical School, Boston, MA
| | - Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Michele T Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Carlos N Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | | | - Hongyu Zhao
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Thomas R Kosten
- Departments of Psychiatry, Neuroscience, Pharmacology, and Immunology and Rheumatology, Baylor College of Medicine, Houston, TX
| | - Mary Brophy
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA,Section of Hematology and Medical Oncology, Boston University School of Medicine, Boston, MA
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA
| | - Yunling Shi
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA
| | - Timothy J O’Leary
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Ronald Przygodzki
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - J Michael Gaziano
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA,Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Grant D Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - John Concato
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY,University of Miami Miller School of Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Mihaela Aslan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Philip D Harvey
- Research Service Bruce W. Carter VA Medical Center, Miami, FL,Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL,To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1450 Miami, FL 33136, USA; tel: (305)-243-4094, fax: (305)-243-1619, e-mail:
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39
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Ali SA, Moyett A, Argyelan M, Barber AD, Homan P, Rubio JM, Fales C, Gallego JA, Lencz T, Malhotra AK. The effects of lorazepam on cortico-striatal connectivity in schizophrenia. Schizophr Res 2020; 223:363-365. [PMID: 32718769 DOI: 10.1016/j.schres.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/23/2020] [Accepted: 07/11/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Sana A Ali
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America.
| | - Ashley Moyett
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America
| | - Miklos Argyelan
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
| | - Anita D Barber
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
| | - Philipp Homan
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
| | - Jose M Rubio
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
| | - Christina Fales
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America
| | - Juan A Gallego
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
| | - Anil K Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States of America; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, United States of America
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Rubio JM, Schoretsanitis G, John M, Tiihonen J, Taipale H, Guinart D, Malhotra AK, Correll CU, Kane JM. Psychosis relapse during treatment with long-acting injectable antipsychotics in individuals with schizophrenia-spectrum disorders: an individual participant data meta-analysis. Lancet Psychiatry 2020; 7:749-761. [PMID: 32828165 DOI: 10.1016/s2215-0366(20)30264-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/16/2020] [Accepted: 05/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most individuals with schizophrenia-spectrum disorders have relapses, which increase the risk of morbidity and mortality. Because non-adherence to antipsychotic maintenance treatment could affect more than half of individuals with schizophrenia-spectrum disorders, psychosis relapse can often be confounded by unnoticed treatment interruption. Research of relapse during confirmed antipsychotic exposure has basic clinical and neurobiological implications, but data are scarce. We aimed to generate reliable estimates of incidence and predictors of relapse during assured antipsychotic treatment. METHODS We did a systematic review and individual participant data (IPD) meta-analysis of clinical trials of long-acting injectable antipsychotics (LAIs) for psychosis relapse-prevention, following IPD-PRISMA guidelines. Datasets were identified by searching relevant repositories from inception to Aug 1, 2019. Each LAI group was reanalysed as a separate cohort, further identifying subcohorts of individuals with and without prospectively determined symptom remission (PSR). Summary incidence rate of relapse, incidence rate ratios (IRRs) of relapse between individuals with and without PSR, hazard ratios (HRs) of covariates on risk of relapse, and standardised mean difference (SMDs) in changes in overall functioning associated with relapse were generated by pooling results from the harmonised reanalysis of each study. This study is registered with PROSPERO, number CRD42019137439. FINDINGS 19 treatment cohorts consisting of 5130 individuals (2938 with PSR, 2192 without PSR), with 3959·53 observed participant-years, were meta-analysed. Pooled incidence of relapse was 22·97 per 100 participant-years (14·76 per 100 participant-years for the PSR subcohort, 31·51 per 100 participant-years for the non-PSR subcohort), with an IRR of 0·19 (95% CI 0·07 to 0·54). Relapse was associated with functional decline (overall SMD -0·76, 95% CI -1·14 to -0·37; PSR SMD -0·52, 95% CI -0·80 to -0·21; non-PSR SMD -0·72, 95% CI -1·18 to -0·26). The strongest predictor of relapse was tardive dyskinesia at treatment onset (HR 2·39, 95% CI 1·05 to 5·42). INTERPRETATION Despite the established efficacy of antipsychotics in preventing relapse, these data indicate that these drugs might not prevent subsequent exacerbations for a proportion of individuals whose illness is stabilised on continuous antipsychotic treatment. Tardive dyskinesia in particular might have pathophysiological implications for relapse. FUNDING Northwell Health.
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Affiliation(s)
- Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
| | - Georgios Schoretsanitis
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Majnu John
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Jari Tiihonen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Heidi Taipale
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Daniel Guinart
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Anil K Malhotra
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
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41
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ter Hark SE, Jamain S, Schijven D, Lin BD, Bakker MK, Boland-Auge A, Deleuze JF, Troudet R, Malhotra AK, Gülöksüz S, Vinkers CH, Ebdrup BH, Kahn RS, Leboyer M, Luykx JJ. A new genetic locus for antipsychotic-induced weight gain: A genome-wide study of first-episode psychosis patients using amisulpride (from the OPTiMiSE cohort). J Psychopharmacol 2020; 34:524-531. [PMID: 32126890 PMCID: PMC7222287 DOI: 10.1177/0269881120907972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Antipsychotic-induced weight gain is a common and debilitating side effect of antipsychotics. Although genome-wide association studies of antipsychotic-induced weight gain have been performed, few genome-wide loci have been discovered. Moreover, these genome-wide association studies have included a wide variety of antipsychotic compounds. AIMS We aim to gain more insight in the genomic loci affecting antipsychotic-induced weight gain. Given the variable pharmacological properties of antipsychotics, we hypothesized that targeting a single antipsychotic compound would provide new clues about genomic loci affecting antipsychotic-induced weight gain. METHODS All subjects included for this genome-wide association study (n=339) were first-episode schizophrenia spectrum disorder patients treated with amisulpride and were minimally medicated (defined as antipsychotic use <2 weeks in the previous year and/or <6 weeks lifetime). Weight gain was defined as the increase in body mass index from before until approximately 1 month after amisulpride treatment. RESULTS Our genome-wide association analyses for antipsychotic-induced weight gain yielded one genome-wide significant hit (rs78310016; β=1.05; p=3.66 × 10-08; n=206) in a locus not previously associated with antipsychotic-induced weight gain or body mass index. Minor allele carriers had an odds ratio of 3.98 (p=1.0 × 10-03) for clinically meaningful antipsychotic-induced weight gain (⩾7% of baseline weight). In silico analysis elucidated a chromatin interaction with 3-Hydroxy-3-Methylglutaryl-CoA Synthase 1. In an attempt to replicate single-nucleotide polymorphisms previously associated with antipsychotic-induced weight gain, we found none were associated with amisulpride-induced weight gain. CONCLUSION Our findings suggest the involvement of rs78310016 and possibly 3-Hydroxy-3-Methylglutaryl-CoA Synthase 1 in antipsychotic-induced weight gain. In line with the unique binding profile of this atypical antipsychotic, our findings furthermore hint that biological mechanisms underlying amisulpride-induced weight gain differ from antipsychotic-induced weight gain by other atypical antipsychotics.
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Affiliation(s)
- Sophie E ter Hark
- Department of Translational Neuroscience, Utrecht University, Utrecht, The Netherlands
| | - Stéphane Jamain
- Psychiatrie Translationnelle, Inserm U955, Créteil, France,Faculté de Médecine, Université Paris Est, Créteil, France,Fondation FondaMental, Créteil, France
| | - Dick Schijven
- Department of Translational Neuroscience, Utrecht University, Utrecht, The Netherlands
| | - Bochao D Lin
- Department of Translational Neuroscience, Utrecht University, Utrecht, The Netherlands
| | - Mark K Bakker
- Department of Translational Neuroscience, Utrecht University, Utrecht, The Netherlands
| | - Anne Boland-Auge
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, Evry, France
| | - Réjane Troudet
- Psychiatrie Translationnelle, Inserm U955, Créteil, France,Faculté de Médecine, Université Paris Est, Créteil, France,Fondation FondaMental, Créteil, France
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, United States of America
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health Neuroscience Maastricht University Medical Center, Maastricht, The Netherlands,Department of Psychiatry, Yale School of Medicine, New Haven, United States of America
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands,Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - René S Kahn
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, United States of America
| | - Marion Leboyer
- Psychiatrie Translationnelle, Inserm U955, Créteil, France,Faculté de Médecine, Université Paris Est, Créteil, France,Fondation FondaMental, Créteil, France,AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d’addictologie des Hôpitaux universitaires Henri Mondor, Créteil, France
| | - Jurjen J Luykx
- Department of Translational Neuroscience, Utrecht University, Utrecht, The Netherlands,Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands,GGNet Mental Health, Apeldoorn, The Netherlands,Jurjen J Luykx, Departments of Translational Neuroscience and Psychiatry, University Medical Center Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands.
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42
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Harvey PD, Sun N, Bigdeli TB, Fanous AH, Aslan M, Malhotra AK, Lu Q, Hu Y, Li B, Chen Q, Mane S, Miller P, Rajeevan N, Sayward F, Cheung KH, Li Y, Greenwood TA, Gur RE, Braff DL, Brophy M, Pyarajan S, O'Leary TJ, Gleason T, Przygodszki R, Muralidhar S, Gaziano JM, Concato J, Zhao H, Siever LJ. Genome-wide association study of cognitive performance in U.S. veterans with schizophrenia or bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2020; 183:181-194. [PMID: 31872970 DOI: 10.1002/ajmg.b.32775] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/22/2019] [Accepted: 12/09/2019] [Indexed: 12/25/2022]
Abstract
Cognitive impairment is a frequent and serious problem in patients with various forms of severe mental illnesses (SMI), including schizophrenia (SZ) and bipolar disorder (BP). Recent research suggests genetic links to several cognitive phenotypes in both SMI and in the general population. Our goal in this study was to identify potential genomic signatures of cognitive functioning in veterans with severe mental illness and compare them to previous findings for cognition across different populations. Veterans Affairs (VA) Cooperative Studies Program (CSP) Study #572 evaluated cognitive and functional capacity measures among SZ and BP patients. In conjunction with the VA Million Veteran Program, 3,959 European American (1,095 SZ, 2,864 BP) and 2,601 African American (1,095 SZ, 2,864 BP) patients were genotyped using a custom Affymetrix Axiom Biobank array. We performed a genome-wide association study of global cognitive functioning, constructed polygenic scores for SZ and cognition in the general population, and examined genetic correlations with 2,626 UK Biobank traits. Although no single locus attained genome-wide significance, observed allelic effects were strongly consistent with previous studies. We observed robust associations between global cognitive functioning and polygenic scores for cognitive performance, intelligence, and SZ risk. We also identified significant genetic correlations with several cognition-related traits in UK Biobank. In a diverse cohort of U.S. veterans with SZ or BP, we demonstrate broad overlap of common genetic effects on cognition in the general population, and find that greater polygenic loading for SZ risk is associated with poorer cognitive performance.
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Affiliation(s)
- Philip D Harvey
- Research Service, Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, Florida.,Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, Florida
| | - Ning Sun
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Tim B Bigdeli
- Department of Psychiatry, VA New York Harbor Healthcare System, Brooklyn, New York.,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Ayman H Fanous
- Department of Psychiatry, VA New York Harbor Healthcare System, Brooklyn, New York.,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Mihaela Aslan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Anil K Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York.,Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York.,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, New York
| | - Qiongshi Lu
- Yale University School of Medicine, New Haven, Connecticut.,Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Yiming Hu
- Yale University School of Medicine, New Haven, Connecticut
| | - Boyang Li
- Yale University School of Medicine, New Haven, Connecticut
| | - Quan Chen
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Shrikant Mane
- Yale University School of Medicine, New Haven, Connecticut
| | - Perry Miller
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Nallakkandi Rajeevan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Frederick Sayward
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Kei-Hoi Cheung
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Yuli Li
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | | | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Child & Adolescent Psychiatry and Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - David L Braff
- Department of Psychiatry, University of California, San Diego, California.,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, California
| | | | - Mary Brophy
- Massachusetts Area Veterans Epidemiology Research, and Information Center (MAVERIC), Jamaica Plain, Massachusetts.,Boston University School of Medicine, Boston, Massachusetts
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology Research, and Information Center (MAVERIC), Jamaica Plain, Massachusetts
| | - Timothy J O'Leary
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia
| | - Ronald Przygodszki
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia
| | - J Michael Gaziano
- Massachusetts Area Veterans Epidemiology Research, and Information Center (MAVERIC), Jamaica Plain, Massachusetts.,Department of Medicine, Harvard University, Boston, Massachusetts
| | - John Concato
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Hongyu Zhao
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut.,Yale University School of Medicine, New Haven, Connecticut
| | - Larry J Siever
- James J. Peters Veterans Affairs Medical Center, Bronx, New York.,Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
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43
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Petrides G, Malur C, Braga RJ, Bailine SH, Schooler NR, Malhotra AK, Kane JM, Sanghani S, Goldberg TE, John M, Mendelowitz A. Electroconvulsive Therapy Augmentation in Clozapine-Resistant Schizophrenia: A Prospective, Randomized Study. Focus (Am Psychiatr Publ) 2020; 17:76-82. [PMID: 32015718 DOI: 10.1176/appi.focus.17106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Reprinted with permission from Am J Psychiatry 2015; 172:52-58).
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44
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Adhikari BM, Jahanshad N, Shukla D, Turner J, Grotegerd D, Dannlowski U, Kugel H, Engelen J, Dietsche B, Krug A, Kircher T, Fieremans E, Veraart J, Novikov DS, Boedhoe PSW, van der Werf YD, van den Heuvel OA, Ipser J, Uhlmann A, Stein DJ, Dickie E, Voineskos AN, Malhotra AK, Pizzagalli F, Calhoun VD, Waller L, Veer IM, Walter H, Buchanan RW, Glahn DC, Hong LE, Thompson PM, Kochunov P. A resting state fMRI analysis pipeline for pooling inference across diverse cohorts: an ENIGMA rs-fMRI protocol. Brain Imaging Behav 2020; 13:1453-1467. [PMID: 30191514 DOI: 10.1007/s11682-018-9941-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Large-scale consortium efforts such as Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) and other collaborative efforts show that combining statistical data from multiple independent studies can boost statistical power and achieve more accurate estimates of effect sizes, contributing to more reliable and reproducible research. A meta- analysis would pool effects from studies conducted in a similar manner, yet to date, no such harmonized protocol exists for resting state fMRI (rsfMRI) data. Here, we propose an initial pipeline for multi-site rsfMRI analysis to allow research groups around the world to analyze scans in a harmonized way, and to perform coordinated statistical tests. The challenge lies in the fact that resting state fMRI measurements collected by researchers over the last decade vary widely, with variable quality and differing spatial or temporal signal-to-noise ratio (tSNR). An effective harmonization must provide optimal measures for all quality data. Here we used rsfMRI data from twenty-two independent studies with approximately fifty corresponding T1-weighted and rsfMRI datasets each, to (A) review and aggregate the state of existing rsfMRI data, (B) demonstrate utility of principal component analysis (PCA)-based denoising and (C) develop a deformable ENIGMA EPI template based on the representative anatomy that incorporates spatial distortion patterns from various protocols and populations.
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Affiliation(s)
- Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Neda Jahanshad
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
| | - Dinesh Shukla
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jessica Turner
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | | | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Jennifer Engelen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Els Fieremans
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Jelle Veraart
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Dmitry S Novikov
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Premika S W Boedhoe
- Department of Psychiatry, Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, Netherlands
| | - Ysbrand D van der Werf
- Department of Psychiatry, Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, Netherlands
| | - Jonathan Ipser
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Erin Dickie
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anil K Malhotra
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York, NY, USA
| | - Fabrizio Pizzagalli
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
| | - Vince D Calhoun
- The Mind Research Network & The University of New Mexico, Albuquerque, NM, USA
| | - Lea Waller
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Matte, Berlin, Germany
| | - Ilja M Veer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Matte, Berlin, Germany
| | - Hernik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Matte, Berlin, Germany
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David C Glahn
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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45
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Raghavendra S, Khurrana T, Malhotra AK. Yet another case of acute methotrexate toxicity due to accidental overdose. J Assoc Physicians India 2020; 68:69. [PMID: 31979693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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46
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Blair Thies M, DeRosse P, Sarpal DK, Argyelan M, Fales CL, Gallego JA, Robinson DG, Lencz T, Homan P, Malhotra AK. Interaction of Cannabis Use Disorder and Striatal Connectivity in Antipsychotic Treatment Response. Schizophr Bull Open 2020; 1:sgaa014. [PMID: 32803161 PMCID: PMC7418867 DOI: 10.1093/schizbullopen/sgaa014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Antipsychotic (AP) medications are the mainstay for the treatment of schizophrenia spectrum disorders (SSD), but their efficacy is unpredictable and widely variable. Substantial efforts have been made to identify prognostic biomarkers that can be used to guide optimal prescription strategies for individual patients. Striatal regions involved in salience and reward processing are disrupted as a result of both SSD and cannabis use, and research demonstrates that striatal circuitry may be integral to response to AP drugs. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate the relationship between a history of cannabis use disorder (CUD) and a striatal connectivity index (SCI), a previously developed neural biomarker for AP treatment response in SSD. Patients were part of a 12-week randomized, double-blind controlled treatment study of AP drugs. A sample of 48 first-episode SSD patients with no more than 2 weeks of lifetime exposure to AP medications, underwent a resting-state fMRI scan pretreatment. Treatment response was defined a priori as a binary (response/nonresponse) variable, and a SCI was calculated in each patient. We examined whether there was an interaction between lifetime CUD history and the SCI in relation to treatment response. We found that CUD history moderated the relationship between SCI and treatment response, such that it had little predictive value in SSD patients with a CUD history. In sum, our findings highlight that biomarker development can be critically impacted by patient behaviors that influence neurobiology, such as a history of CUD.
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Affiliation(s)
- Melanie Blair Thies
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Deepak K Sarpal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Miklos Argyelan
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Christina L Fales
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Juan A Gallego
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Graduate Center—City University of New York, New York, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Delbert G Robinson
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Philipp Homan
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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47
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Barber AD, John M, DeRosse P, Birnbaum ML, Lencz T, Malhotra AK. Parasympathetic arousal-related cortical activity is associated with attention during cognitive task performance. Neuroimage 2019; 208:116469. [PMID: 31846756 PMCID: PMC7200169 DOI: 10.1016/j.neuroimage.2019.116469] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 12/21/2022] Open
Abstract
Parasympathetic arousal is associated with states of heightened attention and well-being. Arousal may affect widespread cortical and subcortical systems across the brain, however, little is known about its influence on cognitive task processing and performance. In the current study, healthy adult participants (n = 20) underwent multi-band echo-planar imaging (TR = 0.72 s) with simultaneous pulse oximetry recordings during performance of the Multi Source Interference Task (MSIT), the Oddball Task (OBT), and during rest. Processing speed on both tasks was robustly related to heart rate (HR). Participants with slower HR responded faster on both the MSIT (33% variance explained) and the OBT (25% variance explained). Within all participants, trial-to-trial fluctuations in processing speed were robustly related to the heartbeat-stimulus interval, a metric that is dependent both on the concurrent HR and the stimulus timing with respect to the heartbeat. Models examining the cardiac-BOLD response revealed that a distributed set of regions showed arousal-related activity that was distinct for different task conditions. Across these cortical regions, activity increased with slower HR. Arousal-related activity was distinct from task-evoked activity and it was robust to the inclusion of additional physiological nuisance regressors into the models. For the MSIT, such arousal-related activity occurred across visual and dorsal attention network regions. For the OBT, this activity occurred within fronto-parietal regions. For rest, arousal-related activity also occurred, but was confined to visual regions. The pulvinar nucleus of the thalamus showed arousal-related activity during all three task conditions. Widespread cortical activity, associated with increased parasympathetic arousal, may be propagated by thalamic circuits and contributes to improved attention. This activity is distinct from task-evoked activity, but affects cognitive performance and therefore should be incorporated into neurobiological models of cognition and clinical disorders.
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Affiliation(s)
- Anita D Barber
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA.
| | - Majnu John
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Department of Mathematics, Hofstra University, 100 Hofstra University, Hempstead, NY, 11549, USA
| | - Pamela DeRosse
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Michael L Birnbaum
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Todd Lencz
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Anil K Malhotra
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
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48
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Argyelan M, Oltedal L, Deng ZD, Wade B, Bikson M, Joanlanne A, Sanghani S, Bartsch H, Cano M, Dale AM, Dannlowski U, Dols A, Enneking V, Espinoza R, Kessler U, Narr KL, Oedegaard KJ, Oudega ML, Redlich R, Stek ML, Takamiya A, Emsell L, Bouckaert F, Sienaert P, Pujol J, Tendolkar I, van Eijndhoven P, Petrides G, Malhotra AK, Abbott C. Electric field causes volumetric changes in the human brain. eLife 2019; 8:49115. [PMID: 31644424 PMCID: PMC6874416 DOI: 10.7554/elife.49115] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/22/2019] [Indexed: 12/13/2022] Open
Abstract
Recent longitudinal neuroimaging studies in patients with electroconvulsive therapy (ECT) suggest local effects of electric stimulation (lateralized) occur in tandem with global seizure activity (generalized). We used electric field (EF) modeling in 151 ECT treated patients with depression to determine the regional relationships between EF, unbiased longitudinal volume change, and antidepressant response across 85 brain regions. The majority of regional volumes increased significantly, and volumetric changes correlated with regional electric field (t = 3.77, df = 83, r = 0.38, p=0.0003). After controlling for nuisance variables (age, treatment number, and study site), we identified two regions (left amygdala and left hippocampus) with a strong relationship between EF and volume change (FDR corrected p<0.01). However, neither structural volume changes nor electric field was associated with antidepressant response. In summary, we showed that high electrical fields are strongly associated with robust volume changes in a dose-dependent fashion. Electroconvulsive therapy, or ECT for short, can be an effective treatment for severe depression. Many patients who do not respond to medication find that their symptoms improve after ECT. During an ECT session, the patient is placed under general anesthesia and two electrodes are attached to the scalp to produce an electric field that generates currents within the brain. These currents activate neurons and make them fire, causing a seizure, but it remains unclear how this reduces symptoms of depression. For many years, researchers thought that the induced seizure must be key to the beneficial effects of ECT, but recent studies have cast doubt on this idea. They show that increasing the strength of the electric field alters the clinical effects of ECT, without affecting the seizure. This suggests that the benefits of ECT depend on the electric field itself. Argyelan et al. now show that electric fields affect the brain by making a part of the brain known as the gray matter expand. In a large multinational study, 151 patients with severe depression underwent brain scans before and after a course of ECT. The scans revealed that the gray matter of the patients’ brains expanded during the treatment. The patients who experienced the strongest electric fields showed the largest increase in brain volume, and individual brain areas expanded if the electric field within them exceeded a certain threshold. This effect was particularly striking in two areas, the hippocampus and the amygdala. Both of these areas are critical for mood and memory. Further studies are needed to determine why the brain expands after ECT, and how long the effect lasts. Another puzzle is why the improvements in depression that the patients reported after their treatment did not correlate with changes in brain volume. Disentangling the relationships between ECT, brain volume and depression will ultimately help develop more robust treatments for this disabling condition.
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Affiliation(s)
- Miklos Argyelan
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, United States.,Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, United States.,Department of Psychiatry, Zucker School of Medicine, Hempstead, United States
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Mohn Medical Imaging and Visualization Centre, Bergen, Norway
| | - Zhi-De Deng
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, United States
| | - Benjamin Wade
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, United States
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of the City University of New York, New York, United States
| | - Andrea Joanlanne
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, United States
| | - Sohag Sanghani
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, United States
| | - Hauke Bartsch
- Department of Radiology, Haukeland University Hospital, Mohn Medical Imaging and Visualization Centre, Bergen, Norway.,Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, United States
| | - Marta Cano
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBERSAM, Carlos III Health Institute, Barcelona, Spain
| | - Anders M Dale
- Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, United States.,Department of Radiology, University of California, San Diego, San Diego, United States.,Department of Neurosciences, University of California, San Diego, San Diego, United States
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Annemiek Dols
- Department of Psychiatry, Amsterdam UMC, location VUmc, GGZinGeest, Old Age Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Verena Enneking
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Randall Espinoza
- Department of Neurology, University of California, Los Angeles, Los Angeles, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States
| | - Ute Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Katherine L Narr
- Department of Neurology, University of California, Los Angeles, Los Angeles, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States
| | - Ketil J Oedegaard
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Mardien L Oudega
- Department of Psychiatry, Amsterdam UMC, location VUmc, GGZinGeest, Old Age Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Ronny Redlich
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Max L Stek
- Department of Psychiatry, Amsterdam UMC, location VUmc, GGZinGeest, Old Age Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Center for Psychiatry and Behavioral Science, Komagino Hospital, Tokyo, Japan
| | - Louise Emsell
- Department of Geriatric Psychiatry, University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Filip Bouckaert
- Department of Geriatric Psychiatry, University Psychiatric Center, KU Leuven, Leuven, Belgium.,Academic center for ECT and Neurostimulation (AcCENT), University Psychiatric Center, KU Leuven, Kortenberg, Belgium
| | - Pascal Sienaert
- Academic center for ECT and Neurostimulation (AcCENT), University Psychiatric Center, KU Leuven, Kortenberg, Belgium
| | - Jesus Pujol
- CIBERSAM, Carlos III Health Institute, Barcelona, Spain.,MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Indira Tendolkar
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.,Faculty of Medicine and LVR Clinic for Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Philip van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands
| | - Georgios Petrides
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, United States.,Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, United States.,Department of Psychiatry, Zucker School of Medicine, Hempstead, United States
| | - Anil K Malhotra
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, United States.,Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, United States.,Department of Psychiatry, Zucker School of Medicine, Hempstead, United States
| | - Christopher Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, United States
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49
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Malhotra AK. Assessing the Candidates. Biol Psychiatry 2019; 86:573-574. [PMID: 31558219 DOI: 10.1016/j.biopsych.2019.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Anil K Malhotra
- The Zucker Hillside Hospital, The Feinstein Institutes for Medical Research, Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, New York.
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50
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Lam M, Hill WD, Trampush JW, Yu J, Knowles E, Davies G, Stahl E, Huckins L, Liewald DC, Djurovic S, Melle I, Sundet K, Christoforou A, Reinvang I, DeRosse P, Lundervold AJ, Steen VM, Espeseth T, Räikkönen K, Widen E, Palotie A, Eriksson JG, Giegling I, Konte B, Hartmann AM, Roussos P, Giakoumaki S, Burdick KE, Payton A, Ollier W, Chiba-Falek O, Attix DK, Need AC, Cirulli ET, Voineskos AN, Stefanis NC, Avramopoulos D, Hatzimanolis A, Arking DE, Smyrnis N, Bilder RM, Freimer NA, Cannon TD, London E, Poldrack RA, Sabb FW, Congdon E, Conley ED, Scult MA, Dickinson D, Straub RE, Donohoe G, Morris D, Corvin A, Gill M, Hariri AR, Weinberger DR, Pendleton N, Bitsios P, Rujescu D, Lahti J, Le Hellard S, Keller MC, Andreassen OA, Deary IJ, Glahn DC, Malhotra AK, Lencz T. Pleiotropic Meta-Analysis of Cognition, Education, and Schizophrenia Differentiates Roles of Early Neurodevelopmental and Adult Synaptic Pathways. Am J Hum Genet 2019; 105:334-350. [PMID: 31374203 PMCID: PMC6699140 DOI: 10.1016/j.ajhg.2019.06.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Susceptibility to schizophrenia is inversely correlated with general cognitive ability at both the phenotypic and the genetic level. Paradoxically, a modest but consistent positive genetic correlation has been reported between schizophrenia and educational attainment, despite the strong positive genetic correlation between cognitive ability and educational attainment. Here we leverage published genome-wide association studies (GWASs) in cognitive ability, education, and schizophrenia to parse biological mechanisms underlying these results. Association analysis based on subsets (ASSET), a pleiotropic meta-analytic technique, allowed jointly associated loci to be identified and characterized. Specifically, we identified subsets of variants associated in the expected ("concordant") direction across all three phenotypes (i.e., greater risk for schizophrenia, lower cognitive ability, and lower educational attainment); these were contrasted with variants that demonstrated the counterintuitive ("discordant") relationship between education and schizophrenia (i.e., greater risk for schizophrenia and higher educational attainment). ASSET analysis revealed 235 independent loci associated with cognitive ability, education, and/or schizophrenia at p < 5 × 10-8. Pleiotropic analysis successfully identified more than 100 loci that were not significant in the input GWASs. Many of these have been validated by larger, more recent single-phenotype GWASs. Leveraging the joint genetic correlations of cognitive ability, education, and schizophrenia, we were able to dissociate two distinct biological mechanisms-early neurodevelopmental pathways that characterize concordant allelic variation and adulthood synaptic pruning pathways-that were linked to the paradoxical positive genetic association between education and schizophrenia. Furthermore, genetic correlation analyses revealed that these mechanisms contribute not only to the etiopathogenesis of schizophrenia but also to the broader biological dimensions implicated in both general health outcomes and psychiatric illness.
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Affiliation(s)
- Max Lam
- Institute of Mental Health, Singapore, 539747, Singapore; Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - W David Hill
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Joey W Trampush
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jin Yu
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
| | - Emma Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Eli Stahl
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Laura Huckins
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - David C Liewald
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway
| | - Ingrid Melle
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway
| | - Kjetil Sundet
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Andrea Christoforou
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Ivar Reinvang
- Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Pamela DeRosse
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, 7807, N-5020, Norway
| | - Vidar M Steen
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Thomas Espeseth
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014, Finland; Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, United Kingdom; Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, 00014, Finland
| | - Johan G Eriksson
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, 00014, Finland; National Institute for Health and Welfare, Helsinki FI-00271, Finland; Folkhälsan Research Center, Helsinki 00290, Finland
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Panos Roussos
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY 10468, USA
| | | | - Katherine E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY 10468, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115
| | - Antony Payton
- Division of Informatics, Imaging, and Data Sciences, School of Health Sciences, University of Manchester, Manchester M139NT, United Kingdom
| | - William Ollier
- Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester M139PL, United Kingdom; School of Healthcare Sciences, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
| | - Ornit Chiba-Falek
- Department of Neurology, Bryan Alzheimer Disease Research Center, Duke University Medical Center, Durham, NC 27705, USA; Center for Genomic and Computational Biology, Duke University Medical Center, Durham, NC 27705, USA
| | - Deborah K Attix
- Department of Neurology, Bryan Alzheimer Disease Research Center, Duke University Medical Center, Durham, NC 27705, USA; Center for Genomic and Computational Biology, Duke University Medical Center, Durham, NC 27705, USA; Psychiatry and Behavioral Sciences, Division of Medical Psychology, Duke University Medical Center, Durham, NC 27708, USA; Department of Neurology, Duke University Medical Center, Durham, NC 27708, USA
| | - Anna C Need
- Division of Brain Sciences, Department of Medicine, Imperial College, London W12 0NN, UK
| | | | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada
| | - Nikos C Stefanis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens 115 27, Greece; Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Dimitrios Avramopoulos
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Alex Hatzimanolis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada; Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens 115 27, Greece
| | - Dan E Arking
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Nikolaos Smyrnis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada; Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Robert M Bilder
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Nelson A Freimer
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT 06511, USA
| | - Edythe London
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA
| | | | - Fred W Sabb
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, 97401, USA
| | - Eliza Congdon
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA
| | | | - Matthew A Scult
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, MD 20814, USA
| | - Richard E Straub
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD 21205, USA
| | - Gary Donohoe
- Neuroimaging, Cognition, and Genomics Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Derek Morris
- Neuroimaging, Cognition, and Genomics Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD 21205, USA
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester M13 9PL, United Kingdom
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete GR-71003, Greece
| | - Dan Rujescu
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, 00014, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki 00014, Finland
| | - Stephanie Le Hellard
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Matthew C Keller
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO 80303, USA
| | - Ole A Andreassen
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - David C Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA.
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