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Dy-Hollins ME, Carr SJ, Essa A, Osiecki L, Lackland DT, Voeks JH, Mejia NI, Sharma N, Budman CL, Cath DC, Grados MA, King RA, Lyon GJ, Rouleau GA, Sandor P, Singer HS, Chibnik LB, Mathews CA, Scharf JM. The Challenge of Examining Social Determinants of Health in People Living With Tourette Syndrome. Pediatr Neurol 2024; 155:55-61. [PMID: 38608551 DOI: 10.1016/j.pediatrneurol.2024.02.008] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND To examine the association between race, ethnicity, and parental educational attainment on tic-related outcomes among Tourette Syndrome (TS) participants in the Tourette Association of America International Consortium for Genetics (TAAICG) database. METHODS 723 participants in the TAAICG dataset aged ≤21 years were included. The relationships between tic-related outcomes and race and ethnicity were examined using linear and logistic regressions. Parametric and nonparametric tests were performed to examine the association between parental educational attainment and tic-related outcomes. RESULTS Race and ethnicity were collapsed as non-Hispanic white (N=566, 88.0%) versus Other (N=77, 12.0%). Tic symptom onset was earlier by 1.1 years (P < 0.0001) and TS diagnosis age was earlier by 0.9 years (P = 0.0045) in the Other group (versus non-Hispanic white). Sex and parental education as covariates did not contribute to the differences observed in TS diagnosis age. There were no significant group differences observed across the tic-related outcomes in parental education variable. CONCLUSIONS Our study was limited by the low number of nonwhite or Hispanic individuals in the cohort. Racial and ethnic minoritized groups experienced an earlier age of TS diagnosis than non-Hispanic white individuals. Tic severity did not differ between the two groups, and parental educational attainment did not affect tic-related outcomes. There remain significant disparities and gaps in knowledge regarding TS and associated comorbid conditions. Our study suggests the need for more proactive steps to engage individuals with tic disorders from all racial and ethnic minoritized groups to participate in research studies.
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Affiliation(s)
- Marisela E Dy-Hollins
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Samuel J Carr
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Angela Essa
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lisa Osiecki
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel T Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
| | - Jenifer H Voeks
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
| | - Nicte I Mejia
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen, Rijks Universiteit Groningen, and Drenthe Mental Health Institute, Groningen, Netherlands
| | - Marco A Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert A King
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Gholson J Lyon
- George A. Jervis Clinic and Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Center, Montreal, Canada
| | - Paul Sandor
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Harvey S Singer
- Departments of Pediatrics and Neurology, Johns Hopkins Hospital, Kennedy Krieger Institute, Baltimore, Maryland
| | - Lori B Chibnik
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, University of Florida, Gainsville, Florida
| | - Jeremiah M Scharf
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Strom NI, Gerring ZF, Galimberti M, Yu D, Halvorsen MW, Abdellaoui A, Rodriguez-Fontenla C, Sealock JM, Bigdeli T, Coleman JR, Mahjani B, Thorp JG, Bey K, Burton CL, Luykx JJ, Zai G, Alemany S, Andre C, Askland KD, Banaj N, Barlassina C, Nissen JB, Bienvenu OJ, Black D, Bloch MH, Boberg J, Børte S, Bosch R, Breen M, Brennan BP, Brentani H, Buxbaum JD, Bybjerg-Grauholm J, Byrne EM, Cabana-Dominguez J, Camarena B, Camarena A, Cappi C, Carracedo A, Casas M, Cavallini MC, Ciullo V, Cook EH, Crosby J, Cullen BA, De Schipper EJ, Delorme R, Djurovic S, Elias JA, Estivill X, Falkenstein MJ, Fundin BT, Garner L, German C, Gironda C, Goes FS, Grados MA, Grove J, Guo W, Haavik J, Hagen K, Harrington K, Havdahl A, Höffler KD, Hounie AG, Hucks D, Hultman C, Janecka M, Jenike E, Karlsson EK, Kelley K, Klawohn J, Krasnow JE, Krebs K, Lange C, Lanzagorta N, Levey D, Lindblad-Toh K, Macciardi F, Maher B, Mathes B, McArthur E, McGregor N, McLaughlin NC, Meier S, Miguel EC, Mulhern M, Nestadt PS, Nurmi EL, O’Connell KS, Osiecki L, Ousdal OT, Palviainen T, Pedersen NL, Piras F, Piras F, Potluri S, Rabionet R, Ramirez A, Rauch S, Reichenberg A, Riddle MA, Ripke S, Rosário MC, Sampaio AS, Schiele MA, Skogholt AH, Sloofman LGSG, Smit J, Soler AM, Thomas LF, Tifft E, Vallada H, van Kirk N, Veenstra-VanderWeele J, Vulink NN, Walker CP, Wang Y, Wendland JR, Winsvold BS, Yao Y, Zhou H, Agrawal A, Alonso P, Berberich G, Bucholz KK, Bulik CM, Cath D, Denys D, Eapen V, Edenberg H, Falkai P, Fernandez TV, Fyer AJ, Gaziano JM, Geller DA, Grabe HJ, Greenberg BD, Hanna GL, Hickie IB, Hougaard DM, Kathmann N, Kennedy J, Lai D, Landén M, Le Hellard S, Leboyer M, Lochner C, McCracken JT, Medland SE, Mortensen PB, Neale BM, Nicolini H, Nordentoft M, Pato M, Pato C, Pauls DL, Piacentini J, Pittenger C, Posthuma D, Ramos-Quiroga JA, Rasmussen SA, Richter MA, Rosenberg DR, Ruhrmann S, Samuels JF, Sandin S, Sandor P, Spalletta G, Stein DJ, Stewart SE, Storch EA, Stranger BE, Turiel M, Werge T, Andreassen OA, Børglum AD, Walitza S, Hveem K, Hansen BK, Rück CP, Martin NG, Milani L, Mors O, Reichborn-Kjennerud T, Ribasés M, Kvale G, Mataix-Cols D, Domschke K, Grünblatt E, Wagner M, Zwart JA, Breen G, Nestadt G, Kaprio J, Arnold PD, Grice DE, Knowles JA, Ask H, Verweij KJ, Davis LK, Smit DJ, Crowley JJ, Scharf JM, Stein MB, Gelernter J, Mathews CA, Derks EM, Mattheisen M. Genome-wide association study identifies 30 obsessive-compulsive disorder associated loci. medRxiv 2024:2024.03.13.24304161. [PMID: 38712091 PMCID: PMC11071577 DOI: 10.1101/2024.03.13.24304161] [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] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Obsessive-compulsive disorder (OCD) affects ~1% of the population and exhibits a high SNP-heritability, yet previous genome-wide association studies (GWAS) have provided limited information on the genetic etiology and underlying biological mechanisms of the disorder. We conducted a GWAS meta-analysis combining 53,660 OCD cases and 2,044,417 controls from 28 European-ancestry cohorts revealing 30 independent genome-wide significant SNPs and a SNP-based heritability of 6.7%. Separate GWAS for clinical, biobank, comorbid, and self-report sub-groups found no evidence of sample ascertainment impacting our results. Functional and positional QTL gene-based approaches identified 249 significant candidate risk genes for OCD, of which 25 were identified as putatively causal, highlighting WDR6, DALRD3, CTNND1 and genes in the MHC region. Tissue and single-cell enrichment analyses highlighted hippocampal and cortical excitatory neurons, along with D1- and D2-type dopamine receptor-containing medium spiny neurons, as playing a role in OCD risk. OCD displayed significant genetic correlations with 65 out of 112 examined phenotypes. Notably, it showed positive genetic correlations with all included psychiatric phenotypes, in particular anxiety, depression, anorexia nervosa, and Tourette syndrome, and negative correlations with a subset of the included autoimmune disorders, educational attainment, and body mass index.. This study marks a significant step toward unraveling its genetic landscape and advances understanding of OCD genetics, providing a foundation for future interventions to address this debilitating disorder.
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Affiliation(s)
- Nora I. Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatric Phenomics and Genomics (IPPG), Ludwig-Maximilians University Munich, Munich, Germany
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Zachary F. Gerring
- Department of Mental Health and Neuroscience, Translational Neurogenomics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Population Health and Immunity, Healthy Development and Ageing, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Marco Galimberti
- Department of Psychiatry, Human Genetics, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Dongmei Yu
- Department of Center for Genomic Medicine, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Matthew W. Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Cristina Rodriguez-Fontenla
- CIMUS (Center for Research in Molecular Medicine and Chronic Diseases), Genomics and Bioinformatics, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
- Grupo de Medicina Xenómica, Genetics, FIDIS (Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, A Coruña, Spain
| | - Julia M. Sealock
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | - Tim Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- VA NY Harbor Healthcare System, Brooklyn, NY, USA
| | - Jonathan R. Coleman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
- National Institute for Health and Care Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, United Kingdom
| | - Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jackson G. Thorp
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Biomedical Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Christie L. Burton
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Jurjen J. Luykx
- Department of Psychiatry, Brain, University Medical Center Utrecht, Utrecht, The Netherlands
- Second opinion outpatient clinic, GGNet, Warnsveld, The Netherlands
| | - Gwyneth Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health,, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Silvia Alemany
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Christine Andre
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Kathleen D. Askland
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Judith Becker Nissen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus, Denmark
- Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, General Hospital Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Donald Black
- Departments of Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Michael H. Bloch
- Department of Child Study Center and Psychiatry, Yale University, New Haven, CT, USA
| | - Julia Boberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
| | - Sigrid Børte
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Rosa Bosch
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salut Carlos III, Centro de Investigación Biomédica en Red de Salut Mental (CIBERSAM), Madrid, Spain
| | - Michael Breen
- Department of Psychiatry, Icahn School of Medicine At Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine At Mount Sinai, New York, NY, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine At Mount Sinai, New York, NY, USA
| | - Brian P. Brennan
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Helena Brentani
- Department of Psychiatry, Universidade De São Paulo, São Paulo, Brazil
| | - Joseph D. Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Enda M. Byrne
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Judit Cabana-Dominguez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Beatriz Camarena
- Pharmacogenetics Department, Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, México
| | | | - Carolina Cappi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
- Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Angel Carracedo
- Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Genomics and Bioinformatics Group, University of Santiago de Compostela, Santiago de Compostela, Spain
- Galiician Foundation of Genomic Medicine, Grupo de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago -IDIS-, Santiago de Compostela, Spain
- Medicina Genómica, Centro de Investigación Biomédica en Red, Enfermedades Raras (CIBERER), Santiago de Compostela, Spain
| | - Miguel Casas
- Programa MIND Escoles, Hospital Sant Joan de Déu , Esplugues de Llobregat, Barcelona, Spain
- Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Valentina Ciullo
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Edwin H. Cook
- Department of Psychiatry, University of Illinois Chicago, Chicago, IL, USA
| | - Jesse Crosby
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Bernadette A. Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore , MD, USA
- Department of Mental Health, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elles J. De Schipper
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
| | - Richard Delorme
- Child and Adolesccent Psycchiatry Department, APHP, Paris, France
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jason A. Elias
- Psychiatry, McLean Hospital OCDI, Harvard Medical School, Belmont, MA, USA
- Adult Psychological Services, CBTeam LLC, Lexington, MA, USA
| | - Xavier Estivill
- qGenomics (Quantitative Genomics Laboratories), Esplugues de Llobregat, Barcelona, Spain
| | - Martha J. Falkenstein
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Bengt T. Fundin
- Department of Medical Epidemiology and Biostatistics, Center for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden
| | - Lauryn Garner
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | | | - Christina Gironda
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Fernando S. Goes
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Child & Adolescent Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Jakob Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus, Denmark
| | - Wei Guo
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Kristen Hagen
- Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Mental Health, Norwegian University for Science and Technology, Trondheim, Norway
| | - Kelly Harrington
- Million Veteran Program (MVP) Coordinating Center, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Alexandra Havdahl
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Kira D. Höffler
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Medical Genetics, Dr. Einar Martens Research Group for Biological Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ana G. Hounie
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Donald Hucks
- Department of Medicine, Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Janecka
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Eric Jenike
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Elinor K. Karlsson
- Department of Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kara Kelley
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Julia Klawohn
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Medicine, MSB Medical School Berlin, Berlin, Germany
| | - Janice E. Krasnow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Kristi Krebs
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Christoph Lange
- Department of Biostatistics, T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Daniel Levey
- Department of Psychiatry, Yale University, West Haven, CT, USA
- Office of Research & Development, United States Department of Veterans Affairs, West Haven, CT, USA
| | - Kerstin Lindblad-Toh
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Department of Vertebrate Genomics, Broad Institute, Cambridge, MA, USA
| | - Fabio Macciardi
- Department of Psychiatry, University of California, Irvine (UCI), Irvine, CA, USA
| | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brittany Mathes
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Evonne McArthur
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicole C. McLaughlin
- Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maureen Mulhern
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Paul S. Nestadt
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, Baltimore, MD, USA
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kevin S. O’Connell
- Department of Clinical Medicine, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - Lisa Osiecki
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Harvard Medical School, Boston, MA, USA
| | - Olga Therese Ousdal
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Department of Biomedicine, Haukeland University Hospital, Bergen, Norway
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Department of Clinical Neuroscience and Neurorehabilitation, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sriramya Potluri
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Raquel Rabionet
- Department of Genetics, microbiology and statistics, IBUB, Universitat de Barcelona, Barcelona, Spain
- CIBERER, Centro de investigación biomédica en red, Madrid, Spain
- Department of Human Molecular Genetics, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, Division of Neurogenetics and Molecular Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany
- DZNE Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Cologne Excellence Cluster for Stress Responses in Ageing-associated diseases (CECAD), University of Cologne, Cologne, Germany
| | - Scott Rauch
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Abraham Reichenberg
- Department of Mental disorders, Norwegian Institute of Public Health, New York, NY, USA
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- site Berlin-Potsdam, German Center for Mental Health (DZPG), Berlin, Germany
| | - Maria C. Rosário
- Department of Psychiatry, Child and Adolescent Psychiatry Unit (UPIA), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Aline S. Sampaio
- Department of Neurosciences and Mental Health, Medical School, Federal University of Bahia, Salvador, Brazil
| | - Miriam A. Schiele
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Medical Center - University of Freiburg, Freiburg, Germany
| | - Anne Heidi Skogholt
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Trondheim, Norway
| | | | - Jan Smit
- Department of Psychiatry, Faculty of Medicine, Locaion Vumc, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Artigas María Soler
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona (UB), Barcelona, Spain
| | - Laurent F. Thomas
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and Nursing, K. G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- BioCore - Bioinformatics Core Facility, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eric Tifft
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
| | - Homero Vallada
- Department of Psychiatry, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Molecular Medicine and Surgery, CMM, Karolinska Institutet, Stockholm, Sweden
| | - Nathanial van Kirk
- OCD Institute, Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Nienke N. Vulink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ying Wang
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jens R. Wendland
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Bendik S. Winsvold
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yin Yao
- Department of Computional Biology, Institute of Life Science, Fudan University, Fudan, China
| | - Hang Zhou
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | | | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Pino Alonso
- Department of Psychiatry, OCD Clinical and Research Unit, Bellvitge Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- Department of Psychiatry and Mental Health, Bellvitge Biomedical Research Institute IDIBELLL, Barcelona, Spain
- CIBERSAM, Mental Health Network Biomedical Research Center, Madrid, Spain
| | - Götz Berberich
- Psychosomatic Department, Windach Hospital of Neurobehavioural Research and Therapy, Windach, Germany
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington U. School of Medicine, St Louis, MO, USA
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Danielle Cath
- Departments of Rijksuniversiteit Groningen and Psychiatry, University Medical Center Groninge, Groningen, The Netherlands
- Department of Specialized Training, Drenthe Mental Health Care Institute, Groningen, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Institute of The Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, NSW, Australia
- Academic Unit of Child Psychiatry South-West Sydney (AUCS), South-West Sydney Clinical School, SWSLHD & Ingham Institute, Sydney, NSW, Australia
| | - Howard Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Department of Psychiatry, Max Planck Institute, Munich, Germany
| | - Thomas V. Fernandez
- Child Study Center and Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Abby J. Fyer
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, , Columbia University Medical Center, New York, NY, USA
| | - J M. Gaziano
- Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Mass General Brigham, Boston, MA, USA
| | - Dan A. Geller
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Hans J. Grabe
- Department of Psychiatry & Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Benjamin D. Greenberg
- COBRE Center on Neuromodulation, Butler Hospital, Providence, RI, USA
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Gregory L. Hanna
- Department of Psychiatry, Child and Adolescent Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Ian B. Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - David M. Hougaard
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - James Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Stéphanie Le Hellard
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Bergen Center for brain plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Marion Leboyer
- Department of Addictology and Psychiatry, Univ Paris Est Créteil, AP-HP, Inserm, Paris, France
| | - Christine Lochner
- Department of Psychiatry, SA MRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch, South Africa
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sarah E. Medland
- Department of Mental Health, Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Preben B. Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Benjamin M. Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, , Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Humberto Nicolini
- Department of Psychiatry, Psychiatry, Carracci Medical Group, Mexico City, México
- Psiquiatría, Instituto Nacional de Medicina Genómica, Mexico City, México
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Copenhagen Research Center for Mental Health, Mental Health services in the Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michele Pato
- Department of Psychiatry, Rutgers University, Piscataway, NJ, USA
| | - Carlos Pato
- Department of Psychiatry, Rutgers University, Piscataway, NJ, USA
| | - David L. Pauls
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | | | - Danielle Posthuma
- Department of Complex Trait Genetics, Vrije Universiteit Amsterdam, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatric, Section Complex Trait Genetics, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Steven A. Rasmussen
- Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Margaret A. Richter
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - David R. Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Child and Adolescent Psychiatry, Wayne State University School of Medicine, Detroit, MI, USA
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Jack F. Samuels
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Sandor
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychiatry and Behavioral Sciences, Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Dan J. Stein
- Dept of Psychiatry & Neuroscience Institute, SAMRC Unit on Risk & Reslience in Mental Disorders, University of Cape Town, Cape Town, Western Cape, South Africa
| | - S. Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute (BCMHSUS), Vancouver, BC, Canada
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Barbara E. Stranger
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Copenhagen University Hospital, Mental Health Services (RHP), Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ole A. Andreassen
- Institute of Clinical Medicine, NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Center for Precision Psychiatry, Oslo University Hospital, Oslo, , Norway
| | - Anders D. Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, CGPM, Aarhus University, Aarhus, Denmark
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich (PUK), University of Zurich, Zürich, Switzerland
- Neuroscience Center Zurich, University of Zurich and the ETH Zuric, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Kristian Hveem
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research, Innovation and Education, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bjarne K. Hansen
- Bergen Center for Brain Plasticity (BCBP), Psychiatry, Haukeland University Hospital, Bergen, Norway
- Centre for Crisis Psychology, Psychology, University of Bergen, Bergen, Norway
| | - Christian P. Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
| | - Nicholas G. Martin
- Department of Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Ole Mors
- Psychosis Reasearch Unit, Aarhus University Hospital - Psychiatry, 8200 Aarhus N, Denmark
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona (UB), Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d’Hebron , Barcelona, Spain
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Vestland
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
| | - Katharina Domschke
- Department of Psychiatry, University of Freiburg - Medical Faculty, Freiburg, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Edna Grünblatt
- Neuroscience Center Zurich, University of Zurich and the ETH Zuric, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich (PUK), University of Zurich, Zürich, Schweiz
| | - Michael Wagner
- Departments of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - John-Anker Zwart
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Innovation, Clinical Neuroscience, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Gerome Breen
- Social, Genetic, and Developmental Psychiatric Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, Baltimore, MD, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Paul D. Arnold
- Department of Psychiatry, The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada
| | - Dorothy E. Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James A. Knowles
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, USA
| | - Helga Ask
- PsychGen Center for Genetic Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Karin J. Verweij
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lea K. Davis
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dirk J. Smit
- Department of Psychiatry, Amsterdam UMC location AMC, Amsterdam, The Netherlands
| | - James J. Crowley
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Services, Region Stockholm , Stockholm, Sweden
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeremiah M. Scharf
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Murray B. Stein
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry and School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Department of Psychiatry, Human Genetics (Psychiatry), Yale University School of Medicine, West Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, CT, USA
| | - Carol A. Mathews
- Psychiatry and Genetics Institute, Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, FL, USA
| | - Eske M. Derks
- Department of Mental Health and Neuroscience, QIMR Berghofer, Brisbane, Australia
| | - Manuel Mattheisen
- Department of Psychiatric Phenomics and Genomics (IPPG), Ludwig-Maximilians University Munich, Munich, Germany
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Community Health and Epidemiology and Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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Dy-Hollins ME, Chibnik LB, Tracy NA, Osiecki L, Budman CL, Cath DC, Grados MA, King RA, Gholson L, Rouleau GA, Sandor P, Singer HS, Sharma N, Mathews CA, Scharf J. Sex Differences in People with Tourette Syndrome and Persistent Motor or Vocal Tic Disorder in the Tourette Association of America International Consortium for Genetics Database. medRxiv 2024:2024.01.07.24300816. [PMID: 38260551 PMCID: PMC10802652 DOI: 10.1101/2024.01.07.24300816] [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: 01/24/2024]
Abstract
Background and Objective Tourette Syndrome (TS) and Persistent Motor or Vocal Tic Disorders (PMVT) are more prevalent in males (vs. females). Females with TS may have a delay in diagnosis, and more complex tic features (vs. males). With respect to comorbidities, obsessive-compulsive disorder (OCD) is more prevalent in females; attention-deficit hyperactivity disorder (ADHD) is more prevalent in males. Less is known about sex differences in PMVT. This study analyzes sex differences in outcomes among individuals with TS and PMVT in the Tourette Association of America International Consortium for Genetics dataset (TAAICG). Design/Methods Data from 2403 individuals (N=2109 TS; N=294 PMVT) from the TAAICG were analyzed to explore the relationship between sex and TS or PMVT outcomes: age at tic onset; age at diagnosis; time-to-diagnosis; tic severity; and comorbidity rates. Regression models were adjusted for age and family relationships to examine the impact of sex on outcomes. Results Females with TS (25.5% of the sample) had a later age of symptom onset (6.5±2.8 vs. 6.0±2.7; p=0.001), later age at diagnosis (13.3±11.2 vs. 10.7±8.1; p=0.0001), and a longer time-to-diagnosis [3 (1,7) vs. 2 (1,5), p=0.01] than males. The total Yale-Global Tic Severity Scale (YGTSS) was lower in females with TS (28.4±9.1 vs. 30.7±8.7); p<0.0001); OCD was slightly more prevalent in females (55% vs. 48.7%; p=0.01) although OCD severity did not differ by sex; ADHD was more prevalent in males (55.7% vs 38.9%; p<0.001). Females with TS had 0.46 lower odds of being diagnosed with TS (p<0.00001). Females with PMVT (42.9% of the sample) had an earlier age of symptom onset (7.9±3.3 vs. 8.9±3.7; p=0.05). Motor or vocal tic severity (YGTSS) was not significantly different. OCD, but not ADHD, was more prevalent in females (OCD: 41.9% vs. 22.2%; p<0.001: ADHD:16.5% vs 21.0%; p=0.4). Conclusion Females with TS are less likely to be formally diagnosed and have a later age of symptom onset, later age at diagnosis, longer time-to-diagnosis, higher prevalence of OCD, and lower prevalence of ADHD (vs. males). Females with PMVT have an earlier age of symptom onset, higher prevalence of OCD, but similar ADHD prevalence rates (vs. males). Females with TS and PMVT may be clinically different than males with TS. Future research is needed to understand differences longitudinally in TS and PMVT.
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Abi-Jaoude E, Bhikram T, Parveen F, Levenbach J, Lafreniere-Roula M, Sandor P. A Double-Blind, Randomized, Controlled Crossover Trial of Cannabis in Adults with Tourette Syndrome. Cannabis Cannabinoid Res 2023; 8:835-845. [PMID: 36040329 DOI: 10.1089/can.2022.0091] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The number of effective evidence-based treatment options for patients with Tourette syndrome (TS) is limited. Emerging evidence shows cannabinoids as promising for the treatment of tics. Objectives: To compare the efficacy and tolerability of single doses of three vaporized medical cannabis products and placebo in reducing tics in adults with TS. Methods: In a randomized, double-blind, crossover design, each participant received a vaporized single 0.25 g dose of Δ9-tetrahydrocannabinol (THC) 10%, THC/cannabidiol (CBD) 9%/9%, CBD 13%, and placebo at 2-week intervals. Our primary outcome was the Modified Rush Video-Based Tic Rating Scale (MRVTRS), taken at baseline and at 0.5, 1, 2, 3, and 5 h after dose administration. Secondary measures included the Premonitory Urge for Tics Scale (PUTS), Subjective Units of Distress Scale (SUDS), and Clinical Global Impression-Improvement (CGI-I). Correlations between outcomes and cannabinoid plasma levels were calculated. Tolerability measures included open-ended and specific questions about adverse events (AEs). Results: Twelve adult patients with TS were randomized, with nine completing the study. There was no statistically significant effect of product on the MRVTRS. However, there was a significant effect of THC 10%, and to a lesser extent THC/CBD 9%9%, versus placebo on the PUTS, SUDS, and CGI-I. As well, there were significant correlations between plasma levels of THC and its metabolites, but not CBD, with MRVTRS, PUTS, and SUDS measures. There were more AEs from all cannabis products relative to placebo, and more AEs from THC 10% versus other cannabis products, particularly cognitive and psychomotor effects. Most participants correctly identified whether they had received cannabis or placebo. Conclusions: In this pilot randomized controlled trial of cannabis for tics in TS, there was no statistically significant difference on the MRVTRS for any of the cannabis products, although the THC 10% product was significantly better than placebo on the secondary outcome measures. Also, THC and metabolite plasma levels correlated with improvement on all measures. The THC 10% product resulted in the most AEs. ClinicalTrials.gov ID: NCT03247244.
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Affiliation(s)
- Elia Abi-Jaoude
- Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Tracy Bhikram
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ferdous Parveen
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jody Levenbach
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Myriam Lafreniere-Roula
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Paul Sandor
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Youthdale Treatment Centers, Toronto, Ontario, Canada
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Kriegel G, Paul S, Leonard KH, Sandor P. Prevalence of Autism Spectrum Disorder (ASD) in Inpatient Adolescent Psychiatric Population. J Autism Dev Disord 2023:10.1007/s10803-023-05923-w. [PMID: 37022576 DOI: 10.1007/s10803-023-05923-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 04/07/2023]
Abstract
The prevalence of autism spectrum disorder (ASD) has increased in recent decades, much of which is related to changes in diagnostic criteria, and greater awareness among professionals and parents. Using a prospective cross-sectional study design, this study explores the prevalence of ASD among 173 adolescents admitted to two psychiatric facilities in Canada, and its association with some early pre and perinatal risk factors. The overall prevalence of ASD in the psychiatric population was 11.56% compared to 1.52% in children and youth in Canada. While prenatal and perinatal factors were not significantly associated with ASD, we found a frequent association of ASD with different comorbid psychiatric conditions. These findings further our knowledge in planning and management of ASD among this population.
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Affiliation(s)
- Graciela Kriegel
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, L1N5S9, Whitby, ON, Canada.
| | - Sayani Paul
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, L1N5S9, Whitby, ON, Canada
| | - Kate H Leonard
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, L1N5S9, Whitby, ON, Canada
| | - Paul Sandor
- Youthdale Treatment Center and Youthdale Research Institute, Toronto, Canada
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Bhikram T, Sandor P. Neutrophil-lymphocyte ratios as inflammatory biomarkers in psychiatric patients. Brain Behav Immun 2022; 105:237-246. [PMID: 35839998 DOI: 10.1016/j.bbi.2022.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 10/05/2021] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE There is a growing amount of evidence to suggest that inflammation may have a role in the onset and prognosis of psychiatric disorders. We reviewed the literature of studies investigating neutrophil-lymphocyte ratios (NLR), a biomarker of inflammation, in both adult and youth psychiatric populations. The limitations of NLR, in addition to the potential mechanisms underlying its relationship with psychiatric disorders, are also discussed. RECENT FINDINGS Unlike in the general population, NLR is elevated in a proportion of adult patients with schizophrenia, major depressive disorder and bipolar disorder, though associations with symptom severity and other clinical parameters are less clear. When compared to baseline, reductions in NLR are sometimes reported after treatment and remission. Results in youth populations largely resemble findings obtained from adult samples, even though youth studies are far fewer in number. SUMMARY The consistent findings of elevated NLR across the reviewed psychiatric disorders suggest that abnormal NLR is not specific to any one disorder but may reflect a pathological brain process that leads to brain dysfunction. These findings support hypotheses of neuroinflammation being important to the etiology of psychiatric disorders. More research is needed to further elucidate the relationship between specific diagnostic and behavioural constructs and NLR. Future work is also needed to determine the specific neuroinflammatory mechanisms that give rise to specific disorders.
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Affiliation(s)
- Tracy Bhikram
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada.
| | - Paul Sandor
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Child Psychiatry, Department of Psychiatry, Youthdale Treatment Centers, Toronto, Ontario, Canada; Youthdale Treatment Centers, Toronto, Ontario, Canada
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7
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Claudio-Campos K, Stevens D, Koo SW, Valko A, Bienvenu OJ, Budman CB, Cath DC, Darrow S, Geller D, Goes FS, Grados MA, Greenberg BD, Greenberg E, Hirschtritt ME, Illmann C, Ivankovic F, King RA, Knowles JA, Krasnow J, Lee PC, Lyon GJ, McCracken JT, Robertson MM, Osiecki L, Riddle MA, Rouleau G, Sandor P, Nestadt G, Samuels J, Scharf JM, Mathews CA. Is Persistent Motor or Vocal Tic Disorder a Milder Form of Tourette Syndrome? Mov Disord 2021; 36:1899-1910. [PMID: 33942911 PMCID: PMC8453968 DOI: 10.1002/mds.28593] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 01/04/2023] Open
Abstract
Background Persistent motor or vocal tic disorder (PMVT) has been hypothesized to be a forme fruste of Tourette syndrome (TS). Although the primary diagnostic criterion for PMVT (presence of motor or vocal tics, but not both) is clear, less is known about its clinical presentation. Objective The goals of this study were to compare the prevalence and number of comorbid psychiatric disorders, tic severity, age at tic onset, and family history for TS and PMVT. Methods We analyzed data from two independent cohorts using generalized linear equations and confirmed our findings using meta‐analyses, incorporating data from previously published literature. Results Rates of obsessive–compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) were lower in PMVT than in TS in all analyses. Other psychiatric comorbidities occurred with similar frequencies in PMVT and TS in both cohorts, although meta‐analyses suggested lower rates of most psychiatric disorders in PMVT compared with TS. ADHD and OCD increased the odds of comorbid mood, anxiety, substance use, and disruptive behaviors, and accounted for observed differences between PMVT and TS. Age of tic onset was approximately 2 years later, and tic severity was lower in PMVT than in TS. First‐degree relatives had elevated rates of TS, PMVT, OCD, and ADHD compared with population prevalences, with rates of TS equal to or greater than PMVT rates. Conclusions Our findings support the hypothesis that PMVT and TS occur along a clinical spectrum in which TS is a more severe and PMVT a less severe manifestation of a continuous neurodevelopmental tic spectrum disorder. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Karla Claudio-Campos
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, Florida, USA.,Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Daniel Stevens
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sang-Wahn Koo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Alexa Valko
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Oscar Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cathy B Budman
- Department of Psychiatry, Zucker School of Medicine, Hempstead, New York, USA
| | - Danielle C Cath
- Department of Psychiatry, University of Groningen, Groningen, the Netherlands.,Department of Specialized Trainings, GGZ Drenthe Mental Health Institute, University Medical Center, Assen, the Netherlands
| | - Sabrina Darrow
- School of Medicine, University of California, San Francisco, San Francisco, California, USA.,Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Daniel Geller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marco A Grados
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Butler Hospital, and Providence VA Medical Center, Providence, Rhode Island, USA
| | - Erica Greenberg
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Matthew E Hirschtritt
- Department of Specialized Trainings, GGZ Drenthe Mental Health Institute, University Medical Center, Assen, the Netherlands
| | - Cornelia Illmann
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Franjo Ivankovic
- Department of Psychiatry and Genetics Institute, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Robert A King
- Yale Child Study Center and Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - James A Knowles
- Department of Cell Biology, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York, USA
| | - Janice Krasnow
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul C Lee
- Department of Behavioral Health, Tripler Army Medical Center, Honolulu, Hawaii, USA
| | - Gholson J Lyon
- Division of Human Genetics, Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, New York, USA.,Biology PhD Program, The Graduate Center, The City University of New York, New York, New York, USA
| | - James T McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, California, USA
| | - Mary M Robertson
- Department of Psychiatry, University College of London, London, United Kingdom
| | - Lisa Osiecki
- Yale Child Study Center and Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mark A Riddle
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guy Rouleau
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences Baltimore, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeremiah M Scharf
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Carol A Mathews
- Department of Psychiatry and Genetics Institute, University of Florida College of Medicine, Gainesville, Florida, USA
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8
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Bhikram T, Elmaghraby R, Abi-Jaoude E, Sandor P. An International Survey of Health Care Services Available to Patients With Tourette Syndrome. Front Psychiatry 2021; 12:621874. [PMID: 33716822 PMCID: PMC7953144 DOI: 10.3389/fpsyt.2021.621874] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/05/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: Tourette syndrome (TS) is a neuropsychiatric disorder that is highly associated with several comorbidities. Given the complex and multifaceted nature of TS, the condition is managed by a wide variety of practitioners in different disciplines. The goal of this study was to investigate health service delivery and care practices by clinicians who see TS patients across different geographic settings internationally. Methods: A comprehensive questionnaire was developed to assess clinical care resources for patients with TS and was sent to clinicians in Canada (CA), the United States (US), Europe (EU), and the United Kingdom (UK). Responses were compared quantitatively between geographic regions. Results: The majority of respondents, regardless of region, reported that fewer than 40% of their case-load are patients with tics. The accessibility of TS services varied among regions, as indicated by differences in wait times, telemedicine offerings, comorbidity management and the availability of behavioral therapies. First-line pharmacotherapy preferences varied among physicians in different geographical regions with CA respondents preferring alpha-2-adrenergic agonists and respondents from the UK and EU preferring dopamine receptor antagonists. Discussion: The results suggest that there is a scarcity of specialized TS clinics, potentially making access to services challenging, especially for patients newly diagnosed with TS. Differences in regional pharmacotherapeutic preferences are reflected in various published treatment guidelines in EU and North America. The lack of dedicated specialists and telemedicine availability, coupled with differences in comorbidity management, highlight the need for interprofessional care and holistic management to improve health care delivery to patients with TS.
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Affiliation(s)
- Tracy Bhikram
- Department of Psychiatry, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Rana Elmaghraby
- Department of Psychiatry, University Health Network and University of Toronto, Toronto, ON, Canada
- Youthdale Treatment Centre, Toronto, ON, Canada
| | - Elia Abi-Jaoude
- Department of Psychiatry, University Health Network and University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Paul Sandor
- Department of Psychiatry, University Health Network and University of Toronto, Toronto, ON, Canada
- Youthdale Treatment Centre, Toronto, ON, Canada
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9
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Tsetsos F, Yu D, Sul JH, Huang AY, Illmann C, Osiecki L, Darrow SM, Hirschtritt ME, Greenberg E, Muller-Vahl KR, Stuhrmann M, Dion Y, Rouleau GA, Aschauer H, Stamenkovic M, Schlögelhofer M, Sandor P, Barr CL, Grados MA, Singer HS, Nöthen MM, Hebebrand J, Hinney A, King RA, Fernandez TV, Barta C, Tarnok Z, Nagy P, Depienne C, Worbe Y, Hartmann A, Budman CL, Rizzo R, Lyon GJ, McMahon WM, Batterson JR, Cath DC, Malaty IA, Okun MS, Berlin C, Woods DW, Lee PC, Jankovic J, Robertson MM, Gilbert DL, Brown LW, Coffey BJ, Dietrich A, Hoekstra PJ, Kuperman S, Zinner SH, Wagner M, Knowles JA, Jeremy Willsey A, Tischfield JA, Heiman GA, Cox NJ, Freimer NB, Neale BM, Davis LK, Coppola G, Mathews CA, Scharf JM, Paschou P, Barr CL, Batterson JR, Berlin C, Budman CL, Cath DC, Coppola G, Cox NJ, Darrow S, Davis LK, Dion Y, Freimer NB, Grados MA, Greenberg E, Hirschtritt ME, Huang AY, Illmann C, King RA, Kurlan R, Leckman JF, Lyon GJ, Malaty IA, Mathews CA, McMahon WM, Neale BM, Okun MS, Osiecki L, Robertson MM, Rouleau GA, Sandor P, Scharf JM, Singer HS, Smit JH, Sul JH, Yu D, Aschauer HAH, Barta C, Budman CL, Cath DC, Depienne C, Hartmann A, Hebebrand J, Konstantinidis A, Mathews CA, Müller-Vahl K, Nagy P, Nöthen MM, Paschou P, Rizzo R, Rouleau GA, Sandor P, Scharf JM, Schlögelhofer M, Stamenkovic M, Stuhrmann M, Tsetsos F, Tarnok Z, Wolanczyk T, Worbe Y, Brown L, Cheon KA, Coffey BJ, Dietrich A, Fernandez TV, Garcia-Delgar B, Gilbert D, Grice DE, Hagstrøm J, Hedderly T, Heiman GA, Heyman I, Hoekstra PJ, Huyser C, Kim YK, Kim YS, King RA, Koh YJ, Kook S, Kuperman S, Leventhal BL, Madruga-Garrido M, Mir P, Morer A, Münchau A, Plessen KJ, Roessner V, Shin EY, Song DH, Song J, Tischfield JA, Willsey AJ, Zinner S, Aschauer H, Barr CL, Barta C, Batterson JR, Berlin C, Brown L, Budman CL, Cath DC, Coffey BJ, Coppola G, Cox NJ, Darrow S, Davis LK, Depienne C, Dietrich A, Dion Y, Fernandez T, Freimer NB, Gilbert D, Grados MA, Greenberg E, Hartmann A, Hebebrand J, Heiman G, Hirschtritt ME, Hoekstra P, Huang AY, Illmann C, Jankovic J, King RA, Kuperman S, Lee PC, Lyon GJ, Malaty IA, Mathews CA, McMahon WM, Müller-Vahl K, Nagy P, Neale BM, Nöthen MM, Okun MS, Osiecki L, Paschou P, Rizzo R, Robertson MM, Rouleau GA, Sandor P, Scharf JM, Schlögelhofer M, Singer HS, Stamenkovic M, Stuhrmann M, Sul JH, Tarnok Z, Tischfield J, Tsetsos F, Willsey AJ, Woods D, Worbe Y, Yu D, Zinner S. Synaptic processes and immune-related pathways implicated in Tourette syndrome. Transl Psychiatry 2021; 11:56. [PMID: 33462189 PMCID: PMC7814139 DOI: 10.1038/s41398-020-01082-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [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: 04/27/2020] [Revised: 09/18/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022] Open
Abstract
Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS.
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Grants
- R01 NS102371 NINDS NIH HHS
- R01 NS096207 NINDS NIH HHS
- R01 NS096008 NINDS NIH HHS
- R01 NS105746 NINDS NIH HHS
- R01 MH115958 NIMH NIH HHS
- K08 MH099424 NIMH NIH HHS
- K02 NS085048 NINDS NIH HHS
- R01 MH115963 NIMH NIH HHS
- U01 HG009086 NHGRI NIH HHS
- R56 MH120736 NIMH NIH HHS
- U54 MD010722 NIMHD NIH HHS
- UL1 TR001863 NCATS NIH HHS
- R01 DC016977 NIDCD NIH HHS
- DP2 HD098859 NICHD NIH HHS
- R01 MH115961 NIMH NIH HHS
- U24 MH068457 NIMH NIH HHS
- R25 NS108939 NINDS NIH HHS
- R01 MH114927 NIMH NIH HHS
- R01 NR014852 NINR NIH HHS
- R21 HG010652 NHGRI NIH HHS
- R01 MH113362 NIMH NIH HHS
- RM1 HG009034 NHGRI NIH HHS
- FT is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning» in the context of the project “Reinforcement of Postdoctoral Researchers - 2nd Cycle” (MIS-5033021), implemented by the State Scholarships Foundation (IKY)
- KMV has received financial or material research support from the EU (FP7-HEALTH-2011 No. 278367, FP7-PEOPLE-2012-ITN No. 316978), the German Research Foundation (DFG: GZ MU 1527/3-1), the German Ministry of Education and Research (BMBF: 01KG1421), the National Institute of Mental Health (NIMH), the Tourette Gesellschaft Deutschland e.V., the Else-Kroner-Fresenius-Stiftung, and GW, Almirall, Abide Therapeutics, and Therapix Biosiences and has received consultant’s honoraria from Abide Therapeutics, Tilray, Resalo Vertrieb GmbH, and Wayland Group, speaker’s fees from Tilray and Cogitando GmbH, and royalties from Medizinisch Wissenschaftliche Verlagsgesellschaft Berlin, Elsevier, and Kohlhammer; and is a consultant for Nuvelution TS Pharma Inc., Zynerba Pharmaceuticals, Resalo Vertrieb GmbH, CannaXan GmbH, Therapix Biosiences, Syqe, Nomovo Pharma, and Columbia Care.
- MMN has received fees for memberships in Scientific Advisory Boards from the Lundbeck Foundation and the Robert-Bosch-Stiftung, and for membership in the Medical-Scientific Editorial Office of the Deutsches Ärzteblatt. MMN was reimbursed travel expenses for a conference participation by Shire Deutschland GmbH. MMN receives salary payments from Life & Brain GmbH and holds shares in Life & Brain GmbH. All this concerned activities outside the submitted work.
- IM has participated in research funded by the Parkinson Foundation, Tourette Association, Dystonia Coalition, AbbVie, Biogen, Boston Scientific, Eli Lilly, Impax, Neuroderm, Prilenia, Revance, Teva but has no owner interest in any pharmaceutical company. She has received travel compensation or honoraria from the Tourette Association of America, Parkinson Foundation, International Association of Parkinsonism and Related Disorders, Medscape, and Cleveland Clinic, and royalties for writing a book with Robert rose publishers.
- MSO serves as a consultant for the Parkinson’s Foundation, and has received research grants from NIH, Parkinson’s Foundation, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association, and the UF Foundation. MSO’s DBS research is supported by: NIH R01 NR014852 and R01NS096008. MSO is PI of the NIH R25NS108939 Training Grant. MSO has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, Perseus, Robert Rose, Oxford and Cambridge (movement disorders books). MSO is an associate editor for New England Journal of Medicine Journal Watch Neurology. MSO has participated in CME and educational activities on movement disorders sponsored by the Academy for Healthcare Learning, PeerView, Prime, QuantiaMD, WebMD/Medscape, Medicus, MedNet, Einstein, MedNet, Henry Stewart, American Academy of Neurology, Movement Disorders Society and by Vanderbilt University. The institution and not MSO receives grants from Medtronic, Abbvie, Boston Scientific, Abbott and Allergan and the PI has no financial interest in these grants. MSO has participated as a site PI and/or co-I for several NIH, foundation, and industry sponsored trials over the years but has not received honoraria. Research projects at the University of Florida receive device and drug donations.
- DW receives royalties for books on Tourette Syndrome with Guilford Press, Oxford University Press, and Springer Press.
- BMN is a member of the scientific advisory board at Deep Genomics and consultant for Camp4 Therapeutics, Takeda Pharmaceutical and Biogen.
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Affiliation(s)
- Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sabrina M Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kirsten R Muller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | | | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Thomas V Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | | | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Douglas W Woods
- Marquette University and University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Paul C Lee
- Tripler Army Medical Center and University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Donald L Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | | | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Samuel H Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA.
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | | | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sabrina Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA
| | - James F Leckman
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jan H Smit
- Department of Psychiatry, VU UniversityMedical Center, Amsterdam, The Netherlands
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Harald Aschauer Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anastasios Konstantinidis
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Center for Mental Health Muldenstrasse, BBRZMed, Linz, Austria
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, 00-001, Warsaw, Poland
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Lawrence Brown
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Keun-Ah Cheon
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Thomas V Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Blanca Garcia-Delgar
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain
| | - Donald Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | - Dorothy E Grice
- Department of Psychiatry, Friedman Brain Institute, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie Hagstrøm
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark
| | - Tammy Hedderly
- Tic and Neurodevelopmental Movements Service (TANDeM), Evelina Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
- Paediatric Neurosciences, Kings College London, London, UK
| | - Gary A Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chaim Huyser
- De Bascule, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | | | - Young-Shin Kim
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yun-Joo Koh
- The Korea Institute for Children's Social Development, Rudolph Child Research Center, Seoul, South Korea
| | - Sodahm Kook
- Kangbuk Samsung Hospital, Seoul, South Korea
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bennett L Leventhal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Marcos Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Pablo Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Kerstin J Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital Carl Gustav CarusTU Dresden, Dresden, Germany
| | - Eun-Young Shin
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Dong-Ho Song
- Yonsei University College of Medicine, Yonsei Yoo & Kim Mental Health Clinic, Seoul, South Korea
| | - Jungeun Song
- National Health Insurance Service Ilsan Hospital, Goyang-Si, South Korea
| | - Jay A Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Samuel Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Hospital for Sick Children, and University of Toronto, Toronto, Canada
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology, and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | | | - Cheston Berlin
- Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Lawrence Brown
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cathy L Budman
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen and Rijksuniversity Groningen, and Drenthe Mental Health Center, Groningen, the Netherlands
| | - Barbara J Coffey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sabrina Darrow
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Yves Dion
- McGill University Health Center, University of Montreal, McGill University Health Centre, Montreal, Canada
| | - Thomas Fernandez
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Donald Gilbert
- Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, Cincinnati, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gary Heiman
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Pieter Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Robert A King
- Yale Child Study Center and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Paul C Lee
- Tripler Army Medical Center and University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Gholson J Lyon
- Jervis Clinic, NYS Institute for Basic Research in Developmental Disabilities (IBR), Staten Island, NY, USA
| | - Irene A Malaty
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN, USA
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Mary M Robertson
- Division of Psychiatry, Department of Neuropsychiatry, University College London, London, UK
| | - Guy A Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Paul Sandor
- University Health Network, Youthdale Treatment Centres, and University of Toronto, Toronto, Canada
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, and the Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Harvey S Singer
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, USA
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers, the State University of New Jersey, Piscataway, NJ, USA
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Jeremy Willsey
- Institute for Neurodegenerative Diseases, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Douglas Woods
- Marquette University and University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique Hôpitaux de Paris, Hopital Saint Antoine, Paris, France
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Samuel Zinner
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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10
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Bhikram T, Crawley A, Arnold P, Abi-Jaoude E, Sandor P. Neuroimaging the emotional modulation of urge inhibition in Tourette Syndrome. Cortex 2020; 135:341-351. [PMID: 33317808 DOI: 10.1016/j.cortex.2020.10.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 05/24/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
Tourette Syndrome (TS) is a neuropsychiatric condition characterized by tics that are typically preceded by uncomfortable urges that build until the tic is performed. Both tics and their associated urges are commonly exacerbated during states of heightened emotion. However, the neural substrates that are responsible for the development of urges have not been fully elucidated, particularly with regards to the influence of emotion. In this study, we investigate the brain areas associated with the development of urges and their modulation by emotion in patients with TS. Moreover, we explore the influence of obsessive-compulsive symptoms (OCS) which are commonly comorbid in TS. Forty patients with TS and 20 healthy controls completed an emotional blink suppression paradigm while undergoing functional magnetic resonance imaging. For the paradigm, participants completed alternating blocks of blink inhibition and free blinking while viewing pictures of angry and neutral facial expressions. Compared to controls, patients exhibited greater activity in the superior temporal gyrus and midcingulate during the inhibition of urges. Within the patient group, tic severity was associated with activity in the superior frontal gyrus during the angry inhibition contrast as compared to neutral; greater premonitory urge severity was associated with greater activity in the hippocampus, middle temporal gyrus and in the subcortex; blink inhibition ability was negatively associated with activity in the thalamus and insula. There were no significant associations with OCS severity for the emotion-related contrasts. The observed activated regions may represent a network that produces urges in patients, or alternatively, could represent compensatory cortical activity needed to keep urges and tics under control during emotional situations. Additionally, our findings suggest that OCS in the context of TS is similar to traditional obsessive-compulsive disorder and is neurobiologically dissociable from tics.
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Affiliation(s)
- Tracy Bhikram
- Tourette Syndrome Neurodevelopmental Clinic, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
| | - Adrian Crawley
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Paul Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Program in Genetics and Genomic Biology, University of Calgary, Calgary, Alberta, Canada
| | - Elia Abi-Jaoude
- Tourette Syndrome Neurodevelopmental Clinic, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Sandor
- Tourette Syndrome Neurodevelopmental Clinic, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Child Psychiatry, Department of Psychiatry, Youthdale Treatment Centers, Toronto, Ontario, Canada.
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11
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Abi-Jaoude E, Segura B, Cho SS, Crawley A, Sandor P. The Neural Correlates of Self-Regulatory Fatigability During Inhibitory Control of Eye Blinking. J Neuropsychiatry Clin Neurosci 2019; 30:325-333. [PMID: 29843584 DOI: 10.1176/appi.neuropsych.17070140] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The capacity to regulate urges is an important human characteristic associated with a range of social and health outcomes. Self-regulatory capacity has been postulated to have a limited reserve, which when depleted leads to failure. The authors aimed to investigate the neural correlates of self-regulatory fatigability. Functional MRI was used to detect brain activations in 19 right-handed healthy subjects during inhibition of eye blinking, in a block design. The increase in number of blinks during blink inhibition from the first to the last block was used as covariate of interest. There was an increase in the number of eye blinks escaping inhibitory control across blink inhibition blocks, whereas there was no change in the number of eye blinks occurring during rest blocks. Inhibition of blinking activated a wide network bilaterally, including the inferior frontal gyrus, dorsolateral prefrontal cortex, dorsal anterior cingulate cortex, supplementary motor area, and caudate. Deteriorating performance was associated with activity in orbitofrontal cortex, ventromedial prefrontal cortex, rostroventral anterior cingulate cortex, precuneus, somatosensory, and parietal areas. As anticipated, effortful eye-blink control resulted in activation of prefrontal control areas and regions involved in urge and interoceptive processing. Worsening performance was associated with activations in brain areas involved in urge, as well as regions involved in motivational evaluation. These findings suggest that self-regulatory fatigability is associated with relatively less recruitment of prefrontal cortical regions involved in executive control.
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Affiliation(s)
- Elia Abi-Jaoude
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Ontario, Canada (EA-J, PS); the Department of Medicine, Faculty of Medicine and Health Science, Institute of Neuroscience, University of Barcelona, Catalonia, Spain (BS); the Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SC); the Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada (AC); and the Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Barbara Segura
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Ontario, Canada (EA-J, PS); the Department of Medicine, Faculty of Medicine and Health Science, Institute of Neuroscience, University of Barcelona, Catalonia, Spain (BS); the Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SC); the Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada (AC); and the Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Sang Soo Cho
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Ontario, Canada (EA-J, PS); the Department of Medicine, Faculty of Medicine and Health Science, Institute of Neuroscience, University of Barcelona, Catalonia, Spain (BS); the Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SC); the Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada (AC); and the Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Adrian Crawley
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Ontario, Canada (EA-J, PS); the Department of Medicine, Faculty of Medicine and Health Science, Institute of Neuroscience, University of Barcelona, Catalonia, Spain (BS); the Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SC); the Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada (AC); and the Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Paul Sandor
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Ontario, Canada (EA-J, PS); the Department of Medicine, Faculty of Medicine and Health Science, Institute of Neuroscience, University of Barcelona, Catalonia, Spain (BS); the Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada (SC); the Department of Medical Imaging, University Health Network, University of Toronto, Ontario, Canada (AC); and the Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
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12
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Yu D, Sul JH, Tsetsos F, Nawaz MS, Huang AY, Zelaya I, Illmann C, Osiecki L, Darrow SM, Hirschtritt ME, Greenberg E, Muller-Vahl KR, Stuhrmann M, Dion Y, Rouleau G, Aschauer H, Stamenkovic M, Schlögelhofer M, Sandor P, Barr CL, Grados M, Singer HS, Nöthen MM, Hebebrand J, Hinney A, King RA, Fernandez TV, Barta C, Tarnok Z, Nagy P, Depienne C, Worbe Y, Hartmann A, Budman CL, Rizzo R, Lyon GJ, McMahon WM, Batterson JR, Cath DC, Malaty IA, Okun MS, Berlin C, Woods DW, Lee PC, Jankovic J, Robertson MM, Gilbert DL, Brown LW, Coffey BJ, Dietrich A, Hoekstra PJ, Kuperman S, Zinner SH, Luðvigsson P, Sæmundsen E, Thorarensen Ó, Atzmon G, Barzilai N, Wagner M, Moessner R, Ophoff R, Pato CN, Pato MT, Knowles JA, Roffman JL, Smoller JW, Buckner RL, Willsey JA, Tischfield JA, Heiman GA, Stefansson H, Stefansson K, Posthuma D, Cox NJ, Pauls DL, Freimer NB, Neale BM, Davis LK, Paschou P, Coppola G, Mathews CA, Scharf JM. Interrogating the Genetic Determinants of Tourette's Syndrome and Other Tic Disorders Through Genome-Wide Association Studies. Am J Psychiatry 2019; 176:217-227. [PMID: 30818990 PMCID: PMC6677250 DOI: 10.1176/appi.ajp.2018.18070857] [Citation(s) in RCA: 175] [Impact Index Per Article: 35.0] [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: 12/11/2022]
Abstract
OBJECTIVE Tourette's syndrome is polygenic and highly heritable. Genome-wide association study (GWAS) approaches are useful for interrogating the genetic architecture and determinants of Tourette's syndrome and other tic disorders. The authors conducted a GWAS meta-analysis and probed aggregated Tourette's syndrome polygenic risk to test whether Tourette's and related tic disorders have an underlying shared genetic etiology and whether Tourette's polygenic risk scores correlate with worst-ever tic severity and may represent a potential predictor of disease severity. METHODS GWAS meta-analysis, gene-based association, and genetic enrichment analyses were conducted in 4,819 Tourette's syndrome case subjects and 9,488 control subjects. Replication of top loci was conducted in an independent population-based sample (706 case subjects, 6,068 control subjects). Relationships between Tourette's polygenic risk scores (PRSs), other tic disorders, ascertainment, and tic severity were examined. RESULTS GWAS and gene-based analyses identified one genome-wide significant locus within FLT3 on chromosome 13, rs2504235, although this association was not replicated in the population-based sample. Genetic variants spanning evolutionarily conserved regions significantly explained 92.4% of Tourette's syndrome heritability. Tourette's-associated genes were significantly preferentially expressed in dorsolateral prefrontal cortex. Tourette's PRS significantly predicted both Tourette's syndrome and tic spectrum disorders status in the population-based sample. Tourette's PRS also significantly correlated with worst-ever tic severity and was higher in case subjects with a family history of tics than in simplex case subjects. CONCLUSIONS Modulation of gene expression through noncoding variants, particularly within cortico-striatal circuits, is implicated as a fundamental mechanism in Tourette's syndrome pathogenesis. At a genetic level, tic disorders represent a continuous spectrum of disease, supporting the unification of Tourette's syndrome and other tic disorders in future diagnostic schemata. Tourette's PRSs derived from sufficiently large samples may be useful in the future for predicting conversion of transient tics to chronic tic disorders, as well as tic persistence and lifetime tic severity.
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Affiliation(s)
- Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus
University of Thrace, Xanthi, Greece
- Department of Biological Sciences, Purdue University, West
Lafayette, Indiana, USA
| | | | - Alden Y. Huang
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
- Bioinformatics Interdepartmental Program, University of
California, Los Angeles, Los Angeles, California, USA
| | - Ivette Zelaya
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
- Bioinformatics Interdepartmental Program, University of
California, Los Angeles, Los Angeles, California, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Sabrina M. Darrow
- Department of Psychiatry, University of California, San
Francisco, San Francisco, California, USA
| | - Matthew E. Hirschtritt
- Department of Psychiatry, UCSF Weill Institute for
Neurosciences, University of California, San Francisco, San Francisco, California,
USA
| | - Erica Greenberg
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Kirsten R. Muller-Vahl
- Clinic of Psychiatry, Social Psychiatry and
Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School,
Hannover, Germany
| | - Yves Dion
- McGill University Health Center (MUHC), University of
Montréal, Centre Universitaire de Santé de Montréal (CHUM),
Montreal, Quebec, Canada
| | - Guy Rouleau
- Montreal Neurological Institute, Department of Neurology
and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical
University Vienna, Vienna, Austria
- Biopsychosocial Corporation, Vienna, Austria
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical
University Vienna, Vienna, Austria
| | | | - Paul Sandor
- University Health Network and Youthdale Treatment Centres
University of Toronto, Toronto, Ontario, Canada
| | - Cathy L. Barr
- Krembil Research Institute, University Health Network,
Hospital for Sick Children, and The University of Toronto, Toronto, Ontario,
Canada
| | - Marco Grados
- Johns Hopkins University School of Medicine, Baltimore,
Maryland, USA
| | - Harvey S. Singer
- Johns Hopkins University School of Medicine, Baltimore,
Maryland, USA
| | - Markus M. Nöthen
- Institute of Human Genetics, University Hospital Bonn,
University of Bonn Medical School, Bonn, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry,
Psychosomatics and Psychotherapy, University Hospital Essen, University of
Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry,
Psychosomatics and Psychotherapy, University Hospital Essen, University of
Duisburg-Essen, Essen, Germany
| | - Robert A. King
- Yale Child Study Center, Yale University School of
Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut, USA
| | - Thomas V. Fernandez
- Yale Child Study Center, Yale University School of
Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut, USA
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and
Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital,
Budapest, Hungary
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital,
Budapest, Hungary
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen,
University Duisburg-Essen, Essen, Germany
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Yulia Worbe
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette
Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
- Assistance Publique-Hôpitaux de Paris, Department
of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
| | - Andreas Hartmann
- Sorbonne Universités, UPMC Université Paris
06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
- French Reference Centre for Gilles de la Tourette
Syndrome, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
- Assistance Publique-Hôpitaux de Paris, Department
of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris,
France
| | - Cathy L. Budman
- Zucker School of Medicine at Hofstra/Northwell,
Hempstead, New York, USA
| | - Renata Rizzo
- Neuropsichiatria Infantile. Dipartimento di Medicina
Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring
Harbor Laboratory, Cold Spring Harbor, New York, USA
| | | | | | - Danielle C. Cath
- Department of Psychiatry, University Medical Center
Groningen & Rijksuniversity Groningen, Groningen, the Netherlands
- Drenthe Mental Health Center, Groningen, the
Netherlands
| | - Irene A. Malaty
- Department of Neurology, Fixel Center for Neurological
Diseases, McKnight Brain Institute, University of Florida, Gainesville, Florida,
USA
| | - Michael S. Okun
- Department of Neurology, Fixel Center for Neurological
Diseases, McKnight Brain Institute, University of Florida, Gainesville, Florida,
USA
| | - Cheston Berlin
- Pennsylvania State University College of Medicine,
Hershey, Pennsylvania, USA
| | - Douglas W. Woods
- Marquette University, Milwaukee, Wisconsin, USA
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin,
USA
| | - Paul C. Lee
- Tripler Army Medical Center, University of Hawai’i
John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders
Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas,
USA
| | - Mary M. Robertson
- Division of Psychiatry, Department of Neuropsychiatry,
University College London, London, UK
| | - Donald L. Gilbert
- Department of Pediatrics, Cincinnati Children’s
Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lawrence W. Brown
- Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania, USA
| | - Barbara J. Coffey
- Department of Psychiatry and Behavioral Sciences,
University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrea Dietrich
- University of Groningen, University Medical Center
Groningen, Department of Child and Adolescent Psychiatry, Groningen, The
Netherlands
| | - Pieter J. Hoekstra
- University of Groningen, University Medical Center
Groningen, Department of Child and Adolescent Psychiatry, Groningen, The
Netherlands
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City,
Iowa, USA
| | - Samuel H Zinner
- Department of Pediatrics, University of Washington,
Seattle, Washington, USA
| | - Pétur Luðvigsson
- Department of Pediatrics, Landspitalinn University
Hospital, Reykjavik, Iceland
| | - Evald Sæmundsen
- Faculty of Medicine, University of Iceland,
Reykjavík, Iceland
- The State Diagnostic and Counselling Centre,
Kópavogur, Iceland
| | - Ólafur Thorarensen
- Department of Pediatrics, Landspitalinn University
Hospital, Reykjavik, Iceland
| | - Gil Atzmon
- Department of Genetics, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Human Biology, Haifa University, Haifa,
Israel
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of
Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of
Medicine, Bronx, New York, USA
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of
Bonn, Bonn, Germany
| | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of
Tuebingen, Tuebingen, Germany
| | - Roel Ophoff
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
| | | | | | | | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Research,
Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts,
USA
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of
Public Health, Boston, Massachusetts, USA
| | - Randy L. Buckner
- Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Research,
Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts,
USA
- Center for Brain Science, Harvard University, Cambridge,
Massachusetts, USA
- Department of Psychology, Harvard University, Cambridge,
Massachusetts, USA
| | - Jeremy A. Willsey
- Department of Psychiatry, UCSF Weill Institute for
Neurosciences, University of California, San Francisco, San Francisco, California,
USA
- Institute for Neurodegenerative Diseases, UCSF Weill
Institute for Neurosciences, University of California San Francisco, San Francisco,
California, USA
| | - Jay A. Tischfield
- Department of Genetics and the Human Genetics Institute
of New Jersey, Rutgers, the State University of New Jersey, Piscataway, New Jersey,
USA
| | - Gary A. Heiman
- Department of Genetics and the Human Genetics Institute
of New Jersey, Rutgers, the State University of New Jersey, Piscataway, New Jersey,
USA
| | | | - Kári Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland,
Reykjavík, Iceland
| | - Danielle Posthuma
- Department of Complex Trait Genetics Center for
Neurogenomics and Cognitive Research, VU University Amsterdam, Amsterdam, the
Netherlands
| | - Nancy J. Cox
- Division of Genetic Medicine, Vanderbilt Genetics
Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
| | - Nelson B. Freimer
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Benjamin M. Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
- Analytic and Translational Genetics Unit, Department of
Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lea K. Davis
- Division of Genetic Medicine, Vanderbilt Genetics
Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West
Lafayette, Indiana, USA
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David
Geffen School of Medicine, University of California Los Angeles, Los Angeles,
California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, California, USA
| | - Carol A. Mathews
- Department of Psychiatry, Genetics Institute, University
of Florida, Gainesville, Florida, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center
for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital,
Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of
MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Brigham and Women’s
Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital,
Boston, Massachusetts, USA
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13
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Anttila V, Bulik-Sullivan B, Finucane HK, Walters RK, Bras J, Duncan L, Escott-Price V, Falcone GJ, Gormley P, Malik R, Patsopoulos NA, Ripke S, Wei Z, Yu D, Lee PH, Turley P, Grenier-Boley B, Chouraki V, Kamatani Y, Berr C, Letenneur L, Hannequin D, Amouyel P, Boland A, Deleuze JF, Duron E, Vardarajan BN, Reitz C, Goate AM, Huentelman MJ, Kamboh MI, Larson EB, Rogaeva E, St George-Hyslop P, Hakonarson H, Kukull WA, Farrer LA, Barnes LL, Beach TG, Demirci FY, Head E, Hulette CM, Jicha GA, Kauwe JSK, Kaye JA, Leverenz JB, Levey AI, Lieberman AP, Pankratz VS, Poon WW, Quinn JF, Saykin AJ, Schneider LS, Smith AG, Sonnen JA, Stern RA, Van Deerlin VM, Van Eldik LJ, Harold D, Russo G, Rubinsztein DC, Bayer A, Tsolaki M, Proitsi P, Fox NC, Hampel H, Owen MJ, Mead S, Passmore P, Morgan K, Nöthen MM, Rossor M, Lupton MK, Hoffmann P, Kornhuber J, Lawlor B, McQuillin A, Al-Chalabi A, Bis JC, Ruiz A, Boada M, Seshadri S, Beiser A, Rice K, van der Lee SJ, De Jager PL, Geschwind DH, Riemenschneider 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Greenberg E, Hanna GL, Hartmann A, Hirschtritt ME, Hoekstra PJ, Huang A, Huyser C, Illmann C, Jenike M, Kuperman S, Leventhal B, Lochner C, Lyon GJ, Macciardi F, Madruga-Garrido M, Malaty IA, Maras A, McGrath L, Miguel EC, Mir P, Nestadt G, Nicolini H, Okun MS, Pakstis A, Paschou P, Piacentini J, Pittenger C, Plessen K, Ramensky V, Ramos EM, Reus V, Richter MA, Riddle MA, Robertson MM, Roessner V, Rosário M, Samuels JF, Sandor P, Stein DJ, Tsetsos F, Van Nieuwerburgh F, Weatherall S, Wendland JR, Wolanczyk T, Worbe Y, Zai G, Goes FS, McLaughlin N, Nestadt PS, Grabe HJ, Depienne C, Konkashbaev A, Lanzagorta N, Valencia-Duarte A, Bramon E, Buccola N, Cahn W, Cairns M, Chong SA, Cohen D, Crespo-Facorro B, Crowley J, Davidson M, DeLisi L, Dinan T, Donohoe G, Drapeau E, Duan J, Haan L, Hougaard D, Karachanak-Yankova S, Khrunin A, Klovins J, Kučinskas V, Lee Chee Keong J, Limborska S, Loughland C, Lönnqvist J, Maher B, Mattheisen M, McDonald C, Murphy KC, Nenadic I, van Os J, Pantelis C, Pato M, Petryshen T, Quested D, Roussos P, Sanders AR, Schall U, Schwab SG, Sim K, So HC, Stögmann E, Subramaniam M, Toncheva D, Waddington J, Walters J, Weiser M, Cheng W, Cloninger R, Curtis D, Gejman PV, Henskens F, Mattingsdal M, Oh SY, Scott R, Webb B, Breen G, Churchhouse C, Bulik CM, Daly M, Dichgans M, Faraone SV, Guerreiro R, Holmans P, Kendler KS, Koeleman B, Mathews CA, Price A, Scharf J, Sklar P, Williams J, Wood NW, Cotsapas C, Palotie A, Smoller JW, Sullivan P, Rosand J, Corvin A, Neale BM, Schott JM, Anney R, Elia J, Grigoroiu-Serbanescu M, Edenberg HJ, Murray R. Analysis of shared heritability in common disorders of the brain. Science 2018; 360:eaap8757. [PMID: 29930110 PMCID: PMC6097237 DOI: 10.1126/science.aap8757] [Citation(s) in RCA: 847] [Impact Index Per Article: 141.2] [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: 04/15/2016] [Revised: 02/07/2017] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Abstract
Disorders of the brain can exhibit considerable epidemiological comorbidity and often share symptoms, provoking debate about their etiologic overlap. We quantified the genetic sharing of 25 brain disorders from genome-wide association studies of 265,218 patients and 784,643 control participants and assessed their relationship to 17 phenotypes from 1,191,588 individuals. Psychiatric disorders share common variant risk, whereas neurological disorders appear more distinct from one another and from the psychiatric disorders. We also identified significant sharing between disorders and a number of brain phenotypes, including cognitive measures. Further, we conducted simulations to explore how statistical power, diagnostic misclassification, and phenotypic heterogeneity affect genetic correlations. These results highlight the importance of common genetic variation as a risk factor for brain disorders and the value of heritability-based methods in understanding their etiology.
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Affiliation(s)
- Verneri Anttila
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Brendan Bulik-Sullivan
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Hilary K Finucane
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Mathematics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Raymond K Walters
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jose Bras
- UK Dementia Research Institute, University College London, London, UK
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Laramie Duncan
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, California, USA
| | - Valentina Escott-Price
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Guido J Falcone
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Padhraig Gormley
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nikolaos A Patsopoulos
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephan Ripke
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Zhi Wei
- Department of Computer Science, New Jersey Institute of Technology, New Jersey, USA
| | - Dongmei Yu
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick Turley
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Benjamin Grenier-Boley
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
| | - Vincent Chouraki
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Centre Hosp. Univ Lille, Lille, France
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Claudine Berr
- INSERM U1061 - Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Luc Letenneur
- INSERM, UMR 1219, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Didier Hannequin
- Rouen University Hospital, Rouen, France
- Inserm U1245, Rouen, France
| | - Philippe Amouyel
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Centre Hosp. Univ Lille, Lille, France
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de biologie François Jacob, CEA, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de biologie François Jacob, CEA, Evry, France
| | - Emmanuelle Duron
- Department of Gerontology, Hôpital Broca, AH-HP, Paris, France
- Hôpital Paul Brousse Université Paris Sud XI, Le Kremlin-Bicêtre, Paris, France
| | - Badri N Vardarajan
- Gertrude H. Sergievsky Center and Dept of Neurology, Columbia University, New York, NY, USA
| | | | - Alison M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew J Huentelman
- Translational Genomics Research Institute, Neurogenomics Division, Phoenix, AZ, USA
| | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Department of Medicine, University of Washington, WA, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Hakon Hakonarson
- Center for Applied Genomics of The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Walter A Kukull
- National Alzheimer Coordinating Center (NACC), Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Lindsay A Farrer
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lisa L Barnes
- Rush Alzheimers Disease Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
- Department of Behavioral Sciences, Rush Medical College, Chicago, IL, USA
| | | | | | - Elizabeth Head
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Christine M Hulette
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Gregory A Jicha
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Jeffrey A Kaye
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Allan I Levey
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Andrew P Lieberman
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Vernon S Pankratz
- University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Wayne W Poon
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Joseph F Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology and Parkinson's Disease Research Education and Clinical Care Center (PADRECC), Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Andrew J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lon S Schneider
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Amanda G Smith
- Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Joshua A Sonnen
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Denise Harold
- School of Biotechnology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Giancarlo Russo
- Functional Genomics Center Zurich, ETH/UZH-Zurich, Zurich, Switzerland
| | - David C Rubinsztein
- Department of Medical Genetics, Cambridge Institute for Medical Research, Cambridge, UK
- UK Dementia Research Institute, Cambridge, UK
| | | | - Magda Tsolaki
- 1st and 3rd Departments of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Petra Proitsi
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Harald Hampel
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
- Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- AXA Research Fund & Sorbonne University Chair, Paris, France
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Simon Mead
- Institute of Prion Diseases and MRC Prion Unit, University College London, London, UK
| | - Peter Passmore
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Kevin Morgan
- Human Genetics, School of Life Sciences, University of Nottingham, Nottingham UK
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
| | - Martin Rossor
- Department of Neurodegeneration, UCL Institute of Neurology, London, UK
| | - Michelle K Lupton
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute of Psychiatry Psychology and Neuroscience, Kings College London, UK
| | - Per Hoffmann
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg University Hospital, Erlangen, Germany
| | - Brian Lawlor
- Department of Psychiatry and Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Andrew McQuillin
- Division of Psychiatry, Molecular Psychiatry Laboratory,University College London, London, UK
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, King's College London, London, UK
- King's College Hospital, London, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Agustin Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Mercè Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA
- Neurology and Neurogenetics Core, Framingham Heart Study, Framingham, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Alexa Beiser
- School of Public Health, Boston University, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Philip L De Jager
- Center for Translational & Computational Neuroimmunology, Columbia University Medical Center, New York, NY, USA
| | - Daniel H Geschwind
- Neurogenetics Program, Departments of Neurology and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Center For Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Gerhard Ransmayr
- Department of Neurology II, Kepler University Clinic, Johannes Kepler University, Linz, Austria
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Carlos Cruchaga
- Washington University School of Medicine, St. Louis, MO, USA
| | - Montserrat Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
| | - Bendik Winsvold
- Communication and Research Unit for Musculoskeletal Disorders (FORMI), Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Priit Palta
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kai-How Farh
- Illumina Inc., San Diego, CA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ester Cuenca-Leon
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lannie Ligthart
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tobias Freilinger
- Institute for Stroke and Dementia Research, Klinikum der Universitaet Muenchen, Munich, Germany
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Guntram Borck
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Juho Wedenoja
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Markus Schürks
- Department of Neurology, University Hospital Essen, Germany
| | | | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Avera Institute for Human Genetics, Sioux Falls, SD, USA
| | - Brenda Penninx
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Ville Artto
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Mari Kaunisto
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Salli Vepsäläinen
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Mitja I Kurki
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Eija Hämäläinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Hailiang Huang
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jie Huang
- Boston VA Research Institute, Boston, MA, USA
- Brigham Women's Hospital Division of Aging, Harvard Medical School, Boston, MA, USA
| | - Cynthia Sandor
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Caleb Webber
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Bertram Muller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
- Clinic of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Elizabeth Loehrer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Alfons Macaya
- Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain
- Headache Research Group, VHIR, Autonomous University of Barcelona, Barcelona, Spain
| | - Thomas Hansen
- Danish Headache Center, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
- Institute of Biological Psychiatry, Roskilde, Denmark
| | - Thomas Werge
- Institute of Biological Psychiatry, Roskilde, Denmark
- Department of Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrea C Belin
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Dorret Boomsma
- Netherlands Twin Register, Vrije Universiteit, Amsterdam, the Netherlands
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jes Olesen
- Danish Headache Center, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Andreja Avbersek
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Larry Baum
- Centre for Genomic Sciences, University of Hong Kong, Hong Kong
| | - Samuel Berkovic
- Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia
| | | | - Russell J Buono
- Cooper Medical School of Rowan University, Camden, NJ, USA
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Claudia B Catarino
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Epilepsy Society, Chalfont-St-Peter, Bucks, UK
| | - Patrick Cossette
- Centre de Recherche du Centre Hospitalier de l'Universite de Montreal and Department of Neurosciences, Université de Montréal, Montréal, Canada
| | - Peter De Jonghe
- Neurogenetics Group, VIB-CMN, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dennis Dlugos
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas N Ferraro
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA
- Department of Psychiatry, Center for Neurobiology and Behavior, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jennifer Jamnadas-Khoda
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Reetta Kälviäinen
- Epilepsy Center/Neurocenter, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Wolfram S Kunz
- Department of Epileptology, University Bonn Medical Center, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Bonn Medical Center, Bonn, Germany
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Costin Leu
- Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London
| | - Dick Lindhout
- Department of Genetics, University Medical Center Utrecht, the Netherlands
- Epilepsy Foundation in the Netherlands (SEIN), Heemstede, the Netherlands
| | - Warren Lo
- Departments of Pediatrics and Neurology, Ohio State University, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Daniel Lowenstein
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Mark McCormack
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rikke S Møller
- Danish Epilepsy Centre, Filadelfia, Dianalund, Denmark
- Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark
| | | | - Ping-Wing Ng
- United Christian Hospital, Hong Kong
- Hong Kong Sanatorium and Hospital, Hong Kong
| | - Karen Oliver
- Epilepsy Research Centre, University of Melbourne, Austin Health, Heidelberg, Australia
| | - Michael Privitera
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
- UC Gardner Neuroscience Institute, Cincinnati, OH, USA
| | - Rodney Radtke
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | | | - Thomas Sander
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - Steven Schachter
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christoph Schankin
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Neurology, University of Munich Hospital, Grosshadern, University of Munich, Germany
| | - Ingrid Scheffer
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Susanne Schoch
- Institute of Neuropathology, Bonn University Medical School, Bonn, Germany
| | - Sanjay M Sisodiya
- UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | | | - Michael Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit-Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, "G. Gaslini" Institute, Genova, Italy
| | - Rainer Surges
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
- Section of Epileptology, Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, UK
| | - Frank Visscher
- Department of Neurology, Admiraal De Ruyter Hospital, Goes, The Netherlands
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Federico Zara
- Laboratory of Neurogenetics, G. Gaslini Institute, Genova, Italy
| | - Erin L Heinzen
- Institute for Genomic Medicine, Columbia University Medical Center, New York, NY, USA
| | - Anthony Marson
- University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Felicitas Becker
- Department of Neurology and Epileptology, University Hospital Tuebingen, Tuebingen, Germany
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Austria
| | - Thomas Gasser
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Peter Heutink
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Maria Martinez
- INSERM U1220, IRSD, Toulouse, France
- Université Paul Sabatier, Toulouse, France
| | | | - Manu Sharma
- Centre for Genetic Epidemiology, Institute for Clinical Epidemiology and Applied Biometery, University of Tubingen, Germany
| | | | - Kin Y Mok
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Division of Life Science, Hong Kong University of Science and Technology, Hong Kong Special Administrative Region, China
| | - Sara Pulit
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Elizabeth Holliday
- Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - John Attia
- University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Thomas Battey
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Giorgio Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
- PhD Program in Neuroscience, University Milano-Bicocca, Monza, Italy
| | - Vincent Thijs
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- Austin Health, Heidelberg, Australia
| | - Wei-Min Chen
- University of Virginia Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Braxton Mitchell
- Dept of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Peter Rothwell
- Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK
- Ashford & St Peters NHS Foundation Trust, Surrey, UK
| | | | - Astrid Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Biosystems and Integrative Sciences Institute - BioISI, University of Lisboa, Lisboa, Portugal
| | - Hugh Markus
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Christina Kourkoulis
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Joana Pera
- Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - Miriam Raffeld
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Scott Silliman
- Department of Neurology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, USA
| | | | - Laura M Thornton
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - N William Rayner
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Cathryn M Lewis
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Monica Gratacos
- Genes and Disease Programme, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Filip Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Anu Raevuori
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Finland
| | - James I Hudson
- Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno,Italy
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Katrin Mannik
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Jessica H Baker
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Sara E Trace
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Oliver S P Davis
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
| | - Sietske G Helder
- Zorg op Orde BV, Leidschendam, The Netherlands
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Stefan Ehrlich
- Division of Psychological & Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technischen Universität Dresden, Dresden, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child & Adolescent Psychiatry & Psychosomatic Medicine of University Clinics, RWTH Aachen, Aachen, Germany
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
- Faculty of Social Sciences, University of Utrecht, Utrecht, the Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
- Faculty of Social Sciences, University of Utrecht, Utrecht, the Netherlands
| | - Maurizio Clementi
- Medical Genetics Unit, Department SDB, University of Padova, Padova, Italy
| | - Monica Forzan
- UOC Genetica ed Epidemiologica Clinica Az. Ospedaliera, Padova, Italy
| | - Elisa Docampo
- Department of Human Genetics, CHU Sart-Tilman, University of Liège, Liège, Belgium
- Department of Rheumatology, CHU Sart-Tilman, University of Liège, Liège, Belgium
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland
| | - Joanna Hauser
- Department of Psychiatry, University of Medical Sciences, Poznan, Poland
| | | | - Mario Maj
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "luigi Vanvitelli", Naples, Italy
| | - Fragiskos Gonidakis
- Eating Disorders Unit, 1st Psychiatric Department, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Hana Papezova
- Eating Disorders Unit, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital, Prague, Czech Republic
| | - Zeynep Yilmaz
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Stefan Herms
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Raquel Rabionet
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Department of Genetics, Microbiology & Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Danielle M Dick
- Departments of Psychology and Human & Molecular Genetics, College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - Ole A Andreassen
- NORMENT, Div. of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Thomas Espeseth
- NORMENT, Div. of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Norway
- K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Vidar M Steen
- NORMENT, K.G. Jebsen Center for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Dalila Pinto
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, 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
- The Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen W Scherer
- McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, Canada
- The Centre for Applied Genomics, Hospital for Sick Children, Toronto, Canada
| | | | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Zentren für Seelische Gesundheit, BBRZ-Med, Vienna, Austria
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
| | | | - James Mitchell
- School of Medicine, University of North Dakota, Grand Forks, ND, USA
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Michael Strober
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrew W Bergen
- BioRealm, Walnut, California, USA
- Oregon Research Institute, Eugene, OR, USA
| | - Walter Kaye
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Bru Cormand
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Department of Genetics, Microbiology & Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Casas
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Programa Corporatiu "Neurodevelopment Disorders along Life Span", Institut Català de la Salut, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Clinica Galatea y PAIMM, Mental Health Program for Impaired Physicians, Barcelona, Spain
| | - Amaia Hervas
- Child and Adolescent Mental Health Unit, Hospital Universitario Mútua de Terrassa, Barcelona, Spain
| | | | - Jan Haavik
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tetyana Zayats
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Norway
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
| | - Stefan Johansson
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Nigel Williams
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - Aribert Rothenberger
- Child and Adolescent Psychiatry/Psychotherapy, University Medical Center, Goettingen, Germany
| | - Jonna Kuntsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robert D Oades
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Alejandro Arias Vasquez
- Department of Psychiatry & Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alysa E Doyle
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Klaus-Peter Lesch
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Translational Psychiatry, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Christine Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Olga Rivero
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Haukur Palmason
- Landspitali National University Hospital, Reykjavik, Iceland
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Kate Langley
- School of Psychology, Cardiff University, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Marcella Rietschel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Soeren Dalsgaard
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Hospital of Telemark, Kragerø, Norway
| | - Anders D Børglum
- Department of Biomedicine and Human Genetics, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Aarhus Genome Center, Aarhus, Denmark
| | - Irwin Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Beth Wilmot
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Nikolas Molly
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Claiton H D Bau
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jennifer Crosbie
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Russell Schachar
- Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Sandra K Loo
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - James J McGough
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Eugenio H Grevet
- ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Elise Robinson
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lauren A Weiss
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Elena Bacchelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Anthony Bailey
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
- Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Vanessa Bal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Agatino Battaglia
- Stella Maris Clinical Research Institute for Child and Adolescent Neuropsychiatry, Pisa, Italy
| | - Catalina Betancur
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Institut de Biologie Paris Seine, Paris, France
| | - Patrick Bolton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre in Mental Health Maudsley Hospital, London, UK
| | - Rita Cantor
- Department of Human Genetics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Silvia De Rubeis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frederico Duque
- Child Developmental Center, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Andrew Green
- Dept of Clinical Genetics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Sabine M Klauck
- Division of Molecular Genome Analysis and Division of Cancer Genome Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marion Leboyer
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- Faculté de Médecine, Université Paris Est, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Pat Levitt
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Elena Maestrini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Shrikant Mane
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Daniel Moreno- De-Luca
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Jeremy Parr
- Institute of Neuroscience, Newcastle University, Newcastle, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Northumberland, Tyne & Wear NHS Foundation Trust, Northumberland, UK
| | - Regina Regan
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Genomics Medicine Ireland, Dublin, Ireland
| | | | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children and University of Toronto, Toronto, Canada
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Canada
| | - Thomas Wassink
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Ellen Wijsman
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Edwin Cook
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Susan Santangelo
- Center for Psychiatric Research, Maine Medical Center Research Institute, Portland, ME, USA
- Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Bernadette Rogé
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé (CERPPS), Université Toulouse Jean Jaurès, Toulouse, France
- CERESA, Toulouse, France
- Institut Universitaire de France, Paris, France
| | - Tiago Magalhaes
- Genomics Medicine Ireland, Dublin, Ireland
- Academic Centre on Rare Diseases University College Dublin (ACoRD/UCD), Dublin, Ireland
| | - Dan Arking
- McKusick-Nathans Institute of Genetic Medicine, 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 Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Human Genetics Branch, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Robert C Thompson
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jana Strohmaier
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- SRH University Heidelberg, Academy for Psychotherapy, Heidelberg, Germany
| | - Keith Matthews
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
- Advanced Interventions Service, NHS Tayside, Dundee, UK
| | - Ingrid Melle
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Derek Morris
- Cognitive Genetics and Cognitive Therapy Group, Neuroimaging, Cognition and Genomics (NICOG) Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | | | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Stéphane Jamain
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- Faculté de Médecine, Université Paris Est, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Anna Maaser
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Sascha B Fischer
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Céline S Reinbold
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - José Guzman-Parra
- Unidad de Salud Mental, Hospital Regional Universitario de Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Fermin Mayoral
- Unidad de Salud Mental, Hospital Regional Universitario de Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - 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 Centre Jülich, Jülich, Germany
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | | | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
| | | | - John Rice
- Washington University, St. Louis, MO, USA
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Guy A Rouleau
- Montreal Neurological Institute, McGill University, Montréal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Roel Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience & Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
- UMC Utrecht, Utrecht, The Netherlands
| | - Carlos Pato
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - Eli Stahl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - Markus Leber
- Hospital for Psychiatry and Psychotherapy, Cologne, Germany
| | - Piotr M Czerski
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Ian R Jones
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Danielle Posthuma
- Department Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam, The Netherlands
- Department Clinical Genetics, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Till F M Andlauer
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Fabian Streit
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Tracy Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Grant Sinnamon
- Bela Menso Brain and Behaviour Centre, James Cook University, Varsity Lakes, Australia
- Bond University, Faculty of Society and Design, Robina, Australia
| | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Donald J MacIntyre
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Jakob Grove
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Department of Biomedicine and Human Genetics, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, Brisbane, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Health and Hospital Service, Brisbane, Australia
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ian Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Divya Mehta
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Johannes H Smit
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Rick Jansen
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Eco de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Erin Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Qingqin S Li
- Janssen Research & Development LLC, Titusville, NJ, USA
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Greifswald, Greifswald, Germany
| | - Robert A Schoevers
- Research School of Behavioural and Cognitive Neurosciences, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Aartjan Tf Beekman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry GGZ INGEEST, Amsterdam, the Netherlands
| | - James A Knowles
- Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Canada
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Gabriel Bedoya-Berrio
- Grupo de Genética Molecular, Instituto de Biología, Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia, Medellín, Colombia
| | | | - Helena Brentani
- Department of Psychiatry, Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Beatriz Camarena
- Depto. Farmacogenética, Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Carolina Cappi
- Department of Psychiatry, Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Danielle Cath
- Department of Psychiatry, University of Groningen and University Medical Center, Groningen, the Netherlands
- Department of Specialized Trainings, GGZ Drenthe Mental Health Care Services, Assen, the Netherlands
| | | | | | | | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Eske M Derks
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Andrea Dietrich
- University of Groningen, Groningen, the Netherlands
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nelson Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience & Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Gloria Gerber
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Marco Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | | | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Andreas Hartmann
- Centre National Maladie 'Syndrome Rare Gilles de la Tourette', Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Départment de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Matthew E Hirschtritt
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alden Huang
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, USA
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Chaim Huyser
- De Bascule, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Samuel Kuperman
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Christine Lochner
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Gholson J Lyon
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Marcos Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Irene A Malaty
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, Barendrecht, The Netherlands
| | - Lauren McGrath
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Eurípedes C Miguel
- Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Humberto Nicolini
- National Institute of Genomic Medicine (INMEGEN), Ciudad de México, Mexico
- Clinical Research, Grupo Médico Carracci, Mexico City, Mexico
| | - Michael S Okun
- Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA
- Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Andrew Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana, USA
| | - John Piacentini
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Kerstin Plessen
- Division of Adolescent and Child Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Vasily Ramensky
- Moscow Institute of Physics and Technology, Dolgoprudny, Institusky 9, Moscow, Russia
| | - Eliana M Ramos
- Department of Psychiatry, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Victor Reus
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Margaret A Richter
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary M Robertson
- Division of Neuropsychiatry, University College London, London, UK
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technischen Universität Dresden, Dresden, Germany
| | - Maria Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, Brazil
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Jack F Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto, Toronto, Canada
- University Health Network, University of Toronto, Toronto, Canada
- Youthdale Treatment Centers, Toronto, Canada
| | - Dan J Stein
- Groote Schuur Hospital, Cape Town, South Africa
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Sarah Weatherall
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Yulia Worbe
- Sorbonne Université, Faculty of Médecine, Paris, France
- Reference center for Gilles de la Tourette syndrome, Pitie-Salpetriere Hospital, Paris, France
- Department of Physiology, Saint Antoine Hospital, Paris, France
| | - Gwyneth Zai
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Nicole McLaughlin
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul S Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Hans-Jorgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- INSERM, U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris, France
- IGBMC, CNRS UMR 7104/INSERM U964/Université de Strasbourg, Illkirch, France
| | | | | | - Ana Valencia-Duarte
- Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia
- Laboratorio de Genética Molecular, SIU, Universidad de Antioquia, Medellín, Colombia
| | - Elvira Bramon
- Division of Psychiatry, Molecular Psychiatry Laboratory,University College London, London, UK
| | - Nancy Buccola
- School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Wiepke Cahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Murray Cairns
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, Australia
- Priority Research Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, Australia
- Schizophrenia Research Institute, Sydney, Australia
| | - Siow A Chong
- Institute of Mental Health, Singapore, Singapore
| | - David Cohen
- Assistance Publique - Hopitaux de Paris, GH Pitié-Salpêtrière, Paris, France
- Sorbonne Université, CNRS UMR 7222 Institut des Systèmes Intelligents et Robotiques, Paris, France
| | - Benedicto Crespo-Facorro
- Departments of Medicine and Psychiatry, School of Medicine University of Cantabria-IDIVAL, University Hospital Marqués de Valdecilla, Santander, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - James Crowley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Davidson
- Minerva Neurosciences Inc., Waltham, MA, USA
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lynn DeLisi
- VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - Gary Donohoe
- Neuroimaging, Cognition and Genomics (NICOG) Centre, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Elodie Drapeau
- 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
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jubao Duan
- Center for Psychiatric Genetics, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Lieuwe Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Arkin, Amsterdam, the Netherlands
| | - David Hougaard
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | | | - Andrey Khrunin
- Department of Molecular Bases of Human Genetics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Jimmy Lee Chee Keong
- Institute of Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Svetlana Limborska
- Department of Human Genetics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Carmel Loughland
- Hunter New England Local Health District, Newcastle, Australia
- University of Newcastle, Callaghan, Australia
| | - Jouko Lönnqvist
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Mattheisen
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), National University of Ireland, Galway, Galway, Ireland
- NCBES Galway Neuroscience Centre, National University of Ireland, Galway, Galway, Ireland
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Igor Nenadic
- Philipps-Universität Marburg and Marburg University Hospital UKGM, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jim van Os
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Victoria, Australia
- Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Michele Pato
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Tracey Petryshen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Panos Roussos
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan R Sanders
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Sibylle G Schwab
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Kang Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Institute of Mental Health, Singapore, Singapore
| | - Hon-Cheong So
- School of Biomedical Sciences, Chinese University of Hong Kong, Shatin, Hong Kong
- KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
- Chinese University of Hong Kong, Hong Kong
| | | | - Mythily Subramaniam
- Institute of Mental Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
| | - John Waddington
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Mark Weiser
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Wei Cheng
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Cloninger
- Departments of Psychiatry and Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - David Curtis
- UCL Genetics Institute, University College London, London, UK
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, London, UK
| | - Pablo V Gejman
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
| | - Frans Henskens
- School of Medicine & Public Health, University of Newcastle, Callaghan, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Morten Mattingsdal
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Unit, Sørlandet Hospital, Kristiansand, Norway
| | - Sang-Yun Oh
- Department of Statistics and Applied Probability, University of California, Santa Barbara, CA, USA
- Computational Research Division, Lawrence Berkeley National Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - Rodney Scott
- University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- NSW Health Pathology, Newcastle, Australia
| | - Bradley Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Gerome Breen
- Institute of Psychiatry, Psychology & Neuroscience, Social Genetics & Developmental Psychiatry Center, MRC, Kings College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London & Maudsley NHS Trust & King's College London, London, UK
| | - Claire Churchhouse
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Cynthia M Bulik
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark Daly
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Rita Guerreiro
- UK Dementia Research Institute, University College London, London, UK
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Peter Holmans
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Bobby Koeleman
- Division Biomedical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Carol A Mathews
- Department of Psychiatry and UF Genetics Institute, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Alkes Price
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jeremiah Scharf
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Pamela Sklar
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie Williams
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Nicholas W Wood
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - Chris Cotsapas
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Aarno Palotie
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick Sullivan
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics and Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jonathan Rosand
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Aiden Corvin
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Benjamin M Neale
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Richard Anney
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Josephine Elia
- Department of Pediatrics, Nemours A.I. duPont Hospital for Children, Wilmington, DE, USA
- Department of Psychiatry, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Maria Grigoroiu-Serbanescu
- Alexandru Obregia Clinical Psychiatric Hospital, Biometric Psychiatric Genetics Research Unit, Bucharest, Romania
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robin Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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14
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Abi-Jaoude E, Chen L, Cheung P, Bhikram T, Sandor P. Preliminary Evidence on Cannabis Effectiveness and Tolerability for Adults With Tourette Syndrome. J Neuropsychiatry Clin Neurosci 2018; 29:391-400. [PMID: 28464701 DOI: 10.1176/appi.neuropsych.16110310] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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] [Indexed: 11/30/2022]
Abstract
The authors retrospectively evaluated effectiveness and tolerability of cannabis in 19 adults with Tourette syndrome. Tics scores decreased by 60%, and 18 of the 19 participants were at least "much improved." Cannabis was generally well tolerated, although most participants reported side effects.
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Affiliation(s)
- Elia Abi-Jaoude
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada (EA-J, PS); Global Medicines Development, AstraZeneca Canada, Inc., Mississauga, Ontario, Canada (LC); the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (PC); the Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada (TB); and Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Lei Chen
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada (EA-J, PS); Global Medicines Development, AstraZeneca Canada, Inc., Mississauga, Ontario, Canada (LC); the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (PC); the Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada (TB); and Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Patrina Cheung
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada (EA-J, PS); Global Medicines Development, AstraZeneca Canada, Inc., Mississauga, Ontario, Canada (LC); the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (PC); the Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada (TB); and Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Tracy Bhikram
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada (EA-J, PS); Global Medicines Development, AstraZeneca Canada, Inc., Mississauga, Ontario, Canada (LC); the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (PC); the Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada (TB); and Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
| | - Paul Sandor
- From the Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada (EA-J); the Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada (EA-J, PS); Global Medicines Development, AstraZeneca Canada, Inc., Mississauga, Ontario, Canada (LC); the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (PC); the Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada (TB); and Youthdale Treatment Centers, Toronto, Ontario, Canada (PS)
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15
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May A, Fritsche G, Kropp P, Lampl C, Limmroth V, Malzacher V, Sandor P, Straube A, Diener HC, Evers S. Akuttherapie und Prophylaxe der Migräne. ACTA ACUST UNITED AC 2018. [DOI: 10.1055/s-0038-1627343] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungDie Deutsche Migräne- und Kopfschmerzgesellschaft und die Deutsche Gesellschaft für Neurologie legen eine revidierte Fassung ihrer gemeinsamen evidenzbasierten Leitlinie für die Therapie der Migräne vor. Zur Akuttherapie der leichten Migräneattacke wird die frühzeitige und hochdosierte Einnahme von NSAR oder von Paracetamol empfohlen. Bei schweren Migräneattacken wird die Einnahme eines Triptans empfohlen, eine generelle Präferenz für eine bestimmte Substanz wird hierbei nicht ausgesprochen. Zur medikamentösen Prophylaxe der Migräne werden als Substanzen der ersten Wahl Metoprolol, Propranolol, Flunarizin, Valproinsäure und Topiramat empfohlen. Substanzen der zweiten Wahl sind Amitriptylin, Venlafaxin, Gabapentin, Naproxen, Acetylsalicylsäure, Pestwurz, Magnesium und Vitamin B2. Im Mittelpunkt der nicht medikamentösen Behandlung der Migräne stehen neben Empfehlungen zur Lebensführung, Entspannungsverfahren (progressive Muskelrelaxation), Biofeedbackverfahren und kognitive Verhaltenstherapie. Gerade die Kombination von nicht medikamentösen Verfahren untereinander oder mit einer medikamentösen Prophylaxe ist besonders wirksam.
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16
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Haag G, May A, Lampl C, Sandor P, Diener HC, Ever S, Straube A, Marziniak M. Therapie des Kopfschmerzes bei Medikamentenübergebrauch. ACTA ACUST UNITED AC 2018. [DOI: 10.1055/s-0038-1628495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungNach der zweiten Ausgabe der Internationalen Kopfschmerzklassifikation (ICHD-II, 2004) wird der Kopfschmerz bei Medikamentenübergebrauch (medication overuse headache – MOH) als chronischer Kopfschmerz definiert, induziert durch den Übergebrauch von Ergotamin, Triptanen, Analgetika, Opioiden, Kombinationspräparaten, Kombinationen einzelner Substanzen oder anderer, nicht näher spezifizierter Medikamente. Obwohl bisher keine epidemiologische Studie die tatsächliche MOH-Prävalenz (incl. erfolgreichen Entzug) untersucht hat, wird seine durchschnittliche Prävalenz auf ca. 1% der Gesamtbevölkerung geschätzt. Die genaue Pathophysiologie ist derzeit noch unklar, eine genetische Prädisposition scheint wahrscheinlich. Die Behandlung besteht in den meisten Fällen aus einem akuten Entzug der Medikation und dem Beginn einer vorbeugenden medikamentösen Therapie. Eine Ausnahme davon stellt der Übergebrauch von Opioiden und Barbituraten (in Europa sehr selten) dar, die schrittweise reduziert werden sollen. Es besteht aktuell keine klare Evidenz für die Bevorzugung einer ambulanten oder stationären Entzugstherapie. Steroide werden zur Begleitung des Entzuges eingesetzt, die Studienlage dazu ist jedoch überwiegend negativ. Topiramat und Onabotulinumtoxin können bei Patienten mit Migräne und MOH die Attackenfrequenz so reduzieren, dass die Kriterien des MOH nicht mehr erfüllt sind, ohne dass vorher ein formaler Entzug durchgeführt worden ist.
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17
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Hirschtritt ME, Darrow SM, Illmann C, Osiecki L, Grados M, Sandor P, Dion Y, King RA, Pauls D, Budman CL, Cath DC, Greenberg E, Lyon GJ, Yu D, McGrath LM, McMahon WM, Lee PC, Delucchi KL, Scharf JM, Mathews CA. Genetic and phenotypic overlap of specific obsessive-compulsive and attention-deficit/hyperactive subtypes with Tourette syndrome. Psychol Med 2018; 48:279-293. [PMID: 28651666 PMCID: PMC7909616 DOI: 10.1017/s0033291717001672] [Citation(s) in RCA: 30] [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: 12/15/2022]
Abstract
BACKGROUND The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) are not well characterized. Here, we examine symptom patterns and heritability of OCD and ADHD in TS families. METHOD OCD and ADHD symptom patterns were examined in TS patients and their family members (N = 3494) using exploratory factor analyses (EFA) for OCD and ADHD symptoms separately, followed by latent class analyses (LCA) of the resulting OCD and ADHD factor sum scores jointly; heritability and clinical relevance of the resulting factors and classes were assessed. RESULTS EFA yielded a 2-factor model for ADHD and an 8-factor model for OCD. Both ADHD factors (inattentive and hyperactive/impulsive symptoms) were genetically related to TS, ADHD, and OCD. The doubts, contamination, need for sameness, and superstitions factors were genetically related to OCD, but not ADHD or TS; symmetry/exactness and fear-of-harm were associated with TS and OCD while hoarding was associated with ADHD and OCD. In contrast, aggressive urges were genetically associated with TS, OCD, and ADHD. LCA revealed a three-class solution: few OCD/ADHD symptoms (LC1), OCD & ADHD symptoms (LC2), and symmetry/exactness, hoarding, and ADHD symptoms (LC3). LC2 had the highest psychiatric comorbidity rates (⩾50% for all disorders). CONCLUSIONS Symmetry/exactness, aggressive urges, fear-of-harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and, rather than being specific subtypes of OCD, transcend traditional diagnostic boundaries, perhaps representing an underlying vulnerability (e.g. failure of top-down cognitive control) common to all three disorders.
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Affiliation(s)
| | - Sabrina M. Darrow
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marco Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Youthdale Treatment Centers, Toronto, Ontario, Canada
| | - Yves Dion
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Robert A. King
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - David Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cathy L. Budman
- Department of Psychiatry, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Danielle C. Cath
- Faculty of Social and Behavioural Sciences, Utrecht University and Altrecht Academic Anxiety Center, Utrecht, GGz Drenthe and department of psychiatry, University Medical Center Groningen, The Netherlands
| | - Erica Greenberg
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Paul C. Lee
- Department of Behavioral Health, Tripler Army Medical Center, Honolulu, HI, USA
| | - Kevin L. Delucchi
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Division of Cognitive and Behavioral Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Carol A. Mathews
- Department of Psychiatry, and University of Florida Genetics Institute, University of Florida, Gainesville, FL, USA
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18
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Abumuamar A, Dorian P, Newman D, Sandor P, Shapiro C. Treatment of obstructive sleep apnea decreases the recurrence of atrial and ventricular ectopy in patients with atrial fibrillation. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Abumuamar A, Sandor P, Dorian P, Newman D, Shapiro C. Obstructive sleep apnea is highly undetected in non-obese patients with atrial fibrillation. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Abumuamar AM, Mollayeva T, Sandor P, Newman D, Nanthakumar K, Shapiro CM. Efficacy of Continuous Positive Airway Pressure Treatment in Patients with Cardiac Arrhythmia and Obstructive Sleep Apnea: What is the Evidence? ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1179559x17734227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Asmaa M Abumuamar
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Tatyana Mollayeva
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paul Sandor
- Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - David Newman
- Department of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Kumaraswamy Nanthakumar
- Department of Cardiology, Peter Munk Cardiac Centre, University of Toronto, Toronto, ON, Canada
| | - Colin M Shapiro
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Abstract
Recent research has identified the important role of disgust in the symptomatology of obsessive-compulsive disorder (OCD). Exaggerated and inappropriate disgust reactions may drive some of the symptoms of OCD, and in some cases, may even eclipse feelings of anxiety. This paper reviews behavioural and neuroimaging research that recognizes the prominent role of disgust in contributing to OCD symptoms, especially contamination-based symptoms. We discuss how elevated behavioural and biological markers of disgust reported in OCD populations support the need for alternative clinical treatment strategies and theoretical models of OCD.
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Affiliation(s)
- Tracy Bhikram
- Correspondence to: T. Bhikram, University Health Network, Tourette Syndrome Neurodevelopmental Clinic, 399 Bathurst St, Toronto, ON M5T 2S8;
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22
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Darrow SM, Grados M, Sandor P, Hirschtritt ME, Illmann C, Osiecki L, Dion Y, King R, Pauls D, Budman CL, Cath DC, Greenberg E, Lyon GJ, McMahon WM, Lee PC, Delucchi KL, Scharf JM, Mathews CA. Autism Spectrum Symptoms in a Tourette's Disorder Sample. J Am Acad Child Adolesc Psychiatry 2017; 56. [PMID: 28647013 PMCID: PMC5648014 DOI: 10.1016/j.jaac.2017.05.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 11/24/2022]
Abstract
OBJECTIVE Tourette's disorder (TD) and autism spectrum disorder (ASD) share clinical features and possibly an overlapping etiology. The aims of this study were to examine ASD symptom rates in participants with TD, and to characterize the relationships between ASD symptom patterns and TD, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD). METHOD Participants with TD (n = 535) and their family members (n =234) recruited for genetic studies reported TD, OCD, and ADHD symptoms and completed the Social Responsiveness Scale Second Edition (SRS), which was used to characterize ASD symptoms. RESULTS SRS scores in participants with TD were similar to those observed in other clinical samples but lower than in ASD samples (mean SRS total raw score = 51; SD = 32.4). More children with TD met cut-off criteria for ASD (22.8%) than adults with TD (8.7%). The elevated rate in children was primarily due to high scores on the SRS Repetitive and Restricted Behaviors (RRB) subscale. Total SRS scores were correlated with TD (r = 0.27), OCD (r = 0.37), and ADHD (r = 0.44) and were higher among individuals with OCD symptom-based phenotypes than for those with tics alone. CONCLUSION Higher observed rates of ASD among children affected by TD may in part be due to difficulty in discriminating complex tics and OCD symptoms from ASD symptoms. Careful examination of ASD-specific symptom patterns (social communication vs. repetitive behaviors) is essential. Independent of ASD, the SRS may be a useful tool for identifying patients with TD with impairments in social communication that potentially place them at risk for bullying and other negative sequelae.
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Affiliation(s)
| | - Marco Grados
- Johns Hopkins University School of Medicine, Baltimore
| | - Paul Sandor
- University of Toronto and University Health Network, and Youthdale Treatment Centers, Ontario, Canada
| | | | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston
| | - Yves Dion
- University of Montreal, Quebec, Canada
| | - Robert King
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT
| | - David Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston
| | - Cathy L. Budman
- North Shore/Long Island Jewish Health System, Feinstein Institute for Medical Research, Manhasset, NY
| | - Danielle C. Cath
- University of Groningen, University Medical Center Groningen; Utrecht University; and Drenthe Mental Health Institution, Assen, the Netherlands
| | - Erica Greenberg
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston
| | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY
| | | | | | | | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston. Massachusetts General and Brigham and Women’s Hospitals, Boston
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23
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Huang AY, Yu D, Davis LK, Sul JH, Tsetsos F, Ramensky V, Zelaya I, Ramos EM, Osiecki L, Chen JA, McGrath LM, Illmann C, Sandor P, Barr CL, Grados M, Singer HS, Nöthen MM, Hebebrand J, King RA, Dion Y, Rouleau G, Budman CL, Depienne C, Worbe Y, Hartmann A, Müller-Vahl KR, Stuhrmann M, Aschauer H, Stamenkovic M, Schloegelhofer M, Konstantinidis A, Lyon GJ, McMahon WM, Barta C, Tarnok Z, Nagy P, Batterson JR, Rizzo R, Cath DC, Wolanczyk T, Berlin C, Malaty IA, Okun MS, Woods DW, Rees E, Pato CN, Pato MT, Knowles JA, Posthuma D, Pauls DL, Cox NJ, Neale BM, Freimer NB, Paschou P, Mathews CA, Scharf JM, Coppola G. Rare Copy Number Variants in NRXN1 and CNTN6 Increase Risk for Tourette Syndrome. Neuron 2017; 94:1101-1111.e7. [PMID: 28641109 PMCID: PMC5568251 DOI: 10.1016/j.neuron.2017.06.010] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [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: 03/20/2017] [Revised: 04/14/2017] [Accepted: 06/06/2017] [Indexed: 11/16/2022]
Abstract
Tourette syndrome (TS) is a model neuropsychiatric disorder thought to arise from abnormal development and/or maintenance of cortico-striato-thalamo-cortical circuits. TS is highly heritable, but its underlying genetic causes are still elusive, and no genome-wide significant loci have been discovered to date. We analyzed a European ancestry sample of 2,434 TS cases and 4,093 ancestry-matched controls for rare (< 1% frequency) copy-number variants (CNVs) using SNP microarray data. We observed an enrichment of global CNV burden that was prominent for large (> 1 Mb), singleton events (OR = 2.28, 95% CI [1.39-3.79], p = 1.2 × 10-3) and known, pathogenic CNVs (OR = 3.03 [1.85-5.07], p = 1.5 × 10-5). We also identified two individual, genome-wide significant loci, each conferring a substantial increase in TS risk (NRXN1 deletions, OR = 20.3, 95% CI [2.6-156.2]; CNTN6 duplications, OR = 10.1, 95% CI [2.3-45.4]). Approximately 1% of TS cases carry one of these CNVs, indicating that rare structural variation contributes significantly to the genetic architecture of TS.
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Affiliation(s)
- Alden Y Huang
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA; Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jae Hoon Sul
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Fotis Tsetsos
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Vasily Ramensky
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA; Moscow Institute of Physics and Technology, Dolgoprudny, Institusky 9, Moscow 141701, Russian Federation
| | - Ivette Zelaya
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA; Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Eliana Marisa Ramos
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jason A Chen
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA; Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Lauren M McGrath
- Department of Psychology, University of Denver, Denver, CO 80210, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Paul Sandor
- Toronto Western Research Institute, University Health Network and Youthdale Treatment Centres, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Marco Grados
- Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Harvey S Singer
- Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, 53127 Bonn, Germany; Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Robert A King
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Yves Dion
- University of Montréal, Montréal, QC H3T 1J4, Canada
| | - Guy Rouleau
- Department of Neurology and Neurosurgery, Montréal Neurological Institute, McGill University, Montréal, QC H3A 2B4, Canada
| | - Cathy L Budman
- Hofstra Northwell School of Medicine, Hempstead, NY 11549, USA
| | - Christel Depienne
- IGBMC, CNRS UMR 7104/INSERM U964/Université de Strasbourg, 67404 Illkirch Cedex, France; Brain and Spine Institute, UPMC/INSERM UMR_S1127, 75013 Paris Cedex 05, France
| | - Yulia Worbe
- Brain and Spine Institute, UPMC/INSERM UMR_S1127, 75013 Paris Cedex 05, France
| | - Andreas Hartmann
- Brain and Spine Institute, UPMC/INSERM UMR_S1127, 75013 Paris Cedex 05, France
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany
| | - Manfred Stuhrmann
- Institute of Human Genetics, Hannover Medical School, 30625 Hannover, Germany
| | - Harald Aschauer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, 1090 Vienna, Austria; Biopsychosocial Corporation, 1090 Vienna, Austria
| | - Mara Stamenkovic
- Department of Psychiatry and Psychotherapy, Medical University Vienna, 1090 Vienna, Austria
| | - Monika Schloegelhofer
- Department of Psychiatry and Psychotherapy, Medical University Vienna, 1090 Vienna, Austria
| | - Anastasios Konstantinidis
- Department of Psychiatry and Psychotherapy, Medical University Vienna, 1090 Vienna, Austria; Center for Mental Health Muldenstrasse, BBRZMed, 4020 Linz, Austria
| | - Gholson J Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - William M McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, 1085 Budapest, Hungary
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary
| | | | - Renata Rizzo
- Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, 95131 Catania, Italy
| | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen & Drenthe Mental Health Center, 9700 RB Groningen, the Netherlands; Department of Clinical Psychology, Utrecht University, 3584 CS Utrecht, the Netherlands
| | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, 00-001 Warsaw, Poland
| | - Cheston Berlin
- Penn State University College of Medicine, Hershey, PA 17033, USA
| | - Irene A Malaty
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32607, USA
| | - Michael S Okun
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32607, USA
| | - Douglas W Woods
- Marquette University, Milwaukee, WI 53233, USA; University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Elliott Rees
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff CF24 4HQ, Wales, UK
| | - Carlos N Pato
- SUNY Downstate Medical Center, Brooklyn, NY 11203, USA
| | | | - James A Knowles
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, VU University Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - David L Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nancy J Cox
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nelson B Freimer
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Carol A Mathews
- Department of Psychiatry, Genetics Institute, University of Florida, Gainesville, FL 32611, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Giovanni Coppola
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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Darrow SM, Hirschtritt ME, Davis LK, Illmann C, Osiecki L, Grados M, Sandor P, Dion Y, King R, Pauls D, Budman CL, Cath DC, Greenberg E, Lyon GJ, Yu D, McGrath LM, McMahon WM, Lee PC, Delucchi KL, Scharf JM, Mathews CA. Identification of Two Heritable Cross-Disorder Endophenotypes for Tourette Syndrome. Am J Psychiatry 2017; 174:387-396. [PMID: 27809572 PMCID: PMC5378637 DOI: 10.1176/appi.ajp.2016.16020240] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 02/05/2023]
Abstract
OBJECTIVE Phenotypic heterogeneity in Tourette syndrome is partly due to complex genetic relationships among Tourette syndrome, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD). Identifying symptom-based endophenotypes across diagnoses may aid gene-finding efforts. METHOD Assessments for Tourette syndrome, OCD, and ADHD symptoms were conducted in a discovery sample of 3,494 individuals recruited for genetic studies. Symptom-level factor and latent class analyses were conducted in Tourette syndrome families and replicated in an independent sample of 882 individuals. Classes were characterized by comorbidity rates and proportion of parents included. Heritability and polygenic load associated with Tourette syndrome, OCD, and ADHD were estimated. RESULTS The authors identified two cross-disorder symptom-based phenotypes across analyses: symmetry (symmetry, evening up, checking obsessions; ordering, arranging, counting, writing-rewriting compulsions, repetitive writing tics) and disinhibition (uttering syllables/words, echolalia/palilalia, coprolalia/copropraxia, and obsessive urges to offend/mutilate/be destructive). Heritability estimates for both endophenotypes were high and statistically significant (disinhibition factor=0.35, SE=0.03; symmetry factor=0.39, SE=0.03; symmetry class=0.38, SE=0.10). Mothers of Tourette syndrome probands had high rates of symmetry (49%) but not disinhibition (5%). Polygenic risk scores derived from a Tourette syndrome genome-wide association study (GWAS) were significantly associated with symmetry, while risk scores derived from an OCD GWAS were not. OCD polygenic risk scores were significantly associated with disinhibition, while Tourette syndrome and ADHD risk scores were not. CONCLUSIONS The analyses identified two heritable endophenotypes related to Tourette syndrome that cross traditional diagnostic boundaries. The symmetry phenotype correlated with Tourette syndrome polygenic load and was present in otherwise Tourette-unaffected mothers, suggesting that this phenotype may reflect additional Tourette syndrome (rather than OCD) genetic liability that is not captured by traditional DSM-based diagnoses.
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Affiliation(s)
| | | | - Lea K. Davis
- Vanderbilt University Department of Medicine, Nashville
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Marco Grados
- Johns Hopkins University School of Medicine Department of Psychiatry and Behavioral Sciences, Baltimore
| | - Paul Sandor
- University of Toronto Department of Psychiatry and University Health Network, and Youthdale Treatment Centers, Ontario, Canada
| | - Yves Dion
- University of Montreal Department of Psychiatry, Quebec, Canada
| | - Robert King
- Yale Child Study Center, Yale University School of Medicine Department of Genetics, New Haven
| | - David Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Cathy L. Budman
- North Shore/Long Island Jewish Health System, Feinstein Institute for Medical Research, Manhasset
| | - Danielle C. Cath
- Utrecht University Faculty of Social and Behavioural Sciences, Utrecht, The Netherlands
| | - Erica Greenberg
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Cold Spring Harbor
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
| | | | | | - Paul C. Lee
- Tripler Army Medical Center Department of Behavioral Health, Honolulu
| | | | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston,Departments of Neurology, Brigham and Women’s and Massachusetts General Hospitals, Boston
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25
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Alexander J, Potamianou H, Xing J, Deng L, Karagiannidis I, Tsetsos F, Drineas P, Tarnok Z, Rizzo R, Wolanczyk T, Farkas L, Nagy P, Szymanska U, Androutsos C, Tsironi V, Koumoula A, Barta C, Sandor P, Barr CL, Tischfield J, Paschou P, Heiman GA, Georgitsi M. Targeted Re-Sequencing Approach of Candidate Genes Implicates Rare Potentially Functional Variants in Tourette Syndrome Etiology. Front Neurosci 2016; 10:428. [PMID: 27708560 PMCID: PMC5030307 DOI: 10.3389/fnins.2016.00428] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022] Open
Abstract
Although the genetic basis of Tourette Syndrome (TS) remains unclear, several candidate genes have been implicated. Using a set of 382 TS individuals of European ancestry we investigated four candidate genes for TS (HDC, SLITRK1, BTBD9, and SLC6A4) in an effort to identify possibly causal variants using a targeted re-sequencing approach by next generation sequencing technology. Identification of possible disease causing variants under different modes of inheritance was performed using the algorithms implemented in VAAST. We prioritized variants using Variant ranker and validated five rare variants via Sanger sequencing in HDC and SLITRK1, all of which are predicted to be deleterious. Intriguingly, one of the identified variants is in linkage disequilibrium with a variant that is included among the top hits of a genome-wide association study for response to citalopram treatment, an antidepressant drug with off-label use also in obsessive compulsive disorder. Our findings provide additional evidence for the implication of these two genes in TS susceptibility and the possible role of these proteins in the pathobiology of TS should be revisited.
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Affiliation(s)
- John Alexander
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandroupoli, Greece
| | - Hera Potamianou
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandroupoli, Greece
| | - Jinchuan Xing
- Department of Genetics, Rutgers, The State University of New JerseyPiscataway, NJ, USA; Human Genetics Institute of New Jersey, Rutgers, The State University of New JerseyPiscataway, NJ, USA
| | - Li Deng
- Department of Genetics, Rutgers, The State University of New JerseyPiscataway, NJ, USA; Human Genetics Institute of New Jersey, Rutgers, The State University of New JerseyPiscataway, NJ, USA
| | - Iordanis Karagiannidis
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandroupoli, Greece
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandroupoli, Greece
| | - Petros Drineas
- Computer Science Department, Purdue University West Lafayette, USA
| | - Zsanett Tarnok
- Vadaskert Clinic for Child and Adolescent Psychiatry Budapest, Hungary
| | - Renata Rizzo
- Department of Clinical and Experimental Medicine, University of Catania Catania, Italy
| | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw Warsaw, Poland
| | - Luca Farkas
- Vadaskert Clinic for Child and Adolescent Psychiatry Budapest, Hungary
| | - Peter Nagy
- Vadaskert Clinic for Child and Adolescent Psychiatry Budapest, Hungary
| | - Urszula Szymanska
- Department of Child Psychiatry, Medical University of Warsaw Warsaw, Poland
| | - Christos Androutsos
- Child and Adolescent Psychiatry Clinic, Sismanoglio General Hospital of Attica Athens, Greece
| | - Vaia Tsironi
- Child and Adolescent Psychiatry Clinic, Sismanoglio General Hospital of Attica Athens, Greece
| | - Anastasia Koumoula
- Child and Adolescent Psychiatry Clinic, Sismanoglio General Hospital of Attica Athens, Greece
| | - Csaba Barta
- Molecular Biology and Pathobiochemistry, Institute of Medical Chemistry, Semmelweis University Budapest, Hungary
| | | | - Paul Sandor
- Department of Psychiatry, University of Toronto Toronto, ON, Canada
| | - Cathy L Barr
- Genetics and Development Division, Krembil Research Institute, University Health NetworkToronto, ON, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick ChildrenToronto, ON, Canada
| | - Jay Tischfield
- Department of Genetics, Rutgers, The State University of New JerseyPiscataway, NJ, USA; Human Genetics Institute of New Jersey, Rutgers, The State University of New JerseyPiscataway, NJ, USA
| | - Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandroupoli, Greece
| | - Gary A Heiman
- Department of Genetics, Rutgers, The State University of New JerseyPiscataway, NJ, USA; Human Genetics Institute of New Jersey, Rutgers, The State University of New JerseyPiscataway, NJ, USA
| | - Marianthi Georgitsi
- Department of Molecular Biology and Genetics, Democritus University of ThraceAlexandroupoli, Greece; Laboratory of General Biology, Department of Medicine, Aristotle University of ThessalonikiThessaloniki, Greece
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26
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Hirschtritt ME, Darrow SM, Illmann C, Osiecki L, Grados M, Sandor P, Dion Y, King RA, Pauls DL, Budman CL, Cath DC, Greenberg E, Lyon GJ, Yu D, McGrath LM, McMahon WM, Lee PC, Delucchi KL, Scharf JM, Mathews CA. Social disinhibition is a heritable subphenotype of tics in Tourette syndrome. Neurology 2016; 87:497-504. [PMID: 27371487 PMCID: PMC4970665 DOI: 10.1212/wnl.0000000000002910] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 10/20/2015] [Accepted: 03/28/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify heritable symptom-based subtypes of Tourette syndrome (TS). METHODS Forty-nine motor and phonic tics were examined in 3,494 individuals (1,191 TS probands and 2,303 first-degree relatives). Item-level exploratory factor and latent class analyses (LCA) were used to identify tic-based subtypes. Heritabilities of the subtypes were estimated, and associations with clinical characteristics were examined. RESULTS A 6-factor exploratory factor analysis model provided the best fit, which paralleled the somatotopic representation of the basal ganglia, distinguished simple from complex tics, and separated out socially disinhibited and compulsive tics. The 5-class LCA model best distinguished among the following groups: unaffected, simple tics, intermediate tics without social disinhibition, intermediate with social disinhibition, and high rates of all tic types. Across models, a phenotype characterized by high rates of social disinhibition emerged. This phenotype was associated with increased odds of comorbid psychiatric disorders, in particular, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder, earlier age at TS onset, and increased tic severity. The heritability estimate for this phenotype based on the LCA was 0.53 (SE 0.08, p 1.7 × 10(-18)). CONCLUSIONS Expanding on previous modeling approaches, a series of TS-related phenotypes, including one characterized by high rates of social disinhibition, were identified. These phenotypes were highly heritable and may reflect underlying biological networks more accurately than traditional diagnoses, thus potentially aiding future genetic, imaging, and treatment studies.
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Affiliation(s)
- Matthew E Hirschtritt
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Sabrina M Darrow
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Cornelia Illmann
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Lisa Osiecki
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Marco Grados
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Paul Sandor
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Yves Dion
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Robert A King
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - David L Pauls
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Cathy L Budman
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Danielle C Cath
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Erica Greenberg
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Gholson J Lyon
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Dongmei Yu
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Lauren M McGrath
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - William M McMahon
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Paul C Lee
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Kevin L Delucchi
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
| | - Jeremiah M Scharf
- From the Department of Psychiatry (M.E.H., S.M.D., K.L.D.), University of California, San Francisco; Psychiatric and Neurodevelopmental Genetics Unit (C.I., L.O., D.L.P., E.G., D.Y., J.M.S.), Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry and Behavioral Sciences (M.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry (P.S.), University of Toronto and University Health Network, Youthdale Treatment Centers; Department of Psychiatry (Y.D.), University of Montreal, Canada; Yale Child Study Center (R.A.K.), Yale University School of Medicine, New Haven, CT; The Feinstein Institute for Medical Research (C.L.B.), North Shore Long Island Jewish Health System, Manhasset, NY; Faculty of Social and Behavioural Sciences (D.C.C.), Utrecht University and Altrecht Academic Anxiety Center, Utrecht, the Netherlands; Stanley Institute for Cognitive Genomics (G.J.L.), Cold Spring Harbor Laboratory, NY; School of Education (L.M.M.), American University, Washington, DC; Department of Psychiatry (W.M.M.), University of Utah, Salt Lake City; Department of Behavioral Health (P.C.L.), Tripler Army Medical Center, Honolulu, HI; Division of Cognitive and Behavioral Neurology (J.M.S.), Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (J.M.S.), Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Department of Psychiatry (C.A.M.), University of Florida, Gainesville
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Hirschtritt ME, Lee PC, Pauls DL, Dion Y, Grados MA, Illmann C, King RA, Sandor P, McMahon WM, Lyon GJ, Cath DC, Kurlan R, Robertson MM, Osiecki L, Scharf JM, Mathews CA. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015; 72:325-33. [PMID: 25671412 PMCID: PMC4446055 DOI: 10.1001/jamapsychiatry.2014.2650] [Citation(s) in RCA: 383] [Impact Index Per Article: 42.6] [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] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, few studies have fully characterized these comorbidities. Furthermore, most studies have included relatively few participants (<200), and none has examined the ages of highest risk for each TS-associated comorbidity or their etiologic relationship to TS. OBJECTIVE To characterize the lifetime prevalence, clinical associations, ages of highest risk, and etiology of psychiatric comorbidity among individuals with TS. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional structured diagnostic interviews conducted between April 1, 1992, and December 31, 2008, of participants with TS (n = 1374) and TS-unaffected family members (n = 1142). MAIN OUTCOMES AND MEASURES Lifetime prevalence of comorbid DSM-IV-TR disorders, their heritabilities, ages of maximal risk, and associations with symptom severity, age at onset, and parental psychiatric history. RESULTS The lifetime prevalence of any psychiatric comorbidity among individuals with TS was 85.7%; 57.7% of the population had 2 or more psychiatric disorders. The mean (SD) number of lifetime comorbid diagnoses was 2.1 (1.6); the mean number was 0.9 (1.3) when obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) were excluded, and 72.1% of the individuals met the criteria for OCD or ADHD. Other disorders, including mood, anxiety, and disruptive behavior, each occurred in approximately 30% of the participants. The age of greatest risk for the onset of most comorbid psychiatric disorders was between 4 and 10 years, with the exception of eating and substance use disorders, which began in adolescence (interquartile range, 15-19 years for both). Tourette syndrome was associated with increased risk of anxiety (odds ratio [OR], 1.4; 95% CI, 1.0-1.9; P = .04) and decreased risk of substance use disorders (OR, 0.6; 95% CI, 0.3-0.9; P = .02) independent from comorbid OCD and ADHD; however, high rates of mood disorders among participants with TS (29.8%) may be accounted for by comorbid OCD (OR, 3.7; 95% CI, 2.9-4.8; P < .001). Parental history of ADHD was associated with a higher burden of non-OCD, non-ADHD comorbid psychiatric disorders (OR, 1.86; 95% CI, 1.32-2.61; P < .001). Genetic correlations between TS and mood (RhoG, 0.47), anxiety (RhoG, 0.35), and disruptive behavior disorders (RhoG, 0.48), may be accounted for by ADHD and, for mood disorders, by OCD. CONCLUSIONS AND RELEVANCE This study is, to our knowledge, the most comprehensive of its kind. It confirms the belief that psychiatric comorbidities are common among individuals with TS, demonstrates that most comorbidities begin early in life, and indicates that certain comorbidities may be mediated by the presence of comorbid OCD or ADHD. In addition, genetic analyses suggest that some comorbidities may be more biologically related to OCD and/or ADHD rather than to TS.
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Affiliation(s)
- Matthew E. Hirschtritt
- Program for Genetics and Epidemiology of Neuropsychiatric Symptoms, Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Paul C. Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Yves Dion
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A. King
- Yale Child Study Center, Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Toronto Western Research Institute and Youthdale Treatment Centers, Toronto, Ontario, Canada
| | | | - Gholson J. Lyon
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Woodbury, NY, USA
| | - Danielle C. Cath
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands,Altrecht Academic Anxiety Disorders Centre, Utrecht, The Netherlands
| | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA
| | - Mary M. Robertson
- University College London and St George's Hospital and Medical School, London, UK,University of Cape Town, Cape Town, South Africa
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Division of Cognitive and Behavioral Neurology, Brigham and Women’s Hospital, Boston, MA, USA,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Carol A. Mathews
- Program for Genetics and Epidemiology of Neuropsychiatric Symptoms, Department of Psychiatry, University of California, San Francisco, CA, USA
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Abi-Jaoude E, Segura B, Obeso I, Cho SS, Houle S, Lang AE, Rusjan P, Sandor P, Strafella AP. Similar striatal D2/D3 dopamine receptor availability in adults with Tourette syndrome compared with healthy controls: A [(11) C]-(+)-PHNO and [(11) C]raclopride positron emission tomography imaging study. Hum Brain Mapp 2015; 36:2592-601. [PMID: 25788222 DOI: 10.1002/hbm.22793] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 10/25/2014] [Revised: 02/07/2015] [Accepted: 03/09/2015] [Indexed: 01/08/2023] Open
Abstract
Pharmacological and anatomical evidence implicates striatal dopamine receptors in Tourette syndrome (TS). Nevertheless, results of positron emission tomography (PET) studies of the dopamine system in TS have been inconsistent. We investigated striatal D2/3 dopamine receptors in TS using the radioligands [(11) C]raclopride and [(11) C]-(+)-PHNO, an agonist that binds preferentially to D3 receptors, thus allowing higher sensitivity and measurement of receptors in a high affinity state. Eleven adults with TS and 11 matched healthy control (HC) participants underwent [(11) C]raclopride and [(11) C]-(+)-PHNO PET scans. General linear model was used for voxelwise contrasts of striatal binding potentials (BPND ) between TS and HC participants. Analysis of variance was performed to investigate main effect of radioligand. In addition, BPND values were extracted for ventral, motor, and associative striatum. Finally, we examined the relationship between BPND measures and symptom severity in TS participants. Main effects analyses showed that [(11) C]-(+)-PHNO BPND was higher in ventral striatum, whereas [(11) C]raclopride BPND was higher in motor and associative striatum. There were no significant group differences between TS and HC. Furthermore, TS and HC participants had similar [(11) C]-(+)-PHNO and [(11) C]raclopride BPND in the three striatal subregions. Moreover, there was no significant correlation between BPND and symptom severity. TS and HC participants had similar striatal D2/3 receptor availability measures. These results challenge the assumption that striatal dopamine receptors have a major role in the pathophysiology of TS. Consistent with previous findings, [(11) C]-(+)-PHNO localized preferentially to ventral striatal, D3 receptor-rich regions, in contrast to [(11) C]raclopride, which localized preferentially in the dorsal striatum.
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Affiliation(s)
- Elia Abi-Jaoude
- Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Segura
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ignacio Obeso
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Institute of Cognitive Sciences, CNRS, Lyon, France
| | - Sang Soo Cho
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, UHN, University of Toronto, Ontario, Canada
| | - Sylvain Houle
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorder Unit & Edmond J. Safra Program in Parkinson's Disease and the Division of Neurology, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada
| | - Pablo Rusjan
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul Sandor
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Youthdale Treatment Centers, Toronto, Ontario, Canada
| | - Antonio P Strafella
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, UHN, University of Toronto, Ontario, Canada.,Morton and Gloria Shulman Movement Disorder Unit & Edmond J. Safra Program in Parkinson's Disease and the Division of Neurology, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada
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Yu D, Mathews CA, Scharf JM, Neale BM, Davis LK, Gamazon ER, Derks EM, Evans P, Edlund CK, Crane J, Fagerness JA, Osiecki L, Gallagher P, Gerber G, Haddad S, Illmann C, McGrath LM, Mayerfeld C, Arepalli S, Barlassina C, Barr CL, Bellodi L, Benarroch F, Berrió GB, Bienvenu OJ, Black D, Bloch MH, Brentani H, Bruun RD, Budman CL, Camarena B, Campbell DD, Cappi C, Cardona Silgado JC, Cavallini MC, Chavira DA, Chouinard S, Cook EH, Cookson MR, Coric V, Cullen B, Cusi D, Delorme R, Denys D, Dion Y, Eapen V, Egberts K, Falkai P, Fernandez T, Fournier E, Garrido H, Geller D, Gilbert D, Girard SL, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Hardy J, Heiman GA, Hemmings SM, Herrera LD, Hezel DM, Hoekstra PJ, Jankovic J, Kennedy JL, King RA, Konkashbaev AI, Kremeyer B, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Liu C, Lochner C, Lowe TL, Lupoli S, Macciardi F, Maier W, Manunta P, Marconi M, McCracken JT, Mesa Restrepo SC, Moessner R, Moorjani P, Morgan J, Muller H, Murphy DL, Naarden AL, Ochoa WC, Ophoff RA, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Rauch SL, Renner T, Reus VI, Richter MA, Riddle MA, Robertson MM, Romero R, Rosário MC, Rosenberg D, Ruhrmann S, Sabatti C, Salvi E, Sampaio AS, Samuels J, Sandor P, Service SK, Sheppard B, Singer HS, Smit JH, Stein DJ, Strengman E, Tischfield JA, Turiel M, Valencia Duarte AV, Vallada H, Veenstra-VanderWeele J, Walitza S, Walkup J, Wang Y, Weale M, Weiss R, Wendland JR, Westenberg HG, Yao Y, Hounie AG, Miguel EC, Nicolini H, Wagner M, Ruiz-Linares A, Cath DC, McMahon W, Posthuma D, Oostra BA, Nestadt G, Rouleau GA, Purcell S, Jenike MA, Heutink P, Hanna GL, Conti DV, Arnold PD, Freimer N, Stewart SE, Knowles JA, Cox NJ, Pauls DL. Cross-disorder genome-wide analyses suggest a complex genetic relationship between Tourette's syndrome and OCD. Am J Psychiatry 2015; 172:82-93. [PMID: 25158072 PMCID: PMC4282594 DOI: 10.1176/appi.ajp.2014.13101306] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) and Tourette's syndrome are highly heritable neurodevelopmental disorders that are thought to share genetic risk factors. However, the identification of definitive susceptibility genes for these etiologically complex disorders remains elusive. The authors report a combined genome-wide association study (GWAS) of Tourette's syndrome and OCD. METHOD The authors conducted a GWAS in 2,723 cases (1,310 with OCD, 834 with Tourette's syndrome, 579 with OCD plus Tourette's syndrome/chronic tics), 5,667 ancestry-matched controls, and 290 OCD parent-child trios. GWAS summary statistics were examined for enrichment of functional variants associated with gene expression levels in brain regions. Polygenic score analyses were conducted to investigate the genetic architecture within and across the two disorders. RESULTS Although no individual single-nucleotide polymorphisms (SNPs) achieved genome-wide significance, the GWAS signals were enriched for SNPs strongly associated with variations in brain gene expression levels (expression quantitative loci, or eQTLs), suggesting the presence of true functional variants that contribute to risk of these disorders. Polygenic score analyses identified a significant polygenic component for OCD (p=2×10(-4)), predicting 3.2% of the phenotypic variance in an independent data set. In contrast, Tourette's syndrome had a smaller, nonsignificant polygenic component, predicting only 0.6% of the phenotypic variance (p=0.06). No significant polygenic signal was detected across the two disorders, although the sample is likely underpowered to detect a modest shared signal. Furthermore, the OCD polygenic signal was significantly attenuated when cases with both OCD and co-occurring Tourette's syndrome/chronic tics were included in the analysis (p=0.01). CONCLUSIONS Previous work has shown that Tourette's syndrome and OCD have some degree of shared genetic variation. However, the data from this study suggest that there are also distinct components to the genetic architectures of these two disorders. Furthermore, OCD with co-occurring Tourette's syndrome/chronic tics may have different underlying genetic susceptibility compared with OCD alone.
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Affiliation(s)
- Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Co-corresponding authors: Dongmei Yu, MS & David L. Pauls, Ph.D., Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Simches Research Building, 6th Floor, 185 Cambridge Street, Boston, MA 02114
| | - Carol A. Mathews
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA,Division of Cognitive and Behavioral Neurology, Brigham and Womens Hospital, Boston, MA, USA
| | - Benjamin M. Neale
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Lea K. Davis
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Eric R. Gamazon
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Eske M. Derks
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick Evans
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Christopher K. Edlund
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jacquelyn Crane
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jesen A. Fagerness
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Patience Gallagher
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gloria Gerber
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephen Haddad
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lauren M. McGrath
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Catherine Mayerfeld
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sampath Arepalli
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Cristina Barlassina
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Cathy L. Barr
- The Toronto Western Research Institute, University Health Network, Toronto, ON, Canada,The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Fortu Benarroch
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Donald Black
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Michael H. Bloch
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Helena Brentani
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Ruth D. Bruun
- North Shore-Long Island Jewish Medical Center, Manhasset, NY, USA,New York University Medical Center, New York, NY, USA
| | - Cathy L. Budman
- North Shore-Long Island Jewish Health System, Manhasset, NY, USA,Hofstra University School of Medicine, Hempstead, NY, USA
| | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Desmond D. Campbell
- University College London, London, UK,Department of Psychiatry, University of Hong Kong, Hong Kong
| | - Carolina Cappi
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | | | | | - Denise A. Chavira
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Sylvain Chouinard
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Edwin H. Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
| | - M. R. Cookson
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Vladimir Coric
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniele Cusi
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Richard Delorme
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France,Foundation Fondamental, French National Science Foundation, France,AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Yves Dion
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Valsama Eapen
- Infant Child and Adolescent Psychiatry, University of New South Wales, Australia,Academic Unit of Child Psychiatry, South West Sydney LHD (AUCS), Australia
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Thomas Fernandez
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Helena Garrido
- Clinica Herrera Amighetti, Avenida Escazú, San José, Costa Rica
| | - Daniel Geller
- OCD Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Donald Gilbert
- Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, USA
| | - Simon L. Girard
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, Helios-Hospital Stralsund, University Medicine Greifswald, Greifswald, Germany
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, USA
| | - Varda Gross-Tsur
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
| | | | - Gary A. Heiman
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, US
| | - Sian M.J. Hemmings
- Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | | | - Dianne M. Hezel
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pieter J. Hoekstra
- Department of Psychiatry, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - James L. Kennedy
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Robert A. King
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Anuar I. Konkashbaev
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA
| | | | - Marion Leboyer
- Foundation Fondamental, French National Science Foundation, France,AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France,Institut Mondor de Recherche Biomédicale, Psychiatric Genetics, Créteil, F 94000, France
| | - James F. Leckman
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Leonhard Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Chunyu Liu
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Christine Lochner
- MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Thomas L. Lowe
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Sara Lupoli
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine (UCI), California, USA
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Paolo Manunta
- Division of Nephrology and Dialysis, San Raffaele Scientific Institute - Chair of Nephrology, Università Vita Salute San Raffaele, Milan, Italy
| | - Maurizio Marconi
- Center of Transfusion Medicine and Immunohematology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, California, USA
| | | | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Priya Moorjani
- Department of Genetics, Harvard University, Cambridge, MA, USA
| | | | | | - Dennis L. Murphy
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Allan L. Naarden
- Department of Clinical Research, Medical City Dallas Hospital, Dallas, Texas, USA
| | | | - Roel A. Ophoff
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Andrew J. Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Michele T. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carlos N. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, California, USA
| | - Christopher Pittenger
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yehuda Pollak
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Scott L. Rauch
- Partners Psychiatry and McLean Hospital, Boston, MA, USA
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Germany
| | - Victor I. Reus
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Margaret A. Richter
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Maria C. Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, Brazil
| | - David Rosenberg
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University and the Detroit Medical Center
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Chiara Sabatti
- Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Erika Salvi
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Aline S. Sampaio
- University Health Care Services - SMURB, Universidade Federal da Bahia, Salvador, Bahia, Brazil,Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Toronto Western Research Institute and Youthdale Treatment Centers, Toronto, Ontario, Canada
| | - Susan K. Service
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Brooke Sheppard
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | | | - Jan H. Smit
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Dan J. Stein
- University of Cape Town, Cape Town, South Africa
| | - Eric Strengman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jay A. Tischfield
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, US
| | - Maurizio Turiel
- Department of Health Technologies, University of Milano, Milano, Italy
| | | | - Homero Vallada
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Jeremy Veenstra-VanderWeele
- Departments of Psychiatry, Pediatrics, and Pharmacology, Kennedy Center for Research on Human Development, and Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland,Department of Child and Adolescent Psychiatry, University of Würzburg, Germany
| | - John Walkup
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Cornell Medical Center, New York, NY, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mike Weale
- Department of Medical & Molecular Genetics, King’s College London, UK
| | | | - Jens R. Wendland
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Herman G.M. Westenberg
- Department of Psychiatry, Academic Medical Center and Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Yin Yao
- Unit on Statistical Genomics, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Ana G. Hounie
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | | | | | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | | | - Danielle C. Cath
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Department of Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - William McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Danielle Posthuma
- Section of Medical Genomics, Department of Clinical Genetics, VU University Medical Center Amsterdam, The Netherlands,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, De Boelelaan Amsterdam, The Netherlands,Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre, Wytemaweg 8, Rotterdam, The Netherlands
| | - Ben A. Oostra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guy A. Rouleau
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Shaun Purcell
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA,Mt. Sinai Medical Center, New York, NY, USA
| | - Michael A. Jenike
- OCD Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter Heutink
- Section of Medical Genomics, Department of Clinical Genetics, VU University Medical Center Amsterdam, The Netherlands,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David V. Conti
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paul D. Arnold
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nelson Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - S. Evelyn Stewart
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,British Columbia Mental Health and Addictions Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - James A. Knowles
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nancy J. Cox
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Co-corresponding authors: Dongmei Yu, MS & David L. Pauls, Ph.D., Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Simches Research Building, 6th Floor, 185 Cambridge Street, Boston, MA 02114
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Abstract
Purpose:To describe an association of Tourette's syndrome with rapid eye movement sleep behaviour disorder (RBD) in a prepubescent boy.Methods:A four year longitudinal single-case study.Results:The co-existence of Tourette's syndrome and RBD was confirmed after polysomnographic studies using the standard criteria. The authors propose possible overlap in the pathophysiological mechanisms underlying the two disorders.
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McGrath LM, Yu D, Marshall C, Davis LK, Thiruvahindrapuram B, Li B, Cappi C, Gerber G, Wolf A, Schroeder FA, Osiecki L, O'Dushlaine C, Kirby A, Illmann C, Haddad S, Gallagher P, Fagerness JA, Barr CL, Bellodi L, Benarroch F, Bienvenu OJ, Black DW, Bloch MH, Bruun RD, Budman CL, Camarena B, Cath DC, Cavallini MC, Chouinard S, Coric V, Cullen B, Delorme R, Denys D, Derks EM, Dion Y, Rosário MC, Eapen V, Evans P, Falkai P, Fernandez TV, Garrido H, Geller D, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Heiman GA, Hemmings SMJ, Herrera LD, Hounie AG, Jankovic J, Kennedy JL, King RA, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Lochner C, Lowe TL, Lyon GJ, Macciardi F, Maier W, McCracken JT, McMahon W, Murphy DL, Naarden AL, Neale BM, Nurmi E, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Reus VI, Richter MA, Riddle M, Robertson MM, Rosenberg D, Rouleau GA, Ruhrmann S, Sampaio AS, Samuels J, Sandor P, Sheppard B, Singer HS, Smit JH, Stein DJ, Tischfield JA, Vallada H, Veenstra-VanderWeele J, Walitza S, Wang Y, Wendland JR, Shugart YY, Miguel EC, Nicolini H, Oostra BA, Moessner R, Wagner M, Ruiz-Linares A, Heutink P, Nestadt G, Freimer N, Petryshen T, Posthuma D, Jenike MA, Cox NJ, Hanna GL, Brentani H, Scherer SW, Arnold PD, Stewart SE, Mathews CA, Knowles JA, Cook EH, Pauls DL, Wang K, Scharf JM. Copy number variation in obsessive-compulsive disorder and tourette syndrome: a cross-disorder study. J Am Acad Child Adolesc Psychiatry 2014; 53:910-9. [PMID: 25062598 PMCID: PMC4218748 DOI: 10.1016/j.jaac.2014.04.022] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [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: 12/11/2013] [Revised: 03/16/2014] [Accepted: 06/18/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are heritable neurodevelopmental disorders with a partially shared genetic etiology. This study represents the first genome-wide investigation of large (>500 kb), rare (<1%) copy number variants (CNVs) in OCD and the largest genome-wide CNV analysis in TS to date. METHOD The primary analyses used a cross-disorder design for 2,699 case patients (1,613 ascertained for OCD, 1,086 ascertained for TS) and 1,789 controls. Parental data facilitated a de novo analysis in 348 OCD trios. RESULTS Although no global CNV burden was detected in the cross-disorder analysis or in secondary, disease-specific analyses, there was a 3.3-fold increased burden of large deletions previously associated with other neurodevelopmental disorders (p = .09). Half of these neurodevelopmental deletions were located in a single locus, 16p13.11 (5 case patient deletions: 0 control deletions, p = .08 in the current study, p = .025 compared to published controls). Three 16p13.11 deletions were confirmed de novo, providing further support for the etiological significance of this region. The overall OCD de novo rate was 1.4%, which is intermediate between published rates in controls (0.7%) and in individuals with autism or schizophrenia (2-4%). CONCLUSION Several converging lines of evidence implicate 16p13.11 deletions in OCD, with weaker evidence for a role in TS. The trend toward increased overall neurodevelopmental CNV burden in TS and OCD suggests that deletions previously associated with other neurodevelopmental disorders may also contribute to these phenotypes.
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Affiliation(s)
- Lauren M McGrath
- Massachusetts General Hospital, Boston; American University, Washington, DC; Harvard-MIT Broad Institute, Boston
| | - Dongmei Yu
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | | | | | | | - Bingbin Li
- University of Toronto and the Hospital for Sick Children, Toronto
| | | | | | | | | | | | | | | | | | | | | | | | - Cathy L Barr
- University of Toronto and the Hospital for Sick Children, Toronto; Toronto Western Research Institute, University Health Network, Toronto
| | | | | | | | | | | | - Ruth D Bruun
- North Shore-Long Island Jewish Medical Center, New Hyde Park, NY; New York University Medical Center, New York
| | - Cathy L Budman
- North Shore-Long Island Jewish Medical Center, New Hyde Park, NY; Hofstra University School of Medicine, Hempstead, NY
| | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico
| | | | | | | | | | | | - Richard Delorme
- Robert Debre University Hospital, Paris and the French National Science Foundation, Creteil, France; Institut Pasteur, Paris
| | - Damiaan Denys
- Netherlands Institute for Neuroscience, Amsterdam; Academic Medical Center, Amsterdam
| | | | | | | | | | | | | | | | - Helena Garrido
- Hospital Nacional de Niños, San Jose, Costa Rica; Clinica Herrera Amighetti, Avenida Escazú, San José, Costa Rica
| | | | - Hans J Grabe
- University Medicine Greifswald, Greifswald, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marion Leboyer
- Robert Debre University Hospital, Paris and the French National Science Foundation, Creteil, France; Institut Mondor de Recherche Biomédicale, Créteil, France
| | | | | | | | - Thomas L Lowe
- University of California at San Francisco School of Medicine
| | | | | | | | | | | | - Dennis L Murphy
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | | | - Benjamin M Neale
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | - Erika Nurmi
- University of California, Los Angeles (UCLA) School of Medicine
| | | | | | | | - John Piacentini
- University of California, Los Angeles (UCLA) School of Medicine
| | | | | | - Victor I Reus
- University of California at San Francisco School of Medicine
| | - Margaret A Richter
- University of Toronto and the Hospital for Sick Children, Toronto; Sunnybrook Health Sciences Centre, Toronto
| | - Mark Riddle
- Johns Hopkins University School of Medicine, Baltimore
| | | | | | | | | | - Aline S Sampaio
- Federal University of São Paulo; Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Jack Samuels
- Johns Hopkins University School of Medicine, Baltimore
| | - Paul Sandor
- University of Toronto and the Hospital for Sick Children, Toronto; Toronto Western Research Institute, University Health Network, Toronto
| | - Brooke Sheppard
- University of California at San Francisco School of Medicine
| | | | - Jan H Smit
- VU Amsterdam and Erasmus University Medical Centre, Rotterdam; VU University Amsterdam; VU Medical Center, Amsterdam
| | | | | | | | | | | | - Ying Wang
- Johns Hopkins University School of Medicine, Baltimore
| | - Jens R Wendland
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | - Yin Yao Shugart
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | | | | | - Ben A Oostra
- Erasmus Medical Center Rotterdam, the Netherlands
| | | | | | | | - Peter Heutink
- German Center for Neurodegenerative Diseases, Bonn and VU Medical Center Amsterdam
| | | | - Nelson Freimer
- University of California, Los Angeles (UCLA) School of Medicine; Semel Institute for Neuroscience and Human Behavior, UCLA
| | - Tracey Petryshen
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | | | | | | | | | | | | | - Paul D Arnold
- University of Toronto and the Hospital for Sick Children, Toronto
| | - S Evelyn Stewart
- Massachusetts General Hospital, Boston; University of British Columbia, Vancouver
| | - Carol A Mathews
- University of California at San Francisco School of Medicine
| | | | | | | | - Kai Wang
- Zilkha Neurogenetic Institute, Los Angeles
| | - Jeremiah M Scharf
- Massachusetts General Hospital, Boston; Brigham and Womens Hospital, Boston; Harvard-MIT Broad Institute, Boston.
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Paschou P, Yu D, Gerber G, Evans P, Tsetsos F, Davis LK, Karagiannidis I, Chaponis J, Gamazon E, Mueller-Vahl K, Stuhrmann M, Schloegelhofer M, Stamenkovic M, Hebebrand J, Noethen M, Nagy P, Barta C, Tarnok Z, Rizzo R, Depienne C, Worbe Y, Hartmann A, Cath DC, Budman CL, Sandor P, Barr C, Wolanczyk T, Singer H, Chou IC, Grados M, Posthuma D, Rouleau GA, Aschauer H, Freimer NB, Pauls DL, Cox NJ, Mathews CA, Scharf JM. Genetic association signal near NTN4 in Tourette syndrome. Ann Neurol 2014; 76:310-5. [PMID: 25042818 DOI: 10.1002/ana.24215] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 12/13/2022]
Abstract
Tourette syndrome (TS) is a neurodevelopmental disorder with a complex genetic etiology. Through an international collaboration, we genotyped 42 single nucleotide polymorphisms (p < 10(-3) ) from the recent TS genomewide association study (GWAS) in 609 independent cases and 610 ancestry-matched controls. Only rs2060546 on chromosome 12q22 (p = 3.3 × 10(-4) ) remained significant after Bonferroni correction. Meta-analysis with the original GWAS yielded the strongest association to date (p = 5.8 × 10(-7) ). Although its functional significance is unclear, rs2060546 lies closest to NTN4, an axon guidance molecule expressed in developing striatum. Risk score analysis significantly predicted case-control status (p = 0.042), suggesting that many of these variants are true TS risk alleles.
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Affiliation(s)
- Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece
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Gomez L, Wigg K, Zhang K, Lopez L, Sandor P, Malone M, Barr CL. Association of the KCNJ5 gene with Tourette Syndrome and Attention-Deficit/Hyperactivity Disorder. Genes Brain Behav 2014; 13:535-42. [PMID: 24840790 DOI: 10.1111/gbb.12141] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 01/23/2014] [Accepted: 05/09/2014] [Indexed: 01/01/2023]
Abstract
Linkage and association of Tourette Syndrome (TS) and Attention-Deficit/Hyperactivity Disorder (ADHD) have previously been reported in the 11q24 chromosomal region. To identify the risk gene within the region we studied the potassium inwardly-rectifying channel J5 (KCNJ5) gene in a sample of 170 nuclear families with TS. We genotyped eight markers across the gene and observed biased transmission of haplotypes from parents to probands in this sample. We then tested these markers in an independent sample of 242 nuclear families with ADHD and found the same haplotype was significantly over transmitted to ADHD probands. Screening of the coding region of KCNJ5 in 48 probands with TS did not identify any variation that could explain the association of the haplotype. We also genotyped two microsatellite markers, one in the promoter and the other in the 3' region and found no evidence for association for either marker for TS, however, we found significant evidence for association with the 3' repeat and ADHD. A small gene (c11orf45) of unknown function lies within the first intron of KCNJ5 that is transcribed in the opposite orientation and this gene may regulate the expression of KCNJ5. We studied the correlation of the expression of KCNJ5 and the antisense transcript in brain tissues from control individuals and found that the antisense transcript and the short KCNJ5 isoform are co-expressed in three brain regions. The results of this study indicate that KCNJ5 is associated with TS and ADHD in our samples, however, the functional variant(s) remain to be identified.
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Affiliation(s)
- L Gomez
- Toronto Western Research Institute, University Health Network, Toronto, Canada
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34
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Tajik-Parvinchi DJ, Sandor P. Enhanced antisaccade abilities in children with Tourette syndrome: the Gap-effect Reversal. Front Hum Neurosci 2013; 7:768. [PMID: 24312038 PMCID: PMC3826111 DOI: 10.3389/fnhum.2013.00768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 10/25/2013] [Indexed: 11/25/2022] Open
Abstract
Tourette Syndrome (TS) is a childhood onset disorder of motor and vocal tics. The neural networks underlying TS overlap with those of saccade eye movements. Thus, deviations on saccadic tasks can provide important information about psychopathology of TS. Tourette syndrome often coexists with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Hence, we manipulated various components of a saccade task to measure its effects on saccades of children with TS-only, TS+ADHD, TS+ADHD+OCD and healthy controls. Children looked toward (prosaccade) or in the opposite direction (antisaccade) of a peripheral target as soon as it appeared. The prosaccade and antisaccade tasks were presented in three conditions. In the Gap200 condition, the fixation dot disappeared 200 ms prior to the appearance of the peripheral target, In the Gap800 condition, the fixation dot disappeared 800 ms prior to the appearance of the peripheral target and in Overlap200 the fixation dot disappeared 200 ms after the appearance of the peripheral target. Fixation-offset manipulations had different effects on each group's antisaccades. The TS+ADHD+OCD group's antisaccade latencies and error rates remained relatively unchanged in the three conditions and displayed a pattern of eye movements that can be interpreted as enhanced. Alternatively, the TS+ADHD group displayed an overall pattern of longer saccadic latencies. Findings corroborate the hypothesis that the combination of tic disorder and ADHD results in unique behavioral profiles. It is plausible that a subgroup of children with TS develop an adaptive ability to control their tics which generalizes to enhanced volitional control of saccadic behavior as well. Supporting evidence and other findings are discussed.
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Affiliation(s)
- Diana J Tajik-Parvinchi
- Department of Psychology, Centre for Vision Research, York University Toronto, ON, Canada ; Tourette Syndrome Neurodevelopmental Clinic and Toronto Western Research Institute, University Health Network Toronto, ON, Canada
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35
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Davis LK, Yu D, Keenan CL, Gamazon ER, Konkashbaev AI, Derks EM, Neale BM, Yang J, Lee SH, Evans P, Barr CL, Bellodi L, Benarroch F, Berrio GB, Bienvenu OJ, Bloch MH, Blom RM, Bruun RD, Budman CL, Camarena B, Campbell D, Cappi C, Cardona Silgado JC, Cath DC, Cavallini MC, Chavira DA, Chouinard S, Conti DV, Cook EH, Coric V, Cullen BA, Deforce D, Delorme R, Dion Y, Edlund CK, Egberts K, Falkai P, Fernandez TV, Gallagher PJ, Garrido H, Geller D, Girard SL, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Haddad S, Heiman GA, Hemmings SMJ, Hounie AG, Illmann C, Jankovic J, Jenike MA, Kennedy JL, King RA, Kremeyer B, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Liu C, Lochner C, Lowe TL, Macciardi F, McCracken JT, McGrath LM, Mesa Restrepo SC, Moessner R, Morgan J, Muller H, Murphy DL, Naarden AL, Ochoa WC, Ophoff RA, Osiecki L, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Rauch SL, Renner TJ, Reus VI, Richter MA, Riddle MA, Robertson MM, Romero R, Rosàrio MC, Rosenberg D, Rouleau GA, Ruhrmann S, Ruiz-Linares A, Sampaio AS, Samuels J, Sandor P, Sheppard B, Singer HS, Smit JH, Stein DJ, Strengman E, Tischfield JA, Valencia Duarte AV, Vallada H, Van Nieuwerburgh F, Veenstra-VanderWeele J, Walitza S, Wang Y, Wendland JR, Westenberg HGM, Shugart YY, Miguel EC, McMahon W, Wagner M, Nicolini H, Posthuma D, Hanna GL, Heutink P, Denys D, Arnold PD, Oostra BA, Nestadt G, Freimer NB, Pauls DL, Wray NR, Stewart SE, Mathews CA, Knowles JA, Cox NJ, Scharf JM. Partitioning the heritability of Tourette syndrome and obsessive compulsive disorder reveals differences in genetic architecture. PLoS Genet 2013; 9:e1003864. [PMID: 24204291 PMCID: PMC3812053 DOI: 10.1371/journal.pgen.1003864] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [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] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 08/21/2013] [Indexed: 11/18/2022] Open
Abstract
The direct estimation of heritability from genome-wide common variant data as implemented in the program Genome-wide Complex Trait Analysis (GCTA) has provided a means to quantify heritability attributable to all interrogated variants. We have quantified the variance in liability to disease explained by all SNPs for two phenotypically-related neurobehavioral disorders, obsessive-compulsive disorder (OCD) and Tourette Syndrome (TS), using GCTA. Our analysis yielded a heritability point estimate of 0.58 (se = 0.09, p = 5.64e-12) for TS, and 0.37 (se = 0.07, p = 1.5e-07) for OCD. In addition, we conducted multiple genomic partitioning analyses to identify genomic elements that concentrate this heritability. We examined genomic architectures of TS and OCD by chromosome, MAF bin, and functional annotations. In addition, we assessed heritability for early onset and adult onset OCD. Among other notable results, we found that SNPs with a minor allele frequency of less than 5% accounted for 21% of the TS heritability and 0% of the OCD heritability. Additionally, we identified a significant contribution to TS and OCD heritability by variants significantly associated with gene expression in two regions of the brain (parietal cortex and cerebellum) for which we had available expression quantitative trait loci (eQTLs). Finally we analyzed the genetic correlation between TS and OCD, revealing a genetic correlation of 0.41 (se = 0.15, p = 0.002). These results are very close to previous heritability estimates for TS and OCD based on twin and family studies, suggesting that very little, if any, heritability is truly missing (i.e., unassayed) from TS and OCD GWAS studies of common variation. The results also indicate that there is some genetic overlap between these two phenotypically-related neuropsychiatric disorders, but suggest that the two disorders have distinct genetic architectures.
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Affiliation(s)
- Lea K. Davis
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
- * E-mail: (LKD); (JMS)
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
| | - Clare L. Keenan
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
- Department of Human Genetics, University of Chicago, Chicago, Illinois, United States of America
| | - Eric R. Gamazon
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Anuar I. Konkashbaev
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Eske M. Derks
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Benjamin M. Neale
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Jian Yang
- The University of Queensland, Diamantina Institute, Queensland, Australia
- The University of Queensland, Queensland Brain Institute, Queensland, Australia
| | - S. Hong Lee
- The University of Queensland, Queensland Brain Institute, Queensland, Australia
| | - Patrick Evans
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Cathy L. Barr
- The Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Fortu Benarroch
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Oscar J. Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Michael H. Bloch
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States of America
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Rianne M. Blom
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruth D. Bruun
- North Shore-Long Island Jewish Medical Center, Manhasset, New York, United States of America
- New York University Medical Center, New York, New York, United States of America
| | - Cathy L. Budman
- North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
- Hofstra University School of Medicine, Hempstead, New York, United States of America
| | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Desmond Campbell
- University College London, London, United Kingdom
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Carolina Cappi
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Danielle C. Cath
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Department of Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands
- Altrecht Academic Anxiety Center, Utrecht, The Netherlands
| | | | - Denise A. Chavira
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
| | | | - David V. Conti
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Edwin H. Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Vladimir Coric
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States of America
| | - Bernadette A. Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Dieter Deforce
- Laboratory of Pharmaceutical Biotechnology, Ghent University, Ghent, Belgium
| | - Richard Delorme
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
- Fondation Fondamental, French National Science Foundation, Creteil, France
- AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Yves Dion
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Christopher K. Edlund
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Thomas V. Fernandez
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Patience J. Gallagher
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Helena Garrido
- Clinica Herrera Amighetti, Avenida Escazú, San José, Costa Rica
| | - Daniel Geller
- OCD Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, Helios-Hospital Stralsund, University Medicine Greifswald, Greifswald, Germany
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, United States of America
| | - Varda Gross-Tsur
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Stephen Haddad
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Gary A. Heiman
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, New Jersey, United States of America
| | - Sian M. J. Hemmings
- Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Ana G. Hounie
- Department of Psychiatry, Faculdade de Medicina da Universidade de Säo Paulo, Brazil
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Michael A. Jenike
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - James L. Kennedy
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Robert A. King
- Yale Child Study Center, Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | | | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, New Jersey, United States of America
| | | | - Marion Leboyer
- Fondation Fondamental, French National Science Foundation, Creteil, France
- AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
- Institut Mondor de Recherche Biomédicale, Psychiatric Genetics, Créteil, France
| | - James F. Leckman
- Child Study Center, Psychiatry, Pediatrics and Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Leonhard Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Chunyu Liu
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Christine Lochner
- MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Thomas L. Lowe
- Department of Psychiatry, University of California at San Francisco, San Francisco, California, United States of America
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine (UCI), Irvine, California, United States of America
| | - James T. McCracken
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine (UCI), Irvine, California, United States of America
| | - Lauren M. McGrath
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | | | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Jubel Morgan
- University of Utah, Salt Lake City, Utah, United States of America
| | - Heike Muller
- University College London, London, United Kingdom
| | - Dennis L. Murphy
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, Maryland, United States of America
| | - Allan L. Naarden
- Department of Clinical Research, Medical City Dallas Hospital, Dallas, Texas, United States of America
| | | | - Roel A. Ophoff
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, United States of America
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Andrew J. Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Michele T. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Carlos N. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, United States of America
| | - Christopher Pittenger
- Departments of Psychiatry and Psychology and the Child Study Center, Yale University, New Haven, Connecticut, United States of America
| | - Yehuda Pollak
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Scott L. Rauch
- Partners Psychiatry and McLean Hospital, Boston, Massachusetts, United States of America
| | - Tobias J. Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Victor I. Reus
- Department of Psychiatry, University of California at San Francisco, San Francisco, California, United States of America
| | - Margaret A. Richter
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Mary M. Robertson
- University College London, London, United Kingdom
- St George's Hospital and Medical School, London, United Kingdom
| | | | - Maria C. Rosàrio
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - David Rosenberg
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University and the Detroit Medical Center, Detroit, Michigan, United States of America
| | - Guy A. Rouleau
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | | | - Aline S. Sampaio
- Department of Psychiatry, Faculdade de Medicina da Universidade de Säo Paulo, Brazil
- University Health Care Services - SMURB, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Toronto Western Research Institute and Youthdale Treatment Centers, Toronto, Ontario, Canada
| | - Brooke Sheppard
- Department of Psychiatry, University of California at San Francisco, San Francisco, California, United States of America
| | - Harvey S. Singer
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jan H. Smit
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Dan J. Stein
- University of Cape Town, Cape Town, South Africa
| | - E. Strengman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jay A. Tischfield
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, New Jersey, United States of America
| | | | - Homero Vallada
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Jeremy Veenstra-VanderWeele
- Departments of Psychiatry, Pediatrics, and Pharmacology, Kennedy Center for Research on Human Development, and Brain Institute, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, University of Würzburg, Würzburg, Germany
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jens R. Wendland
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, Maryland, United States of America
| | - Herman G. M. Westenberg
- Department of Psychiatry, Academic Medical Center and Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Yin Yao Shugart
- Unit on Statistical Genomics, NIMH Intramural Research Program, Bethesda, Maryland, United States of America
| | - Euripedes C. Miguel
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - William McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, United States of America
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Humberto Nicolini
- National Institute of Genomic Medicine-SAP, Carracci Medical Group, Mexico City, Mexico
| | - Danielle Posthuma
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, De Boelelaan, Amsterdam, The Netherlands
- Department of Clinical Genetics, VU Medical Centre, De Boelelaan, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Peter Heutink
- Section of Medical Genomics, Department of Clinical Genetics, VU University Medical Center Amsterdam, The Netherlands
- German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Paul D. Arnold
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ben A. Oostra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, United States of America
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Naomi R. Wray
- The University of Queensland, Queensland Brain Institute, Queensland, Australia
| | - S. Evelyn Stewart
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- British Columbia Mental Health and Addictions Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carol A. Mathews
- Department of Psychiatry, University of California at San Francisco, San Francisco, California, United States of America
| | - James A. Knowles
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Nancy J. Cox
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Division of Cognitive and Behavioral Neurology, Brigham and Womens Hospital, Boston, Massachusetts, United States of America
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- * E-mail: (LKD); (JMS)
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Karagiannidis I, Dehning S, Sandor P, Tarnok Z, Rizzo R, Wolanczyk T, Madruga-Garrido M, Hebebrand J, Nöthen MM, Lehmkuhl G, Farkas L, Nagy P, Szymanska U, Anastasiou Z, Stathias V, Androutsos C, Tsironi V, Koumoula A, Barta C, Zill P, Mir P, Müller N, Barr C, Paschou P. Support of the histaminergic hypothesis in Tourette syndrome: association of the histamine decarboxylase gene in a large sample of families. J Med Genet 2013; 50:760-4. [PMID: 23825391 DOI: 10.1136/jmedgenet-2013-101637] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [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: 11/04/2022]
Abstract
BACKGROUND Gilles de la Tourette Syndrome is a neurodevelopmental disorder that is caused by the interaction of environment with a complex genetic background. The genetic etiology of the disorder remains, so far, elusive, although multiple promising leads have been recently reported. The recent implication of the histamine decarboxylase (HDC) gene, the key enzyme in histamine production, raises the intriguing hypothesis of a possible role of histaminergic dysfunction leading to TS onset. METHODS Following up on the finding of a nonsense mutation in a single family with TS, we investigated variation across the HDC gene for association with TS. As a result of a collaborative international effort, we studied a large sample of 520 nuclear families originating from seven European populations (Greek, Hungarian, Italian, Polish, German, Albanian, Spanish) as well as a sample collected in Canada. RESULTS AND CONCLUSIONS Interrogating 12 tagging SNPs (tSNP) across the HDC region, we find strong over-transmission of alleles at two SNPs (rs854150 and rs1894236) in the complete sample, as well as a statistically significant associated haplotypes. Analysis of individual populations also reveals signals of association in the Canadian, German and Italian samples. Our results provide strong support for the histaminergic hypothesis in TS etiology and point to a possible role of histamine pathways in neuronal development.
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Affiliation(s)
- Iordanis Karagiannidis
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (IN10-1.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in10-1.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (S32.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s32.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Affiliation(s)
- Paul Sandor
- Professor, Deparment of Psychiatry, University of Toronto, Toronto, Ontario; Director, Tourette Syndrome Neurodevelpmental Clinic, University Health Network, Toronto, Ontario; Head, Neuropsychiatric Studies, Youthdale Treatment Centres, Toronto, Ontario
| | - Alan Carroll
- Clinical Professor, University of Alberta, Edmonton, Alberta; Director, Child and Family Psychiatry, Glenrose Rehabilitation Hospital, Edmonton, Alberta; Director, Child Psychiatry, Royal Alexandra Hospital, Edmonton, Alberta
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Pringsheim T, Doja A, Gorman D, McKinlay D, Day L, Billinghurst L, Carroll A, Dion Y, Luscombe S, Steeves T, Sandor P. Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy. Can J Psychiatry 2012; 57:133-43. [PMID: 22397999 DOI: 10.1177/070674371205700302] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This article seeks to provide the practising clinician with guidance on the pharmacological management of tic disorders in children and adults. We performed a systematic review of the literature on the treatment of tic disorders. A multi-institutional group of 14 experts in psychiatry, child psychiatry, neurology, pediatrics, and psychology engaged in a consensus meeting. The evidence was presented and discussed, and nominal group techniques were employed to arrive at consensus on recommendations. A strong recommendation is made when the benefits of treatment clearly outweigh the risks and burdens, and can apply to most patients in most circumstances without reservation. With a weak recommendation, the benefits, risks, and burdens are more closely balanced, and the best action may differ depending on the circumstances. Based on these principles, weak recommendations were made for the use of pimozide, haloperidol, fluphenazine, metoclopramide (children only), risperidone, aripiprazole, olanzapine, quetiapine, ziprasidone, topiramate, baclofen (children only), botulinum toxin injections, tetrabenazine, and cannabinoids (adults only). Strong recommendations were made for the use of clonidine and guanfacine (children only). While the evidence supports the efficacy of many of the antipsychotics for the treatment of tics, the high rates of side effects associated with these medications resulted in only weak recommendations for these drugs. In situations where tics are not severe or disabling, the use of a medication with only a weak recommendation is not warranted. However, when tics are more distressing and interfering, the need for tic suppression to improve quality of life is stronger, and patients and clinicians may be more willing to accept the risks of pharmacotherapy.
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Affiliation(s)
- Tamara Pringsheim
- Department of Clinical Neurosciences and Pediatrics, University of Calgary, Calgary, Alberta.
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Steeves T, McKinlay BD, Gorman D, Billinghurst L, Day L, Carroll A, Dion Y, Doja A, Luscombe S, Sandor P, Pringsheim T. Canadian guidelines for the evidence-based treatment of tic disorders: behavioural therapy, deep brain stimulation, and transcranial magnetic stimulation. Can J Psychiatry 2012; 57:144-51. [PMID: 22398000 DOI: 10.1177/070674371205700303] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This clinical guideline provides recommendations for nonpharmacological treatments for tic disorders. We conducted a systematic literature search for clinical trials on the treatment of tics. One evidence-based review (including 30 studies) and 3 studies on behavioural interventions, 3 studies on deep brain stimulation (DBS), and 3 studies on transcranial magnetic stimulation (TMS) met our inclusion criteria. Based on this evidence, we have made strong recommendations for the use of habit reversal therapy and exposure and response prevention, preferably embedded within a supportive, psychoeducational program, and with the option to combine either of these approaches with pharmacotherapy. Although evidence exists for the efficacy of DBS, the quality of this evidence is poor and the risks and burdens of the procedure are finely balanced with the perceived benefits. Our recommendation is that this intervention continues to be considered an experimental treatment for severe, medically refractory tics that have imposed severe limitations on quality of life. We recommend that the procedure should only be performed within the context of research studies and by physicians expert in DBS programming and in the management of tics. There is no evidence to support the use of TMS in the treatment of tics. However, the procedure is associated with a low rate of known complications and could continue to be evaluated within research protocols. The recommendations we provide are based on current knowledge, and further studies may result in their revision in future.
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Affiliation(s)
- Thomas Steeves
- Department of Medicine, University of Toronto, Toronto, Ontario
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Stade BC, Barozzino T, Bennett D, Jeffs L, Laird H, Patterson K, Reynolds J, Sandor P, Stephens R, Tran S. The Nature of Sleep in Canadian Children with Fetal Alcohol Spectrum Disorder. Paediatr Child Health 2010. [DOI: 10.1093/pch/15.suppl_a.51aa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Steeves TDL, Ko JH, Kideckel DM, Rusjan P, Houle S, Sandor P, Lang AE, Strafella AP. Extrastriatal dopaminergic dysfunction in tourette syndrome. Ann Neurol 2010; 67:170-81. [DOI: 10.1002/ana.21809] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
Previously the Slit and Trk-like family member 1 (SLITRK1) gene was identified as a candidate gene for Gilles de la Tourette Syndrome (GTS) based on a patient that carried a chromosomal inversion on 13q, as well as the identification of two rare DNA variants in the SLITRK1 gene. Since that report, studies have tested for the two rare variants in GTS and either did not find them, or when found, they did not segregate with the disorder in families, casting doubt on the relationship of this gene to GTS. We tested for these two rare variants and genotyped three polymorphisms that tag the currently identified major haplotypes of this gene in a sample of 154 nuclear families with GTS. In addition, the entire coding region was screened for novel DNA variants. We did not find the two reported rare variants in any of the probands or siblings in these families. We did however find significant evidence for association of a single polymorphism and of haplotypes of the three tagging polymorphisms. These findings provide the first support for the original finding indicating SLITRK1 as a susceptibility gene for GTS and indicate that further study of this gene in GTS is warranted.
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Affiliation(s)
- Debora M Miranda
- Department of Pharmacology of Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Abstract
The aim of this study was to understand how children with Tourette syndrome (TS), with or without attention-deficit-hyperactivity disorder (ADHD) and/or obsessive-compulsive disorder (OCD), experience disability. Children seen at two TS centres were eligible for participation. Clinicians compiled baseline information and symptom severity rating scales. Parents completed the Child Health Questionnaire, a measure of physical and psychosocial health. Seventy-one children (56 males, 15 females); mean age 11y 2mo [SD 3y 1mo], range 7-17y) were analyzed in the subgroups: TS only (n=20), TS+ADHD (n=22), TS+ADHD+OCD (n=18), and TS+OCD (n=11). Almost all psychosocial domain scores were significantly lower than national norms for the TS+ADHD and TS+ADHD+OCD subgroups (p<0.001). For the TS only subgroup, only the family activities domain was significantly affected. Psychosocial summary scores were 53.2 for norms, 54.4 for the TS only subgroup (ns), 41.4 for the TS+ADHD subgroup (p<0.001), 35.3 for the TS+ADHD+OCD subgroup (p<0.001), and 35.5 for the TS+OCD group (p=0.003). A multiple linear regression model including diagnosis, age, sex, and TS, OCD, and ADHD symptom severity found that the most significant predictor of the psychosocial summary score was ADHD symptom severity (R(2)=0.55, p<0.001). Children with TS+ADHD+/-OCD experience impairment in all aspects of psychosocial health. For children with TS only, psychosocial health was not different from that of the normative population in the majority of domains tested. This suggests treatment of ADHD and OCD should be the priority in children with multiple diagnoses.
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Affiliation(s)
- Tamara Pringsheim
- Tourette Syndrome Neurodevelopmental Clinic, Department of Psychiatry, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
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Staroselsky A, Fantus E, Sussman R, Sandor P, Koren G, Nulman I. Both parental psychopathology and prenatal maternal alcohol dependency can predict the behavioral phenotype in children. Paediatr Drugs 2009; 11:22-5. [PMID: 19127947 DOI: 10.2165/0148581-200911010-00009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [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] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To identify whether a child's behavior phenotype can be predicted by parental psychopathology and/or prenatal maternal alcohol dependency by using the Child Behavior List (CBCL) as a screening tool. METHODS A retrospective cohort of four non-exclusive groups of children (aged 8-15 years) was studied: (i) children exposed to alcohol in utero (n = 25); (ii) children not exposed to alcohol in utero (n = 46); (iii) children exposed to parental psychopathology (n = 37); (iv) children not exposed to parental psychopathology (n = 34). To distinguish between the effects of alcohol and parental psychopathology, the children were further subdivided into groups with alcohol exposure in utero and parental psychopathology (n = 23), and psychopathology without alchohol exposure (n = 14). Each child was assessed with the CBCL. Subscale scores and selected subscale items were compared between the groups using t-tests and regression analysis. RESULTS Children exposed to alcohol in utero scored significantly lower than unexposed children on school competency (p = 0.015). They were more likely to attend special classes (p = 0.048), repeat a grade (p = 0.011), and display more disobedience (p = 0.039) and vandalism (p = 0.033). For special classes and disobedience at school, gender proved to be a significant predictor, while maternal alcohol dependency was a significant predictor of vandalism and repeated grades. Children with parental psychopathology differed from children without parental psychopathology in the anxious/depressed (p = 0.04), social problems (p = 0.004), and attention problems (p = 0.04) subscales. The subscale items that were significantly different between the groups were nervousness (p = 0.002), self-consciousness (p = 0.019), feelings of worthlessness (p = 0.041), loneliness (p = 0.005), and difficulty with concentration (p = 0.02). Parental psychopathology was a significant predictor of all five items. Age and gender, however, were significant predictors only of difficulty with concentration. No significant differences were found when the groups with alcohol exposure in utero and parental psychopathology, and psychopathology without alcohol exposure were compared. In summary, parental psychopathology was a significant predictor of a child's internalizing behavior, as well as social problems, whereas alcohol exposure was more predictive of externalizing behaviour. CONCLUSION Parental psychopathology and prenatal exposure to maternal alcohol can contribute to the child's behavioral phenotype as measured by the CBCL. Therefore, the CBCL can be used to screen for such behaviors.
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Affiliation(s)
- Arthur Staroselsky
- Division of Clinical Pharmacology, Motherisk Program, The Hospital for Sick Children, Ontario, Canada
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Laurin N, Wigg KG, Feng Y, Sandor P, Barr CL. Chromosome 5 and Gilles de la Tourette syndrome: Linkage in a large pedigree and association study of six candidates in the region. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:95-103. [PMID: 18454440 DOI: 10.1002/ajmg.b.30779] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [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] [Indexed: 11/06/2022]
Abstract
Gilles de la Tourette Syndrome (TS) is a neuropsychiatric disorder characterized by both motor and vocal tics. In our previous genome scan for TS we identified evidence for linkage to the centromeric region of chromosome 5 in a single large family of 32 individuals with 10 family members with TS or chronic multiple tics (CMT). In this paper we report further analyses of the 5p-centromeric region in this pedigree. An additional 11 family members were identified and screened for TS. Using a set of 14 microsatellite markers we refined the linked region to a approximately 28 Mb interval between the markers D5S1506 and D5S76. A set of six candidate genes located in this region were selected to be tested for genetic association with TS. These genes were GDNF, ITGA1, ISL1, FGF10, HCN1 and SLC1A3. The TDT statistic was used for the association tests in a sample of 171 independent nuclear families with 241 affected children with TS. We found no evidence for an association between TS and markers in these genes in this sample of families. This study represents the first efforts to narrow the linkage region in the extended pedigree and the first tests of candidate genes in the chromosome 5 region linked to TS.
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Affiliation(s)
- Nancy Laurin
- Toronto Western Research Institute, University Health Network, ON, Canada
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Miranda DM, Wigg K, Feng Y, Sandor P, Barr CL. Association study between Gilles de la Tourette Syndrome and two genes in the Robo-Slit pathway located in the chromosome 11q24 linked/associated region. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:68-72. [PMID: 17671968 DOI: 10.1002/ajmg.b.30580] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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] [Indexed: 11/10/2022]
Abstract
Gilles de la Tourette Syndrome (GTS) is an inherited neuropsychiatric disorder characterized by the presence of motor and phonic tics. Previous genetic studies have identified linkage and association between GTS and the 11q24 chromosomal region. We selected for study, within this region, two possible susceptibility genes for GTS, the ROBO3 and ROBO4 genes. These two genes were selected because of the recent identification of SLITRK1 as a potential susceptibility gene for GTS based on a translocation breakpoint and the further finding of two mutations in the SLITRK1 gene in three patients with GTS. While thus far, the SLITRK1 gene appears to account for only a few cases of GTS, these findings, if confirmed, point to other genes in these pathways that may contribute to GTS. Based on this, we examined two genes in the Slit-Robo pathway involved in cell migration, axonal pathfinding, and/or neuronal differentiation because of their location in 11q24, a region previously identified as linked and associated with GTS. We selected six haplotype tagging single nucleotide polymorphisms (SNPs) for ROBO3 and four for ROBO4 and genotyped them in our sample of trios and sibpair families diagnosed with GTS. Based on 155 nuclear families with 255 affected children, we did not find evidence for association between GTS and either the ROBO3 or ROBO4 genes. Thus, these two genes are unlikely to be the susceptibility genes contributing to GTS on 11q24.
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Affiliation(s)
- D M Miranda
- Department of Pharmacology of Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ozbay F, Wigg KG, Turanli ET, Asherson P, Yazgan Y, Sandor P, Barr CL. Analysis of the dopamine beta hydroxylase gene in Gilles de la Tourette syndrome. Am J Med Genet B Neuropsychiatr Genet 2006; 141B:673-7. [PMID: 16838359 DOI: 10.1002/ajmg.b.30393] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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] [Indexed: 11/06/2022]
Abstract
Numerous lines of evidence support the role of the catecholamines in the development of tics and Gilles de la Tourette syndrome (GTS). Dopamine-beta-hydroxylase (DBH) is the key enzyme in the conversion of dopamine to norepinephrine and the alleles of several polymorphisms of the DBH gene are correlated with individual variation in serum levels of the enzyme. We investigated the genetic relationship of the gene for DBH to GTS in two samples, one collected in Canada and one collected in Turkey. In total 106 affected probands and siblings in 71 nuclear pedigrees and 40 affected individuals and 71 family members in five multi-generational pedigrees were genotyped for three polymorphisms in the DBH locus. In the Canadian pedigrees we found no convincing evidence for linkage either in the multi-generational pedigrees or association in the nuclear families. We found significant evidence for association in the Turkish pedigrees (n = 29) for the 19 bp insertion/deletion markers; however, there was no supporting evidence for association with the other two markers. Based on the small sample size and low number of informative transmissions, we conclude that the results from the 19 bp insertion/deletion markers may be a chance false positive finding. These findings, in total, suggest that the DBH locus is unlikely to be a major gene influencing the susceptibility to DBH.
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Affiliation(s)
- Fatih Ozbay
- Department of Child and Adolescent Psychiatry, Marmara University Faculty of Medicine, Istanbul, Turkey
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Abstract
OBJECTIVE The purpose of the present study was to analyze the frequency and type of speech disfluencies in a relatively large group of individuals with Tourette's syndrome (TS) and to compare their results with similar speech data from a control group of unselected individuals. METHOD Self-report data, as well as conversation and reading samples, were obtained from 69 children diagnosed with TS (mean age=12.49) and 27 control participants (mean age=10.9). RESULTS Self-report data on fluency difficulties did not reveal significant group differences; however, detailed analysis of fluency during reading and spontaneous speech revealed an overall higher level of more typical (normal) disfluencies in the TS group. No overall differences in less typical (stuttering) disfluencies were observed between the two groups of children. CONCLUSION Results are discussed in light of previous studies proposing a common aetiology and neuropathological link between TS and developmental stuttering.
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Affiliation(s)
- Luc F De Nil
- Graduate Department of Speech-Language Pathology, University of Toronto, Room 160, 500 University Avenue, Toronto, ON, Canada M5G 1V7.
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