Mutations in ASH1L confer susceptibility to Tourette syndrome

Mol Psychiatry. 2020 Feb;25(2):476-490. doi: 10.1038/s41380-019-0560-8. Epub 2019 Oct 31.

Abstract

Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by repetitive motor movements and vocal tics. The clinical manifestations of TS are complex and often overlap with other neuropsychiatric disorders. TS is highly heritable; however, the underlying genetic basis and molecular and neuronal mechanisms of TS remain largely unknown. We performed whole-exome sequencing of a hundred trios (probands and their parents) with detailed records of their clinical presentations and identified a risk gene, ASH1L, that was both de novo mutated and associated with TS based on a transmission disequilibrium test. As a replication, we performed follow-up targeted sequencing of ASH1L in additional 524 unrelated TS samples and replicated the association (P value = 0.001). The point mutations in ASH1L cause defects in its enzymatic activity. Therefore, we established a transgenic mouse line and performed an array of anatomical, behavioral, and functional assays to investigate ASH1L function. The Ash1l+/- mice manifested tic-like behaviors and compulsive behaviors that could be rescued by the tic-relieving drug haloperidol. We also found that Ash1l disruption leads to hyper-activation and elevated dopamine-releasing events in the dorsal striatum, all of which could explain the neural mechanisms for the behavioral abnormalities in mice. Taken together, our results provide compelling evidence that ASH1L is a TS risk gene.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Child
  • Child, Preschool
  • China
  • DNA-Binding Proteins / genetics*
  • DNA-Binding Proteins / metabolism
  • Exome Sequencing / methods
  • Family
  • Female
  • Genetic Predisposition to Disease / genetics
  • Histone-Lysine N-Methyltransferase / genetics*
  • Histone-Lysine N-Methyltransferase / metabolism
  • Humans
  • Male
  • Mice
  • Mice, Transgenic
  • Middle Aged
  • Mutation / genetics
  • Parents
  • Tic Disorders / genetics
  • Tourette Syndrome / complications
  • Tourette Syndrome / genetics*
  • Transcription Factors / genetics

Substances

  • DNA-Binding Proteins
  • Transcription Factors
  • ASH1L protein, human
  • Ash1l protein, mouse
  • Histone-Lysine N-Methyltransferase