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Heitzer AM, Rashkin SR, Trpchevska A, Longoria JN, Rampersaud E, Olufadi Y, Wang WC, Raches D, Potter B, Steinberg MH, King AA, Kang G, Takemoto CM, Hankins JS. Catechol-O-methyltransferase gene (COMT) is associated with neurocognitive functioning in patients with sickle cell disease. Curr Res Transl Med 2024; 72:103433. [PMID: 38244277 PMCID: PMC11106217 DOI: 10.1016/j.retram.2023.103433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE Neurocognitive impairment is a common and debilitating complication of sickle cell disease (SCD) resulting from a combination of biological and environmental factors. The catechol-O-methyltransferase (COMT) gene modulates levels of dopamine availability in the prefrontal cortex. COMT has repeatedly been implicated in the perception of pain stimuli and frequency of pain crises in patients with SCD and is known to be associated with neurocognitive functioning in the general population. The current study aimed to examine the associations of genetic variants in COMT and neurocognitive functioning in patients with SCD. PATIENTS AND METHODS The Sickle Cell Clinical Research and Intervention Program (SCCRIP) longitudinal cohort was used as a discovery cohort (n = 166). The genotypes for 5 SNPs (rs6269, rs4633, rs4818, rs4680, and rs165599) in COMT were extracted from whole genome sequencing data and analyzed using a dominant model. A polygenic score for COMT (PGSCOMT) integrating these 5 SNPs was analyzed as a continuous variable. The Cooperative Study of Sickle Cell Disease (CSSCD, n = 156) and the Silent Cerebral Infarction Transfusion (SIT, n = 114) Trial were used as 2 independent replication cohorts. Due to previously reported sex differences, all analyses were conducted separately in males and females. The Benjamini and Hochberg approach was used to calculate false discovery rate adjusted p-value (q-value). RESULTS In SCCRIP, 1 out of 5 SNPs (rs165599) was associated with IQ at q<0.05 in males but not females, and 2 other SNPs (rs4633 and rs4680) were marginally associated with sustained attention at p<0.05 in males only but did not maintain at q<0.05. PGSCOMT was negatively associated with IQ and sustained attention at p<0.05 in males only. Using 3 cohorts' data, 4 out of 5 SNPs (rs6269, rs4633, rs4680, rs165599) were associated with IQ (minimum q-value = 0.0036) at q<0.05 among male participants but not female participants. The PGSCOMT was negatively associated with IQ performance among males but not females across all cohorts. CONCLUSION Select COMT SNPs are associated with neurocognitive abilities in males with SCD. By identifying genetic predictors of neurocognitive performance in SCD, it may be possible to risk-stratify patients from a young age to guide implementation of early interventions.
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Affiliation(s)
- Andrew M Heitzer
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States.
| | - Sara R Rashkin
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Ana Trpchevska
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer N Longoria
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Evadnie Rampersaud
- Center for Applied Bioinformatics, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Yunusa Olufadi
- Biostatistics Department, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Winfred C Wang
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Darcy Raches
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Brian Potter
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Martin H Steinberg
- Department of Medicine, Boston University Chobanian & Avidesian School of Medicine, Boston, MA, United States
| | - Allison A King
- Program in Occupational Therapy and Departments of Pediatrics and Medicine, Washington University, St. Louis, MO, United States
| | - Guolian Kang
- Biostatistics Department, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Clifford M Takemoto
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States; Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
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Ellison V, Berlin KS, Longoria J, Potter B, Raches D, Hankins JS, Takemoto C, Heitzer AM. Empirically derived profiles of neurocognitive functioning in youth and young adults with sickle cell disease. J Pediatr Psychol 2024:jsae029. [PMID: 38623054 DOI: 10.1093/jpepsy/jsae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE Sickle cell disease (SCD) is an inherited blood disorder associated with neurocognitive deficits. In contrast to variable-centered approaches, no known research has utilized person-centered strategies to identify multidimensional patterns of neurocognitive functioning of an individual with SCD. The purpose of the present study was to create empirically derived profiles and identify predictors of neurocognitive functioning subgroups among youth and young adults with SCD. METHODS Individuals with SCD (N = 393, mean age 14.05 years, age range 8-24, 50.4% female/49.6% male) completed neurocognitive assessments. Latent profile analysis derived subgroups/classes of neurocognitive functioning and determined relations with demographic and medical variables. RESULTS Three latent classes emerged: average functioning (n = 102, 27%), low average functioning (n = 225, 60%), and exceptionally low functioning (n = 46, 12%). Older age was associated with membership in the low average and exceptionally low functioning groups (relative to the average group). Being prescribed hydroxyurea was associated with membership in the average functioning group (relative to the low average group) and absence of hydroxyurea use was associated with membership in the exceptionally low group (relative to the low average group). Lower social vulnerability was associated with membership in the average functioning group compared to the low average and exceptionally low groups. CONCLUSIONS Clinicians can help reduce disparities in cognitive development for individuals with SCD by promoting early treatment with hydroxyurea and implementing methods to reduce social vulnerabilities that can interfere with access to evidence-based care.
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Affiliation(s)
- Vinkrya Ellison
- Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, TN, United States
- The Department of Psychology, The University of Memphis, Memphis, TN, United States
- The Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, United States
| | - Kristoffer S Berlin
- The Department of Psychology, The University of Memphis, Memphis, TN, United States
- The Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, United States
| | - Jennifer Longoria
- Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Brian Potter
- Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Darcy Raches
- Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Jane S Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, United States
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Clifford Takemoto
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Andrew M Heitzer
- Department of Psychology and Biobehavioral Sciences, St Jude Children's Research Hospital, Memphis, TN, United States
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Ordak M. Current research in translational medicine - biostatistical recommendations for authors. Curr Res Transl Med 2023; 71:103381. [PMID: 36731378 DOI: 10.1016/j.retram.2023.103381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023]
Affiliation(s)
- Michal Ordak
- Department of Pharmacodynamics, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., Warsaw 02-097, Poland.
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Heitzer AM, Longoria J, Porter JS, MacArthur E, Potter B, Ding J, Gossett J, Kang G, Hankins JS. Internalizing Symptoms in Adolescents With Sickle Cell Disease. J Pediatr Psychol 2023; 48:91-103. [PMID: 35980301 PMCID: PMC10120839 DOI: 10.1093/jpepsy/jsac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Sickle cell disease (SCD) is a genetic blood disorder that may affect patients' mood and behavior. However, measuring the prevalence of internalizing symptoms (anxiety and depression) in patients with SCD has been elusive. We assessed internalizing symptoms in adolescents with SCD to evaluate prevalence and to test whether neurocognitive performance and frequency of pain-related episodes were associated with internalizing concerns. METHODS One hundred eighty-five patients (57% HbSS/HbSß0-thalassemia, 43% HbSC/HbSß+-thalassemia), ages 12-18 years, received a neuropsychological evaluation as a part of a larger cohort study. Internalizing symptoms were measured using the Behavior Assessment System for Children, Second or Third Edition. Scores on the depression and anxiety scales were compared to normative values using Wilcoxon signed rank test. Spearman correlations examined associations between neurocognitive performances and internalizing symptoms. Robust multivariable regression models measured associations between internalizing symptoms and age, sex, sickle genotype, total hemoglobin, fetal hemoglobin, socioeconomic status, and frequency of pain episodes. RESULTS Parent- and self-reported ratings of internalizing symptoms were not elevated compared to normative expectations. Overall, 1.8% and 6.3% of the sample displayed clinically elevated symptoms of anxiety and depression based on self-report, respectively. There were no associations between internalizing symptoms and neurocognitive performance (all p > .05). In multivariable analyses, the frequency of pain episodes was positively associated with self-reported anxiety (p = .006) and parent-reported depressive symptoms (p = .017). CONCLUSIONS Adolescents with SCD do not report elevated internalizing symptoms compared to normative expectations. Further research is needed to examine the trajectory of internalizing symptoms and the bidirectional relationship between pain and psychosocial functioning in SCD.
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Affiliation(s)
- Andrew M Heitzer
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Jennifer Longoria
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Jerlym S Porter
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Erin MacArthur
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Brian Potter
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Juan Ding
- Department of Biostatistics, St. Jude Children's Research Hospital, USA
| | - Jeffrey Gossett
- Department of Biostatistics, St. Jude Children's Research Hospital, USA
| | - Guolian Kang
- Department of Biostatistics, St. Jude Children's Research Hospital, USA
| | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, USA
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