About 35% of patients with 22q11 deletion syndrome (22q11DS), which includes DiGeorge and velocardiofacial syndromes, develops psychiatric disorders, mainly schizophrenia and bipolar disorder. We previously reported that mice carrying a multigene deletion (Df1) that models 22q11DS have reduced prepulse inhibition (PPI), a behavioral abnormality and schizophrenia endophenotype. Impaired PPI is associated with several psychiatric disorders, including those that occur in 22q11DS, and recently, reduced PPI was reported in children with 22q11DS. Here, we have mapped PPI deficits in a panel of mouse mutants that carry deletions that partially overlap with Df1 and have defined a PPI critical region encompassing four genes. We then used single-gene mutants to identify the causative genes. We show that PPI deficits in Df1͞؉ mice are caused by haploinsufficiency of two genes, Tbx1 and Gnb1l. Mutation of either gene is sufficient to cause reduced PPI. Tbx1 is a transcription factor, the mutation of which is sufficient to cause most of the physical features of 22q11DS, but the gene had not been previously associated with the behavioral͞psychiatric phenotype. A likely role for Tbx1 haploinsufficiency in psychiatric disease is further suggested by the identification of a family in which the phenotypic features of 22q11DS, including psychiatric disorders, segregate with an inactivating mutation of TBX1. One family member has Asperger syndrome, an autistic spectrum disorder that is associated with reduced PPI. Thus, Tbx1 and Gnb1l are strong candidates for psychiatric disease in 22q11DS patients and candidate susceptibility genes for psychiatric disease in the wider population.mouse model ͉ psychiatric disease ͉ DiGeorge syndrome ͉ sensorimotor gating C aused by a heterozygous multigene deletion, 22q11 deletion syndrome (22q11DS) is a relatively common genetic disorder (1:4,000 live births). Behavioral and psychiatric disorders are a prominent part of the 22q11DS phenotype. In children, these disorders include cognitive defects, anxiety, attention deficit disorder, and problems of social interaction that are increasingly recognized to meet the criteria of autistic spectrum disorder (1, 2), a neurodevelopmental disorder. In adults, high rates of psychotic disorders, especially schizophrenia, have been reported (2-5).It is likely that the pathophysiological basis of many psychiatric disorders is heterogeneous involving multiple genes and environmental factors. Therefore, when they occur frequently in association with a defined genetic defect, as in the case of 22q11DS (3, 4, 6, 7), it offers a unique opportunity to identify causative or contributing genes, especially if a good animal model is available. We developed a mouse model of 22q11DS (8), the Df1͞ϩ mouse, which carries a heterozygous deletion encompassing 22 genes. Df1͞ϩ mice recapitulate many of the cardiovascular defects associated with 22q11DS (8), and they also display abnormal behavior, including impaired sensorimotor gating, as measured by prepulse inhibition (PPI) o...

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Evidence that a gene or genes on chromosome 22 is involved in susceptibility to schizophrenia comes from two sources: the increased incidence of schizophrenia in individuals with 22q11 deletion syndrome (22q11DS) and genetic linkage studies. In mice, hemizygous deletion of either Tbx1 or Gnb1l can cause deficits in pre-pulse inhibition, a sensory motor gating defect which is associated with schizophrenia. We tested the hypothesis that variation at this locus confers risk of schizophrenia and related disorders in a series of case-control association studies. First, we found evidence for a male-specific genotypic association (P = 0.00017) TBX1/GNB1L in 662 schizophrenia cases and 1416 controls from the UK. Moreover, we replicated this finding in two independent case-control samples (additional 746 cases and 1330 controls) (meta analysis P = 1.8 x 10(-5)) and also observed significant evidence for genotypic association in an independent sample of 480 schizophrenia parent-proband trios from Bulgaria with markers at this locus, which was again strongest in the male probands (P = 0.004). Genotyping the most significant SNPs in a sample of 83 subjects with 22q11DS with and without psychosis again revealed a significant allelic association with psychosis in males with 22q11DS (P = 0.01). Finally, using allele specific expression analysis, we have shown that the markers associated with psychosis are also correlated with alterations in GNB1L expression, raising the hypothesis that the risk to develop psychosis at this locus could be mediated in a dose sensitive manner via gene expression. However, other explanations are possible, and further analyses will be required to clarify the correct functional mechanism.