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Marjan Kromkamp, MD, PhD; Harry B. M. Uylings, PhD; Marten P. Smidt, PhD; Anita J. C. G. M. Hellemons, BSc; J. Peter H. Burbach, PhD; René S. Kahn, MD, PhD

Arch Gen Psychiatry. 2003;60:869-874.

Context  A shared vulnerability to develop psychosis can be related to abnormalities in thalamic circuits in schizophrenia and bipolar disorder and could be a genetic link between these disorders. Homeobox genes involved in development and differentiation of the brain could play an important role in these disorders.

Objective  To determine whether patients with schizophrenia and bipolar disorder have different thalamic expression patterns of 2 homeobox genes, DLX1 and SHOX2 (alias OG12X or SHOT) compared with psychiatric and nonpsychiatric control subjects.

Design  Postmortem sections containing the thalamic mediodorsal nucleus were subjected to in situ hybridization with mouse Dlx1 and human SHOX2 RNA probes. The number of both DLX1- and SHOX2-positive neurons relative to Nissl-stained neurons was estimated in systematic randomly sampled volume probes.

Patients  Fifteen patients with schizophrenia, 15 with bipolar disorder with or without history of psychosis, 15 with major depressive disorder, and 15 nonpsychiatric controls from the Stanley Foundation Brain Bank.

Main Outcome Measure  Relative numbers of DLX1- and SHOX2-positive neurons in patients with schizophrenia and bipolar disorder with history of psychosis compared with psychiatric and nonpsychiatric controls.

Results  Patients with a history of psychosis showed significantly decreased relative numbers of DLX1-positive neurons compared with patients without history of psychosis and nonpsychiatric controls (P = .02), whereas no differences could be found in relative numbers of SHOX2-positive neurons (P>.15). Results were obtained blind to diagnosis, symptoms, or any other variable except hemisphere.

Conclusion  Decreased thalamic expression of DLX1 in schizophrenia and bipolar disorder with psychosis suggests shared genetic deficits in expression of this homeobox gene.

From the Departments of Pharmacology and Anatomy (Drs Kromkamp, Smidt, and Burbach and Ms Hellemons) and Psychiatry (Drs Kromkamp and Kahn), Rudolf Magnus Institute for Neurosciences, University Medical Center, Utrecht, the Netherlands; Netherlands Institute for Brain Research, Graduate School Neurosciences Amsterdam, KNAW (Royal Netherlands Academy of Arts and Sciences) (Dr Uylings); Department of Anatomy, VU (Free University) University Medical Center, Amsterdam (Dr Uylings).

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