Association Study of Wnt Signaling Pathway Genes in Bipolar Disorder

Peter P. Zandi, Akula N, Cabanero M, Cardona I, Corona W, Klemens B, Schulze TG, Cichon S, Rietschel M, Nothen MM, Georgi A, Schumacher J, Schwarz M, Abou JR, Hofels S, Propping P, Satagopan J, Detera-Wadleigh SD, Hardy J, McMahon FJSherrington R, FA O'Neill, Walsh D, Kendler KS, Ekelund J, Paunio T, Lonnqvist J, Peltonen L, O'Donovan MC, Owen MJ, Wildenauer DB, Maier W, Nestadt G, Blouin JL, Antonarakis SE, Mowry BJ, Silverman JM, Crowe RR, Cloninger CR, Tsuang MT, Malaspina D, Harkavy-Friedman JM, Svrakic DM, Bassett AS, Holcomb J, Kalsi G, McQuillin A, Brynjolfson J, Sigmundsson T, Petursson H, Jazin E, Zoega T, Helgason T, Spence MA, Luebbert H, Adams LJ, Donald JA, Mitchell PB, Barden N, Shink E, Byerley W, Muir W, Visscher PM, Macgregor S, Gurling H, Kalsi G, McQuillin A, Escamilla MA, Reus VI, Leon P, Freimer NB, Ewald H, Kruse TA, Mors O, Radhakrishna U, Blouin JL, Antonarakis SE, Akarsu N

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57 Citations (Scopus)



The Wnt signaling pathways promote cell growth and are best known for their role in embryogenesis and cancer. Several lines of evidence suggest that these pathways might also be involved in bipolar disorder.


To test for an association between candidate genes in the Wnt signaling pathways and disease susceptibility in a family-based bipolar disorder study.


Two hundred twenty-seven tagging single- nucleotide polymorphisms (SNPs) from 34 genes were successfully genotyped. Initial results led us to focus on the genePPARD, in which we genotyped an additional 13 SNPs for follow-up.


Nine academic medical centers in the United States.


Five hundred fifty-four offspring with bipolar disorder and their parents from 317 families.

Main Outcome Measures

Family-based association using FBAT and HBAT (; Harvard School of Public Health, Boston, Massachusetts). Exploratory analyses testing for interactions ofPPARDSNPs with clinical covariates and with other Wnt genes were conducted with GENASSOC (Stata Corp, College Station, Texas).


In the initial analysis, the most significantly associated SNP was rs2267665 inPPARD(nominalP < .001). This remained significant atP = .05 by permutation after accounting for all SNPs tested. Additional genotyping inPPARDyielded 4 SNPs in 1 haplotype block that were significantly associated with bipolar disorder (P < .01), the most significant being rs9462082 (P < .001). Exploratory analyses revealed significant evidence (P < .01) for interactions of rs9462082 with poor functioning on the Global Assessment Scale (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.85-6.08) and with SNPs inWNT2B(rs3790606: OR, 2.56; 95% CI, 1.67-4.00) andWNT7A(rs4685048: OR, 1.79; 95% CI, 1.23-2.63).


We found evidence for association of bipolar disorder withPPARD,a gene in the Wnt signaling pathway. The consistency of this result with one from the Wellcome Trust Case-Control Consortium encourages further study. If the finding can be confirmed in additional samples, it may illuminate a new avenue for understanding the pathogenesis of severe bipolar disorder and developing more effective treatments.

Original languageEnglish
Pages (from-to)785
Number of pages1
JournalArchives of General Psychiatry
Issue number7
Publication statusPublished - 07 Jul 2008


  • bipolar disorder
  • genes
  • signal pathway
  • signal transduction pathways
  • single nucleotide polymorphism

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