Molecular Psychiatry

Major depressive disorders (MDD) are predicted to become the first cause of burden of disease worldwide in 2030, but 30% of patients still do not respond to antidepressants. Current rodent models of MDD mainly result either from one genetic or one environmental risk factor exposure, not recapitulating the multifactorial and polygenic nature of MDD. We recently generated a polygenic mouse model of MDD from selective breeding after mild stress in the Tail Suspension Test (TST), named H-TST. Here, we selected animals exhibiting high immobility during the Forced Swim Test (FST) to generate a new stable polygenic model of MDD, called H-FST. Unlike our previous H-TST model, H-FST mice did not exhibit any anxiety-or anhedonia-like behaviors, nor did they display any sleep disturbances. Moreover, H-TST and H-FST mice showed opposite response after administration of various antidepressant treatments. The gene expression level in the prefrontal cortex of H-TST and H-FST mice revealed little overlap in genes and biological pathways associated with depressive-like behaviors and opposite dysregulation of excitatory/inhibitory synaptic imbalance. Finally, these two models allowed in humans the identification biomarkers of treatment response specific of clinical subgroup of patients.

Postpartum depression (PPD) arises during a period of profound endocrine and immune reorganisation, yet it is unclear whether women who develop PPD show distinct trajectories of immune-related DNA methylation compared to euthymic mothers. In a longitudinal cohort, women with PPD (n = 17) and healthy postpartum controls (n = 24) were followed from birth to 12 weeks postpartum, with repeated assessment of depressive symptoms and perceived stress and whole-blood sampling at 2-3 days (T0) and 12 weeks (T4) for Infinium MethylationEPIC array profiling. Healthy postpartum women showed a widespread gain in DNA methylation from T0 to T4 with strong enrichment of genes involved in neutrophil activation, chemokine signalling and interleukin-1 production, consistent with a normative immune-epigenetic down-tuning after childbirth. Women with PPD also exhibited immune-related changes, but with fewer differentially methylated CpGs and increased variance at sites that were stably hypermethylated in controls, indicating an attenuated and more heterogeneous epigenetic response. Although no CpG reached epigenome-wide significance in direct case-control contrasts, longitudinal consistency analyses highlighted a small set of CpGs with reproducible PPD-associated hypermethylation in stress- and signalling-related genes, including FKBP5 and AVP, suggesting that disrupted immune-epigenetic adaptation and altered regulation at these loci may contribute to postpartum vulnerability.

Suicide is a leading cause of death worldwide, yet the biological mechanisms underlying suicide remain poorly understood. A clearer understanding at the molecular level is essential for developing objective biomarkers and targeted interventions. In this study, we used transcriptomic profiling to investigate gene expression patterns associated with suicidal thoughts and behaviors across peripheral blood (n=264) and postmortem brain tissue from two prefrontal regions (dorsolateral prefrontal cortex, DLPFC; subgenual anterior cingulate cortex, sgACC) of individuals with and without psychiatric illness (n=249). Peripheral analyses revealed broad transcriptional changes associated with suicidal thoughts and behaviors, marked by dysregulated immune-related and inflammatory processes. Longitudinal modeling further revealed gene co-expression modules that predicted future suicide attempts over a 12-month follow-up, highlighting processes related to apoptosis, mitochondrial function, and immune regulation. By contrast, transcriptomic analyses of postmortem tissue derived from the DLPFC and sgACC revealed largely suppressed neuroimmune activity. Gene co-expression analyses in the brain identified suicide-associated modules enriched for synaptic plasticity, oxidative stress, and neuroimmune function, some of which displayed regional specificity. Cross-tissue comparison showed minimal gene-level overlap between brain and blood, although shared pathway-level themes emerged in immune, sensory, and cellular stress processes. Taken together, these findings suggest that suicide is associated with distinct but functionally convergent transcriptional alterations across brain and blood. By integrating tissue-specific and systems-level molecular signatures, this work provides insight into the biological architecture of suicide and lays the groundwork for developing novel biomarkers and therapeutic targets to improve prevention and treatment outcomes.

Psilocybin, a serotonergic psychedelic, can produce rapid and enduring antidepressant effects in patients with major depressive disorder (MDD)[1, 2], yet the neural mechanisms underlying these effects remain unclear. Negative affective biases are an important neuropsychological mechanism central to the development and perpetuation of MDD[3]. Using a translational rodent model, we previously demonstrated that psilocybin modulates negative affective biases which, we hypothesize, contribute to its antidepressant effects[4]. Here, we identify the prelimbic subregion (PrL) of the rat medial prefrontal cortex (mPFC) as a key locus for the modulation of affective biases by psilocin, the active metabolite of psilocybin, and reveal a cell-type-specific bidirectional regulation of synaptic transmission. Psilocin selectively suppressed excitatory synaptic input to cortico-amygdala (CA) projection neurons, but enhanced excitatory transmission to other, putatively cortico-cortical, targets. Interestingly, suppression of the excitatory input to CA cells by psilocin, and modulation of affective biases by psilocybin, were both dependent on 5HT1A and 5HT2A receptor signaling. Consistent with the long-term therapeutic effects of rapidly acting antidepressants[1, 2, 4, 5], psilocin produced sustained changes to affective biases evident 24 hours after PrL infusion. In parallel, the suppressed excitatory transmission shifted to enhanced inhibitory synaptic input selectively in CA cells. Finally, chemogenetic inhibition of CA neurons in PrL recapitulated both the acute and sustained modulation of negative affective biases by psilocybin, as well as positively biasing new reward memories. Together, these findings identify modulation of the PrL cortico-amygdala circuit as a key substrate for affective bias modification by psilocybin, an effect which could explain its rapid and sustained antidepressant actions.

Neurodevelopmental disorders (NDDs) encompass heterogeneous cognitive, motor, and psychiatric manifestations that typically require extensive behavioural assessments for characterization. Individuals carrying 16p11.2 copy number variations (CNVs), including both deletions and duplications, represent a relatively common NDD subgroup marked by wide variability in psychiatric symptoms, as well as metabolic and peripheral abnormalities, complicating prediction of disease trajectory and treatment response. The identification of biomarkers in easily accessible tissues, such as peripheral blood mononuclear cells (PBMCs), could provide valuable tools for diagnosis and prognosis, yet remains an unmet clinical need. Converging evidence implicates dysregulation of ubiquitous signalling pathways, including ERK and mTOR cascades, in altered protein synthesis across both idiopathic and genetic NDDs. Here, using a hypothesis-driven screening approach, we examined candidate peripheral biomarkers in individuals with 16p11.2 deletions and duplications. We identified a significant reduction of ribosomal protein S6 kinase (p70S6K) levels in PBMCs across both genotypes. Notably, the magnitude of p70S6K reduction correlated with the severity of autistic symptoms independently of CNV genotype. In parallel, MAPK3/ERK1 protein levels mirrored gene dosage, showing increased expression in duplication carriers and reduced levels in deletion carriers, in accordance with the genotype. Collectively, these findings indicate that peripheral molecular alterations may support clinical stratification and suggest that p70S6K represents a promising biomarker for symptom severity and potentially treatment responsiveness in NDD patients carrying 16p11.2 CNVs.

Mutations in SCN2A, which encodes the voltage-gated sodium channel Nav1.2, are associated with a wide spectrum of neurodevelopmental and neuropsychiatric disorders, including epilepsy, autism spectrum disorder (ASD), and schizophrenia. Although dysfunction of SCN2A-dependent neural circuits has been implicated in these disorders, the circuit mechanisms underlying social behavioral abnormalities remain poorly understood. Here, we investigated the neural circuit basis of social behavioral deficits associated with Scn2a dysfunction, focusing on the nucleus accumbens (NAc), a key hub in cortico-limbic circuits that regulates emotional and motivational behaviors. Using conditional genetic and chemogenetic approaches in mice, we examined the roles of dorsal telencephalic excitatory neurons, including those in the cerebral cortex, hippocampus, and amygdala, as well as parvalbumin-positive fast-spiking interneurons (PV FSIs) in the NAc. Mice with Scn2a haploinsufficiency in dorsal telencephalic excitatory neurons (Scn2afl/+/Emx1-Cre) exhibited reduced sociability in the three-chamber social interaction test. Similarly, chemogenetic inhibition of NAc PV FSIs decreased sociability without affecting locomotor activity or anxiety-like behavior. Scn2afl/+/Emx1-Cre mice also showed a trend toward reduced prepulse inhibition of the acoustic startle response. Notably, dopamine release into the NAc in the Scn2afl/+/Emx1-Cre and systemic Scn2a heterozygous knockout (Scn2a+/-) mice was largely comparable to that in control mice. Together, these findings indicate that reduced activity of dorsal telencephalic excitatory neurons or NAc PV FSIs is sufficient to impair sociability independently of mesolimbic dopamine hypofunction. Our results highlight a potential role of cortico-accumbal circuits in social behavioral deficits associated with SCN2A dysfunction.

Schizophrenia (SCZ) is increasingly linked to neuroimmune dysregulation and impaired synaptic plasticity, yet the cellular mechanisms connecting inflammatory signaling to neural dysfunction remain poorly understood. Using human induced pluripotent stem cell (iPSC)-derived cortical spheroids (hCS) and astrocytes from patients with SCZ and matched controls, we investigated the effects of GABAA receptor modulation on immune signaling and neuroplasticity. Inflammatory stimulation induced robust interferon-responsive transcriptional programs, prominently involving the antiviral effector MX1 and related interferon-stimulated genes. Computational deconvolution and cell type-specific analyses identified astrocytes as key mediators of these responses. Muscimol, a non-classic psychedelic and GABAA receptor agonist, suppressed inflammatory gene expression, reduced secretion of proinflammatory cytokines, and attenuated interferon-associated signaling. In addition, muscimol induced neuroplasticity-associated transcriptional programs, including upregulation of NTRK2 and ELK1 in hCSs, and restored impaired glutamate uptake in iPSC-derived SCZ astrocytes. These effects were blocked by GABAA receptor inhibition, confirming receptor-dependent mechanisms. Proteomic analyses of hCS cultures, and independent human dorsolateral prefrontal cortex datasets revealed baseline dysregulation of GABAergic and neurotrophin signaling in SCZ, supporting translational relevance. Together, these findings demonstrate that GABAA receptor activation by muscimol suppresses inflammatory signaling while promoting neuroplasticity in hCSs, and identify astrocytes as central regulators of interferon-dependent neuroimmune dysfunction in SCZ. These results establish non-classic psychedelic compounds as potential modulators of neuroimmune-plasticity coupling and suggest that targeting astrocyte GABAergic signaling may represent a therapeutic strategy for restoring neural homeostasis in SCZ.

Psychedelics show therapeutic potential for treating psychiatric disorders. While studies have emphasized the roles of cortical pyramidal cells, GABAergic neurons also express serotonin receptors and are therefore likely targets of psychedelics. In this study, we determine the effect of psilocybin on the activity dynamics of major GABAergic cell types in the mouse medial frontal cortex. Psilocybin reduces the firing of somatostatin-expressing interneurons, but increases the activity of parvalbumin-expressing interneurons. This cell type-specific response is unlikely to involve vasoactive intestinal peptide-expressing interneurons. Instead, pharmacological blockade and conditional knockout experiments demonstrate that psilocybin acts on the 5-HT1A receptor at SST interneurons, which contributes to the drugs long-term behavioral effects. Collectively, the results reveal that the classic psychedelic psilocybin alters cortical inhibition in a cell type-specific manner.

The 7-nicotinic acetylcholine receptor (7nAChR) has driven extensive research over the past three decades for its pro-cognitive potential. It is the leading druggable target for the cognitive deficits associated with schizophrenia and has motivated major pharmaceutical and clinical efforts to ameliorate similar impairments in other neurological disorders, such as Alzheimers disease (AD). Yet, a systematic evaluation of the role played by 7nAChR in cognition, and its mechanistic underpinnings, is still lacking. Here we report that 7nAChRs on principal and inhibitory forebrain neurons are largely inconsequential to mouse behavior, including in domains that are most sensitive to schizophrenia-related cognitive impairments. By contrast, loss of 7nAChR from astrocytes produces profound behavioral alterations that are cognitive domain-specific, are time-of-day dependent, coincide with reduced levels of the N-methyl D-aspartate receptor (NMDAR) co-agonist D-serine, and are fully restored by D-serine supplementation. Further, an 7nAChR partial agonist previously evaluated in Phase III trials for cognitive enhancement in schizophrenia and AD fails to augment behavior in mice lacking astrocytic 7nAChRs. Together, these findings identify astrocytes and D-serine/NMDAR signaling as a central mechanism through which 7nAChR, a major drug target, promotes cognitive behavior.

Leucine-rich repeat-containing 8 (LRRC8) proteins form the volume-regulated anion channel (VRAC) and participate in diverse physiological processes, including cell volume regulation, gliotransmitter release, and insulin secretion. In mammals, five paralogs (LRRC8A-E) exist; LRRC8A is the obligatory subunit that assembles into functional hexameric channels with LRRC8C, D, or E. LRRC8B is distinct: we previously demonstrated its role in regulating endoplasmic reticulum (ER) Ca{superscript 2} homeostasis and ER Ca{superscript 2} leak. A LRRC8B variant (Y380S) identified in an Indian family with severe mental illness has been associated with disease pathology, but its molecular and cellular consequences remain unknown. Here, we show that this disease-associated mutant perturbs Ca{superscript 2} signalling, mitochondrial bioenergetics, and redox homeostasis. Both wild-type and mutant LRRC8B localize to the ER and mitochondria. LRRC8B knockdown significantly reduced mitochondrial Ca{superscript 2} uptake and maximal respiratory the Y380S mutant phenocopied LRRC8B knockdown, altering ER Ca{superscript 2} release, elevating basal cytosolic Ca{superscript 2}, and impairing mitochondrial Ca{superscript 2} uptake, consistent with a dominant-negative mechanism. The mutant further induced mitochondrial dysfunction, including loss of membrane potential, oxidative stress, and defective antioxidant responses, ultimately compromising cellular bioenergetics and viability. Mechanistically, the Y380S mutation disrupted LRRC8B interaction with the mitochondrial outer membrane channel VDAC. These findings identify LRRC8B-VDAC coupling as a key determinant of mitochondrial Ca{superscript 2} handling and provide a mechanistic link between LRRC8B dysfunction and neuropsychiatric disease. HighlightsO_LIA psychiatric disease-associated LRRC8B variant (Y380S) acts as a dominant-negative regulator of ER Ca{superscript 2} homeostasis. It enlarges the releasable ER Ca{superscript 2} pool and reduces cell viability. C_LIO_LILRRC8B promotes mitochondrial Ca{superscript 2} uptake through interaction with VDAC. The Y380S mutation disrupts this interaction, reducing mitochondrial Ca{superscript 2} uptake. C_LIO_LIThe Y380S mutant increases mitochondrial superoxide production without activating compensatory antioxidant responses. C_LIO_LIThe mutant also causes mitochondrial membrane depolarization and bioenergetic failure, as evidenced by reduced oxygen consumption rate and ATP production. C_LI Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=140 SRC="FIGDIR/small/718892v1_ufig1.gif" ALT="Figure 1"> View larger version (47K): org.highwire.dtl.DTLVardef@171fda8org.highwire.dtl.DTLVardef@c43f15org.highwire.dtl.DTLVardef@998d0org.highwire.dtl.DTLVardef@faee4_HPS_FORMAT_FIGEXP M_FIG C_FIG

Antipsychotic drugs are the first-line treatment for psychosis yet their mechanism of action remains poorly understood, largely due to the challenge to faithfully model psychosis preclinically. Here, we focus on the emerging concept that psychosis can be caused by brain autoimmunity and present a novel mouse model of anti-N-methyl-D-aspartate-receptor (anti-NMDAR) encephalitis, a condition that manifests with psychosis and autoanti-bodies against the NMDAR. We devised a new mRNA-based approach to immunize mice against the NMDAR. Immunized mice developed psychosis-like behaviors that were caused by anti-NMDAR autoantibodies leading to phagocytosis of NMDARs by brain microglia. The antipsychotic drug clozapine rescued psychosis-like behaviors and, remarkably, reduced anti-NMDAR autoantibody levels and antibody-mediated phagocytosis of NMDARs. The immunomodulatory effects of clozapine were confirmed in a mouse model of systemic lupus erythematosus. Our results demonstrate that clozapine suppresses autoimmunity driving psychosis-like behaviors, raising the possibility that immunomodulation contributes to antipsychotic drug action. HIGHLIGHTSO_LImRNA immunization against the NMDAR induces psychosis-like behavior in mice C_LIO_LIAnti-NMDAR autoantibodies are sufficient for psychosis-like behavior C_LIO_LIMicroglial phagocytosis of NMDARs mediates psychosis-like behavior induced by anti-NMDAR autoanti-bodies. C_LIO_LIClozapine reduces anti-NMDAR autoantibodies, microglial phagocytosis and psychosis-like behavior, consistent with immunomodulation as a potential mechanism of antipsychotic drug action. C_LI

BackgroundSchizophrenia is a neurodevelopmental disorder shaped by immune-related mechanisms, particularly dysregulated complement-mediated synaptic pruning. Genome-wide association studies have identified CSMD1 as a major schizophrenia risk gene, an association robustly replicated across populations of diverse ancestries. As a complement regulator, CSMD1 further links genetic vulnerability to synaptic refinement processes. However, the transcriptional status of CSMD1 and its homolog CSMD2 in individuals with schizophrenia (SZ individuals) remains poorly characterized. We conducted a meta-analysis of gene-expression datasets to determine whether CSMD1 and CSMD2 are differentially expressed in brain and peripheral tissues, and to assess the concordance between central and peripheral transcriptional signals. MethodsTranscriptional data were obtained from gene expression omnibus. Random-effects meta-analyses were performed on CSMD1 and CSMD2 expression data from 854 postmortem brain samples derived from 348 SZ individuals and 346 healthy controls (HC), and 295 peripheral blood samples from 162 SZ individuals and 133 HC. Sex-stratified analyses and meta-regressions evaluated potential moderators. ResultsIn brain tissues, CSMD2 expression was significantly increased in SZ individuals vs. HC (SMD: 0.22 [0.05; 0.39], adj-p=0.026), whereas CSMD1 showed no differential expression. The female-only meta-analysis revealed nominal CSMD2 overexpression (p=0.037) in brain tissues, not surviving correction. No significant transcriptional differences were detected in peripheral blood. ConclusionIn schizophrenia, our findings point to a dissociation between genetic vulnerability and transcriptional activity within the CSMD gene family. Schizophrenia is associated with selective brain CSMD2 overexpression, contrasting with unchanged CSMD1 transcription and absent peripheral blood alterations. These findings support complement-related dysregulation as a central pathway in schizophrenia.

Several neurodevelopmental disorders (NDDs) are characterized by impairments in social behavior and affective dysregulation. Converging evidence implicates the endocannabinoid system in the control of both behaviors. However, the brain region-specific contribution of cannabinoid receptor type 1 (CB1R) signaling to these NDD-relevant phenotypes remains unclear. The anterior insular cortex (aINS) is a key integrative hub involved in socio-emotional processing and social novelty recognition. Whether CB1Rs within this region are sufficient to regulate behavioral domains disrupted in NDDs remains unclear. Here, we employed a Cre-dependent viral strategy to selectively restore CB1R mRNA expression in the aINS of global CB1R-deficient mice. Region-specific rescue of CB1R in the aINS normalized social novelty discrimination and reduced anxiety-like behavior as compared to mice lacking CB1R, while leaving basal sociability and locomotor activity unaffected. In addition, insular CB1R re-expression modulated repetitive-like behaviors without broadly altering other behavioral domains. These effects were observed in the absence of off-target expression, supporting the specificity of the genetic manipulation. Our findings demonstrate that CB1R mRNA expression within the aINS is sufficient to regulate distinct socio-emotional and repetitive behavioral domains. These results identify the aINS as a critical CB1-dependent modulatory node and provide mechanistic insight into how region-specific endocannabinoid signaling contributes to behavioral phenotypes relevant to NDDs.

AO_SCPLOWBSTRACTC_SCPLOWAltered social behaviors are prevalent in neurodevelopmental disorders like monogenic Rett syndrome, which is caused by pathogenic variants in the gene encoding the methylated DNA binding transcriptional regulator MeCP2. Monosynaptic projections from the ventral hippocampus to the medial prefrontal cortex (mPFC) modulate social memory, and are altered in male Mecp2 knockout (KO) mice. The standard tube test was used to define the social hierarchy between age- and genotype-matched triads over six consecutive days of round-robin competitions, and revealed that male Mecp2 KO mice form social ranks but display more submissive behaviors than those observed between similarly aged triads of male wild-type (WT) littermate controls. The same triads of each genotype performed similarly in the warm spot test, where mice of each genotype compete to stand on a single warm spot in a cage with a cooled floor. The dominant WT mouse from the prior tube test had preferential and active access to the beneficial place in the competition test (warm spot) showing more dominant behaviors than the other two WT mice. On the contrary, all three Mecp2 KO mice shared the warm spot equally, showing more submissive behaviors than those observed between the three WT mice. In vivo Ca2+ imaging from pyramidal neurons in the prelimbic mPFC during the warm spot test confirmed the presence of socially sensitive neurons, i.e., neurons that either increase or decrease their spiking activity during social interactions. mPFC pyramidal neurons in male Mecp2 KO mice showed fewer and smaller Ca2+ transients during baseline, as well as during each social interaction in the warm spot test, when their activity is less synchronous than in those of WT mice. In addition, chronically inhibiting the activity of mPFC-projecting excitatory neurons of the ventral hippocampus using an intersectional DREADD approach restored behavioral deficits in male Mecp2 KO mice. Together, these results demonstrate that male Mecp2 mice show a low behavioral engagement during social competition tests that alters their social hierarchy and is reflected in altered activity and synchrony between mPFC pyramidal neurons. Our observations also underscore the potential relevance of this long-range projection for altered social behaviors in other mouse models of neurodevelopmental disorders associated with autism.

Twin studies reveal high genetic overlap between anxiety disorders and depression, contributing to the internalising spectrum. Some genetic specificity for fear-based anxiety disorders (fear), distinct from general anxiety and depression (distress), has also emerged. Limited datasets with detailed phenotyping across anxiety disorders have restricted most genome-wide association studies (GWAS) to "any anxiety diagnosis". Additional genome-wide evidence to discern genetic differences between fear and distress is required. We conducted GWAS meta-analyses of fear (panic, agoraphobia, specific phobia, social anxiety disorder) and generalised anxiety disorder (GAD), measured using brief single-item and detailed symptom-based diagnoses from three datasets. We explored two control group criteria: phenotype-specific (fear/GAD) or broader anxiety/depression screening. We identified one SNP-based independent locus and three gene-level genome-wide significant (GWS) associations with fear (up to 35,523 Ncases; 157,447 Ncontrols). Four GWS SNP-based loci and three gene-level loci were associated with GAD (up to 60,879 Ncases; 117,064 Ncontrols). The genetic correlation between fear and GAD was significantly different from unity only when excluding a depression-enriched dataset and using phenotype-specific control screening (rg = 0.87; P = 9.32 x 10-3). Most complex traits had statistically similar genetic correlations with fear and GAD, including depression. Exceptions included general cognitive ability, educational attainment, and coronary artery disease, showing statistically stronger genetic correlations with fear than GAD, while bipolar disorder type I, anorexia nervosa, and neuroticism displayed the opposite pattern. Our findings partially support a distress-fear genetic distinction, but show stronger evidence for an overarching genetic liability to internalising psychopathology driving comorbidity across anxiety disorders and depression.

Disruption of social behavior is a core feature of autism spectrum disorder (ASD), yet the molecular and cellular mechanisms governing social behavior development are not well understood. We previously identified topoisomerase II (Top2a) as a critical regulator of social behavior and restricted and repetitive behavior through antagonism of polycomb repressive complex 2 (PRC2)-mediated H3K27 trimethylation (H3K27me3), based mainly on pharmacological perturbations during embryogenesis in zebrafish and mouse. However, whether neuronal Top2a is genetically required for social behavior in mammals, and whether PRC2 inhibition can rescue genetically induced social deficits, remain untested. Here, we establish a neuron-specific Top2a conditional knockout mouse model and demonstrate that neuronal Top2a haploinsufficiency selectively impairs social interaction without inducing restricted and repetitive behaviors or cognitive deficits. Pharmacological inhibition of PRC2 using the EZH2 inhibitor tazemetostat, combined with elacridar to facilitated blood-brain barrier penetration, robustly rescues social deficits in Top2a conditional knockout mice. Strikingly, a one-week oral dosing regimen produced a rescue effect that persisted for up to two months after treatment cessation, far exceeding the temporal window typically observed for neuromodulatory drugs targeting neurotransmitter systems. These results showcase the unique capability of epigenetic modulatory therapy to induce durable behavioral improvements and their therapeutic potential for treating social dysfunction in neuropsychiatric disorders. Together, our results provide direct genetic evidence that neuronal Top2a governs social behavior in mice and establish the neuronal Top2a-PRC2 axis as a conserved, targetable epigenetic pathway regulating social behavior.

A growing number of studies point to a key role of the amygdala in Autism Spectrum Disorders (ASD). The amygdala is involved in several processes in ASD including emotional valence, facial recognition, regulation of social learning, empathy, and anxiety. Brain imaging and postmortem studies demonstrate altered amygdala development in children with ASD, associated with impairment in social behavior and anxiety. There is limited information regarding the molecular pathology of the amygdala in children with ASD. We conducted RNAseq profiling on postmortem amygdala samples from male children (4-14 yrs old) with ASD (n=8) and normotypic male children (n=6). Furthermore, we conducted drug repurposing analysis to identify compounds predicted to reverse the transcriptomic signatures identified in order to identify potential therapeutic targets for development of early intervention treatments. Full transcriptome gene expression profiling implicated molecular pathways involved in neuroimmune signaling, glycogen and carbohydrate metabolism, matrix metalloproteases, neurodevelopment, estrogen receptor signaling, and synaptic signaling. Targeted pathway analysis of the top 10% of differentially expressed genes implicated pathways involved in extracellular matrix organization, immune signaling, and synaptic signaling. Our drug repurposing analysis identified sleep modifying compounds and anti-inflammatory compounds including COX2 and GSK3 inhibitors amongst the top predicted therapeutic compound classifications. PDGF receptor tyrosine kinase inhibitors were identified as a top potential therapeutic mechanism of action. Our results point to alterations in immune signaling, extracellular matrix organization, and synaptic signaling in the amygdala of children with ASD. Furthermore, our results identified a number of potential therapeutic drug targets for development of early intervention strategies.

In a pooled analysis of 3 prospective studies in adults with mood disorders, EMOCARE depressive symptom severity scores derived from passive multimodal remote monitoring showed moderate-to-strong convergent validity and sensitivity to change versus established clinician- and self-rated symptom scales, including the Montgomery-[A]sberg Depression Rating Scale (MADRS) and Patient Health Questionnaire-9 (PHQ-9).

Background: The Neuro-Immune-Metabolic-Oxidative Stress (NIMETOX) theory identified systemic dysregulation in Major Depressive Disorder (MDD), yet the precise gut-derived metabolic triggers initiating this cascade remain elusive. This study investigated the interplay between fecal short-chain fatty acids (SCFAs), systemic immune activation, and clinical phenotypes to identify a potential gut-immune biotype for MDD. Methods: Fecal SCFA profiles and serum immune-inflammatory markers were quantified in 102 patients with MDD and 38 matched healthy controls. A multistage statistical approach was employed: binary logistic regression and 10-fold cross-validated linear discriminant analysis (LDA) were utilized to evaluate diagnostic accuracy, while multivariable regression models were applied to identify robust predictors of clinical phenotypes, including the overall severity of depression (OSOD), physiosomatic symptoms, and recurrence of illness (ROI). Results: MDD patients exhibited a significant depletion of protective straight-chain SCFAs (acetate, propionate, butyrate) and an elevation in branched-chain SCFAs (BSCFAs), indicating a pathological shift from saccharolytic to proteolytic fermentation. This metabolic shift correlated with elevated acute phase-inflammatory index (API) and epidermal growth factor (EGF). A multidimensional model combining BSCFAs, acetate, API, EGF, and T helper 2 discriminated MDD from controls with adequate accuracy (AUC = 0.874). Furthermore, elevated BSCFAs and decreased protective SCFAs strongly predicted higher OSOD, more severe physiosomatic symptoms, and increased ROI. Notably, 5-Hydroxytryptamine receptor 1A agonists were independently associated with elevated BSCFAs. Conclusion: MDD is characterized by a distinct gut-immune biotype tightly linked to toxic proteolytic gut fermentation. This metabolic-immune fingerprint offers an objective diagnostic tool and highlights the need for microbiome-targeted interventions in precision psychiatry.

Major psychiatric disorders typically emerge in youth and exhibit shared and disorder-specific behavioral phenotypes and neuroanatomical alterations, yet the transdiagnostic neurobehavioral gradients and environmental interactions contributing to this heterogeneity remain poorly understood. Here, we present a transdiagnostic cohort of 1,755 youths aged 10-24 years, including 1,040 patients with bipolar disorder (BD), major depressive disorder (MDD), or schizophrenia spectrum disorder, and 715 healthy controls. Individualized gray matter volume (GMV) were quantified relative to population-based norms and integrated with behavioral phenotypes and environmental exposures. We identified transdiagnostic severity gradients across emotional and non-emotional symptoms, cognition, and personality traits, alongside widespread negative GMV deviations and diagnosis-specific effects in the pars opercularis and posterior cingulate, key hubs of the action-mode network orchestrating goal-directed functions. Two brain-behavior modes were identified: a cognitive mode linking posterior cortical variation with processing speed and an emotional mode associating prefrontal regions and the paracentral lobule with self-injurious behaviors. Further analyses indicated that adverse social environments were indirectly associated with brain structural deviations through behavioral pathways in BD and MDD, whereas air pollution (PM2.5) specifically moderated brain-behavior relationships in MDD. Together, these findings elucidate transdiagnostic neurobehavioral gradients across youth psychiatric disorders, with environmental exposures differentially embedded within neurobehavioral systems.