Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology.

Journal: Nature genetics

Volume: 53

Issue: 6

Year of Publication: 2021

Affiliated Institutions:  Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. niamh.mullins@mssm.edu. Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany. Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK. Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia. iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark. Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Japan. Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA. Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia. Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany. Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. deCODE Genetics/Amgen, Reykjavik, Iceland. K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. Russian Academy of Medical Sciences, Mental Health Research Center, Moscow, Russian Federation. Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany. iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. Division of Psychiatry, University College London, London, UK. Department of Neuroscience, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA. Psychiatry, Berkshire Healthcare NHS Foundation Trust, Bracknell, UK. Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA. nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece. Department of Psychiatry, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea. Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria. Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway. Psychiatry, Brain Center UMC Utrecht, Utrecht, the Netherlands. Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain. Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany. Psychiatry, University of California San Francisco, San Francisco, CA, USA. University of Newcastle, Newcastle, New South Wales, Australia. Mood Disorders Program, Department of Psychiatry, McGill University Health Center, Montreal, Quebec, Canada. Division of Psychiatry, University of Edinburgh, Edinburgh, UK. Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. Centre for Psychiatry, Queen Mary University of London, London, UK. Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland. Center for Multimodal Imaging and Genetics, Departments of Neurosciences, Radiology, and Psychiatry, University of California, San Diego, CA, USA. Department of Medical Genetics, Oslo University Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK. Academic Psychiatry, Newcastle University, Newcastle upon Tyne, UK. Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA. Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. Department of Psychological Sciences, University of Missouri, Columbia, MO, USA. Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. Psychological Medicine, University of Worcester, Worcester, UK. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain. Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea. Landspitali University Hospital, Reykjavik, Iceland. Department of Psychology, Eberhard Karls Universität Tübingen, Tübingen, Germany. Neuropsychiatrie Translationnelle, Inserm U, Créteil, France. Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Cell Biology, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA. ISGlobal, Barcelona, Spain. Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece. Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA. RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. Psychiatry, Altrecht, Utrecht, the Netherlands. Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. Psychiatry, North East London NHS Foundation Trust, Ilford, UK. Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany. Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea. Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA. Department of Human Genetics, McGill University, Montréal, Quebec, Canada. Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany. Division of Psychiatry, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. Clinical Biochemistry Laboratory, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Systems Genetics Working Group, Department of Genetics, Stellenbosch University, Stellenbosch, South Africa. Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France. Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA. Centre for Neuroimaging and Cognitive Genomics (NICOG), National University of Ireland Galway, Galway, Ireland. Institute of Neuroscience and Medicine (INM-), Research Centre Jülich, Jülich, Germany. Medical Faculty, School of Science and Technology, University Sarajevo, Sarajevo, Bosnia and Herzegovina. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. Outpatient Clinic for Bipolar Disorder, Altrecht, Utrecht, the Netherlands. Department of Psychiatry, Washington University in Saint Louis, Saint Louis, MO, USA. Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain. Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany. Medicine, Psychiatry, Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA. Mood Disorders, PsyQ, Rotterdam, the Netherlands. SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland. Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. Neuroscience Research Australia, Sydney, New South Wales, Australia. Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA. Psychiatry, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany. Computational Sciences Center of Emphasis, Pfizer Global Research and Development, Cambridge, MA, USA. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation. Department of Psychiatry, University of Münster, Münster, Germany. Université de Paris, INSERM, Optimisation Thérapeutique en Neuropsychopharmacologie, UMRS , Paris, France. Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. University of Queensland, Brisbane, Queensland, Australia. Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland. st Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece. Department of Genetics, Harvard Medical School, Boston, MA, USA. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania. University of Western Australia, Nedlands, Western Australia, Australia. Neuroscience Therapeutic Area, Janssen Research and Development, LLC, Titusville, NJ, USA. Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa. Department of Psychiatry and Genetics Institute, University of Florida, Gainesville, FL, USA. Research Institute, Lindner Center of HOPE, Mason, OH, USA. Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA. Division of Psychiatry, Haukeland Universitetssjukehus, Bergen, Norway. Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden. Human Genetics and Computational Biomedicine, Pfizer Global Research and Development, Groton, CT, USA. University of Melbourne, Melbourne, Victoria, Australia. Psychiatry, Harvard Medical School, Boston, MA, USA. Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada. Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy. Department of Psychiatry, Hospital Namsos, Namsos, Norway. Department of Psychiatry, McGill University, Montreal, Quebec, Canada. Department of Psychiatry, Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway. Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain. Department of Psychology, Emory University, Atlanta, GA, USA. Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA. Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. ole.andreassen@medisin.uio.no.

Abstract summary 

Bipolar disorder is a heritable mental illness with complex etiology. We performed a genome-wide association study of 41,917 bipolar disorder cases and 371,549 controls of European ancestry, which identified 64 associated genomic loci. Bipolar disorder risk alleles were enriched in genes in synaptic signaling pathways and brain-expressed genes, particularly those with high specificity of expression in neurons of the prefrontal cortex and hippocampus. Significant signal enrichment was found in genes encoding targets of antipsychotics, calcium channel blockers, antiepileptics and anesthetics. Integrating expression quantitative trait locus data implicated 15 genes robustly linked to bipolar disorder via gene expression, encoding druggable targets such as HTR6, MCHR1, DCLK3 and FURIN. Analyses of bipolar disorder subtypes indicated high but imperfect genetic correlation between bipolar disorder type I and II and identified additional associated loci. Together, these results advance our understanding of the biological etiology of bipolar disorder, identify novel therapeutic leads and prioritize genes for functional follow-up studies.

Authors & Co-authors:  Mullins Forstner O'Connell Coombes Coleman Qiao Als Bigdeli Børte Bryois Charney Drange Gandal Hagenaars Ikeda Kamitaki Kim Krebs Panagiotaropoulou Schilder Sloofman Steinberg Trubetskoy Winsvold Won Abramova Adorjan Agerbo Al Eissa Albani Alliey-Rodriguez Anjorin Antilla Antoniou Awasthi Baek Bækvad-Hansen Bass Bauer Beins Bergen Birner Bøcker Pedersen Bøen Boks Bosch Brum Brumpton Brunkhorst-Kanaan Budde Bybjerg-Grauholm Byerley Cairns Casas Cervantes Clarke Cruceanu Cuellar-Barboza Cunningham Curtis Czerski Dale Dalkner David Degenhardt Djurovic Dobbyn Douzenis Elvsåshagen Escott-Price Ferrier Fiorentino Foroud Forty Frank Frei Freimer Frisén Gade Garnham Gelernter Giørtz Pedersen Gizer Gordon Gordon-Smith Greenwood Grove Guzman-Parra Ha Haraldsson Hautzinger Heilbronner Hellgren Herms Hoffmann Holmans Huckins Jamain Johnson Kalman Kamatani Kennedy Kittel-Schneider Knowles Kogevinas Koromina Kranz Kranzler Kubo Kupka Kushner Lavebratt Lawrence Leber Lee Lee Levy Lewis Liao Lucae Lundberg MacIntyre Magnusson Maier Maihofer Malaspina Maratou Martinsson Mattheisen McCarroll McGregor McGuffin McKay Medeiros Medland Millischer Montgomery Moran Morris Mühleisen O'Brien O'Donovan Olde Loohuis Oruc Papiol Pardiñas Perry Pfennig Porichi Potash Quested Raj Rapaport DePaulo Regeer Rice Rivas Rivera Roth Roussos Ruderfer Sánchez-Mora Schulte Senner Sharp Shilling Sigurdsson Sirignano Slaney Smeland Smith Sobell Søholm Hansen Soler Artigas Spijker Stein Strauss Świątkowska Terao Thorgeirsson Toma Tooney Tsermpini Vawter Vedder Walters Witt Xi Xu Yang Young Young Zandi Zhou Zillich Adolfsson Agartz Alda Alfredsson Babadjanova Backlund Baune Bellivier Bengesser Berrettini Blackwood Boehnke Børglum Breen Carr Catts Corvin Craddock Dannlowski Dikeos Esko Etain Ferentinos Frye Fullerton Gawlik Gershon Goes Green Grigoroiu-Serbanescu Hauser Henskens Hillert Hong Hougaard Hultman Hveem Iwata Jablensky Jones Jones Kahn Kelsoe Kirov Landén Leboyer Lewis Li Lissowska Lochner Loughland Martin Mathews Mayoral McElroy McIntosh McMahon Melle Michie Milani Mitchell Morken Mors Mortensen Mowry Müller-Myhsok Myers Neale Nievergelt Nordentoft Nöthen O'Donovan Oedegaard Olsson Owen Paciga Pantelis Pato Pato Patrinos Perlis Posthuma Ramos-Quiroga Reif Reininghaus Ribasés Rietschel Ripke Rouleau Saito Schall Schalling Schofield Schulze Scott Scott Serretti Shannon Weickert Smoller Stefansson Stefansson Stordal Streit Sullivan Turecki Vaaler Vieta Vincent Waldman Weickert Werge Wray Zwart Biernacka Nurnberger Cichon Edenberg Stahl McQuillin Di Florio Ophoff Andreassen

Study Outcome 

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Citations :  GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390, 1211–1259 (2017).;Moon S et al. The Korea Biobank Array: design and identification of coding variants associated with blood biochemical traits. Sci. Rep 9, 1382 (2019).
Authors :  318
Identifiers
Doi : 10.1038/s41588-021-00857-4
SSN : 1546-1718
Study Population
Male,Female
Mesh Terms
Bipolar Disorder
Other Terms
Study Design
Study Approach
Quantitative
Country of Study
Publication Country
United States