Psychological Medicine

Original Articles

The one and the many: effects of the cell adhesion molecule pathway on neuropsychological function in psychosis

A. Hargreavesa1, R. Anneya1, C. O'Dushlainea1, K. K. Nicodemusa1, Schizophrenia Psychiatric Genome-Wide Association Study Consortium (PGC-SCZ) , Wellcome Trust Case Control Consortium 2 , M. Gilla1, A. Corvina1, D. Morrisa1 and Gary Donohoea1a2 c1

a1 Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Republic of Ireland

a2 School of Psychology, National University of Ireland, Galway, Republic of Ireland


Background Genetic studies of single gene variants have been criticized as providing a simplistic characterization of the genetic basis of illness risk that ignores the effects of other variants within the same biological pathways. Of candidate biological pathways for schizophrenia (SZ), the cell adhesion molecule (CAM) pathway has repeatedly been linked to both psychosis and neurocognitive dysfunction. Here we tested, using risk allele scores derived from the Schizophrenia Psychiatric Genome-Wide Association Study Consortium (PGC-SCZ), whether alleles within the CAM pathway were correlated with poorer neuropsychological function in patients.

Method In total, 424 patients with psychosis were assessed in areas of cognitive ability typically found to be impaired in SZ: intelligence quotient, memory, working memory and attentional control. CAM pathway genes were identified using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Alleles within these genes identified as significantly associated with SZ risk in the PGC-SCZ were then used to calculate a CAM pathway-based polygenic risk allele score for each patient and these scores were tested for association with cognitive ability.

Results Increased CAM pathway polygenic risk scores were significantly associated with poorer performance on measures of memory and attention, explaining 1–3% of variation on these measures. Notably, the most strongly associated single nucleotide polymorphism (SNP) in the CAM pathway (rs9272105 within HLA-DQA1) explained a similar amount of variance in attentional control, but not memory, as the polygenic risk analysis.

Conclusions These data support a role for the CAM pathway in cognitive function, both at the level of individual SNPs and the wider pathway. In so doing these data highlight the value of pathway-based polygenic risk score studies as well as single gene studies for understanding SZ-associated deficits in cognition.

(Received June 21 2013)

(Revised September 20 2013)

(Accepted September 21 2013)

(Online publication November 28 2013)

Key words

  • Cell adhesion molecules;
  • cognition;
  • gene;
  • HLA-DQA1 ;
  • pathway;
  • psychosis;
  • schizophrenia


c1 Address for correspondence: Professor G. Donohoe, National University of Ireland, Galway, Republic of Ireland. (Email:


  For Consortium members and affiliations, see Supplementary online material.