Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study

Liping Hou; Urs Heilbronner; Franziska Degenhardt; Mazda Adli; Kazufumi Akiyama; Nirmala Akula; Raffaella Ardau; Bárbara Arias; Lena Backlund; Claudio E.M. Banzato; Antoni Benabarre; Susanne Bengesser; Abesh Kumar Bhattacharjee; Joanna M. Biernacka; Armin Birner; Clara Brichant-Petitjean; Elise T. Bui; Pablo Cervantes; Guo Bo Chen; Hsi Chung Chen; Caterina Chillotti; Sven Cichon; Scott R. Clark; Francesc Colom; David A. Cousins; Cristiana Cruceanu; Piotr M. Czerski; Clarissa R. Dantas; Alexandre Dayer; Bruno Étain; Peter Falkai; Andreas J. Forstner; Louise Frisén; Janice M. Fullerton; Sébastien Gard; Julie S. Garnham; Fernando S. Goes; Paul Grof; Oliver Gruber; Ryota Hashimoto; Joanna Hauser; Stefan Herms; Per Hoffmann; Andrea Hofmann; Stephane Jamain; Esther Jiménez; Jean Pierre Kahn; Layla Kassem; Sarah Kittel-Schneider; Sebastian Kliwicki; Barbara König; Ichiro Kusumi; Nina Lackner; Gonzalo Laje; Mikael Landén; Catharina Lavebratt; Marion Leboyer; Susan G. Leckband; Carlos A.López Jaramillo; Glenda Macqueen; Mirko Manchia; Lina Martinsson; Manuel Mattheisen; Michael J. McCarthy; Susan L. McElroy; Marina Mitjans; Francis M. Mondimore; Palmiero Monteleone; Caroline M. Nievergelt; Markus M. Nöthen; Urban Ösby; Norio Ozaki; Roy H. Perlis; Andrea Pfennig; Daniela Reich-Erkelenz; Guy A. Rouleau; Peter R. Schofield; K. Oliver Schubert; Barbara W. Schweizer; Florian Seemüller; Giovanni Severino; Tatyana Shekhtman; Paul D. Shilling; Kazutaka Shimoda; Christian Simhandl; Claire M. Slaney; Jordan W. Smoller; Alessio Squassina; Thomas Stamm; Pavla Stopkova; Sarah K. Tighe; Alfonso Tortorella; Gustavo Turecki; Julia Volkert; Stephanie Witt; Adam Wright; L. Trevor Young; Peter P. Zandi; James B. Potash; J. Raymond Depaulo; Michael Bauer; Eva Z. Reininghaus; Tomas Novák; Jean Michel Aubry; Mario Maj; Bernhard T. Baune; Philip B. Mitchell; Eduard Vieta; Mark A. Frye; Janusz K. Rybakowski; Po Hsiu Kuo; Tadafumi Kato; Maria Grigoroiu-Serbanescu; Andreas Reif; Maria Del Zompo; Frank Bellivier; Martin Schalling; Naomi R. Wray; John R. Kelsoe; Martin Alda; Marcella Rietschel; Francis J. McMahon; Thomas G. Schulze

doi:10.1016/S0140-6736(16)00143-4

Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study

Liping Hou, Urs Heilbronner, Franziska Degenhardt, Mazda Adli, Kazufumi Akiyama, Nirmala Akula, Raffaella Ardau, Bárbara Arias, Lena Backlund, Claudio E.M. Banzato, Antoni Benabarre, Susanne Bengesser, Abesh Kumar Bhattacharjee, Joanna M. Biernacka, Armin Birner, Clara Brichant-Petitjean, Elise T. Bui, Pablo Cervantes, Guo Bo Chen, Hsi Chung ChenCaterina Chillotti, Sven Cichon, Scott R. Clark, Francesc Colom, David A. Cousins, Cristiana Cruceanu, Piotr M. Czerski, Clarissa R. Dantas, Alexandre Dayer, Bruno Étain, Peter Falkai, Andreas J. Forstner, Louise Frisén, Janice M. Fullerton, Sébastien Gard, Julie S. Garnham, Fernando S. Goes, Paul Grof, Oliver Gruber, Ryota Hashimoto, Joanna Hauser, Stefan Herms, Per Hoffmann, Andrea Hofmann, Stephane Jamain, Esther Jiménez, Jean Pierre Kahn, Layla Kassem, Sarah Kittel-Schneider, Sebastian Kliwicki, Barbara König, Ichiro Kusumi, Nina Lackner, Gonzalo Laje, Mikael Landén, Catharina Lavebratt, Marion Leboyer, Susan G. Leckband, Carlos A.López Jaramillo, Glenda Macqueen, Mirko Manchia, Lina Martinsson, Manuel Mattheisen, Michael J. McCarthy, Susan L. McElroy, Marina Mitjans, Francis M. Mondimore, Palmiero Monteleone, Caroline M. Nievergelt, Markus M. Nöthen, Urban Ösby, Norio Ozaki, Roy H. Perlis, Andrea Pfennig, Daniela Reich-Erkelenz, Guy A. Rouleau, Peter R. Schofield, K. Oliver Schubert, Barbara W. Schweizer, Florian Seemüller, Giovanni Severino, Tatyana Shekhtman, Paul D. Shilling, Kazutaka Shimoda, Christian Simhandl, Claire M. Slaney, Jordan W. Smoller, Alessio Squassina, Thomas Stamm, Pavla Stopkova, Sarah K. Tighe, Alfonso Tortorella, Gustavo Turecki, Julia Volkert, Stephanie Witt, Adam Wright, L. Trevor Young, Peter P. Zandi, James B. Potash, J. Raymond Depaulo, Michael Bauer, Eva Z. Reininghaus, Tomas Novák, Jean Michel Aubry, Mario Maj, Bernhard T. Baune, Philip B. Mitchell, Eduard Vieta, Mark A. Frye, Janusz K. Rybakowski, Po Hsiu Kuo, Tadafumi Kato, Maria Grigoroiu-Serbanescu, Andreas Reif, Maria Del Zompo, Frank Bellivier, Martin Schalling, Naomi R. Wray, John R. Kelsoe, Martin Alda, Marcella Rietschel, Francis J. McMahon, Thomas G. Schulze

Research output: Contribution to journal › Article › peer-review

168 Scopus citations

Abstract

Background Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified. Methods Here, we report the results of a genome-wide association study of lithium response in 2563 patients collected by 22 participating sites from the International Consortium on Lithium Genetics (ConLiGen). Data from common single nucleotide polymorphisms (SNPs) were tested for association with categorical and continuous ratings of lithium response. Lithium response was measured using a well established scale (Alda scale). Genotyped SNPs were used to generate data at more than 6 million sites, using standard genomic imputation methods. Traits were regressed against genotype dosage. Results were combined across two batches by meta-analysis. Findings A single locus of four linked SNPs on chromosome 21 met genome-wide significance criteria for association with lithium response (rs79663003, p=1·37×10^-8; rs78015114, p=1·31×10^-8; rs74795342, p=3·31×10^-9; and rs75222709, p=3·50×10^-9). In an independent, prospective study of 73 patients treated with lithium monotherapy for a period of up to 2 years, carriers of the response-associated alleles had a significantly lower rate of relapse than carriers of the alternate alleles (p=0·03268, hazard ratio 3·8, 95% CI 1·1-13·0). Interpretation The response-associated region contains two genes for long, non-coding RNAs (lncRNAs), AL157359.3 and AL157359.4. LncRNAs are increasingly appreciated as important regulators of gene expression, particularly in the CNS. Confirmed biomarkers of lithium response would constitute an important step forward in the clinical management of bipolar disorder. Further studies are needed to establish the biological context and potential clinical utility of these findings. Funding Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program.

Original language	English (US)
Pages (from-to)	1085-1093
Number of pages	9
Journal	The Lancet
Volume	387
Issue number	10023
DOIs	https://doi.org/10.1016/S0140-6736(16)00143-4
State	Published - Mar 12 2016

ASJC Scopus subject areas

Medicine(all)

Access to Document

10.1016/S0140-6736(16)00143-4

Cite this

Hou, L., Heilbronner, U., Degenhardt, F., Adli, M., Akiyama, K., Akula, N., Ardau, R., Arias, B., Backlund, L., Banzato, C. E. M., Benabarre, A., Bengesser, S., Bhattacharjee, A. K., Biernacka, J. M., Birner, A., Brichant-Petitjean, C., Bui, E. T., Cervantes, P., Chen, G. B., ... Schulze, T. G. (2016). Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study. The Lancet, 387(10023), 1085-1093. https://doi.org/10.1016/S0140-6736(16)00143-4

Hou, L, Heilbronner, U, Degenhardt, F, Adli, M, Akiyama, K, Akula, N, Ardau, R, Arias, B, Backlund, L, Banzato, CEM, Benabarre, A, Bengesser, S, Bhattacharjee, AK, Biernacka, JM, Birner, A, Brichant-Petitjean, C, Bui, ET, Cervantes, P, Chen, GB, Chen, HC, Chillotti, C, Cichon, S, Clark, SR, Colom, F, Cousins, DA, Cruceanu, C, Czerski, PM, Dantas, CR, Dayer, A, Étain, B, Falkai, P, Forstner, AJ, Frisén, L, Fullerton, JM, Gard, S, Garnham, JS, Goes, FS, Grof, P, Gruber, O, Hashimoto, R, Hauser, J, Herms, S, Hoffmann, P, Hofmann, A, Jamain, S, Jiménez, E, Kahn, JP, Kassem, L, Kittel-Schneider, S, Kliwicki, S, König, B, Kusumi, I, Lackner, N, Laje, G, Landén, M, Lavebratt, C, Leboyer, M, Leckband, SG, Jaramillo, CAL, Macqueen, G, Manchia, M, Martinsson, L, Mattheisen, M, McCarthy, MJ, McElroy, SL, Mitjans, M, Mondimore, FM, Monteleone, P, Nievergelt, CM, Nöthen, MM, Ösby, U, Ozaki, N, Perlis, RH, Pfennig, A, Reich-Erkelenz, D, Rouleau, GA, Schofield, PR, Schubert, KO, Schweizer, BW, Seemüller, F, Severino, G, Shekhtman, T, Shilling, PD, Shimoda, K, Simhandl, C, Slaney, CM, Smoller, JW, Squassina, A, Stamm, T, Stopkova, P, Tighe, SK, Tortorella, A, Turecki, G, Volkert, J, Witt, S, Wright, A, Young, LT, Zandi, PP, Potash, JB, Depaulo, JR, Bauer, M, Reininghaus, EZ, Novák, T, Aubry, JM, Maj, M, Baune, BT, Mitchell, PB, Vieta, E, Frye, MA, Rybakowski, JK, Kuo, PH, Kato, T, Grigoroiu-Serbanescu, M, Reif, A, Del Zompo, M, Bellivier, F, Schalling, M, Wray, NR, Kelsoe, JR, Alda, M, Rietschel, M, McMahon, FJ & Schulze, TG 2016, 'Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study', The Lancet, vol. 387, no. 10023, pp. 1085-1093. https://doi.org/10.1016/S0140-6736(16)00143-4

@article{45cb38f9cfef4bfeaaa0d527f61d3cdc,

title = "Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study",

abstract = "Background Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified. Methods Here, we report the results of a genome-wide association study of lithium response in 2563 patients collected by 22 participating sites from the International Consortium on Lithium Genetics (ConLiGen). Data from common single nucleotide polymorphisms (SNPs) were tested for association with categorical and continuous ratings of lithium response. Lithium response was measured using a well established scale (Alda scale). Genotyped SNPs were used to generate data at more than 6 million sites, using standard genomic imputation methods. Traits were regressed against genotype dosage. Results were combined across two batches by meta-analysis. Findings A single locus of four linked SNPs on chromosome 21 met genome-wide significance criteria for association with lithium response (rs79663003, p=1·37×10-8; rs78015114, p=1·31×10-8; rs74795342, p=3·31×10-9; and rs75222709, p=3·50×10-9). In an independent, prospective study of 73 patients treated with lithium monotherapy for a period of up to 2 years, carriers of the response-associated alleles had a significantly lower rate of relapse than carriers of the alternate alleles (p=0·03268, hazard ratio 3·8, 95% CI 1·1-13·0). Interpretation The response-associated region contains two genes for long, non-coding RNAs (lncRNAs), AL157359.3 and AL157359.4. LncRNAs are increasingly appreciated as important regulators of gene expression, particularly in the CNS. Confirmed biomarkers of lithium response would constitute an important step forward in the clinical management of bipolar disorder. Further studies are needed to establish the biological context and potential clinical utility of these findings. Funding Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program.",

author = "Liping Hou and Urs Heilbronner and Franziska Degenhardt and Mazda Adli and Kazufumi Akiyama and Nirmala Akula and Raffaella Ardau and B{\'a}rbara Arias and Lena Backlund and Banzato, {Claudio E.M.} and Antoni Benabarre and Susanne Bengesser and Bhattacharjee, {Abesh Kumar} and Biernacka, {Joanna M.} and Armin Birner and Clara Brichant-Petitjean and Bui, {Elise T.} and Pablo Cervantes and Chen, {Guo Bo} and Chen, {Hsi Chung} and Caterina Chillotti and Sven Cichon and Clark, {Scott R.} and Francesc Colom and Cousins, {David A.} and Cristiana Cruceanu and Czerski, {Piotr M.} and Dantas, {Clarissa R.} and Alexandre Dayer and Bruno {\'E}tain and Peter Falkai and Forstner, {Andreas J.} and Louise Fris{\'e}n and Fullerton, {Janice M.} and S{\'e}bastien Gard and Garnham, {Julie S.} and Goes, {Fernando S.} and Paul Grof and Oliver Gruber and Ryota Hashimoto and Joanna Hauser and Stefan Herms and Per Hoffmann and Andrea Hofmann and Stephane Jamain and Esther Jim{\'e}nez and Kahn, {Jean Pierre} and Layla Kassem and Sarah Kittel-Schneider and Sebastian Kliwicki and Barbara K{\"o}nig and Ichiro Kusumi and Nina Lackner and Gonzalo Laje and Mikael Land{\'e}n and Catharina Lavebratt and Marion Leboyer and Leckband, {Susan G.} and Jaramillo, {Carlos A.L{\'o}pez} and Glenda Macqueen and Mirko Manchia and Lina Martinsson and Manuel Mattheisen and McCarthy, {Michael J.} and McElroy, {Susan L.} and Marina Mitjans and Mondimore, {Francis M.} and Palmiero Monteleone and Nievergelt, {Caroline M.} and N{\"o}then, {Markus M.} and Urban {\"O}sby and Norio Ozaki and Perlis, {Roy H.} and Andrea Pfennig and Daniela Reich-Erkelenz and Rouleau, {Guy A.} and Schofield, {Peter R.} and Schubert, {K. Oliver} and Schweizer, {Barbara W.} and Florian Seem{\"u}ller and Giovanni Severino and Tatyana Shekhtman and Shilling, {Paul D.} and Kazutaka Shimoda and Christian Simhandl and Slaney, {Claire M.} and Smoller, {Jordan W.} and Alessio Squassina and Thomas Stamm and Pavla Stopkova and Tighe, {Sarah K.} and Alfonso Tortorella and Gustavo Turecki and Julia Volkert and Stephanie Witt and Adam Wright and Young, {L. Trevor} and Zandi, {Peter P.} and Potash, {James B.} and Depaulo, {J. Raymond} and Michael Bauer and Reininghaus, {Eva Z.} and Tomas Nov{\'a}k and Aubry, {Jean Michel} and Mario Maj and Baune, {Bernhard T.} and Mitchell, {Philip B.} and Eduard Vieta and Frye, {Mark A.} and Rybakowski, {Janusz K.} and Kuo, {Po Hsiu} and Tadafumi Kato and Maria Grigoroiu-Serbanescu and Andreas Reif and {Del Zompo}, Maria and Frank Bellivier and Martin Schalling and Wray, {Naomi R.} and Kelsoe, {John R.} and Martin Alda and Marcella Rietschel and McMahon, {Francis J.} and Schulze, {Thomas G.}",

note = "Funding Information: Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program. We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientifi c Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network. MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003?07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigaci?n en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d?Universitats i Recerca del Departament d?Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the {"}Estrategia de Sostenibilidad 2014-2015{"} program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler- Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007?2013?Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Funding Information: We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientific Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174 ). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network . MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003–07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigaci{\'o}n en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the “Estrategia de Sostenibilidad 2014-2015” program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler-Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007–2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Funding Information: Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program. We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientifi c Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network. MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003–07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigaci{\'o}n en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the {"}Estrategia de Sostenibilidad 2014-2015{"} program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler- Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007–2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Publisher Copyright: {\textcopyright} 2016 Elsevier Ltd.",

year = "2016",

month = mar,

day = "12",

doi = "10.1016/S0140-6736(16)00143-4",

language = "English (US)",

volume = "387",

pages = "1085--1093",

journal = "The Lancet",

issn = "0140-6736",

publisher = "Elsevier Limited",

number = "10023",

}

TY - JOUR

T1 - Genetic variants associated with response to lithium treatment in bipolar disorder

T2 - A genome-wide association study

AU - Hou, Liping

AU - Heilbronner, Urs

AU - Degenhardt, Franziska

AU - Adli, Mazda

AU - Akiyama, Kazufumi

AU - Akula, Nirmala

AU - Ardau, Raffaella

AU - Arias, Bárbara

AU - Backlund, Lena

AU - Banzato, Claudio E.M.

AU - Benabarre, Antoni

AU - Bengesser, Susanne

AU - Bhattacharjee, Abesh Kumar

AU - Biernacka, Joanna M.

AU - Birner, Armin

AU - Brichant-Petitjean, Clara

AU - Bui, Elise T.

AU - Cervantes, Pablo

AU - Chen, Guo Bo

AU - Chen, Hsi Chung

AU - Chillotti, Caterina

AU - Cichon, Sven

AU - Clark, Scott R.

AU - Colom, Francesc

AU - Cousins, David A.

AU - Cruceanu, Cristiana

AU - Czerski, Piotr M.

AU - Dantas, Clarissa R.

AU - Dayer, Alexandre

AU - Étain, Bruno

AU - Falkai, Peter

AU - Forstner, Andreas J.

AU - Frisén, Louise

AU - Fullerton, Janice M.

AU - Gard, Sébastien

AU - Garnham, Julie S.

AU - Goes, Fernando S.

AU - Grof, Paul

AU - Gruber, Oliver

AU - Hashimoto, Ryota

AU - Hauser, Joanna

AU - Herms, Stefan

AU - Hoffmann, Per

AU - Hofmann, Andrea

AU - Jamain, Stephane

AU - Jiménez, Esther

AU - Kahn, Jean Pierre

AU - Kassem, Layla

AU - Kittel-Schneider, Sarah

AU - Kliwicki, Sebastian

AU - König, Barbara

AU - Kusumi, Ichiro

AU - Lackner, Nina

AU - Laje, Gonzalo

AU - Landén, Mikael

AU - Lavebratt, Catharina

AU - Leboyer, Marion

AU - Leckband, Susan G.

AU - Jaramillo, Carlos A.López

AU - Macqueen, Glenda

AU - Manchia, Mirko

AU - Martinsson, Lina

AU - Mattheisen, Manuel

AU - McCarthy, Michael J.

AU - McElroy, Susan L.

AU - Mitjans, Marina

AU - Mondimore, Francis M.

AU - Monteleone, Palmiero

AU - Nievergelt, Caroline M.

AU - Nöthen, Markus M.

AU - Ösby, Urban

AU - Ozaki, Norio

AU - Perlis, Roy H.

AU - Pfennig, Andrea

AU - Reich-Erkelenz, Daniela

AU - Rouleau, Guy A.

AU - Schofield, Peter R.

AU - Schubert, K. Oliver

AU - Schweizer, Barbara W.

AU - Seemüller, Florian

AU - Severino, Giovanni

AU - Shekhtman, Tatyana

AU - Shilling, Paul D.

AU - Shimoda, Kazutaka

AU - Simhandl, Christian

AU - Slaney, Claire M.

AU - Smoller, Jordan W.

AU - Squassina, Alessio

AU - Stamm, Thomas

AU - Stopkova, Pavla

AU - Tighe, Sarah K.

AU - Tortorella, Alfonso

AU - Turecki, Gustavo

AU - Volkert, Julia

AU - Witt, Stephanie

AU - Wright, Adam

AU - Young, L. Trevor

AU - Zandi, Peter P.

AU - Potash, James B.

AU - Depaulo, J. Raymond

AU - Bauer, Michael

AU - Reininghaus, Eva Z.

AU - Novák, Tomas

AU - Aubry, Jean Michel

AU - Maj, Mario

AU - Baune, Bernhard T.

AU - Mitchell, Philip B.

AU - Vieta, Eduard

AU - Frye, Mark A.

AU - Rybakowski, Janusz K.

AU - Kuo, Po Hsiu

AU - Kato, Tadafumi

AU - Grigoroiu-Serbanescu, Maria

AU - Reif, Andreas

AU - Del Zompo, Maria

AU - Bellivier, Frank

AU - Schalling, Martin

AU - Wray, Naomi R.

AU - Kelsoe, John R.

AU - Alda, Martin

AU - Rietschel, Marcella

AU - McMahon, Francis J.

AU - Schulze, Thomas G.

N1 - Funding Information: Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program. We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientifi c Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network. MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003?07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigaci?n en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d?Universitats i Recerca del Departament d?Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the "Estrategia de Sostenibilidad 2014-2015" program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler- Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007?2013?Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Funding Information: We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientific Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174 ). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network . MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003–07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigación en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the “Estrategia de Sostenibilidad 2014-2015” program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler-Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007–2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Funding Information: Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program. We are greatly indebted to all the study participants without whom this research would not have been possible. We thank the members of our Scientifi c Advisory Board for critical input over the course of the project. This work was in part funded by the Deutsche Forschungsgemeinschaft (DFG; grant no RI 908/7-1; grant FOR2107, RI 908/11-1 to Marcella Rietschel, Michael Bauer, and Thomas G Schulze, NO 246/10-1 to MMN) and the Intramural Research Program of the National Institute of Mental Health (ZIA-MH00284311; NCT00001174). The genotyping was in part funded by the German Federal Ministry of Education and Research (BMBF) through the Integrated Network IntegraMent (Integrated Understanding of Causes and Mechanisms in Mental Disorders), under the auspices of the e:Med Programme (grants awarded to TGS, MR, and MMN). OG, AP, TSt, MB, AR, and TGS received support from the German Federal Ministry of Education and Research (BMBF) within the framework of the BipolLife network. MMN received support from the Alfried Krupp von Bohlen und Halbach-Stiftung. Franziska Degenhardt received support from the BONFOR Programme of the University of Bonn, Germany. EZR received funding from the Land Steiermark as principal investigator. MS received funds from the Swedish Research Council, Swedish Brain Foundation and funds from Karolinska Institutet and Karolinska University Hospital. Some data and biomaterials were collected as part of eleven projects (Study 40) that participated in the National Institute of Mental Health (NIMH) Bipolar Disorder Genetics Initiative. From 2003–07, the principal investigators and co-investigators were: Indiana University, Indianapolis, IN, R01 MH59545 (John Nurnberger, Marvin J Miller, Elizabeth S Bowman, N Leela Rau, P Ryan Moe, Nalini Samavedy, Rif El-Mallakh [University of Louisville], Husseini Manji [Johnson and Johnson], Debra A Glitz [Wayne State University], Eric T Meyer [Oxford University, UK], Carrie Smiley, Tatiana Foroud, Leah Flury, Danielle M Dick [Virginia Commonwealth University], Howard Edenberg); Washington University, St Louis, MO, R01 MH059534 (John Rice, Theodore Reich, Allison Goate, Laura Bierut [K02 DA21237]); Johns Hopkins University, Baltimore, R01 MH59533 (Melvin McInnis, J Raymond DePaulo Jr, Dean F MacKinnon, Francis M Mondimore, James B Potash, Peter P Zandi, Dimitrios Avramopoulos, Jennifer Payne); University of Pennsylvania, PA, R01 MH59553 (Wade Berrettini); University of California at San Francisco, CA, R01 MH60068 (William Byerley, Sophia Vinogradov); University of Iowa, IA, R01 MH059548 (William Coryell, Raymond Crowe); University of Chicago, IL, R01 MH59535 (Elliot Gershon, Judith Badner, Francis McMahon, Chunyu Liu, Alan Sanders, Maria Caserta, Steven Dinwiddie, Tu Nguyen, Donna Harakal); University of California at San Diego, CA, R01 MH59567 (John Kelsoe, Rebecca McKinney); Rush University, IL, R01 MH059556 (William Scheftner, Howard M Kravitz, Diana Marta, Annette Vaughn-Brown, Laurie Bederow); and NIMH Intramural Research Program, Bethesda, 1Z01MH002810-01 (Francis J McMahon, Layla Kassem, PsyD, Sevilla Detera-Wadleigh, Lisa Austin, Dennis L Murphy [Howard University], William B Lawson, Evarista Nwulia, Maria Hipolito). This work was supported by the NIH grants P50CA89392 from the National Cancer Institute and 5K02DA021237 from the National Institute of Drug Abuse. The Canadian part of the study was supported by a grant #64410 from the Canadian Institutes of Health Research to MAl. We wish to thank Joanne Petite and Giselle Kraus for assistance with data collection. Collection and phenotyping of the Australian UNSW sample, by PBM, PRS, JMF, and AW, was funded by an Australian NHMRC Program Grant (No. 1037196). The collection of the Barcelona sample was supported by the Centro de Investigación en Red de Salud Mental (CIBERSAM) IDIBAPS (grant numbers PI080247, PI1200906, PI12/00018), and Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2014SGR1636 and 2014SGR398). J-MA and AD were supported by the Swiss National Science Foundation (grant number 32003B_125469 and NCCR Synapsy). DC was supported by a Medical Research Council Clinician Scientist Fellowship Award (MR/L006642/1). LF was supported by the Swedish Research Council (grant no 523-2011-3807). MG-S was supported by UEFISCDI, Romania, grant no 89/2012. P-HK was funded by the Taiwan Ministry of Science and Technology (grant no MST 99-2314-B-002-140-MY3 and 102-2314-B-002-117-MY3). CALJ was funded by the "Estrategia de Sostenibilidad 2014-2015" program of the University of Antioquia. TN was supported by the Ministry of Health of the Czech Republic (grant no IGA NT13891). JBP was supported by the Reuben Stoltzfus Bipolar Research Fund and with SKT received funding from the James Wah Fund and Project MATCH. TGS and UH received support from the Dr-Lisa-Oehler- Foundation (Kassel, Germany). AS has a postdoctoral fellowship funded by the Sardinia Regional Government POR Sardegna FSE Operational Program of the Autonomous Region of Sardinia, European Social Fund 2007–2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1. NRW was funded by Australian NHMRC Fellowships 613602 and 1078901. MMan is now a resident in the psychiatry training program at the Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. This study used the high-performance computational capabilities of the Biowulf Linux cluster at the National Institutes of Health, Bethesda, MD. Genotyping for part of the Swedish sample was funded by the Stanley Center for Psychiatric Research at the Broad Institute. Publisher Copyright: © 2016 Elsevier Ltd.

PY - 2016/3/12

Y1 - 2016/3/12

N2 - Background Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified. Methods Here, we report the results of a genome-wide association study of lithium response in 2563 patients collected by 22 participating sites from the International Consortium on Lithium Genetics (ConLiGen). Data from common single nucleotide polymorphisms (SNPs) were tested for association with categorical and continuous ratings of lithium response. Lithium response was measured using a well established scale (Alda scale). Genotyped SNPs were used to generate data at more than 6 million sites, using standard genomic imputation methods. Traits were regressed against genotype dosage. Results were combined across two batches by meta-analysis. Findings A single locus of four linked SNPs on chromosome 21 met genome-wide significance criteria for association with lithium response (rs79663003, p=1·37×10-8; rs78015114, p=1·31×10-8; rs74795342, p=3·31×10-9; and rs75222709, p=3·50×10-9). In an independent, prospective study of 73 patients treated with lithium monotherapy for a period of up to 2 years, carriers of the response-associated alleles had a significantly lower rate of relapse than carriers of the alternate alleles (p=0·03268, hazard ratio 3·8, 95% CI 1·1-13·0). Interpretation The response-associated region contains two genes for long, non-coding RNAs (lncRNAs), AL157359.3 and AL157359.4. LncRNAs are increasingly appreciated as important regulators of gene expression, particularly in the CNS. Confirmed biomarkers of lithium response would constitute an important step forward in the clinical management of bipolar disorder. Further studies are needed to establish the biological context and potential clinical utility of these findings. Funding Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program.

AB - Background Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified. Methods Here, we report the results of a genome-wide association study of lithium response in 2563 patients collected by 22 participating sites from the International Consortium on Lithium Genetics (ConLiGen). Data from common single nucleotide polymorphisms (SNPs) were tested for association with categorical and continuous ratings of lithium response. Lithium response was measured using a well established scale (Alda scale). Genotyped SNPs were used to generate data at more than 6 million sites, using standard genomic imputation methods. Traits were regressed against genotype dosage. Results were combined across two batches by meta-analysis. Findings A single locus of four linked SNPs on chromosome 21 met genome-wide significance criteria for association with lithium response (rs79663003, p=1·37×10-8; rs78015114, p=1·31×10-8; rs74795342, p=3·31×10-9; and rs75222709, p=3·50×10-9). In an independent, prospective study of 73 patients treated with lithium monotherapy for a period of up to 2 years, carriers of the response-associated alleles had a significantly lower rate of relapse than carriers of the alternate alleles (p=0·03268, hazard ratio 3·8, 95% CI 1·1-13·0). Interpretation The response-associated region contains two genes for long, non-coding RNAs (lncRNAs), AL157359.3 and AL157359.4. LncRNAs are increasingly appreciated as important regulators of gene expression, particularly in the CNS. Confirmed biomarkers of lithium response would constitute an important step forward in the clinical management of bipolar disorder. Further studies are needed to establish the biological context and potential clinical utility of these findings. Funding Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program.

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U2 - 10.1016/S0140-6736(16)00143-4

DO - 10.1016/S0140-6736(16)00143-4

M3 - Article

C2 - 26806518

AN - SCOPUS:84961211119

SN - 0140-6736

VL - 387

SP - 1085

EP - 1093

JO - The Lancet

JF - The Lancet

IS - 10023

ER -

Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study

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