Archive for October, 2009
My 2 Brains: my new blog
Oct 31st
I have just started a new blog called My 2 Brains and you can read more about that blog and what topics and themes it will cover over here.
One of the first posts is about the real-time stream and analyzes it from a psychological perspective focusing on the virtual self one can associate with one’s stream. I am planning to write the other posts too in a similar format, though the topics covered would range from sociology, culture and politics to current affairs.
Please do visit the My 2 Brains blog and give me some feedback as to how you like the concept and what topics/ themes you would like me to cover there.
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The epigenetics of Autism: Oxytocin factor and implications for schizophrenia
Oct 31st
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Autism is a hard disorder to nail down genetically- single nucleotide polymorphisms (SNPs) or even multiple locus genetic effects are not able to account for the large genetic component to the disorder. In recent times, Copy number variations (CNVs) has come to the forefront of Autism research , suggesting that microdeletions, duplications etc may account for some cases. Another new , till now unsuspected mechanism that has recently been implicated in autism is epigenetic mechanism of increased methylation in promoter regions that has the effect of silencing/reducing the expression of genes involved to a certain extent. The recent study by Gregory et al, is just such a step in the right direction, which will hopefully bring us closer to the truth.
The study is available in full at BMC Medicine site and is accompanied by a must read commentary that explains a lot of things and puts the finding in context.
In a nutshell, the study authors used CNV determining methods to discover that a deletion of OXTR (oxytocin receptor) gene was presnet in an autistic subject and was not de novo , but the deletion was inherited from his mother. One of the affected siblings of the autistic subject, who too was autistic, on the other hand did not have a deletion, but had increased methylation of the OXTR. this led the study authors to revisit their genomics data and look at adta across all autistic subjects and controls and discover that indeed, in other autistics too the OXTR had increased methylation. Then they looked for expression of OXTR in peripheral blood cells and temporal cortex and found that indedd in autistics, as compared to controls, there was reduced expression of OXTR. This strongly suggest that the epigentic changes that lead to autism (the efffect of OXTR suppression) happen quite early in the devlopmenet and might happen in utero.
Before I elaborate on my take home from the study, there are some excerpts (as I know you didn’t read the originals)
Classic autism comprises a spectrum of behavioral and cognitive disturbances of childhood development. The core autism phenotype includes deficits in social interaction, language development and patterns of repetitive behaviors and/or restricted interests. The population prevalence of the spectrum of autism disorders is estimated to range between 1/300 [1] to 1/100 (http://www.nschdata.org/), with a male: female ratio of 4:1 [2,3]. The disorder has been shown to be highly heritable with the relative risk for siblings being approximately 2% to 8%, much higher than that of the general population [4]. To date, only a small percentage of autism cases (<10%) have been ascribed to single gene disorders such as fragile X syndrome, tuberous sclerosis [5] and Rett syndrome [6]. Numerous approaches including genetic linkage, genome-wide association, candidate gene association and gene expression analysis have been used to identify the additional genes
implicated in the development of autism [7,8]. However, the heterogeneous nature of autism and autism spectrum disorders has limited their success.An additional approach to identify genes involved in autism is to characterize copy number variants (CNVs), that is, chromosomal deletions and duplications, that are known to be present within at least 5% of individuals with idiopathic autism [9]. Autism CNVs have been shown to involve almost all chromosomes [10,11], with the most frequently observed alteration localizing to chromosome 15q11-13 [12-23]. A number of different methods have been used to characterize autism related CNVs, including but not limited to, cytogenetic Gbanding [14,23,24], metaphase fluorescence in situ hybridization (FISH) [22], Southern blotting [18], loss of heterozygosity (LOH) analysis [15-17,19], quantitative polymerase chain reaction (PCR) [25] and, more recently, genotyping and representational oligonucleotide microarray analysis (ROMA) [26].
Here we describe the use of genome-wide tilepath microarrays and array comparative genomic hybridization (CGH) to identify CNVs in a dataset of 119 unrelated probands from multiplex autism families [27]. The genomic profiles of our autism dataset were compared to the array CGH profiles of 54 phenotypically normal individuals, to previously published CNVs present within the database of genomic variants [28] and to the Autism Chromosome Rearrangement Database (http://projects.tcag.ca/autism/). The most significant finding thus far from our analysis is a heterozygous deletion of the oxytocin receptor gene (OXTR) (MIM accession no.: 167055) in an individual with autism and his mother with putative obsessive-compulsive disorder (OCD). We further investigated the relationship between OXTR and autism by carrying out epigenetic analysis of the promoter region of OXTR. We show that the gene is hypermethylated in independent cohorts with autism as compared to controls, in both peripheral blood mononuclear cells (PBMCs) and the temporal cortex. Additionally, our analysis of expression levels of OXTR in the temporal cortex shows decreased levels of expression in individuals with autism as compared to controls matched for age and sex.These data suggest that OXTR and the oxytocin signaling pathway play an important role in the etiology of autism and autism spectrum disorders and implicate epigenetic misregulation of OXTR in this complex disease.
…
Epigenetic control of autism susceptibility is a recent concept and most certainly a topic of great interest in the field. Over the past decade, researchers have uncovered suggestive links between epigenetics and autism, for example, autism is associated with duplications of 15q11-13 (especially maternally inherited), an imprinted region in the genome where DNA methylation status has been linked to Prader-Willi syndrome (PWS) and Angelman syndrome (AS) [66]; mutation within a gene that encodes a methyl-DNA-binding protein (MECP2, (MIM accession no.: 300005)) is the causative agent of Rett syndrome [67]; and mutation of this same gene has been associated with both autism and AS populations [55]. Nagarajan et al. have shown that 79% of autism cases have a decrease in MECP2 expression in the frontal cortex and that an increase in aberrant DNA methylation correlates with this decrease in MECP2 expression [68]. These data implicate epigenetic dysregulation as a mechanism for the development of autism and justify the examination of DNA methylation of autism candidate genes, such as OXTR identified in this study.
Now from the accompanying (more accessible) commentary:
The article by Gregory et al. published this month in BMC Medicine, reports on genomic and epigenetic alterations of OXTR, the gene encoding the receptor for oxytocin. The involvement of this gene was suggested by its deletion in an autistic patient. The subsequent analysis of a group of unrelated autistic subjects did not show an OXTR deletion, but rather hypermethylation of the gene promoter, with a reduced mRNA expression.
These findings address two major points of the current debate on the etiology and pathogenesis of autism: the role of oxytocin, known to be involved in modeling human behavior, and the possible involvement of epigenetic mechanisms. The nature of this epigenetic dysregulation is unknown but, if proved to be true, might explain the failure to identify sequence alterations in a host of candidate genes. Practical implications of these findings may be forthcoming, however not before extension and validation on a larger scale have confirmed their value.
..
The second issue raised by Gregory et al. deals with the epigenetic inhibition of OXTR expression in ASD. Such epigenetic modification, at least as reported so far, does not seem to be sequence based but rather of a different, as yet unknown nature. This might explain why researchers have been looking for decades for genetic mutations in ASD and yet have found almost none. An epigenetic mechanism would justify the ‘unusual’, non-Mendelian familial aggregations of ASD. In this respect, even the family with OXTR deficiency reported by Gregory et al. shows an unusual genotype-phenotype correlation, in that the same phenotype is caused by alterations of the same gene but due to different molecular defects (deletion versus hypermethylation).Also, the possibility that in most ASD patients there might be an epigenomic instability is of interest in consideration of the fact that it has been shown that the epigenetic status in early fetal development can be reprogrammed by maternal behavior in a reversible way [34]. Therefore, other environmental factors, yet to be discovered, might also be able to reprogram the epigenotype of the embryo.
I hope the fact that epigenetic changes may happen during pregnancy line of reasoning does not lead to the harmful and without-any-basis vaccination is cause of autism arguments. On the other hand I had covered earlier how Autism is more likely if mother was exposed to valproate during pregnancy or the child soon after birth. What if valproate is instrumental in an epigenetic fashion in leading to more or less methylation and gene expression. It is well known that valproate and valporic acid is given as treatment for psychosis/bipolar. In a similar vein, I am inclined to stick my neck out and claim that in schizophrenics/psychotics , the OXTR should be more expressed : perhaps more methylation, duplications etc . However I am checked in my musings by these studies that claim that negative symptoms of schizophrneia may be associated with reduced oxytocin activity in the brain. Yet, all said and done I would like to see a study that analyzes for epigenetic mechanisms in schizophrneia especially at the OXTR locus. Although the negative symptoms like social withdrawal of schizophrenia may lead to the opposite hypothesis regarding schizophrenia and oxytocin correlation, I am inclined to believe that schizophrenics (at least those suffering from positive symptoms predominantly) are too much oxytocin guided , trusting and socially too much involved in others type of people.
Gregory, S., Connelly, J., Towers, A., Johnson, J., Biscocho, D., Markunas, C., Lintas, C., Abramson, R., Wright, H., Ellis, P., Langford, C., Worley, G., Delong, G., Murphy, S., Cuccaro, M., Persico, A., & Pericak-Vance, M. (2009). Genomic and epigenetic evidence for oxytocin receptor deficiency in autism BMC Medicine, 7 (1) DOI: 10.1186/1741-7015-7-62
Gurrieri, F., & Neri, G. (2009). Defective oxytocin function: a clue to understanding the cause of autism? BMC Medicine, 7 (1) DOI: 10.1186/1741-7015-7-63
Hat tip to @Boraz for tweeting about this study.
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Splitting the self : “me” and “I”:
Oct 30th
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I came across this study article today by Farb et al, that talks about two distinct neural networks in the brain that are involved in self-reference. To be fair, the networks are somewhat blurred and overlap in naive people, while in people who practice mindfulness meditation, the networks are more distinct and non-overlapping. My interest was piqued as I am a keen follower of default-brain network , which has been implicated in self-referential thinking and this article seems to at one point argue that the narrative self viz ‘me’ is grounded in default brain network, while the experiencer ‘I” has some other nearby related areas as the neural substrates.
But first let us clarify what we mean by ‘me’ and ‘I’. For this I would like to quote form a Gallagher article:
Ever since William James (1890) provided a catalogue of different senses of the self, philosophers and psychologists have been hard at work refining and expanding the possible variations of this concept. Supplementing James’ inventory of physical self, mental self, spiritual self, and the ego, Neisser (1988), for example, suggested important distinctions between ecological, interpersonal, extended, private, and conceptual aspects of self. More recently, reviewing a contentious collection of essays from various disciplines, Strawson (1999) found an overabundance of delineations between cognitive, embodied, fictional, and narrative selves, among others. It would be impossible to review all of these diverse notions of self in this short paper, so I have focused on several recently developed approaches that promise the best exchange between philosophy of mind and the other cognitive sciences. Because these approaches move in divergent theoretical directions they should help to convey the breadth of philosophical analysis on this topic. They can be divided into two groups that are focused, respectively, on two important aspects of self.
A first approach involves various attempts to account for a ‘minimal’ sense of self. If we strip away all of the unessential features of self, the intuition is that there is a basic, immediate, or primitive something that we are still willing to call a self. This approach leaves aside questions about the degree to which the self is extended beyond the short-term or ‘specious’ present to include past thoughts and actions. Although identity over time is a major issue in the philosophical definition of personal identity, the concept of the minimal self is limited to that which is accessible to immediate and present self-consciousness. Non-philosophers have found that certain aspects of the minimal self are relevant to current research in robotics. Furthermore, aspects of the minimal self that involve senses of ownership and agency in the context of both motor action and cognition can be clarified by neurocognitive models (developed to explain pathologies such as schizophrenia) that suggest the involvement of specific brain systems (including prefrontal cortex, SMA, and cerebellum).
A second approach involves conceiving of the self in terms of narrative, a concept imported into the cognitive-science context by Dennett (1991) , but one which may have a more complex significance than indicated in Dennett’s account. The narrative self is extended in time to include memories of the past and intentions toward the future. It is what Neisser refers to as the extended self, and what Dennett calls a ‘nonminimal selfy’ self. Neuropsychological accounts of episodic memory or loss of memory can help to circumscribe the neurological underpinnings of the narrative self.
If you haven’t guessed by now, the minimal self is ‘I’: the doer , experiencer experiencing the immediate present; the narrative self is ‘me’ -an entity stretched in time and living as much in past and future as in the present. The study authors delineate the same as follows (note that they too start with William James reference):(* references removed)
Since William James’ early conceptualization, the ‘self ’ has been characterised as a source of permanence beneath the constantly shifting set of experiences that constitute conscious life. This permanence is often related to the construction of narratives that weave together the threads of temporally disparate experiences into a cohesive fabric. To account for this continuity, William James posited an explanatory ‘me’ to make sense of the ‘I’ acting in the present moment . Recently, progress has been made in characterizing the neural bases of the processes supporting William James’ ‘me’ in the form of ‘narrative’ self-reference , highlighting the role of the medial prefrontal cortices (mPFC) in supporting self awareness by linking subjective experiences across time . The mPFC has been shown to support an array of self-related capacities, including memory for self-traits , traits of similar others , reflected self-knowledge , and aspirations for the future . As such, cortical midline processes may be characterised as supporting narrative self-reference that maintains continuity of identity across time .
Narrative self-reference stands in stark contrast to the immediate, agentic ‘I’ supporting the notion of momentary experience as an expression of selfhood. Most examinations of self-reference ignore mechanisms of momentary consciousness, which may represent core aspects of self-experience achieved earlier in development and may have evolved in earlier animal species. Indeed, little is known about whether the neural substrates underlying momentary self-reference are one and the same, or distinct from, cortical midline structures supporting narrative experience. One hypothesis suggests that awareness of momentary self-reference is neurally distinct from narrative self-reference and is derived from neural markers of transient body states, in particular, right lateralised exteroceptive somatic and interoceptive insular cortices. In the present study, we examined this thesis.
In short using fMRI, they tried to find the different hypothesized neural networks underlying the two senses of self and did find evidence for clear segregation in those practicing mindfulness meditation. Their methodology however, is not fool proof and this they themselves note in their conclusions. Here are their findings:
Consistent with a theory of self-reference as mentalising, linguistically mediated and of higher order executive origin , participants engaged midline prefrontal cortices and a left lateralised linguistic-semantic network (inferior lateral PFC, middle temporal and angular gyri) during NF (narrative focus: ‘me’ condition). Demonstrating a default bias towards NF as previously revealed in ‘resting’ mind wandering states , relatively restricted reductions in the cortical midline network were found when attention was explicitly directed towards a moment-to-moment EF (experiential focus: ‘I’ condition) in novice participants with little training in this form of self-reflection. These individuals revealed increased left lateralised prefrontal-parietal activations during EF likely reflecting greater task-related linguistic processing that has been shown to be associated with decreased medial prefrontal recruitment .
So what they found was that a part of default network was engaged in ‘me’ condition; while task-related areas were recruited in “I” condition and appropriate task-related suppression of some part of default network observed. This effect was with naive subjects, but with those trained in mindfulness meditation, they observed a sort of double dissociation:
Following an intensive 8 week course in mindfulness meditation, during which individuals learn to develop the capacity to monitor moment-to-moment experience, EF resulted in a pronounced shift away from midline cortices towards a right lateralised network comprised of the ventral and dorsolateral PFC, as well as right insula, SII and inferior parietal lobule. Consistent with a dual-mode hypothesis of self-awareness, these results suggest a fundamental neural dissociation in modes of self-representation that support distinct, but habitually integrated, aspects of self-reference: (i) higher order self-reference characterised by neural processes supporting awareness of a self that extends across time and (ii) more basic momentary self-reference characterised by neural changes supporting awareness of the psychological present. The latter, represented by evolutionary older neural regions, may represent a return to the neural origins of identity, in which self-awareness in each moment arises from the integration of basic interoceptive and exteroceptive bodily sensory processes. In contrast, the narrative mode of self-reference may represent an overlearned mode of information processing that has become automatic through practice, consistent with established findings on training-induced automaticity.
To me this sounds interesting: If I had to stretch my neck and relate this to autism and schizophrenia , I would say that based on earlier coverage on this blog: Schizophrenics have a higher default brain activity and perhaps try to spin too much of a narrative. Perhaps they are the ones that would best benefit with mindfulness meditation trainings to calm their default ‘me’ and activate the ‘I’ also at relevant times. On the opposite side, one is all too aware of the here-and-now feeling of self that many autistics have- a direct and immediate perceptual relation with world. Perhaps, they too can benefit from some for of mindfulness meditation by learning to use the default brain network too at times – letting teh mind wander and spinning a tale (however fictional) about themselves.
Farb, N., Segal, Z., Mayberg, H., Bean, J., McKeon, D., Fatima, Z., & Anderson, A. (2007). Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference Social Cognitive and Affective Neuroscience, 2 (4), 313-322 DOI: 10.1093/scan/nsm030
Gallagher, S. (2000). Philosophical conceptions of the self: implications for cognitive science Trends in Cognitive Sciences, 4 (1), 14-21 DOI: 10.1016/S1364-6613(99)01417-5
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A brief history of Neuroscience
Oct 29th
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The Society for Neuroscience(SfN) was formed 40 years ago and to commemorate the occasion, the journal of Neuroscience has made some review articles open-access. They are written by leading luminaries in their filed and are somewhat scholarly- though I found some of them pretty accessible too.
Two articles relate to reviewing memory research in the past 40 years and both are a pretty good read. The first is written by Larry Squire and gives you a broad overview of memory research. The second by Eric Kandel focuses more on the molecular aspects of memory formation- but is an excellent article and ends with 11 still unresolved questions for the next 40 years in the memory research.
There is another article by Marcus Raichle that I found pretty interesting, partly because of my continuing fascination with the default brain network and the intrinsic activity of the brain. this again is a very accessible article that brings one up to speed on the 40 yrs of imaging with special focus on the default brain network.
There are other retrospectives there including one on neurotransmitters so go to the source and enjoy the ride.
Hat Tip: Mind Hacks
Squire, L. (2009). Memory and Brain Systems: 1969-2009 Journal of Neuroscience, 29 (41), 12711-12716 DOI: 10.1523/JNEUROSCI.3575-09.2009
Kandel, E. (2009). The Biology of Memory: A Forty-Year Perspective Journal of Neuroscience, 29 (41), 12748-12756 DOI: 10.1523/JNEUROSCI.3958-09.2009
Raichle, M. (2009). A Paradigm Shift in Functional Brain Imaging Journal of Neuroscience, 29 (41), 12729-12734 DOI: 10.1523/JNEUROSCI.4366-09.2009
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Autism, Schizophrenia and CNV in 16p11.2
Oct 26th
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There is a letter published in the advance online edition of Nature Genetics, that reports that microduplication of genes in the region 16p11.2 are associated with the risk of schizophrenia in a large cohort. It has been earlier shown that microdeletions in the same region confer the risk of Autism.Thus, it seems that the region codes for genes too much of which causes schizophrenia and too little autism. Here is the abstract of the study:
Recurrent microdeletions and microduplications of a 600-kb genomic region of chromosome 16p11.2 have been implicated in childhood-onset developmental disorders. We report the association of 16p11.2 microduplications with schizophrenia in two large cohorts. The microduplication was detected in 12/1,906 (0.63%) cases and 1/3,971 (0.03%) controls (P = 1.2 times 10-5, OR = 25.8) from the initial cohort, and in 9/2,645 (0.34%) cases and 1/2,420 (0.04%) controls (P = 0.022, OR = 8.3) of the replication cohort. The 16p11.2 microduplication was associated with a 14.5-fold increased risk of schizophrenia (95% CI (3.3, 62)) in the combined sample. A meta-analysis of datasets for multiple psychiatric disorders showed a significant association of the microduplication with schizophrenia (P = 4.8 times 10-7), bipolar disorder (P = 0.017) and autism (P = 1.9 times 10-7). In contrast, the reciprocal microdeletion was associated only with autism and developmental disorders (P = 2.3 times 10-13). Head circumference was larger in patients with the microdeletion than in patients with the microduplication (P = 0.0007).
Here is what medical news today (via which I found this article) has to say about the findings:
An international team of researchers led by geneticist Jonathan Sebat, Ph.D., of Cold Spring Harbor Laboratory (CSHL), has identified a mutation on human chromosome 16 that substantially increases risk for schizophrenia.
The mutation in question is what scientists call a copy number variant (CNV). CNVs are areas of the genome where the number of copies of genes differs between individuals. The CNV is located in a region referred to by scientists as 16p11.2. By studying the genomes of 4,551 patients and 6,391 healthy individuals, Sebat’s team has shown that having one extra copy of this region is associated with schizophrenia. The study appears online today ahead of print in the journal Nature Genetics.
Schizophrenia and autism: two sides of the same coin?“This is not the first time that the 16p11.2 region has caught our eye,” says Sebat. It was previously spotted in a 2007 study with Professor Michael Wigler at CSHL — a deletion of the identical region was identified in a girl with autism. Studies by several other groups have shown that losing one copy of 16p11.2 confers high risk of autism and other developmental disorders in children.
Taken together these studies suggest that some genes are shared between schizophrenia and autism, according to Sebat and colleagues. “In some ways, we might consider the two disorders to be at opposite ends of the same neurobiological process” says Shane McCarthy, Ph.D., the lead author of the study, “and this process is influenced by the copy number of genes on chromosome 16.” One hypothesis is that the loss of 16p11.2 leads to the deprivation of key genes involved in brain development, while an extra copy of this region might have the opposite effect.
A correlation between 16p11.2 mutations and head size
It is not known what biological processes are affected by the copy number of 16p11.2, Sebat notes. He believes, however, that the team may have stumbled on to an important clue. By studying the clinical records of patients, they discovered that patients with deletions of the region differ significantly in head size from those with duplications of the same region. Sebat reports, “Head circumference of patients with the deletion were larger than average by more than one standard deviation. Head circumference was slightly below average in patients with the duplication.” These findings, he notes, are consistent with some previous studies that have observed a trend towards larger brain size in autism and an opposite trend toward smaller brain size in schizophrenia.
All this nicely fits in with what I have been proclaiming from the rooftops from the early days of this blog: that autism and Schizophrenia are opposites on the same continuum and the genes involved should also be the same. More copy numbers leading to propensity towards psychosis while lesser number or deletions associated with autistic traits. One more puzzle piece fits in and now we know why the brain size differences exist in autistic and schizophrenic persons and what the poetntial function (mentalizing) of region 16p11.2 may be.
McCarthy, S., Makarov, V., Kirov, G., Addington, A., McClellan, J., Yoon, S., Perkins, D., Dickel, D., Kusenda, M., Krastoshevsky, O., Krause, V., Kumar, R., Grozeva, D., Malhotra, D., Walsh, T., Zackai, E., Kaplan, P., Ganesh, J., Krantz, I., Spinner, N., Roccanova, P., Bhandari, A., Pavon, K., Lakshmi, B., Leotta, A., Kendall, J., Lee, Y., Vacic, V., Gary, S., Iakoucheva, L., Crow, T., Christian, S., Lieberman, J., Stroup, T., Lehtimäki, T., Puura, K., Haldeman-Englert, C., Pearl, J., Goodell, M., Willour, V., DeRosse, P., Steele, J., Kassem, L., Wolff, J., Chitkara, N., McMahon, F., Malhotra, A., Potash, J., Schulze, T., Nöthen, M., Cichon, S., Rietschel, M., Leibenluft, E., Kustanovich, V., Lajonchere, C., Sutcliffe, J., Skuse, D., Gill, M., Gallagher, L., Mendell, N., Craddock, N., Owen, M., O’Donovan, M., Shaikh, T., Susser, E., DeLisi, L., Sullivan, P., Deutsch, C., Rapoport, J., Levy, D., King, M., & Sebat, J. (2009). Microduplications of 16p11.2 are associated with schizophrenia Nature Genetics DOI: 10.1038/ng.474
UPDATE: I just revisited my 20th may 2008 post on the matter and realized how prophetic my musings were. Reproducing part of it below the fold for the benefit of newbies to this blog:
CNVs on the other hand present a different model of disease. One can have one or more types of CNVs (deletions, duplications, multiple duplications etc) associated with the same genetic code sequence and this in my view would lead to spectrum like diseases where one may find variations along a continuum on a particular trait- based on how many copies of the genetic sequence one has. One would remember that I adhere to a spectrum based view of schizophrenia/psychosis and also a spectrum based view of Autism. Moreover I believe that Schizophrenia and Autism are the opposite ends of the spectrum, whose middle is normalcy and that the appropriate traits may have to do with social brain, creativity etc.
now as it happen previous research has also found that CNVs are also found to a higher extent in autistics. Moreover, research has indicated that the same chromosomal regions have CNVs in both Autism and Schizophrenia. To me this is exciting news. Probably the chromosomal region (neurexin related is one such region) commonly involved in both schizophrenia and autism is related to cognitive style, creativity and social thinking. Qualitatively (deletions as opposed to duplications) and quantitatively (more duplications) different type of CNVs may lead to differential eruption of either Schizophrenia or Autism as the same underlying neural circuit gets affected due to CNVs, though in a different qualitative and quantitative way.
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