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Biol Psychiatry. 2014 Oct 1;76(7):536-41. doi: 10.1016/j.biopsych.2013.10.028. Epub 2014 Jan 19.

Rare copy number variation in treatment-resistant major depressive disorder.

Author information

1
Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge.
2
Icahn School of Medicine at Mount Sinai, New York, New York.
3
Department of Psychiatry, University of California, San Francisco, California.
4
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
5
Information Systems, Massachusetts General Hospital, Boston, Massachusetts.
6
Information Systems, Massachusetts General Hospital, Boston, Massachusetts; Laboratory of Computer Science and Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
7
Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
8
Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Partners HealthCare System, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: rperlis@partners.org.

Abstract

BACKGROUND:

While antidepressant treatment response appears to be partially heritable, no consistent genetic associations have been identified. Large, rare copy number variants (CNVs) play a role in other neuropsychiatric diseases, so we assessed their association with treatment-resistant depression (TRD).

METHODS:

We analyzed data from two genome-wide association studies comprising 1263 Caucasian patients with major depressive disorder. One was drawn from a large health system by applying natural language processing to electronic health records (i2b2 cohort). The second consisted of a multicenter study of sequential antidepressant treatments, Sequenced Treatment Alternatives to Relieve Depression. The Birdsuite package was used to identify rare deletions and duplications. Individuals without symptomatic remission, despite two antidepressant treatment trials, were contrasted with those who remitted with a first treatment trial.

RESULTS:

CNV data were derived for 778 subjects in the i2b2 cohort, including 300 subjects (37%) with TRD, and 485 subjects in Sequenced Treatment Alternatives to Relieve Depression cohort, including 152 (31%) with TRD. CNV burden analyses identified modest enrichment of duplications in cases (empirical p = .04 for duplications of 100-200 kilobase) and a particular deletion region spanning gene PABPC4L (empirical p = .02, 6 cases: 0 controls). Pathway analysis suggested enrichment of CNVs intersecting genes regulating actin cytoskeleton. However, none of these associations survived genome-wide correction.

CONCLUSIONS:

Contribution of rare CNVs to TRD appears to be modest, individually or in aggregate. The electronic health record-based methodology demonstrated here should facilitate collection of larger TRD cohorts necessary to further characterize these effects.

KEYWORDS:

Antidepressant; copy number; deletion; duplication; pharmacogenetic; pharmacogenomic; rare genetic variation

PMID:
24529801
PMCID:
PMC4104153
DOI:
10.1016/j.biopsych.2013.10.028
[Indexed for MEDLINE]
Free PMC Article

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