The pathophysiology of restricted repetitive behavior

Restricted, repetitive behaviors (RRBs) are heterogeneous ranging from stereotypic body movements to rituals to restricted interests. RRBs are most strongly associated with autism but occur in a number of other clinical disorders as well as in typical development. There does not seem to be a category of RRB that is unique or specific to autism and RRB does not seem to be robustly correlated with specific cognitive, sensory or motor abnormalities in autism. Despite its clinical significance, little is known about the pathophysiology of RRB. Both clinical and animal models studies link repetitive behaviors to genetic mutations and a number of specific genetic syndromes have RRBs as part of the clinical phenotype. Genetic risk factors may interact with experiential factors resulting in the extremes in repetitive behavior phenotypic expression that characterize autism. Few studies of individuals with autism have correlated MRI findings and RRBs and no attempt has been made to associate RRB and post-mortem tissue findings. Available clinical and animal models data indicate functional and structural alterations in cortical-basal ganglia circuitry in the expression of RRB, however. Our own studies point to reduced activity of the indirect basal ganglia pathway being associated with high levels of repetitive behavior in an animal model. These findings, if generalizable, suggest specific therapeutic targets. These, and perhaps other, perturbations to cortical basal ganglia circuitry are mediated by specific molecular mechanisms (e.g., altered gene expression) that result in long-term, experience-dependent neuroadaptations that initiate and maintain repetitive behavior. A great deal more research is needed to uncover such mechanisms. Work in areas such as substance abuse, OCD, Tourette syndrome, Parkinson’s disease, and dementias promise to provide findings critical for identifying neurobiological mechanisms relevant to RRB in autism. Moreover, basic research in areas such as birdsong, habit formation, and procedural learning may provide additional, much needed clues. Understanding the pathophysioloy of repetitive behavior will be critical to identifying novel therapeutic targets and strategies for individuals with autism

Identification Of Novel Molecular-Genetic Pathways Regulating The Development Of Subpallial Derivatives

The embryonic subpallium produces many different neuronal cell types present throughout the adult telencephalon, including striatal medium spiny neurons (MSN) and cortical interneurons. Dysfunction of either cell type leads to neurological and psychiatric disorders including schizophrenia, epilepsy, and Tourette’s syndrome. Thus, understanding the molecular pathways that regulate their development and function has important implications for understanding disease pathogenesis. This work describes novel methods and genetic factors that expand our ability to characterize the development and function of two major subpallial derivatives: cortical interneurons and striatal MSN. The first part of this thesis characterizes a novel enrichment method for producing parvalbumin-expressing (PV) interneurons from mouse embryonic stem cells. This method, which uses an atypical protein kinase C inhibitor to enhance intermediate neurogenesis, results in a markedly increased ratio of PV+ to somatostatin-expressing interneurons. The findings suggest that the mode of neurogenesis influences cortical interneuron fate determination. Moreover, PV+ interneurons can now be generated in large numbers to study their development, screen for factors that affect their physiology, and used in therapeutic applications. The second part of this thesis examines the function of two putative transcription factors, Zswim5 and Zswim6, in the regulation of striatal development. We show that these genes are expressed in subpallial precursors, and in the case of Zswim6, expressed in the adult striatum. Next, through the generation of Zswim5 and Zswim6 knockout mice, we provide a detailed anatomical, molecular, and behavioral characterization of the resulting phenotypes. Our findings reveal that loss of Zswim6 causes a reduction in striatal volume and morphological changes in MSN. Additionally, these structural changes are associated with alterations in motor behaviors including hyperactivity, impaired rotarod performance, and hyperresponsiveness to amphetamine. These results demonstrate that Zswim6 is indispensable for normal brain development and support findings in human genome-wide association studies that implicate Zswim6 with schizophrenia. Collectively, this dissertation provides novel insights into telencephalic development through the development of in vitro stem cell systems and in vivo disease mouse models that further our ability to test and understand neurological diseases

Convergent Evidence from Animal and Human Studies

Schizophrenia is a highly heritable disorder with diverse mental and somatic symptoms. The molecular mechanisms leading from genes to disease pathology in schizophrenia remain largely unknown. Genome-wide association studies (GWASs) have shown that common single-nucleotide polymorphisms associated with specific diseases are enriched in the recognition sequences of transcription factors that regulate physiological processes relevant to the disease. We have used a “bottom-up” approach and tracked a developmental trajectory from embryology to physiological processes and behavior and recognized that the transcription factor NK2 homeobox 1 (NKX2-1) possesses properties of particular interest for schizophrenia. NKX2-1 is selectively expressed from prenatal development to adulthood in the brain, thyroid gland, parathyroid gland, lungs, skin, and enteric ganglia, and has key functions at the interface of the brain, the endocrine-, and the immune system. In the developing brain, NKX2-1-expressing progenitor cells differentiate into distinct subclasses of forebrain GABAergic and cholinergic neurons, astrocytes, and oligodendrocytes. The transcription factor is highly expressed in mature limbic circuits related to context-dependent goal-directed patterns of behavior, social interaction and reproduction, fear responses, responses to light, and other homeostatic processes. It is essential for development and mature function of the thyroid gland and the respiratory system, and is involved in calcium metabolism and immune responses. NKX2-1 interacts with a number of genes identified as susceptibility genes for schizophrenia. We suggest that NKX2-1 may lie at the core of several dose dependent pathways that are dysregulated in schizophrenia. We correlate the symptoms seen in schizophrenia with the temporal and spatial activities of NKX2-1 in order to highlight promising future research areas

Molecular neuroanatomy: mouse-human homologies and the landscape of genes implicated in language disorders

The distinctiveness of brain structures and circuits depends on interacting gene products, yet the organization of these molecules (the "transcriptome") within and across brain areas remains unclear. High-throughput, neuroanatomically-specific gene expression datasets such as the Allen Human Brain Atlas (AHBA) and Allen Mouse Brain Atlas (AMBA) have recently become available, providing unprecedented opportunities to quantify molecular neuroanatomy. This dissertation seeks to clarify how transcriptomic organization relates to conventional neuroanatomy within and across species, and to introduce the use of gene expression data as a bridge between genotype and phenotype in complex behavioral disorders. The first part of this work examines large-scale, regional transcriptomic organization separately in the mouse and human brain. The use of dimensionality reduction methods and cross-sample correlations both revealed greater similarity between samples drawn from the same brain region. Sample profiles and differentially expressed genes across regions in the human brain also showed consistent anatomical specificity in a second human dataset with distinct sampling properties. The frequent use of mouse models in clinical research points to the importance of comparing molecular neuroanatomical organization across species. The second part of this dissertation describes three comparative approaches. First, at genome scale, expression profiles within homologous brain regions tended to show higher similarity than those from non-homologous regions, with substantial variability across regions. Second, gene subsets (defined using co-expression relationships or shared annotations), which provide region-specific, cross-species molecular signatures were identified. Finally, brain-wide expression patterns of orthologous genes were compared. Neuron and oligodendrocyte markers were more correlated than expected by chance, while astrocyte markers were less so. The localization and co-expression of genes reflect functional relationships that may underlie high-level functions. The final part of this dissertation describes a database of genes that have been implicated in speech and language disorders, and identifies brain regions where they are preferentially expressed or co-expressed. Several brain structures with functions relevant to four speech and language disorders showed co-expression of genes associated with these disorders. In particular, genes associated with persistent developmental stuttering showed stronger preferential co-expression in the basal ganglia, a structure of known importance in this disorder

Stereotypies in the autism spectrum disorder: Can we rely on an ethological model?

Background: Stereotypic behaviour can be defined as a clear behavioural pattern where a specific function or target cannot be identified, although it delays on time. Nonetheless, repetitive and stereotypical behaviours play a key role in both animal and human behaviour. Similar behaviours are observed across species, in typical human developmental phases, and in some neuropsychiatric conditions, such as Autism Spectrum Disorder (ASD) and Intellectual Disability. This evidence led to the spread of animal models of repetitive behaviours to better understand the neurobiological mechanisms underlying these dysfunctional behaviours and to gain better insight into their role and origin within ASD and other disorders. This, in turn, could lead to new treatments of those disorders in humans. Method: This paper maps the literature on repetitive behaviours in animal models of ASD, in order to improve understanding of stereotypies in persons with ASD in terms of characterization, pathophysiology, genomic and anatomical factors. Results: Literature mapping confirmed that phylogenic approach and animal models may help to improve understanding and differentiation of stereotypies in ASD. Some repetitive behaviours appear to be interconnected and mediated by common genomic and anatomical factors across species, mainly by alterations of basal ganglia circuitry. A new distinction between stereotypies and autotypies should be considered. Conclusions: Phylogenic approach and studies on animal models may support clinical issues related to stereotypies in persons with ASD and provide new insights in classification, pathogenesis, and management

Autism and Williams syndrome: Dissimilar socio-cognitive profiles with similar patterns of abnormal gene expression in the blood

Autism spectrum disorders and Williams syndrome exhibit quite opposite features in the social domain, but also share some common underlying behavioral and cognitive deficits. It is not clear, however, which genes account for the attested differences (and similarities) in the socio-cognitive domain. In this article, we adopted a comparative molecular approach and looked for genes that might be differentially (or similarly) regulated in the blood of subjects with these two conditions. We found a significant overlap between differentially expressed genes compared to neurotypical controls, with most of them exhibiting a similar trend in both conditions, but with genes being more dysregulated in Williams syndrome than in autism spectrum disorders. These genes are involved in aspects of brain development and function (particularly dendritogenesis) and are expressed in brain areas (particularly the cerebellum, the thalamus, and the striatum) of relevance for the autism spectrum disorder and the Williams syndrome etiopathogenesi

Animal models of tic disorders: A translational perspective

Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders