Word Count: 244 Main Text Word Count: 4761 Number of Figures: 7 Number of Tables: 2Supplements: 1 supplementary information file + 1 excel file containing 2 supplementary data tables Abstract Background: 22q11.2 copy number variants (CNVs) are among the most highly penetrant genetic risk variants for developmental neuropsychiatric disorders such as schizophrenia (SCZ) and autism spectrum disorder (ASD). However, the specific mechanisms through which they confer risk remain unclear.Methods: Using a functional genomics approach, we integrated transcriptomic data from the developing human brain, genome-wide association findings for SCZ and ASD, protein interaction data, and pathophysiological signatures of SCZ and ASD to: 1) organize genes into the developmental cellular and molecular systems within which they operate; 2) identify neurodevelopmental processes associated with polygenic risk for SCZ and ASD across the allelic frequency spectrum; and 3) elucidate pathways and individual genes through which 22q11.2 CNVs may confer risk for each disorder.Results: Polygenic risk for SCZ and ASD converged on partially overlapping gene networks involved in synaptic function and transcriptional regulation, with ASD risk variants additionally enriched for networks involved in neuronal differentiation during fetal development. The 22q11.2 locus formed a large protein network that disproportionately affected SCZ-and ASD-associated neurodevelopmental networks, including loading highly onto synaptic and gene regulatory pathways. SEPT5, PI4KA, and SNAP29 genes are candidate drivers of 22q11.2 synaptic pathology relevant to SCZ and ASD, and DGCR8 and HIRA are candidate drivers of disease-relevant alterations in gene regulation.
Conclusions:The current approach provides a powerful framework to identify neurodevelopmental processes affected by diverse risk variants for SCZ and ASD and elucidate mechanisms through which highly penetrant multi-gene CNVs contribute to disease risk.(M4,M6,M7,M12,M13,M15). M1 was consistently enriched for ASD risk variants, but not for down-regulated genes in ASD cortex. However, M1 was highly enriched for genes expressed specifically during fetal development, suggesting that this likely reflects a floor effect in postnatal expression of these genes. Down-regulated genes in ASD and SCZ cortextherefore appear to at least partially reflect direct effects of genetic risk, and we focused on 22qBD-PPI network overlap with down-regulated genes for subsequent analyses.Given the size of the 22qBD-PPI network and each DGE gene-set, the 22qBD-PPI network was significantly enriched for down-regulated genes in both SCZ (~11% of the 22qBD-PPI network; p=0.006) and ASD (~14% of the 22qBD-PPI network;p=2.0x10 -4 ). Additionally, compared to all regions of the genome (i.e., Genomic-RegionBD-PPI networks), the 22qBD-PPI network was in the ~93 rd and ~96 th percentiles for overlap with down-regulated genes in SCZ and ASD, respectively ( Fig. 6B; Table S4). Compared to the connectivity of random sets of 38 seed genes (i.e...