O’Connell, K. S., et al (2025).
Nature.
Abstract
Bipolar disorder is a leading contributor to the global burden of disease1. Despite high heritability (60–80%), the majority of the underlying genetic determinants remain unknown2. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.8 million controls), combining clinical, community and self-reported samples. We identified 298 genome-wide significant loci in the multi-ancestry meta-analysis, a fourfold increase over previous findings3, and identified an ancestry-specific association in the East Asian cohort. Integrating results from fine-mapping and other variant-to-gene mapping approaches identified 36 credible genes in the aetiology of bipolar disorder. Genes prioritized through fine-mapping were enriched for ultra-rare damaging missense and protein-truncating variations in cases with bipolar disorder4, highlighting convergence of common and rare variant signals. We report differences in the genetic architecture of bipolar disorder depending on the source of patient ascertainment and on bipolar disorder subtype (type I or type II). Several analyses implicate specific cell types in the pathophysiology of bipolar disorder, including GABAergic interneurons and medium spiny neurons. Together, these analyses provide additional insights into the genetic architecture and biological underpinnings of bipolar disorder.
Here are some thoughts:
The recent genomic study on bipolar disorder (BD) provides groundbreaking insights into its genetic architecture and biological mechanisms. By analyzing data from over 158,000 BD cases across diverse ancestries, researchers identified 298 genome-wide significant loci, marking a fourfold increase from previous findings. The study highlights distinct genetic variations associated with BD subtypes, such as bipolar I and II, and underscores the importance of GABAergic interneurons and medium spiny neurons in BD pathophysiology. Furthermore, ancestry-specific analyses reveal unique genetic contributions in East Asian populations, emphasizing the need for inclusivity in genomic research. These findings not only advance our understanding of BD but also pave the way for targeted therapies and precision medicine, offering hope for improved treatment outcomes. This landmark research underscores the value of integrating diverse genetic data to unravel complex psychiatric disorders.
