Pituitary dysmaturation affects psychopathology and neurodevelopment in 22q11.2 Deletion Syndrome. (March 2020)

• Record Type: Journal Article
• Authors: Sandini, Corrado; Chambaz, Maëlle; Schneider, Maude; Armando, Marco; Zöller, Daniela; Schaer, Marie; Sandi, Carmen; Van De Ville, Dimitri; Eliez, Stephan
• Is Part Of: Psychoneuroendocrinology. Volume 113(2020)
• Publication Date: 2020-03
• Subjects: Psychiatric comorbidity -- Hippocampus -- Cortical thickness -- HPA-axis -- Resilience; Psychoneuroendocrinology -- Periodicals; Endocrinology -- Periodicals; Neurology -- Periodicals; Psychiatry -- Periodicals; Neuropsychoendocrinologie -- Périodiques; 616.8
• DOI: 10.1016/j.psyneuen.2019.104540
• Languages: English
• ISSNs: 0306-4530

Abstract

Highlights: 222q11.2 Deletion Syndrome is characterized by reductions in pituitary volume emerging from longitudinal volumetric decline during adolescence. Declining pituitary volume is associated with reduced tolerance to stress and could indicate progressive extinction of HPA-axis functionality. Declining pituitary volume is associated with pleiotropic increase in psychopathology and to increased risk for psychiatric comorbidity. Declining pituitary volume is associated with blunted hippocampal growth and with atypical accelerated cortical thinning. Pituitary dysmaturation could represent an endophenotype associated with pleiotropic psychopathology and atypical neurodevelopment. Abstract: Background: 22q11.2 Deletion Syndrome (22q11DS) confers strongly increased genetic risk for multiple psychiatric disorders. Similarly to the general population, rates of psychiatric comorbidity suggest that common disease mechanisms are shared across dimensions of psychopathology. Such pleiotropic disease mechanisms remain however currently unknown. We hypothesized that pituitary dysmaturation, indicative of HPA-axis dysregulation, could correlate to reduced tolerance to daily life stressors and reflect pleiotropic risk factor for psychopathology. Moreover HPA-axis dysregulation could affect atypical cortical and hippocampal development previously described in 22q11DS. Methods: Pituitary volume, hippocampal volume and cortical thickness measures were obtained from T1-weighted MRI images in a large longitudinal cohort of youth with 22q11DS (115 subjects, 260 scans, age-range = 5.4–31.6) and healthy controls (151 subjects, 280 scans, age-range = 5.1–32.3). We explored effects of pituitary dysmaturation on tolerance to stress, psychopathology and neurodevelopment employing mixed-models linear regression. Associations of pituitary and cortical development were correlated with the expression pattern of glucocorticoid receptor gene NR3C1 obtained from the Allen-Human-Brain-Atlas. Results: We observed aberrant pituitary developmental trajectories in 22q11DS, with volumetric reductions emerging by young-adulthood (P = 0.0006). Longitudinal pituitary decline was associated with to reduced tolerance to stress (P = 0.04), higher overall psychopathology (P = 0.0003) and increased risk of psychiatric comorbidity (P = 0.02). Moreover, pituitary decline correlated with blunted growth of the right hippocampus (P = 0.03) and to increased cortical thinning of mostly temporal and orbitofrontal regions mediated by NR3C1 gene expression. Conclusion: Atypical pituitary development could reflect progressive extinction of HPAA due to chronic hyper-activation, in agreement with existing biochemical evidence in 22q11DS. HPAA dysregulation could represent and endophenotype that confers pleiotropic vulnerability to psychopathology and atypical neurodevelopment in 22q11DS.