Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA.
Nat Neurosci. 2020 Apr;23(4):475-480. doi: 10.1038/s41593-020-0609-7. Epub 2020 Mar 30.
Over the last decade, genome-wide association studies of psychiatric disorders have identified numerous significant loci. Whereas these studies initially depended on cohorts ascertained for specific disorders, there has been a gradual shift in the ascertainment strategy toward population-based cohorts for which both genotype and heterogeneous phenotypic information are available. One of the advantages of population-based cohorts is that, in addition to clinical diagnoses and various proxies for diagnoses ('minimal phenotyping'), many of them also provide non-clinical phenotypes, including putative endophenotypes, that can be used to study domains of normal function in addition to, or instead of, clinical diagnoses. By studying endophenotypes it is possible to both dissect psychiatric disorders ('splitting') and to combine multiple phenotypes ('clumping'), which can either reinforce or challenge traditional diagnostic categories. Such endophenotypes may also permit a deeper exploration of the neurobiology of psychiatric disorders. A coordinated effort to fully exploit the potential of endophenotypes is overdue.
在过去的十年中,精神疾病的全基因组关联研究已经确定了许多重要的基因座。虽然这些研究最初依赖于特定疾病的队列确定,但已经逐渐转向基于人群的队列,这些队列既有基因型又有异构表型信息。基于人群的队列的一个优点是,除了临床诊断和各种诊断的替代指标(“最小表型化”)之外,其中许多还提供非临床表型,包括可能的内表型,可用于研究正常功能的领域,除了临床诊断之外,或者代替临床诊断。通过研究内表型,可以对精神疾病进行剖析(“分裂”)和对多个表型进行组合(“聚类”),这既可以加强也可以挑战传统的诊断类别。这种内表型也可能允许更深入地探索精神疾病的神经生物学。充分利用内表型的潜力的协调努力已经滞后。