Depression is the most common psychiatric disorder and the leading cause of disability worldwide. Despite evidence for a genetic component, the genetic aetiology of this disorder remains elusive. To date, only one association study has identified and replicated risk loci for depression. This thesis focuses on aiding genetic discovery by revisiting the depressed phenotype and developing a quantitative trait, using data from Generation Scotland: The Scottish Family Health Study. These analyses aim to test whether this derived quantitative trait has improved statistical power to identify genetic risk variants for depression, relative to the binary classification of case/control. Measures of genetic covariation were used to evaluate and rank ten measures of mood, personality and cognitive ability as endophenotypes for depression. The highest ranking traits were subjected to principal component analysis, and the first principal component used as a quantitative measure of depression. This composite trait was compared to the binary classification of depression in terms of ability to identify risk loci in a genome-wide association study, and phenotypic variance explained by polygenic profile scores for psychiatric disorders. I also compared the composite trait to the univariate traits in terms of their ability to fulfill the endophenotype criteria as described by Gottesman and Gould, namely: being heritable, genetically and phenotypically correlated with depression, state independent, co-segregating with illness in families, and observed at a higher rate in unaffected relatives than in unrelated controls. Four out of ten traits fulfilled most endophenotype criteria, however, only two traits - neuroticism and the general health questionnaire (a measure of current psychological distress) - consistently ranked highest across all analyses. As such, three composite traits were derived incorporating two, three, or four traits. Association analyses of binary depression, univariate traits and composite traits yielded no genome-wide significant results, with most traits performing equivalently. However, composite traits were more heritable and more highly correlated with depression than their constituent traits, suggesting that analyzing these traits in combination was capturing more of the heritable component of depression. Polygenic scores for psychiatric disorders explained more trait variance for the composite traits than the univariate traits, and depression itself. Overall, whilst the composite traits generally obtained more significant results, they did not identify any further insight into the genetic aetiology of depression. This work therefore provides support for the urgent need to redefine the depressed phenotype based on objective and quantitative measures. This is essential for risk stratification, better diagnoses, novel target identification and improved treatment.

Indiana University-Purdue University Indianapolis (IUPUI) / Alzheimer’s Disease (AD) is one of the most common forms of dementia and is known to have a strong genetic component, but known genetic loci do not fully account for the observed genetic heritability of late onset AD. This genetic complexity is further complicated by disease heterogeneity, with non-uniform presentation and progression of AD neuropathology. Endophenotypes lie upstream of observed AD clinical outcomes and downstream of genetic contributors, allowing for a biological understanding of genetic effects. Understanding the genetic architecture of AD endophenotypes can aid in breaking down AD genetic complexity and heterogeneity. In this study we utilized a variety of models to evaluate the genetic contributors to pathological change and heterogeneity in the top markers of AD pathology: amyloid, tau, neurodegeneration, and cerebrovascular (A/T/N/V framework). Additional composite quantitative measures of cognitive performance were used to relate to downstream AD presentation. These biomarkers allow the investigation of genetic effects contributing to the disease over the stages of disease progression from amyloid deposition to neurofibrillary tangle formation, disruption of metabolism, brain atrophy, and finally to clinical outcomes. First, we performed genome-wide association studies (GWAS) for AD endophenotypes at baseline using a cross-sectional regression model. This method identified sixteen novel or replicated loci, with six (SRSF10, MAPT, XKR3, KIAA1671, ZNF826P, and LOC100507506) associated across multiple A/T/N biomarkers. Cross-sectional data was further utilized to identify three genetic loci (BACH2, EP300, PACRG-AS1) that showed disease stage specific interaction effects. We built upon those results by performing a longitudinal association analysis with linear-mixed effects modeling. Gene enrichment analysis of these results identified 19 significant genetic regions associated with linear longitudinal change in AD endophenotypes. To further break down longitudinal heterogeneity, a latent class mixed model approach was utilized to identify subgroups of longitudinal progression within cognitive and MRI measures, with 16 genetic loci associated with membership in different classes. The genetic patterns of these subgroups show biological relevance in AD. The methods and results from this study provide insight into the complex genetic architecture of AD endophenotypes and a foundation to build upon for future studies into AD genetic architecture. / 2022-11-26

Patients with schizophrenia frequently display neurocognitive dysfunction, and genetic studies suggest it to be an endophenotype for schizophrenia. Genetic studies of such traits may thus help elucidate the biological pathways underlying genetic susceptibility to schizophrenia. This study aimed to identify loci influencing neurocognitive performance in schizophrenia. The sample comprised of 1207 affected individuals and 1035 unaffected individuals of Han Chinese ethnicity from 557 sib-pair families co-affected with DSM-IV (Diagnostic and Statistical Manual, Fourth Edition) schizophrenia. Subjects completed a face-to-face semi-structured interview, the continuous performance test (CPT) and the Wisconsin card sorting test (WCST), and were genotyped with 386 microsatellite markers across the genome. A series of autosomal genome-wide multipoint nonparametric quantitative trait loci (QTL) linkage analysis were performed in affected individuals only. Determination of genome-wide empirical significance was performed using 1000 simulated genome scans. One linkage peak attaining genome-wide significance was identified: 12q24.32 for undegraded CPT hit rate [nonparametric linkage z (NPL-Z) scores = 3.32, genome-wide empirical P = 0.03]. This result was higher than the peak linkage signal obtained in the previous genome-wide scan using a dichotomous diagnosis of schizophrenia. The identification of 12q24.32 as a QTL has not been consistently implicated in previous linkage studies on schizophrenia, which suggests that the analysis of endophenotypes provides additional information from what is seen in analyses that rely on diagnoses. This region with linkage to a particular neurocognitive feature may inform functional hypotheses for further genetic studies for schizophrenia.

Introduction. Callous-unemotional (CU) traits predict socially debilitating outcomes including Antisocial Personality Disorder and violent crime in adulthood. Despite significant research, the etiology of CU traits is not well understood. This dissertation incorporates genetic, physiological, neuroanatomical, and self-report measures to investigate the etiology of CU traits. Specifically, this project focuses on measures previously found to associate with impaired fear-processing observed in individuals high on CU. Brain morphometry for paralimbic regions of interest (ROIs) and electromyographic facial eyeblink reflex to startle and fear-potentiated startle probes were investigated as potential endophenotypes for CU traits. Methods. Two genetically informative (ages 9-20) twin samples (N=1696 individuals; 848 twin pairs) were used to estimate the changing heritable and environmental influences on CU over the age range of 9-20 using age-moderated biometric structural equation modeling (SEM). To determine potential endophenotypes, shared genetic variance with CU was examined for baseline and fear-potentiated startle reflex and morphometric measures of brain ROIs. Results. The heritability of CU increases over the ages of 9-20, from approximately 34% at age 9 to 47% at age 20. Therefore, environmental mechanisms for CU are most influential at younger ages. Although there were no significant associations after correction for multiple testing, there was some evidence to suggest potential positive associations between CU traits and baseline and fear-potentiated startle in younger (9-14) females. There was also evidence suggesting potential negative associations between CU traits and right anterior cingulate cortex thickness as well as right posterior cingulate cortex thickness in females only. There was no genetic covariance between CU and any of the examined physiological or neuroanatomical phenotypes. Discussion. These results suggest that middle childhood may be the most salient time for environmental interventions associated with preventing or ameliorating CU traits. Furthermore, these results suggest that the cingulate cortex may play a role in the development of CU traits, possibly in females specifically. The cingulate cortex may influence CU traits through its roles in emotional processing, learning, and memory. Larger samples will likely be needed to determine the genetic relationship between CU traits and the structural development of the cingulate cortex.

Bipolar disorder is a heritable psychiatric disorder, and several of the genes associated with bipolar disorder and related psychotic disorders are involved in the development and maintenance of white matter in the brain. Patients with bipolar disorder have an increased incidence of white matter hyper-intensities, and quantitative brain imaging studies collectively indicate subtle decreases in white matter density and integrity in bipolar patients. This suggests that genetic vulnerability to psychosis may manifest itself as reduced white matter integrity, and that white matter integrity is an endophenotype of bipolar disorder. This thesis comprises a series of studies designed to test the role of white matter in genetic risk to bipolar disorder by analysis of diffusion tensor imaging (DTI) data in the Bipolar Family Study. Various established analysis methods for DTI, including whole-brain voxel-based statistics, tract-based spatial statistics (TBSS) and probabilistic neighbourhood tractography, were applied with fractional anisotropy (FA) as the outcome measure. Widespread but subtle white matter integrity reductions were found in unaffected relatives of patients with bipolar disorder, whilst more localised reductions were associated with cyclothymic temperament. Next, the relation of white matter to four of the most prominent psychosis candidate genes, NRG1, ErbB4, DISC1 and ZNF804A, was investigated. A core haplotype in NRG1, and three of the four key single nucleotide polymorphisms (SNPs) within it, showed an association with FA in the anterior thalamic radiations and the uncinate fasciculi. For the three SNPs considered in ErbB4, results were inconclusive, but this was consistent with the background literature. Most notable however, was a clear association of a non-synonymous DISC1 SNP, Ser704Cys, with FA extending over most of the white matter in the TBSS and voxel-based analyses. Finally, FA was not associated with a genome-wide supported risk SNP in ZNF804A, a finding which could not be attributed to a lack of statistical power, and which contradicts a strong, but previously untested hypothesis. Whilst the above results need corroboration from independent studies, other studies are needed to address the cellular and molecular basis of these findings. Overall, this work provides strong support for the role of white matter integrity in genetic vulnerability to bipolar disorder and the wider psychosis spectrum and encourages its future use as an endophenotype.

No description available.

Background: Given the complex and progressive nature of Alzheimer's disease (AD), a precision medicine approach for diagnosis and treatment requires the identification of patient subgroups with biomedically distinct and actionable phenotype definitions. Methods: Longitudinal patient-level data for 1160 AD patients receiving placebo or no treatment with a follow-up of up to 18 months were extracted from an integrated clinical trials dataset. We used latent class mixed modelling (LCMM) to identify patient subgroups demonstrating distinct patterns of change over time in disease severity, as measured by the Alzheimer's Disease Assessment Scale-cognitive subscale score. The optimal number of subgroups (classes) was selected by the model which had the lowest Bayesian Information Criterion. Other patient-level variables were used to define these subgroups' distinguishing characteristics and to investigate the interactions between patient characteristics and patterns of disease progression. Results: The LCMM resulted in three distinct subgroups of patients, with 10.3% in Class 1, 76.5% in Class 2 and 13.2% in Class 3. While all classes demonstrated some degree of cognitive decline, each demonstrated a different pattern of change in cognitive scores, potentially reflecting different subtypes of AD patients. Class 1 represents rapid decliners with a steep decline in cognition over time, and who tended to be younger and better educated. Class 2 represents slow decliners, while Class 3 represents severely impaired slow decliners: patients with a similar rate of decline to Class 2 but with worse baseline cognitive scores. Class 2 demonstrated a significantly higher proportion of patients with a history of statins use; Class 3 showed lower levels of blood monocytes and serum calcium, and higher blood glucose levels. Conclusions: Our results, 'learned' from clinical data, indicate the existence of at least three subgroups of Alzheimer's patients, each demonstrating a different trajectory of disease progression. This hypothesis-generating approach has detected distinct AD subgroups that may prove to be discrete endophenotypes linked to specific aetiologies. These findings could enable stratification within a clinical trial or study context, which may help identify new targets for intervention and guide better care.

La maladie d’Alzheimer (MA) est caractérisée par l’accumulation de protéines β-amyloïde (Aβ) et Tau malconformées. L’hypothèse que la MA soit transmissible de manière similaire à celles des maladies à prion est un sujet d’intense recherche. L’objectif de cette thèse est d’étudier la transmission des endophénotypes de la maladie d’Alzheimer par l’inoculation intracérébral d’homogénats de patients souffrant de MA.Tout d’abord, nous avons montré que la transmission expérimentale de la MA accélère l’amyloïdose dans des modèles murins d’amyloïdose génétique précoce et tardive. Ensuite, nous avons observé le développement d’altérations fonctionnelles et morphologiques semblables à celles observées dans la MA chez le primate microcèbe (Microcebus murinus) et accompagnées d’une amyloïdose subtile sans pathologie Tau. Une telle transmission en l’absence de sévères lésions neuropathologiques a été rapportée dans les maladies à prions mais jamais dans le contexte de la MA. Nos résultats suggèrent que les agents responsables des altérations observées puissent être des formes d’Aβ et/ou Tau non détectées en immunohistochimie et pouvant être transmises expérimentalement. En conclusion, nos résultats supportent l’hypothèse de type prion de la MA et le consensus actuel sur la toxicité des formes solubles d’Aβ et Tau. Pour finir, ils soutiennent la possibilité que l’amyloïdose soit transmissible chez l’Homme sous certaines conditions et appellent à l’évaluation des impacts fonctionnels chez les sujets à risque de contamination. / Alzheimer's disease (AD) is characterized by the accumulation of misfolded β-amyloid (Aβ) and Tau proteins. There has been longstanding interest as to whether AD might be transmissible similarly to prion diseases. Our objective was to study the transmissibility of AD endophenotypes after AD brain intracerebral inoculation in mice and primates.First, we showed that AD experimental transmission accelerated Aβ pathology in two rodent models of early or late genetic β-amyloidosis. Then, we focused on a primate model of sporadic AD, the mouse lemur (Microcebus murinus). AD-inoculated adult lemurs progressively developed cognitive impairments, neuronal activity alterations and cerebral atrophy. AD-inoculated mouse lemurs also developed subtle β-amyloidosis in the absence of Tau pathology, 18 months after inoculation. The transmission of an AD-like pathology in the absence of severe neuropathological lesions is striking. Such observations have already been reported for prion diseases but never in the context of AD. Our results suggest that agents leading to AD-like alterations may be not immunohistopathological-detectable forms of Aβ or Tau proteins and transmitted experimentally.In conclusion, our results support the “prion-like” hypothesis of AD and provide further arguments for a dichotomy between the toxicity of deposited and soluble assemblies of Aβ or Tau proteins. Finally, they complement recent evidence supporting iatrogenic β-amyloidosis in humans and provide strong arguments to evaluate functional outcomes in potentially contaminated individuals.

Mitochondria are essential cellular organelles and the location of the electron transport chain, the site of the majority of energy production in the cell. Mitochondria contain their own circular genome approximately 16,000 base pairs in length. The mitochondrial genome (mtDNA) encodes 11 protein-coding genes essential for the electron transport chain, 22 tRNA genes, and two rRNA genes. Mitochondrial malfunction occurs in many diseases, and changes in the mitochondrial genome lead to numerous disorders. Multiple mitochondrial haplotypes and sequence features are associated with Alzheimer's disease. In this dissertation we utilized TreeScanning, an evolutionary-based haplotype approach to identify haplotypes and sequence variation associated with specific phenotypes: Alzheimer's disease case-control status, mitochondrial copy number, and 16 neuroimaging phenotypes related to Alzheimer's disease neurodegeneration. In the first two studies we utilized 1007 complete mitochondrial genomes from participants in the Cache County Study on Memory Health and Aging. First, individuals with mitochondrial haplotypes H6A1A and H6A1B showed a reduced risk of AD. Our study is the largest to date and the only study with complete mtDNA genome sequence data. Next, each cell contains multiple mitochondria, and each mitochondrion contains multiple copies of its own circular genome. The ratio of mitochondrial genomes to nuclear genomes is referred to as mitochondrial copy number. Decreases in mitochondrial copy number are known to occur in many tissues as people age, and in certain diseases. Three variants belonging to mitochondrial haplogroups U5A1 and T2 were significantly associated with higher mitochondrial copy number in our dataset. Each of these three variants was associated with higher mitochondrial copy number and we suggest several hypotheses for how these variants influence mitochondrial copy number by interacting with known regulators of mitochondrial copy number. Our results are the first to report sequence variation in the mitochondrial genome that lead to changes in mitochondrial copy number. The identification of these variants that increase mtDNA copy number has important implications in understanding the pathological processes that underlie these phenotypes. Lastly, we used an endophenotype-based approach to further characterize mitochondrial genetic variation and its relationship to risk markers for Alzheimer's disease. We analyzed longitudinal data from non-demented, mild cognitive impairment, and late onset Alzheimer's disease participants in the Alzheimer's Disease Neuroimaging Initiative with genetic, brain imaging, and behavioral data. Four clades were associated with three different endophenotypes: whole brain volume, percent change in temporal pole thickness, and left hippocampal atrophy over two years. This was the first study of its kind to identify mitochondrial variation associated with brain imaging endophenotypes of Alzheimer's disease. Together, these projects provide evidence of mtDNA involvement in the risk and physiological changes of Alzheimer's disease.

Indiana University-Purdue University Indianapolis (IUPUI) / New neurons are generated throughout adulthood in two regions of the brain, the dentate gyrus of the hippocampus, which is important for memory formation and cognitive functions, and the sub-ventricular zone of the olfactory bulb, which is important for the sense of smell, and are incorporated into hippocampal network circuitry. Disruption of this process has been postulated to contribute to neurodegenerative disorders including Alzheimer’s disease [1]. AD is the most common form of adult-onset dementia and the number of patients with AD escalates dramatically each year. The generation of new neurons in the dentate gyrus declines with age and in AD. Many of the molecular players in AD are also modulators of adult neurogenesis, but the genetic mechanisms influencing adult neurogenesis in AD are unclear. The overall goal of this project is to identify candidate genes and pathways that play a role in neurogenesis in the adult brain and to test the hypotheses that 1) hippocampal neurogenesis-related genes and pathways are significantly perturbed in AD and 2) neurogenesis-related pathways are significantly associated with hippocampal volume and other AD-related biomarker endophenotypes including brain deposition of amyloid-β and tau pathology. First, potential modulators of adult neurogenesis and their roles in neurodegenerative diseases were evaluated. Candidate genes that control the turnover process of neural stem cells/precursors to new functional neurons during adult neurogenesis were manually curated using a pathway-based systems biology approach. Second, a targeted neurogenesis pathway-based gene analysis was performed resulting in the identification of ADORA2A as associated with hippocampal volume and memory performance in mild cognitive impairment and AD. Third, a genome-wide gene-set enrichment analysis was conducted to discover associations between hippocampal volume and AD related endophenotypes and neurogenesis-related pathways. Within the discovered neurogenesis enriched pathways, a gene-based association analysis identified TESC and ACVR1 as significantly associated with hippocampal volume and APOE and PVLR2 as significantly associated with tau and amyloid beta levels in cerebrospinal fluid. This project identifies new genetic contributions to hippocampal neurogenesis with translational implications for novel therapeutic targets related to learning and memory and neuroprotection in AD.