This case report applied whole genome sequencing to 25 individuals across two multiplex OCD pedigrees to identify rare protein-disrupting variants segregating with OCD. The analysis focused on rare, protein-disrupting variants that co-segregated with illness within families.
In the first pedigree, a highly deleterious missense variant in NPY5R was identified and carried by the majority of affected individuals. In the second pedigree, a large deletion of DLGAP1 and a missense variant in MAPK8IP3 perfectly co-segregated in a specific branch of the family. No effect sizes, absolute numbers, p-values, or confidence intervals were reported.
Safety and tolerability were not reported, as this was a genetic sequencing study without therapeutic intervention. The study is limited by its small sample from two pedigrees, generalizability may be restricted to multiplex families, and preclinical genetic findings require further validation.
These findings suggest association of variants with OCD in specific pedigrees; causation is not established. The evidence is preliminary and requires replication before any clinical application.
View Original Abstract ↓
Obsessive compulsive disorder (OCD) is significantly heritable, but only a fraction of the contributory genetic variation has been identified, and the molecular etiology involved remains obscure. Identifying rare contributory variants of large effect would be an important milestone in helping to elucidate the mechanisms involved. Analysis of densely affected pedigrees is a potentially useful strategy to bypass the sample size challenges of standard case-control approaches. Here we performed whole genome sequencing (WGS) of 25 individuals across two multiplex OCD pedigrees. We prioritised rare variants using a Bayesian inference approach which incorporates variant pathogenicity and co-segregation with OCD. In the first pedigree, we identified a highly deleterious missense variant in NPY5R, carried by the majority of affected individuals. This gene is brain-expressed and has previously been implicated in panic disorder and internet addiction GWAS studies. In the second pedigree, we identified a large deletion of DLGAP1 and a missense variant in MAPK8IP3, that perfectly co-segregated in a specific branch of the family: both genes have previously been implicated in OCD and autism. Both genes contribute to a protein interaction network including ERBB4 and RAPGEF1 which we had previously identified in a large Tourette Syndrome pedigree. Our analysis suggests that both energy homeostasis and downstream signalling from the post-synaptic density may both be important avenues for future research.