Fanous, A. H. | Search bioRxiv

bioRxiv2018

Contribution of rare copy number variants to bipolar disorder risk is limited to schizoaffective cases

BackgroundGenetic risk for bipolar disorder (BD) is conferred through many common alleles, while a role for rare copy number variants (CNVs) is less clear. BD subtypes schizoaffective disorder bipolar type (SAB), bipolar I disorder (BD I) and bipolar II disorder (BD II) differ according to the prominence and timing of psychosis, mania and depression. The factors contributing to the combination of symptoms within a given patient are poorly understood.\n\nMethodsRare, large CNVs were analyzed in 6353 BD cases (3833 BD I [2676 with psychosis, 850 without psychosis], 1436 BD II, 579 SAB) and 8656 controls. Measures of CNV burden were integrated with polygenic risk scores (PRS) for schizophrenia (SCZ) to evaluate the relative contributions of rare and common variants to psychosis risk.\n\nResultsCNV burden did not differ in BD relative to controls when treated as a single diagnostic entity. Burden in SAB was increased compared to controls (p-value = 0.001), BD I (p-value = 0.0003) and BD II (p-value = 0.0007). Burden and SCZ PRS were higher in SAB compared to BD I with psychosis (CNV p-value = 0.0007, PRS p-value = 0.004) and BD I without psychosis (CNV p-value = 0.0004, PRS p-value = 3.9 x 10-5). Within BD I, psychosis was associated with higher SCZ PRS (p-value = 0.005) but not with CNV burden.\n\nConclusionsCNV burden in BD is limited to SAB. Rare and common genetic variants may contribute differently to risk for psychosis and perhaps other classes of psychiatric symptoms.

genetics↗

bioRxiv2017

Proof Of Concept: Molecular Prediction Of Schizophrenia Risk

Key PointsO_ST_ABSQuestionC_ST_ABSTo what extent do global polygenic risk scores (PRS), molecular pathway-specific PRS, complement component (C4) gene expression, MHC loci, sex, and ancestry jointly contribute to risk for schizophrenia-spectrum disorders (SZ)?\n\nFindingsGlobal polygenic risk for schizophrenia, sex, and their interaction most robustly predict risk in a classification and regression tree model, with highest risk groups having 50/50 chance of SZ.\n\nMeaningPsychometric risk indicators, such as prodromal symptom assessments, may be enhanced by the examination of genetic risk metrics. Preliminary results suggest that of genetic risk metrics, global polygenic information has the most potential to significantly aide in the prediction of SZ.\n\nAbstractO_ST_ABSImportanceC_ST_ABSSchizophrenia (SZ) has a complex, heterogeneous symptom presentation with limited established associations between biological markers and illness onset. Many (gene) molecular pathways (MPs) are enriched for SZ signal, but it is still unclear how these MPs, global PRS, major histocompatibility complex (MHC) complement component (C4) gene expression, and MHC loci might jointly contribute to SZ and its clinical presentation. It is also unclear whether sex or ancestry interacts with these metrics to increase risk in certain individuals.\n\nObjectiveTo examine multiple genetic metrics, sex, and their interactions as possible predictors of SZ risk. Genetic information could aid in the clinical prediction of risk, but it is still unclear which genetic metrics are most promising, and how sex interacts with genetic risk metrics.\n\nDesign, Setting, and ParticipantsTo examine molecular risk in a proof-of-concept study, we used the Wellcome Trust case-control cohort and classified cases as a function of 1) polygenic risk score (PRS) for both whole genome and for 345 implicated molecular pathways, 2) predicted C4 expression, 3) SZ-relevant MHC loci, 4) sex, and 5) ancestry.\n\nMain Outcomes and MeasuresPRSs, C4 expression, SZ-relevant MHC loci, sex, and ancestry as joint risk factors for SZ.\n\nResultsRecursive partitioning yielded 15 molecular risk classes and retained as significant psychosis classifiers only sex, genome-wide SZ polygenic risk, and one MP PRS. Sex was the most robust classifier in a stepwise regression, and there was a significant interaction of sex with SZ PRS on case status, suggesting males have a lower polygenic risk threshold. By down-sampling case proportion to 1% and 1.4% population base rates in males and females, respectively, high-risk subtypes defined by this model had roughly a 52% odds of developing SZ (individuals with SZ PRS elevated by 2.6 SDs; incidence = 51.8%).\n\nConclusions and RelevanceThis proof-of-concept suggests that global SZ PRS, sex, and their interaction are robust predictors of risk and that males have a lower PRS threshold for onset. Implications for the integration of these metrics with psychometrically-identified risk are discussed.

genomics↗