Traumatic brain injury and bipolar psychosis in the Genomic Psychiatry Cohort.
Traumatic brain injury and bipolar psychosis in the Genomic Psychiatry Cohort.
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基因组精神病学队列中的创伤性脑损伤和双相精神病。
DOI：
10.1002/ajmg.b.32350
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Malaspina,Dolores
中科院分区：
文献类型：
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作者：
Cieslak,Kristina;Pato,Michelle;Buckley,Peter;Pato,Carlos;Sobell,JanetL;Medeiros,Helena;Zhao,Yuan;Ahn,Hongshik;GenomicPsychiatryCohortConsortium;Malaspina,Dolores
美国每年约有300万人遭受创伤性脑损伤（TBI），记录了对一系列神经和精神障碍的影响，包括躁狂症，抑郁症和精神病。识别可能表现出创伤后症状倾向增加的个体子集，以及可能共享基因-环境相互作用的遗传脆弱性的个体子集，可以加强理解，预测和预防这些现象的努力。本研究使用了来自基因组精神病学队列（GPC）的11，489例病例样本，GPC是NIMH管理的用于调查精神分裂症和双相情感障碍的数据库。如果TBI被认为是精神疾病的原因，则将其排除在外。使用Ak均值聚类算法来探讨精神分裂症和双相情感障碍之间的差异，这些差异与发病年龄、幻觉、妄想、头部损伤和TBI等变量相关。病例被分成最佳数量的七个聚类，其中两个聚类包括所有脑损伤病例。双相情感障碍与精神病和TBI在一个集群中显着相关，其中72%的病例为男性，99.2%的病例持续头部损伤。这一组也有最长的平均无意识期。这项研究表明，TBI与精神病在双相情感障碍的情况下，一个子集的关联，这表明创伤性压力源可能有能力影响基因表达在一个脆弱的人群，和/或有一个TBI的发生率升高的个人与潜在的精神病。进一步的研究应该更密切地检查双相情感障碍的遗传变异和TBI后精神病易感性之间的相互作用。© 2015威利期刊公司.
Approximately three million individuals in the United States sustain traumatic brain injury (TBI) every year, with documented impact on a range of neurological and psychiatric disturbances including mania, depression, and psychosis. Identification of subsets of individuals that may demonstrate increased propensity for posttraumatic symptoms and who may share genetic vulnerabilities for gene‐environment interactions can enhance efforts to understand, predict, and prevent these phenomena. A sample of 11,489 cases from the Genomic Psychiatry Cohort (GPC), a NIMH‐managed data repository for the investigation of schizophrenia and bipolar disorder, was used for this study. Cases were excluded if TBI was deemed causal to their mental illness. Ak‐means clustering algorithm was used to probe differences between schizophrenia and bipolar disorder associated with variables including onset age, hallucinations, delusions, head injury, and TBI. Cases were separated into an optimum number of seven clusters, with two clusters including all cases with brain injury. Bipolar disorder with psychosis and TBI were significantly correlated in one cluster in which 72% of cases were male and 99.2% sustained head injury. This cluster also carried the longest average period of unconsciousness. This study demonstrates an association of TBI with psychosis in a subset of bipolar cases, suggesting that traumatic stressors may have the ability to impact gene expression in a vulnerable population, and/or there is a heightened occurrence of TBI in individuals with underlying psychosis. Further studies should more closely examine the interplay between genetic variation in bipolar disorder and susceptibility to psychosis following TBI. © 2015 Wiley Periodicals, Inc.