Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology
Nature Genetics·2021
Mullins, Niamh and Forstner, Andreas J. and O'Connell, Kevin S. and Coombes, Brandon and Coleman, Jonathan R. I. and Qiao, Zhen and Als, Thomas D. and Bigdeli, Tim B. and B{\o}rte, Sigrid and Bryois, Julien and Charney, Alexander W. and Drange, Ole Kristian and Gandal, Michael J. and Hagenaars, Saskia P. and Ikeda, Masashi and Kamitaki, Nolan and Kim, Minsoo and Krebs, Kristi and Panagiotaropoulou, Georgia and Schilder, Brian M. and Sloofman, Laura G. and Steinberg, Stacy and Trubetskoy, Vassily and Winsvold, Bendik S. and Won, Hong-Hee and Abramova, Liliya and Adorjan, Kristina and Agerbo, Esben and Al Eissa, Mariam and Albani, Diego and Alliey-Rodriguez, Ney and Anjorin, Adebayo and Antilla, Verneri and Antoniou, Anastasia and Awasthi, Swapnil and Baek, Ji Hyun and B{\ae}kvad-Hansen, Marie and Bass, Nicholas and Bauer, Michael and Beins, Eva C. and Bergen, Sarah E. and Birner, Armin and B{\o}cker Pedersen, Carsten and B{\o}en, Erlend and Boks, Marco P. and Bosch, Rosa and Brum, Murielle and Brumpton, Ben M. and Brunkhorst-Kanaan, Nathalie and Budde, Monika and Bybjerg-Grauholm, Jonas and Byerley, William and Cairns, Murray and Casas, Miquel and Cervantes, Pablo and Clarke, Toni-Kim and Cruceanu, Cristiana and Cuellar-Barboza, Alfredo and Cunningham, Julie and Curtis, David and Czerski, Piotr M. and Dale, Anders M. and Dalkner, Nina and David, Friederike S. and Degenhardt, Franziska and Djurovic, Srdjan and Dobbyn, Amanda L. and Douzenis, Athanassios and Elvs{\aa}shagen, Torbj{\o}rn and Escott-Price, Valentina and Ferrier, I. Nicol and Fiorentino, Alessia and Foroud, Tatiana M. and Forty, Liz and Frank, Josef and Frei, Oleksandr and Freimer, Nelson B. and Fris{\'e}n, Louise and Gade, Katrin and Garnham, Julie and Gelernter, Joel and Gi{\o}rtz Pedersen, Marianne and Gizer, Ian R. and Gordon, Scott D. and Gordon-Smith, Katherine and Greenwood, Tiffany A. and Grove, Jakob and Guzman-Parra, Jos{\'e} and Ha, Kyooseob and Haraldsson, Magnus and Hautzinger, Martin and Heilbronner, Urs and Hellgren, Dennis and Herms, Stefan and Hoffmann, Per and Holmans, Peter A. and Huckins, Laura and Jamain, St{\'e}phane and Johnson, Jessica S. and Kalman, Janos L. and Kamatani, Yoichiro and Kennedy, James L. and Kittel-Schneider, Sarah and Knowles, James A. and Kogevinas, Manolis and Koromina, Maria and Kranz, Thorsten M. and Kranzler, Henry R. and Kubo, Michiaki and Kupka, Ralph and Kushner, Steven A. and Lavebratt, Catharina and Lawrence, Jacob and Leber, Markus and Lee, Heon-Jeong and Lee, Phil H. and Levy, Shawn E. and Lewis, Catrin and Liao, Calwing and Lucae, Susanne and Lundberg, Martin and MacIntyre, Donald J. and Magnusson, Sigurdur H. and Maier, Wolfgang and Maihofer, Adam and Malaspina, Dolores and Maratou, Eirini and Martinsson, Lina and Mattheisen, Manuel and McCarroll, Steven A. and McGregor, Nathaniel W. and McGuffin, Peter and McKay, James D. and Medeiros, Helena and Medland, Sarah E. and Millischer, Vincent and Montgomery, Grant W. and Moran, Jennifer L. and Morris, Derek W. and M{\"u}hleisen, Thomas W. and O'Brien, Niamh and O'Donovan, Claire and Olde Loohuis, Loes M. and Oruc, Lilijana and Papiol, Sergi and Pardi{\~n}as, Antonio F. and Perry, Amy and Pfennig, Andrea and Porichi, Evgenia and Potash, James B. and Quested, Digby and Raj, Towfique and Rapaport, Mark H. and DePaulo, J. Raymond and Regeer, Eline J. and Rice, John P. and Rivas, Fabio and Rivera, Margarita and Roth, Julian and Roussos, Panos and Ruderfer, Douglas M. and S{\'a}nchez-Mora, Cristina and Schulte, Eva C. and Senner, Fanny and Sharp, Sally and Shilling, Paul D. and Sigurdsson, Engilbert and Sirignano, Lea and Slaney, Claire and Smeland, Olav B. and Smith, Daniel J. and Sobell, Janet L. and S{\o}holm Hansen, Christine and Soler Artigas, Maria and Spijker, Anne T. and Stein, Dan J. and Strauss, John S. and {\'S}wiatkowska, Beata and Terao, Chikashi and Thorgeirsson, Thorgeir E. and Toma, Claudio and Tooney, Paul and Tsermpini, Evangelia-Eirini and Vawter, Marquis P. and Vedder, Helmut and Walters, James T. R. and Witt, Stephanie H. and Xi, Simon and Xu, Wei and Yang, Jessica Mei Kay and Young, Allan H. and Young, Hannah and Zandi, Peter P. and Zhou, Hang and Zillich, Lea and {HUNT All-In Psychiatry} and Adolfsson, Rolf and Agartz, Ingrid and Alda, Martin and Alfredsson, Lars and Babadjanova, Gulja and Backlund, Lena and Baune, Bernhard T. and Bellivier, Frank and Bengesser, Susanne and Berrettini, Wade H. and Blackwood, Douglas H. R. and Boehnke, Michael and B{\o}rglum, Anders D. and Breen, Gerome and Carr, Vaughan J. and Catts, Stanley and Corvin, Aiden and Craddock, Nicholas and Dannlowski, Udo and Dikeos, Dimitris and Esko, T{\~o}nu and Etain, Bruno and Ferentinos, Panagiotis and Frye, Mark and Fullerton, Janice M. and Gawlik, Micha and Gershon, Elliot S. and Goes, Fernando S. and Green, Melissa J. and Grigoroiu-Serbanescu, Maria and Hauser, Joanna and Henskens, Frans and Hillert, Jan and Hong, Kyung Sue and Hougaard, David M. and Hultman, Christina M. and Hveem, Kristian and Iwata, Nakao and Jablensky, Assen V. and Jones, Ian and Jones, Lisa A. and Kahn, Ren{\'e} S. and Kelsoe, John R. and Kirov, George and Land{\'e}n, Mikael and Leboyer, Marion and Lewis, Cathryn M. and Li, Qingqin S. and Lissowska, Jolanta and Lochner, Christine and Loughland, Carmel and Martin, Nicholas G. and Mathews, Carol A. and Mayoral, Fermin and McElroy, Susan L. and McIntosh, Andrew M. and McMahon, Francis J. and Melle, Ingrid and Michie, Patricia and Milani, Lili and Mitchell, Philip B. and Morken, Gunnar and Mors, Ole and Mortensen, Preben Bo and Mowry, Bryan and M{\"u}ller-Myhsok, Bertram and Myers, Richard M. and Neale, Benjamin M. and Nievergelt, Caroline M. and Nordentoft, Merete and N{\"o}then, Markus M. and O'Donovan, Michael C. and Oedegaard, Ketil J. and Olsson, Tomas and Owen, Michael J. and Paciga, Sara A. and Pantelis, Chris and Pato, Carlos and Pato, Michele T. and Patrinos, George P. and Perlis, Roy H. and Posthuma, Danielle and Ramos-Quiroga, Josep Antoni and Reif, Andreas and Reininghaus, Eva Z. and Ribas{\'e}s, Marta and Rietschel, Marcella and Ripke, Stephan and Rouleau, Guy A. and Saito, Takeo and Schall, Ulrich and Schalling, Martin and Schofield, Peter R. and Schulze, Thomas G. and Scott, Laura J. and Scott, Rodney J. and Serretti, Alessandro and Shannon Weickert, Cynthia and Smoller, Jordan W. and Stefansson, Hreinn and Stefansson, Kari and Stordal, Eystein and Streit, Fabian and Sullivan, Patrick F. and Turecki, Gustavo and Vaaler, Arne E. and Vieta, Eduard and Vincent, John B. and Waldman, Irwin D. and Weickert, Thomas W. and Werge, Thomas and Wray, Naomi R. and Zwart, John-Anker and Biernacka, Joanna M. and Nurnberger, John I. and Cichon, Sven and Edenberg, Howard J. and Stahl, Eli A. and McQuillin, Andrew and Di Florio, Arianna and Ophoff, Roel A. and Andreassen, Ole A.
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.
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