Abstract
Genes associated with risk for brain disease exhibit characteristic expression patterns that reflect both anatomical and cell type relationships. Brain-wide transcriptomic patterns of disease risk genes provide a molecular-based signature, based on differential co-expression, that is often unique to that disease. Brain diseases can be compared and aggregated based on the similarity of their signatures which often associates diseases from diverse phenotypic classes. Analysis of 40 common human brain diseases identifies 5 major transcriptional patterns, representing tumor-related, neurodegenerative, psychiatric and substance abuse, and 2 mixed groups of diseases affecting basal ganglia and hypothalamus. Further, for diseases with enriched expression in cortex, single-nucleus data in the middle temporal gyrus (MTG) exhibits a cell type expression gradient separating neurodegenerative, psychiatric, and substance abuse diseases, with unique excitatory cell type expression differentiating psychiatric diseases. Through mapping of homologous cell types between mouse and human, most disease risk genes are found to act in common cell types, while having species-specific expression in those types and preserving similar phenotypic classification within species. These results describe structural and cellular transcriptomic relationships of disease risk genes in the adult brain and provide a molecular-based strategy for classifying and comparing diseases, potentially identifying novel disease relationships.
Analysis of the transcription patterns of risk genes for human brain disease reveals characteristic expression signatures across brain anatomy; these can be used to compare and aggregate diseases, providing associations that often differ from conventional phenotypic classification.
Introduction
Brain diseases are increasingly recognized as major causes of death and disability worldwide [1–3]. These diverse and multifactorial diseases may be largely grouped into cerebrovascular, neurodegenerative, movement related, psychiatric disorders, developmental and congenital disorders, substance abuse disorders, brain tumors, and a set of other brain-related diseases (Institute for Health Metrics (IHME), healthdata.org). The economic impact of brain diseases also varies substantially, as reflected in the comprehensive and annually updated Global Burden of Disease Study [4] (Fig A in S1 Text). The etiology of brain-related diseases and their genetics is complex and widely studied [5–7]. However, phenotypic classification of brain diseases is challenging and does not uniquely partition characteristics of genetic risk, disease manifestation, and treatment. Except for mendelian diseases arising from single-gene mutations, most brain disorders present as a complex interplay between genetics and environment through interaction of the brain transcriptome and its regulatory network. Genetic analysis of brain disease, through profiling of tissues, cells, and more recently at the resolution of single nuclei [8] provides means for population scale sampling to disentangle basic molecular relationships [9,10].
Characterizing the neuroanatomy of major transcriptomic relationships for brain diseases and its relationship to cell type provides a novel means of disease comparison and classification. The premise of the present study is the hypothesis that spatial and temporal co-expression of disease genes is indicative of a potential interaction between these genes [11,12] and that disease aggregation based on these patterns is informative. Studying brain samples from donor populations exhibiting coherent transcriptomic and anatomic relationships of disease-related genes, both in neurotypical and diseased brains and at multiple scales, promises important insight in developing further approaches to study the pathophysiology of brain disorders, particularly as brain-wide cellular data becomes increasingly available. Large-scale transcriptome profiling of the human brain has already produced useful resources for exploring the genetics of neurotypical and disease states [13–16] and in describing the larger scale relationship of brain diseases and the neuroanatomy of transcriptomic patterning [13,17].
Transcriptomic relationships at a mesoscale, intermediate between the larger brain structures (e.g., cortex, hypothalamus) and those at cellular resolution, provide a framework and starting point for classifying broad disease associations in comparison with common phenotypic grouping. Starting with the Allen Human Brain Atlas (human.brain-map.org) [13,14], we investigated anatomic patterning and differential expression of the transcriptional patterns in the adult neurotypical brain of genes for 40 brain-related disorders across 104 structures from cortex, hippocampus, amygdala, basal ganglia, epithalamus, thalamus, ventral thalamus, hypothalamus, mesencephalon, cerebellum, pons, pontine nuclei, myelencephalon, ventricles, and white matter. Using single-nucleus data from the human middle temporal gyrus (MTG), we further characterize a subset of 24 diseases with primary expression in cortex by comparing expression of cell types from a taxonomy of 45 inhibitory, 24 excitatory, 6 non-neuronal types, and with special attention to psychiatric diseases. This multiresolution approach combining tissue-based and single-nucleus data connects mesoscale anatomic analysis with cell types of the cortex and is a recognized approach for extracting information from tissue-based sampling [18,19]. Finally, juxtaposing these results with single-cell data in mouse [15,20] allows identification of potential important human-specific cell type differences as well as insight into the overlapping mechanisms in animal models of brain disorders.
Brain disorders and associated genes
The diseases selected are representative of 7 phenotypic classes from the Global Burden of Disease Study (referred to as GBD classes in this study). The important group of cerebrovascular diseases was excluded due to limitations of representative endothelial and pericyte cell types and related blood cells in data sources. To identify gene–disease associations (GDAs), we used the DisGeNET database (www.disgenet.org) [21–23], a platform aggregated from multiple sources including curated repositories, GWAS catalogs, animal models, and the scientific literature. From an initial survey of the Online Mendelian Inheritance in Man (OMIM) (www.omim.org) repository, we previously identified 549 potential brain-related diseases [13] that are now intersected with the DisGeNET repository. We required reported GDAs to be present in at least 1 confirmed curated source (see https://www.disgenet.org/dbinfo) and with a minimum of 10 genes per disease. For each disease, the main variant of the disease was selected with rare familial and genetic forms not included. This conservative selection resulted in 40 major brain disorders with 1,646 unique associated genes. S1 Table contains definitions, gene sets, and metadata identifying each disease (Methods).
Gene sets associated with brain disease vary widely in size and the proportion of shared genes, and diseases can be associated by phenotypic similarity based on clinical manifestations [24,25]. The gene set sizes in this study range widely from frontotemporal lobar degeneration (g = 11) to schizophrenia (g = 733) and distribute widely across GBD classes as (number, % unique to GBD class) psychiatric (1,107, 0.723), neurodegenerative (257, 0.513), substance abuse (212, 0.320), brain tumors (168, 0.667), developmental disorders (139, 0.676), movement related (136, 0.272), and other brain related (123, 0.414) (Fig B in S1 Text). The large gene set intersection (g = 132) between psychiatric and substance abuse GBD classes, with 62% of substance abuse genes also associated with psychiatric disorders, reflects the well-established comorbidity of these diseases [26]. Movement disorders are also commonly found in neurodegenerative diseases [27], with neurodegenerative sharing 30% (g = 41) of movement-related genes, while GBD tumor based and developmental share the least with other classes (2.5% and 2.6%, respectively). Clustering the 40 diseases and disorders based on relative pairwise gene set intersection (Jaccard) shows moderate agreement with GBD phenotypic groupings (Fig B in S1 Text), with the highest percentage of shared genes among psychiatric disorders 7.64% (p = 1.55 × 10−4), followed by substance abuse 6.33% (p = 2.82 × 10−4), and brain tumors 5.43% (p = 8.35 × 10−3). (Significance is likelihood of observed percentage corrected for GBD class size.) Functional enrichment analysis (https://toppgene.cchmc.org) of genes unique to each GBD describes major biological processes and pathways of these groups (Fig C in S1 Text and S2 Table).
Neuroanatomy and transcriptomic profiles of brain diseases
Expression profiles from the Allen Human Brain Atlas (AHBA, https://human.brain-map.org) from 6 neurotypical donor brains are used to summarize major neuroanatomical relationships of genes associated with the 40 diseases. Using an ontology of 104 structures (S3 Table) from cortex (CTX, 8 substructures), hippocampus (HIP, 7), amygdala (AMG, 6), basal ganglia (BG, 12), epithalamus (ET, 3), thalamus (TH, 12), hypothalamus (HY, 16), mesencephalon (MES, 11), cerebellum and cerebellar nuclei (CB, 4), pons and pontine nuclei (P, 10), myelencephalon (MY, 12), ventricles (V, 1), and white matter (WM, 2), we obtained a mean transcriptomic disease profile by averaging expression for genes associated with each of 40 diseases across the 104 structures and z-score normalizing (Fig 1 and S4 Table). Performing hierarchical clustering with Ward linkage using Pearson correlation (Methods) presents brain-wide transcriptomic associations in 5 primary Anatomic Disease Groups (ADG 1–ADG 5) interpretable with respect to GBD classification (Fig 1A, left color bar) as tumor related (ADG 1), neurodegenerative (ADG 2), psychiatric, substance abuse, and movement disorders (ADG 3), a group without developmental, psychiatric, or tumor diseases associated with hypothalamic function (ADG 4), and a group of diseases related to basal ganglia (ADG 5).
The anatomic representation of transcriptomic patterning within each ADG group is described as ADG 1: thalamus, brain stem, ventricle wall, white matter; ADG 2: cortico-thalamic, brain stem, white matter; ADG 3: (telencephalon) cortex, thalamus, hippocampus, amygdala, basal ganglia; ADG 4: basal ganglia, hypothalamus, brain stem; and ADG 5: thalamus, hypothalamus, brain stem. Fig 1 illustrates the complex anatomic structure of disease gene expression and remarkably, the division and structure of ADG groups is largely preserved (67%) upon removing genes common between pairs of diseases (Fig D in S1 Text) showing that distinct co-expressing genes drive the major ADG groups. The clustering also remains stable subsampling the diseases having very large gene sets (Fig E in S1 Text). ADG transcriptome signatures are also consistent across subjects as individual brain holdout analysis (Figs F and G in S1 Text, Methods) finds that both the correlation of expression across structures and differential relationships between ADG groups at a fixed structure are preserved within the subjects.
Disease gene burden can vary significantly (from high burden to risk factor), and the strength of evidence supporting each gene varies where some are convergently supported by multiple large cohort studies, whereas others may have conflicting data. To account for these effects, we used the literature-based GDA weights provided by the DisGeNET dataset through a GDA score (Methods). Although there may be variability in accuracy of gene-disease weights, the result of the weighting analysis (Fig H in S1 Text) corroborates the disease associations of Fig 1 with 85% agreement. Furthermore, the diseases presented have very different temporal genetic signatures and this may confound associations. We observe, however, that even genes that likely act mostly in development to cause pathology may continue to contribute to disease state in adulthood, and neurodevelopmental disorders have symptoms that are persistent across life span. While our analysis does not account for temporal dynamics, examination of the BrainSpan (https://www.brainspan.org) data using donors from 60 days old to 39 years (Fig I in S1 Text) highlights the expected temporal patterning and onset of expression, with clustering retaining many associations found in the adult.
The complex anatomic organization of gene expression reflected in Fig 1 associates diseases with common phenotypic classification by the GBD study, but with important divergences (Fig 1A, left sidebar) that are supported by the literature. ADG 1, driven by co-expression in the diencephalon, myelencephalon, and white matter, comprises tumor-based diseases with the association of migraine disorders and multiple sclerosis (MS). The concurrence of MS and brain tumors has been widely described [28–30], and MS patients have decreased overall cancer risk, but an increased risk for brain tumors [31], a hypothesis being that remyelinating processes coincide with a decline of the CNS immune function. Patients with brain tumors also experience an increased risk of having a prior migraine diagnosis [32]. ADG 2 comprises most of the neurodegenerative diseases, with the association of Williams syndrome and hereditary spastic paraplegia, and early aging, dementia, autoimmunity, and chronic inflammation are characteristics of diseases associated with oxidative stress [33]. Amyotrophic lateral sclerosis has been associated with Alzheimer disease ([34] as well as with frontotemporal dementia [35]. In addition to strong substantia nigra (SNC) expression in dementia and Parkinson’s disease, this group has stronger expression in cortex and hypothalamus mammillary bodies, where abnormalities have been observed in neurodegeneration [36]. The common association of all psychiatric diseases, and most movement, and substance disorders in ADG 3 is driven by strong telencephalic patterning. Psychiatric manifestations after occurrence of epilepsy have often been noted yet are not completely understood [35,37]. Seizures are known to be extremely effective modulators of psychiatric symptoms, and electroconvulsive therapy (ECT) still is used today as one of the most effective antidepressant and antipsychotic treatments. ADG 4 comprises diseases from mixed phenotypic classes, with a consistent hypothalamic signature (Fig 1C), and where amnesia and narcolepsy may be associated with hypothalamic lesions [38,39], and narcolepsy with excess marijuana use [40,41]. Finally, ADG 5 is dominated by diseases affecting the basal ganglia Parkinsonian signs of bradykinesia in Huntington’s disease have been found to typically manifest over time [42].
To understand the variability of expression across ADG groups, we apply ANOVA for mean differences in expression across at each structure (BH corrected p-values, top annotation, Fig 1). Particularly striking in Fig 1A is the white matter signature common to tumor and neurodegenerative diseases (ADG 1–2), effectively absent in psychiatric disorders and diseases of addiction (ADG 3–4) [43], and substantial enrichment of telencephalic expression (CTX, HIP, AMG, and BG) in ADG 3 [44,45]. The most significant transcriptomic variation in disease genes across the adult brain occurs across the diverse nuclei of lower brain structures: in the hypothalamus (e.g., cuneate nucleus (Cu, p < 3.35 × 10−8), tuberomammillary nucleus (TM, p < 1.3 × 10−6), supramammillary nucleus (SuM, p < 2.07 × 10−6), in the myelencephalon (gracile nucleus (GR, p < 1.48 × 10−8)), central glial substance (CGS, p < 3.86 × 10−6), in the basal ganglia (globus pallidus (GP, p < 5.01 × 10−7)), and cerebellar nuclei (CN, and white matter, in particular, corpus callosum (cc, p < 5.01 × 10−7)). The distinction between ADG 1 and ADG 2 is more subtle with variation in cortex (frontal lobe, FL, p < 2.82 × 10−3), epithalamus (lateral habenular nucleus, (HI, p < 2.85 × 5)), and mesencephalon (pretectal region, (PTec, p < 6.24 × 10−5)) and will be further examined using module-based analysis (Fig 2). For details see Fig J in S1 Text.
While the expression of disease genes may vary considerably in a population [46,47], the anatomic expression signature of each disease in an individual brain is typically closely correlated with a disease in the same ADG group in other brains (Fig 1C) (ADG 1–5: 96.7%, 77.0%, 96.1%, 100.0%, and 92.5%), and often identifies the exact disease in other subjects (Figs 1C and 1G in S1 Text, Methods). The ability to identify a disease from its expression signature provides a characterization of that disease by neuroanatomy. Surprisingly, the expression signature associated with the ADG 3 group diseases ataxia, language development disorders, temporal lobe epilepsy, obsessive compulsive disorder, and cocaine-related disorder most closely correlates with these same diseases in each of the subjects. Similarly, in ADG 4 and 5, genes associated with Parkinsonian disorders, Huntington’s disease, amnesia, narcolepsy, neuralgia, and tobacco use disorder exhibit unique profiles across subjects due to consistent, differentiated expression in the basal ganglia, hypothalamus, and myelencephalon. Conversely, the mesoscale transcriptomic profile of ADG 2 Alzheimer’s disease and amyotrophic lateral sclerosis, and ADG 3 bipolar disorder, autistic disorder, and schizophrenia are less unique to those diseases, suggesting potential cellular, anatomical, and phenotypic overlaps between them and other disorders in the same ADG groups. Phenotypically, GBD movement disorders and substance abuse have the most consistent anatomic signatures (94.0%, 89.5%) (Fig 1D), while psychiatric and developmental diseases the least (64.0%, 55.0%).
Canonical expression patterns of brain diseases
The neuroanatomy of transcription patterns for disease risk genes can be further characterized by directly identifying differential expression relationships and reproducible patterns that are conserved in the adult. By mapping disease genes to these canonical expression patterns [13], we describe the co-expressing patterns of the brain disorders and the major constituent cell types. Differential stability (DS), introduced in [13], is quantified as the mean Pearson correlation ρ of expression between pairs of specimens over a fixed set of anatomic regions and measures the fraction of preserved differential relationships between anatomic regions for a set of subjects. For example, the gene GRIA2 with remarkably high DS (ρ = 0.918), (Fig 2A) is implicated in bipolar disorder [48], schizophrenia [49], and substance withdrawal syndrome [50] and has a highly reproducible brain-wide expression profile across AHBA subjects with highest expression in hippocampus and amygdala.
Although disease genes show a marginally significant (p < 0.031) difference in their expression levels compared with non-disease associated genes (panel A of Fig K in S1 Text), disease genes have a significantly higher percentage of differentially stable genes, particularly for substance abuse, (mean DS = 0.702, p < 4.7 × 10−21), psychiatric (DS = 0.675, p < 3.17 × 10−17), and movement disorders (DS = 0.635, p < 1.21 × 10−17) (panel B of Fig K in S1 Text). DS prioritizes neuronal cell types with strong structural markers and less the non-neuronal broad non-regional expression common in glial cells (Fig L in S1 Text). High DS disease genes are also substantially enriched for cell type processes, e.g., anterograde trans-synaptic signaling, (low DS 1.8 × 10−4, high 2.9 × 10−12), and presynaptic membrane (low DS 0.049, high 4.62 × 10−7), indicating high DS selects for cell type specificity. Notably, the stability of genes in ADG 3 (median 0.625, p < 4.1 × 10−70), ADG 4 (0.642, 1.24 × 10−6), and ADG 5 (0.644, 2.95 × 10−14) are markedly higher than ADG 1 (0.592 × 10−6, 1.02) and ADG 2 (0.582, 7.70 × 10−7) indicating a higher percentage of neuronal cell types and structural markers in these groups. Panel C of Fig K in S1 Text shows the distribution of DS genes for each disease, confirming that diseases with higher DS are those with more anatomic structural markers.
A previous characterization of the reproducible gene co-expression patterns [13] in the Allen Human Brain Atlas using the top half of DS genes (DS > 0.5284, g = 8,674) identified 32 primary transcriptional patterns, or modules, each represented by a characteristic expression pattern (i.e., eigengene) across brain structures and ordered by cell type content. Fig 2B illustrates the membership of certain disease risk genes to modules for 2 representative modules M1 and M12. Module M1 has strong telencephalic expression in the hippocampus, in particular, dentate gyrus, and representative genes include GRIA2 (correlation to eigengene, ρ = 0.907) and DLG3 (ρ = 0.896).
Alterations in glutamatergic neurotransmission have known associations with psychiatric and neurodevelopmental disorders and mutations in GRIA2 have been related with these disorders [46–48]. M12 is a unique neuronal marker of substantia nigra pars compacta, pars reticulata, and ventral tegmental area and provides a clearer connection of dystonia, Parkinson’s disease, and dementia for these comorbidities (Fig 2C). Both the dopamine transporter gene SLC6A3 (ρ = 0.967), a candidate risk gene for dopamine or other toxins in the dopamine neurons [51,52] and aldehyde dehydrogenase-1 (ALDH1A1, ρ = 0.949), whose polymorphisms are implicated in alcohol use disorders, map to module M12 (ρ = 0.949) [53]. Brain-wide association of expression module profiles may potentially be used to implicate genes without previous association to a given disease, particularly when that profile is highly conserved between donors.
A set of disease risk genes can be mapped to the canonical modules, by finding the closest correlated module eigengene for each gene, thereby providing the distribution of expression patterns associated with the disease (S5 Table). Fig 2C shows the normalized mean correlation of the 40 disease-associated gene sets with the module M1-M32 eigengenes ordered by ADG as in Fig 1 (Methods). The basic cell class composition of neuronal, oligodendrocyte, astrocyte of AHBA tissue samples was determined from earlier single-cell studies [13] and the modules M1-M32 are ordered by decreasing proportion of neuron-enriched cells. Interestingly, Fig 2C clarifies the distinction between ADG groups of Fig 1, shows major cell type content, and illustrates the primary anatomic co-expression patterns of brain diseases.
Primarily tumor-based ADG 1 maps to modules M21-M32 having enriched glial content (p < 2.413 × 10−15), while ADG 3 psychiatric and substance abuse-related diseases map to neuronal enriched patterned modules M1-M10 (p < 2.2 × 10−16). Importantly, the neurodegenerative disorders of ADG 2 including Alzheimer’s, Parkinson’s, ALS, and frontotemporal lobe degeneration show more uniform distribution across the modules, and now importantly separate this group from ADG 1 (p < 1.55 × 10−15). ADG 4 and 5 are both enriched in specific anatomic markers, e.g., M10 (striatum), narcolepsy, marijuana, M14 (hypothalamus), neuralgia, amnesia, M11 (thalamus), Parkinsonian and tobacco use disorders, M12 (substantia nigra), Parkinsonian, and alcoholic intoxication, yet have lower expression in neuronal modules M1-12 than ADG 3 (1-sided, p < 3.84 × 10−13). The distribution of Fig 2C validates the clustering of Fig 1, clarifies the distinction between ADGs and provides a classification of diseases through common transcriptional patterns and major constituent cell types (Figs N and O in S1 Text).
Disease genes and cell types of middle temporal gyrus
A primary telencephalic expression pattern is common to diseases of ADG 3, and while mesoscale systems level analysis describes brain-wide anatomic relationships, it is limited in its ability to implicate specific cell types in diseases [12,54]. To examine these diseases more finely, we now restrict to those 24 diseases having higher than median cortical expression in the brain-wide analysis shown in Figs 1 and 2, essentially the entirety of ADG 3 and several neurodegenerative diseases from ADG 2. We used human single nucleus (snRNA-seq) data from 8 donor brains (15,928 nuclei) from the MTG [15] where 75 transcriptomic distinct cell types were previously identified, including 45 inhibitory neuron types and 24 excitatory types as well as 6 non-neuronal cell types. A set of 142 marker genes are used to differentially distinguish the MTG cell types in [15]. These genes form a highly differentially stable group (DS = 0.734, p < 8.66 × 10−7), indicating strong cell type specificity, with 30 among the disease genes, several uniquely associated with a disease (S6 Table).
We measure the tendency for disease gene co-expression to enrich in a specific cell type, using the Tau-score (τ) defined in [55] (Methods). For a gene g, 0 ≤ τ(g)≤1 measures the tendency for expression to range from uniform across cell types to concentrated in a specific cell type. Averaging τ over sets of genes representing a given disease, we obtain a measure of cell type specificity of each disease within MTG (panel C of Fig P in S1 Text). Expression level differences between brain and non-brain disease genes while present (p = 0.005), are not as substantial as the significant difference in τ specificity between these groups p < 2.2 × 10−16 (panels A and B of Fig P in S1 Text) confirming specialized cell type involvement in genes associated with brain diseases. Pooling to the 7 GBD categories (Fig 3B), the genes from psychiatric (p < 2.52 × 10−74), movement (p < 1.71 × 10−11), and substance abuse disorders (p < 3.58 × 10−11) show the highest cell type specificity, while tumors, developmental disorders, and neurodegenerative diseases less.
Fig 3A presents the clustering of mean expression profiles across the 24 cortical brain diseases. Diseases are clustered by cell type specific expression and with annotations showing primary subclass level types (Inhibitory: Lamp5, Pvalb, Sst, Sst Chodl, Vip; Excitatory: IT, NP, ET, CT, L6b; and 5 non-neuronal types.) Cell type analysis in Fig 3 identifies 4 primary Cell Type Groups (CTG 1–4) for these cortical diseases. Here, CTG 1, representing several movement and substance abuse disorders, is characterized by a strong enrichment of neuronal excitatory IT over inhibitory Vip cell types (p < 5.53 × 10−12) and low expression of non-neuronal types. CTG 2, dominated by psychiatric [56] diseases, exhibits more balanced pan-neuronal expression and is low in non-neuronal types. CTG 3, representing the non-neuronal enriched tumor-based diseases, has pronounced non-neuronal expression and captures ADG 1 diseases from the whole brain analysis. Finally, CTG 4, associated with the neurodegenerative diseases, has predominant enrichment in Vip inhibitory neurons over excitatory and specialized non-neuronal types. The major cell types (inhibitory, excitatory, non-neuronal) of Fig 3 differentiate the major disease groups of Fig 1, and corroborate the module-based analysis of Fig 2C for these diseases. Color consistency in the top annotation bars of Fig 3 show that the data clusters both at the subclass type level Vip, Sst, Pvalb, IT, L6b, and non-neuronal types. Furthermore, analysis of variance at fixed cell types (Fig Q in S1 Text) shows that the highest variation across diseases occurs for excitatory and non-neuronal types. Interestingly, Fig 3 illustrates gradients of increasing expression in excitatory cell types from CTG 1–4 (CTG 3–4, p < 0.0623; CTG 2–4, p < 3.56 × 10−9; CTG 1–4, 2.93 × 10−18) in IT, ET, and L6b cell types across CTG with enrichment in language development, obsessive-compulsive disorders (OCD), and epilepsy. While inhibitory variation as a class is not significant across cell type groups, vasoactive intestinal peptide-expressing (Vip) interneurons show, by contrast, a decreasing gradient in expression from CTG 1–4 (CTG 1–2, 4.09 × 10−10; CTG 1–4, 8.26 × 10−11; CTG 2–4, 0.0006). Here, pronounced enrichment of Vip interneurons, regulating feedback inhibition of pyramidal neurons [57], is seen in Alzheimer’s disease [58], frontotemporal lobar degeneration, ALS [59], and Williams syndrome [60].
The structural (Fig 1) and cell type analysis (Fig 3) and their grouping by phenotypic classes is consistent, despite data being limited to nuclei from a single cortical area (Fig R in S1 Text). We combine the mesoscale and cell type approaches, averaging disease gene expression correlation matrices for 24 cortical diseases (Methods) and forming a consensus UMAP Fig 3C that graphically illustrates the transcriptomic landscape of major cortical expressing brain diseases, with key congruences and differences with phenotype association. The embedding in Fig 3C shows grouping by original ADG, colored by phenotype, with labeling of primary cell types, and the excitatory cell type gradient in cortical expression.
There is evidence in the literature consistent with a gradient in expression among these disease risk genes. Drugs of abuse have been shown to strongly alter neuronal excitability of layer 5 pyramidal cell types [61] and the largest transcriptomic change in epilepsy have been found to occur in distinct neuronal subtypes from the cell types L5-6_Fezf2 and GABAergic interneurons Sst amd Pvalb, consistent with higher expression in these CTG 1 diseases [62]. Further, the comorbidity of temporal lobe epilepsy with OCD [63] and with language development [64] is established. Genes associated with psychiatric disorders (CTG 2) are known to be widely expressed in the cortex [13], and GWAS studies in schizophrenia and depression show broad expression of susceptibility genes across neuronal cell types [65,66]. There is also increasing evidence that Vip expression is altered in numerous neurodegenerative disorders (CTG 4) [67] and the role of glial cells and their interactions with neurons is increasingly studied in neurodegenerative processes [68,69]. Co-expression relationships confirm these known associations linking diverse phenotypic disease groups.
Excitatory cell type variation in psychiatric disease
The primary psychiatric diseases autism, bipolar disorder, and schizophrenia exhibit a largely similar expression profile (Fig 3A), but detailed variation is overshadowed by stronger variation in other disease groups, and by the large number of genes associated with these 3 diseases. These disorders with a heritability of at least 0.8, are among the most heritable psychiatric disorders and show a significant overlap in their risk gene pools [56]. We formed 3 matrices for the diseases autism, bipolar disorder, and schizophrenia, where each matrix measures covariation of cell type expression between MTG cell types (using genes unique to that disorder) and are independently thresholded for significance (Methods). Using these matrices, we investigate significant covarying cell types unique to autism, bipolar, and schizophrenia (Aut, Bip, and Scz), as well as those specific to pairs of diseases (Aut-Bip, Aut-Scz, and Bip-Scz) (Fig 4A and inset). Interestingly, excitatory variation dramatically exceeds inhibitory and non-neuronal variation for these diseases [70] accounting for 70.7% of significant cell type interactions. In particular, we find Aut-Scz (green) interactions with cell types of superficial layers (Linc00507 Glp2r, Linc00507 Frem3, Rorb Carm1p1), Bip-Scz in intermediate layer types (Rorb Filip1, Rorb C1r), and a unique enrichment of bipolar risk gene expression in Rorb C1r. Remarkably, although the genes enriched in a given cell type differ between the 3 disorders (Fig S in S1 Text), specific neuronal circuits are shared between the diseases [71,72]. Fig 4C shows associated biological processes and pathways of the genes unique to Aut, Bip, Scz (g = 19, 20, 25) that pass the threshold in the interaction map of Fig 4B (S7 Table). The graph illustrates differential phenotypes, with genes uniquely associated with autism linked to brain development, schizophrenia-associated enriched genes implicated in dendritic outgrowth, and bipolar-associated genes linked to circadian rhythm [73]. The expressions of these unique genes have distinct profiles across the implicated cell types, with schizophrenia exhibiting pan-excitatory expression (Fig S in S1 Text). Cell type-specific interrogation of risk gene expression profiles provides insight into how polygenic risk might impact distinct types of neurons and neuronal circuits in psychiatric diseases while affecting overlapping pathways and processes.
Brain diseases in mouse and human cell types
Single-cell profiling allows the alignment of cell type taxonomies between species, analogously to homology alignment of genomes between species. To examine conservation of disease-based cellular architecture between mouse and human, we used an alignment [15] of transcriptomic cell types from human MTG to 2 distinct mouse cortical areas: primary visual cortex (V1) and a premotor area, the anterior lateral motor (ALM) cortex. This homologous cell type taxonomy is based on expression covariation and the alignment demonstrates a largely conserved cellular architecture between cortical areas and species, identifying 20 interneuron, 12 excitatory, and 5 non-neuronal types (Fig 5A). We use this alignment to study species-specific cell type distribution over the 24 cortex disease groups both at resolution of broad cell type class (N = 7, e.g., excitatory), and subclasses (N = 20) where non-neuronal cell types are common between both levels of analysis.
To identify cell type differences in brain disorders between mouse and human cell types, we used expression-weighted cell type enrichment (EWCE) analysis [74]. Briefly, EWCE compares expression levels of a set of genes associated with a given disease to the genomic background with similar gene set size, determining significance through permutation analysis and excluding disease-related genes (Methods). EWCE evaluates all genes in a disease simultaneously, identifies the distribution of cell type expression for the group, and can be interpreted as characterizing the profile of active enriched cell types of a disease. The correlation of EWCE values aligned between mouse and human (panel A of Fig T in S1 Text, ρ = 0.633) is reflective of broadly conserved expression patterns [13] with minimally significant (K-S test: D = 0.0916, p = 0.03) difference in global EWCE distribution (Fig 5B). More remarkably, simultaneous clustering of EWCE mouse and human aligned cell types (Fig 5C, mouse (orange), human (blue)) shows a pairing of most diseases between species and indicates highly conserved cell type signatures at the subclass level. Remarkably, Fig 5B shows that the EWCE enrichment signature for ataxia, autistic disorder, epilepsy, bipolar disorder, ALS, Alzheimer’s disease, and schizophrenia, and others are closer to the same disease across species than to any other disease signature within species. Fig 5D presents a similar co-clustering of normalized expression values for each disease in mouse and human. However, here the data clusters by species specific profiles while preserving many phenotypic GBD associations (left annotation). By homology mapping of cell types across mouse and human, we therefore find that mouse and human disease risk genes act in homologous cell types while having distinct species-specific expression (e.g., psychiatric diseases).
Cell type-specific enrichment by EWCE corroborates specificity of major cell types and subclasses in both mouse and human. Panel B of Fig T in S1 Text presents the significant EWCE p-values (after false discovery rate (FDR) correction) among mouse and human cell types, showing that psychiatric and substance abuse dominate the inhibitory (64%) and excitatory (70%) enrichments. While find no significant enrichments in either species for several diseases after correcting for multiple comparison including astrocytoma, neurofibromatosis 1, and frontotemporal lobar degeneration, the inhibitory subclasses Lamp5, Sncg, Vip, Sst Chodl show increased enrichment in both species (Sst Chodl, cocaine; Sncg, autistic, bipolar). Unique inhibitory enrichments are more common in mouse (Vip, autistic, bipolar, cocaine), while unique human enrichments are far more common in excitatory subclasses (L6 IT Car3, bipolar; L2/3 IT, L5 ET, depressive; L6 CT, learning disorders), and the only unique non-neuronal enrichment found is in human microglia/PVM for Alzheimer’s disease (p < 0.0012).
Discussion
We presented a brain-wide molecular characterization of common brain diseases from the perspective of neuroanatomic structure, aiming to describe how major transcriptomic relationships vary with common phenotypic classification. Precise phenotypic classification of diseases is challenging due to variations in manifestation, severity of symptoms, and comorbidities [4,73]. We used the Global Burden of Disease (GBD) study from the Institute for Health Metrics and Evaluation (www.healthdata.org) for high-level phenotypic categorization, as this work is a continuously updated, globally used, comprehensive, and a data-driven resource. While our approach cannot identify disease-specific gene expression changes precisely, we describe brain-wide transcriptomic architecture of genetic risk for major classes of brain diseases.
This study finds that diverse phenotypes and clinical presentations have shared anatomic expression patterns and may provide insight into disease mechanisms and frequency of comorbidity. Using anatomically mapped tissue sources and cell types, we observe that disease risk genes show convergent physiological-based expression patterns that associate diseases in expected and sometimes less expected ways. For example, language development disorders, OCD, and temporal lobe epilepsy are phenotypically diverse, yet all belong to ADG 3, and cell type analysis of Fig 3A indicates these diseases have a correlated cell type signature with strong IT excitatory subclass expression, and comorbidities identified in the literature. There is reproducible structure to these anatomic disease profiles illustrated through differential expression stability analysis and correspondence between mouse and human cell type profiles (Fig 5C). While the molecular basis of disease will ultimately reveal deeper associations which may lead to therapeutic options, our study is a step toward a biologically driven approach that uses transcriptomic and cell/pathway data to inform brain disorder classification.
For disease-associated genes, DisGeNet is one of the largest resources integrating human disease genes and variants from curated repositories and provides a standard approach to select genes for the study. Determining implicated genes in disease states presents considerable uncertainty, and any study is likely to miss important associations. Notably absent from our analysis are cerebrovascular diseases that account for the largest global burden of disability [4], and this limitation is due to relative under-sampling of rare vascular cell types in the Allen Human Brain Atlas. Also, the disease burden carried by each gene can vary significantly where the strength of the evidence supporting each gene varies, and the nature of the mutations causing each disease, or the mode of inheritance are essential to characterization. However, sources of variation are subtle, not well elucidated in the literature, and it is a major challenge of the translational studies to identify meaningful association and weights. The approach of DisGeNET prioritization relies on a statistical point of view where the affected brain structure, neural pathway, and cell type that can be identified is based on the normative expression profile of each gene. The utility of this assumption is potentially less meaningful when it comes to the effects of individual genes involved, and to address these issues, we conducted further analysis to evaluate the effect of gene importance as reflected in the literature. We used literature-based gene disease association weights provided by the DisGeNET dataset to allow for gene prioritization. The main disease categories show a very similar pattern across brain regions confirming the original classification to 85% agreement between class assignment of diseases.
The brain disorders included in this study have very different ages of onset and likely result from pathogenetic mechanisms active during different stages in lifespan. While the current study is performed with adult brain transcriptome data without considering developmental expression, genes that act in developmental period to cause pathology may continue to contribute to disease state in adulthood, and neurodevelopmental disorders have symptoms that are persistent across the life span. Although we do not claim to capture the developmental aspects of the disorders with our approach, it will still provide information about adult pathophysiology and it remains useful to elucidate these patterns in adults in comparison with other brain diseases. We have examined the presented set of diseases in the BrainSpan (https://www.brainspan.org) data using donors from 60 days old to 39 years confirming known developmental trajectory of expression patterns and their convergence to adult patterning.
Brain-wide association of expression profiles may potentially implicate genes without previous association to a given disease, particularly when that profile is highly conserved between donors. The canonical transcriptional modules have been shown to be highly reproducible as default expression patterns in the adult [13]. The ability to associate genes through canonical expression patterns quantifies the global cell type distribution of expression related to disease risk genes. This has the potential of identifying new candidate risk genes not previously associated with disease risk. Similarly, brain-wide or regional expression datasets having divergent expression from normative in patients may provide clues to disease-specific alterations. We provide supplementary for the mapping of disease genes to modules and other closely correlated genes.
While previous work has shown conservation of neuronal enriched expression between the mouse and human [13,16], a recent novel alignment of mouse and human cell types in MTG now enabled a more specific analysis. For example, microglial involvement in Alzheimer’s disease is well established, seen in Fig 3 and found uniquely human enriched (Fig 5B and panel B of Fig T in S1 Text). Here, we show a striking conserved signature across subclass cell types for many diseases, and that the mouse appears to be evolutionarily sufficiently close to identify potentially relevant cell types, suggesting that we can leverage cross species cell type atlases to indicate disease risk gene patterning [75]. While homology alignment of cell types between mouse and human may provide insight into convergent mechanisms based on species-specific differences, further human data is needed to implicate disease genes with cell function.
The general correspondence of structural and cell type approaches even when restricted to a single cortical area (MTG) suggests a consensus organization and amplifies the value of cell type and tissue-based deconvolution methods, particularly when extrapolating these results to multiple brain regions. An intriguing finding is how diseases associated with pronounced cortical expression are organized along a gradient of excitatory cell types. This organization, also anti-correlated with an inhibitory gradient of specialized subclass interneurons, potentially provides insight into new methods for classifying cortical brain diseases. Cortical spatial gradients of gene expression were first observed in earlier tissue-based studies [14] and although originally attributed to sampling resolution have been now observed at cellular resolution [20,76]. With the increasing scale of single-cell studies, this may provide an important means of resolving cell type definitions and their relationship to disease.
A striking finding is the increased variability of excitatory cell types in psychiatric diseases (Fig 4) and certain species-specific expression differences in psychiatric and substance abuse diseases (Fig 5B). While there have been several lines of evidence that inhibitory cell types are impaired in the psychiatric disorders depression, bipolar disorder, and schizophrenia [77,78], results here indicate that excitatory pathways may be equally important. There are of course limitations to a cell type enrichment approach. Some diseases may involve gene pathways shared across cells rather than involvement of subsets of cell types or brain regions, and as others have found, cell type enrichment of disease genes does not necessarily match cell types with expression differences in disease versus control tissue [75,79]. Exploring the transcriptomic architecture of these disorders is a fully new field that has been underexplored and these findings support the transcriptomic hypothesis of vulnerability that in polygenic disorders, genes that are co-expressed in a certain brain region or cell type are much more likely to interact with each other than those that do not follow such a pattern [11,12].
Our results describe the structural and cellular transcriptomic landscape of common brain diseases in the adult brain providing an approach to characterizing the cellular basis of disorders as brain-wide cell type studies become available. The approach we present is flexible and data driven and by following the steps in our accompanying Jupyter notebooks can be readily extended to multiple brain regions, with other diseases of interest and their associated genes, or updated with enriched or restricted gene sets. As cell type data is now being generated in multiple regions of the human brain through the Brain Initiative Cell Census Network (BICCN, www.biccn.org) and Brain Initiative Cell Atlas Network (BICAN), this work can be readily extended.
Methods
Disease genes
To obtain the gene disease associations, we used the DisGeNET database [21], a discovery platform with aggregated information from multiple sources including curated repositories, GWAS catalogs, animal models, and the scientific literature. DisGeNET provides one of the largest GDA collections. The data were obtained from the April 2019 update, the latest update related to the GDA at the time of analysis. An original list of 549 diseases from OMIM [13] with connection to the brain was intersected with the provided repository at DisGeNET. For each disease, the main variant was selected, and rare familial/genetic forms were not included in the analysis. For this study, we included genes with GDA reported at least in 1 confirmed curated (i.e., UNIPROT, CTD, ORPHANET, CLINGEN, GENOMICS ENGLAND, CGI, and PSYGENET) (for details, see https://www.disgenet.org/dbinfo). Since the goal of the study is to investigate the similarities and distinctions between brain-related disorders, disorders with less than 10 associated were excluded from the analysis. Finally, 15 disorders of peripheral nervous system or a second-level association to the brain (e.g., retinal degeneration) were removed. This procedure resulted in 40 brain disorders with their corresponding associated genes. Finally, for these 40 disorders, we performed a literature review of the current GWAS studies to add all the missing genes from the DisGeNET dataset. The 40 diseases include brain tumors, substance related, neurodevelopmental, neurodegenerative, movement, and psychiatric disorders (Fig A in S1 Text).
Datasets
Anatomic-based gene expression data was extracted from 6 postmortem brains [14]. The extracted samples were divided into 132 regions based on the anatomical/histological extraction regions. These 132 regions were further pooled/aggregated into 104 regions including cortex (CTX, 8), hippocampus (HIP, 7), amygdala (AMG, 6), basal ganglia (BG, 12), epithalamus (ET, 3), thalamus (TH, 10), ventral thalamus (VT, 2), hypothalamus (HY, 16), mesencephalon (MES, 11), cerebellum (CB, 4), pons (P, 8), pontine nuclei (PN, 2), myelencephalon (MY, 12), ventricles (V, 1), and white matter (WM, 2) (S3 Table). The resulting gene by region matrix was averaged between subjects to produce 1 representative gene expression by region matrix and normalized across the brain regions. Cell type data is based on snRNA-seq from MTG largely from postmortem brains [15]. Nuclei were collected from 8 donor brains representing 15,928 nuclei passing quality control, including those from 10,708 excitatory neurons, 4,297 inhibitory neurons, and 923 non-neuronal cells. Cell type data from the mouse represents 23,822 single cells isolated from 2 cortical areas (VISp, ALM) from the C57GL/6J mouse [20].
Uniqueness of disease transcriptomic profiles
Gene expression profiles across regions from each donor are correlated (Pearson correlation) to profiles from other donors and averaged to determine consistency of mapping to ADG and GBD groups and to identify exact disease associations between donors in Fig 1.
Cell type specificity
Calculated based on the Tau-score defined in [55] and has previously been employed using the dataset [15]. Cell type specificity τ is defined as:
where x(i) is the gene expression level in each cell type for a given gene normalized by the maximum cell type expression of that gene, and the summation is over N cell-types in the analysis.
Disease–disease similarity index
To calculate the similarity between each pair of disorders, we used the gene expression patterns across 104 brain structures. Distance metric between diseases is 1 – ρ, where ρ is Pearson correlation between structure or cell type profile. The procedure for disease similarity using cell type data used the gene expression pattern across the 75 cell types (instead of brain regions) in human cells extracted from MTG. For clustering in both cases, we used agglomerative hierarchical clustering with Ward linkage algorithm (Ward.2 in R hclust function, R version 3.6.3).
Gene expression differential stability (DS)
Gene expression DS was calculated for each gene as the similarity of its expression pattern across 6 postmortem brains. For each pair of brains, the correlation of expression patterns across overlapping brain structures was calculated. The mean correlation over these 15 pairs was used as the DS for the given gene (for more details, see [13]).
Disease-module association
Mapping gene expression for each gene to canonical modules, correlates the eigengene pattern from modules within each of 6 postmortem brains as explained in [14]. Correlation values are then normalized using Fisher r-to-z transform and averaged across brains. For each module, the gene associations were then standardized (μ = 0, σ = 1). Finally, these values are averaged across genes associated with each disease to calculate the disease module association.
Disease-related gene expression within cell types
We used EWCE analysis (https://bioconductor.riken.jp/packages/3.4/bioc/html/EWCE.html; [74]) to identify cell types showing enriched gene expression. EWCE compares the expression levels of the genes associated with a given disease to the background gene expression (all genes, excluding the disease-related genes) by performing permutation analysis and defining the probability for the observed expression level of the given gene set compared against a random set of genes with the same size. We used N = 100,000 as the permutation parameter and performed the analysis at 2 cell type category levels. The 2 levels included broad cell types (N = 7) and cell-subclasses (N = 20) with non-neuronal cell types common between the 2 levels of analysis. The 2 levels were selected due to the availability of the homologous cell types in mouse and human cell dataset. For each disease, we used FDR correction for multiple comparisons for disease-cell type associations for each disease.
Cell type-specific interaction and functional enrichment
Gene expression covariation is computed as the absolute value of cosine distance similarity of cell type expression across MTG cell types. Matrices are computed for each of 3 psychiatric diseases using non-overlapping genes, and then independently thresholded to 1.5σ. Entries are combined into a single matrix and are color coded if a given disease exceeds the threshold. Functional enrichment analysis to identify significantly enriched (p-value <0.05 FDR Benjamini and Hochberg) ontological terms and pathways for unique disease gene sets was done using the ToppFun application of the ToppGene Suite [80]. Representative enriched terms and genes were used to generate network visualization using Cytoscape application [81].
Consensus representation
Consensus UMAP was constructed by averaging pairwise gene set correlation matrices for structural and cell type data and forming a 2D UMAP using R.
Statistical analysis
All statistical analysis and visualization were conducted in R (www.r-project.org), a Jupyter notebook reproduces all analysis. To examine the differences in mean expression level between ADG groups, we performed ANOVA tests, followed by direct comparisons between ADG pairs using unpaired t test. All results were corrected for multiple comparisons using Benjamini–Hochberg correction controlling the FDR. To examine the stability of the gene expression profiles, we repeated our analysis across 6 brains and searched for the matching pattern in other subjects for any given brain across ADG and GBD disease groups. Kolmogorov–Smirnoff test for goodness of fit is used in Fig 5.
Supporting information
Acknowledgments
The authors thank Christof Koch, Liane Ong, Stephen J. Smith, and Theo Vos for insightful and helpful discussions.
Abbreviations
- ADG
Anatomic Disease Group
- AHBA
Allen Human Brain Atlas
- ALM
anterior lateral motor
- BICAN
Brain Initiative Cell Atlas Network
- BICCN
Brain Initiative Cell Census Network
- CGS
central glial substance
- CN
cerebellar nuclei
- DS
differential stability
- ECT
electroconvulsive therapy
- EWCE
expression-weighted cell type enrichment
- FDR
false discovery rate
- FL
frontal lobe
- GBD
Global Burden of Disease
- GDA
gene–disease association
- GP
globus pallidus
- GR
gracile nucleus
- IHME
Institute for Health Metrics
- MS
multiple sclerosis
- MTG
middle temporal gyrus
- OCD
obsessive-compulsive disorder
- OMIM
Online Mendelian Inheritance in Man
Data Availability
All data used in this manuscript are publicly available. The gene disease association data can be downloaded from https://www.disgenet.org/. The large-scale anatomic transcriptional patterns can be downloaded from http://human.brain-map.org/ and cell type data is available at http://celltypes.brain-map.org/. The script (Jupyter notebook) and the data files for producing the figures are provided at https://doi.org/10.5281/zenodo.7709525.
Funding Statement
This work was in part supported by funding from the Canada First Research Excellence Fund, awarded to McGill University for the Healthy Brains, Healthy Lives (HBHL) initiative New Recruit Start-Up Supplements Program, as well as Réseau de Bio-Imagerie du Québec (RBIQ /QBIN). MH was also supported by R01MH123220 (PI) 08/01/2020-07/31/2022 (NIH): A Community Framework for Data-driven Brain Transcriptomic Cell Type Definition, Ontology, and Nomenclature grant. "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
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