1
|
Merritt VC, Maihofer AX, Gasperi M, Chanfreau-Coffinier C, Stein MB, Panizzon MS, Hauger RL, Logue MW, Delano-Wood L, Nievergelt CM. Genome-wide association study of traumatic brain injury in U.S. military veterans enrolled in the VA million veteran program. Mol Psychiatry 2024; 29:97-111. [PMID: 37875548 DOI: 10.1038/s41380-023-02304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Large-scale genetic studies of traumatic brain injury (TBI) are lacking; thus, our understanding of the influence of genetic factors on TBI risk and recovery is incomplete. This study aimed to conduct a genome-wide association study (GWAS) of TBI in VA Million Veteran Program (MVP) enrollees. Participants included a multi-ancestry cohort (European, African, and Hispanic ancestries; N = 304,485; 111,494 TBI cases, 192,991 controls). TBI was assessed using MVP survey data and International Classification of Diseases (ICD) codes from the Veterans Health Administration's electronic health record. GWAS was performed using logistic regression in PLINK, and meta-analyzed in METAL. FUMA was used for post-GWAS analysis. Genomic structural equation modeling (gSEM) was conducted to investigate underlying genetic associations with TBI, and bivariate MiXeR was used to estimate phenotype specific and shared polygenicity. SNP-based heritability was 0.060 (SE = 0.004, p = 7.83×10-66). GWAS analysis identified 15 genome-wide significant (GWS) loci at p < 5×10-8. Gene-based analyses revealed 14 gene-wide significant genes; top genes included NCAM1, APOE, FTO, and FOXP2. Gene tissue expression analysis identified the brain as significantly enriched, particularly in the frontal cortex, anterior cingulate cortex, and nucleus accumbens. Genetic correlations with TBI were significant for risk-taking behaviors and psychiatric disorders, but generally not significant for the neurocognitive variables investigated. gSEM analysis revealed stronger associations with risk-taking traits than with psychiatric traits. Finally, the genetic architecture of TBI was similar to polygenic psychiatric disorders. Neurodegenerative disorders including Alzheimer's and Parkinson's disease showed much less polygenicity, however, the proportion of shared variance with TBI was high. This first well-powered GWAS of TBI identified 15 loci including genes relevant to TBI biology, and showed that TBI is a heritable trait with comparable genetic architecture and high genetic correlation with psychiatric traits. Our findings set the stage for future TBI GWASs that focus on injury severity and diversity and chronicity of symptom sequelae.
Collapse
Affiliation(s)
- Victoria C Merritt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA.
| | - Adam X Maihofer
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Marianna Gasperi
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | | | - Murray B Stein
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Matthew S Panizzon
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Richard L Hauger
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Department of Psychiatry, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, MA, USA
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Caroline M Nievergelt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| |
Collapse
|
2
|
Panenka WJ, Gardner AJ, Dretsch MN, Crynen GC, Crawford FC, Iverson GL. Systematic Review of Genetic Risk Factors for Sustaining a Mild Traumatic Brain Injury. J Neurotrauma 2017; 34:2093-2099. [PMID: 28100103 DOI: 10.1089/neu.2016.4833] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This systematic review examined the association between genetics and risk for sustaining a traumatic brain injury. We retrieved articles published in English from 1980 to July 2016 obtained from the online databases PubMed, PsycINFO®, MEDLINE®, Embase, and Web of Science. In total 5903 articles were identified, 77 underwent full-text screening, and 6 were included in this review. Five studies examined the risk of concussion associated with apolipoprotein E alleles (APOE-ɛ2, ɛ3,ɛ4), and polymorphisms of the APOE promoter (rs405509), brain derived neurotrophic factor (BDNF, rs6265), and dopamine receptor D2 (DRD2, rs1800497) were each considered in two studies. Microtubule associated protein tau (TAU exon 6 polymorphisms His47Tyr [rs2258689] and Ser53Pro [rs10445337]), and neurofilament heavy (NEHF, rs165602) genotypic variants, were the focus of single studies. No study showed an increased risk associated solely with the presence of the APOE-ɛ4 allele, nor were there any significant findings for the NEFH, TAU, or DRD2 genotypic variants. Two studies examined the APOE promoter -219G/T polymorphism in athletes, and both found an association with concussion. Both BDNF studies also found a significant association with concussion incidence; United States soldiers with the Met/Met genotype were more likely to report a history of concussion prior to deployment and to sustain a concussion during deployment. We conclude that the APOE promoter -219G/T polymorphism and the BDNF Met/Met genotype might confer risk for sustaining a TBI. Based on research to date, the APOE-ɛ4 allele does not appear to influence risk. More research is needed to determine if these findings replicate.
Collapse
Affiliation(s)
- William J Panenka
- 1 British Columbia Neuropsychiatry Program and Department of Psychiatry, University of British Columbia , Vancouver, British Columbia, Canada
| | - Andrew J Gardner
- 2 Hunter New England Local Health District Sports Concussion Program; & Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle , Callaghan, New South Wales, Australia
| | - Michael N Dretsch
- 3 Human Dimension Division (HDD), Headquarters Army Training and Doctrine Command (HQ TRADOC) , Fort Eustis, Virginia
| | | | | | - Grant L Iverson
- 5 Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; MassGeneral Hospital for Children Sports Concussion Program; and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston, Massachusetts
- 6 Defense and Veterans Brain Injury Center , Bethesda, Maryland
| |
Collapse
|
4
|
Zeng S, Jiang JX, Xu MH, Xu LS, Shen GJ, Zhang AQ, Wang XH. Prognostic Value of Apolipoprotein E Epsilon4 Allele in Patients with Traumatic Brain Injury: A Meta-Analysis and Meta-Regression. Genet Test Mol Biomarkers 2014; 18:202-10. [PMID: 24475734 DOI: 10.1089/gtmb.2013.0421] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Shi Zeng
- Department of Neurosurgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - Jian-Xin Jiang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - Min-Hui Xu
- Department of Neurosurgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - Lun-Shan Xu
- Department of Neurosurgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - Guang-Jian Shen
- Department of Neurosurgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - An-Qiang Zhang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| | - Xu-Hui Wang
- Department of Neurosurgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, YuZhong District, Chongqing, People's Republic of China
| |
Collapse
|
6
|
Strain influences on inflammatory pathway activation, cell infiltration and complement cascade after traumatic brain injury in the rat. Brain Behav Immun 2013; 27:109-22. [PMID: 23044177 DOI: 10.1016/j.bbi.2012.10.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 09/21/2012] [Accepted: 10/01/2012] [Indexed: 01/21/2023] Open
Abstract
Increasing evidence suggests that genetic background affects outcome of traumatic brain injuries (TBI). Still, there is limited detailed knowledge on what pathways/processes are affected by genetic heterogeneity. The inbred rat strains DA and PVG differ in neuronal survival following TBI. We here carried out global expressional profiling to identify differentially regulated pathways governing the response to an experimental controlled brain contusion injury. One of the most differentially regulated molecular networks concerned immune cell trafficking. Subsequent characterization of the involved cells using flow cytometry demonstrated greater infiltration of neutrophils and monocytes, as well as a higher degree of microglia activation in DA compared to PVG rats. In addition, DA rats displayed a higher number of NK cells and a higher ratio of CD161bright compared to CD161dim NK cells. Local expression of complement pathway molecules such as C1 and C3 was higher in DA and both the key complement component C3 and membrane-attack complex (MAC) could be demonstrated on axons and nerve cells. A stronger activation of the complement system in DA was associated with higher cerebrospinal fluid levels of neurofilament-light, a biomarker for nerve/axonal injury. In summary, we demonstrate substantial differences between DA and PVG rats in activation of inflammatory pathways; in particular, immune cell influx and complement activation associated with neuronal/axonal injury after TBI. These findings suggest genetic influences acting on inflammatory activation to be of importance in TBI and motivate further efforts using experimental forward genetics to identify genes/pathways that affect outcome.
Collapse
|
7
|
Jiang Y, Brody DL. Administration of COG1410 reduces axonal amyloid precursor protein immunoreactivity and microglial activation after controlled cortical impact in mice. J Neurotrauma 2012; 29:2332-41. [PMID: 22676717 DOI: 10.1089/neu.2012.2362] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Traumatic axonal injury (TAI) accounts for at least 35% of the morbidity and mortality in traumatic brain injury (TBI) patients without space-occupying lesions. It is also believed to be a key determinant of adverse outcomes such as cognitive dysfunction across the spectrum of TBI severity. Previous studies have shown that COG1410, a synthetic peptide derived from the apolipoprotein E (apoE) receptor binding region, has anti-inflammatory effects after experimental TBI, with improvements in cognitive recovery. However, the effects of COG1410 on axonal injury following TBI are not known. The current study evaluated the effects of 1 mg/kg daily COG1410 versus saline administered intravenously starting 30 min after controlled cortical impact (CCI) injury on pericontusional TAI in young, wild-type C57BL6/J male mice. We found that COG1410 did not affect the number of amyloid precursor protein (APP)-immunoreactive axonal varicosities in the pericontusional corpus callosum and external capsule at 24 h, but reduced APP-immunoreactive varicosities by 31% at 3 days (p=0.0023), and 36% at 7 days (p=0.0009). COG1410 significantly reduced the number of Iba1-positive cells with activated microglial morphology at all three time points by 21-30%. There was no effect of COG1410 on pericontusional white matter volume or silver staining at any time point. This indicates a possible effect of COG1410 on delayed but not immediate TAI. Future studies are needed to investigate the underlying mechanisms, therapeutic time window, and physiological implications of this effect.
Collapse
Affiliation(s)
- Yong Jiang
- Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, P.R. China
| | | |
Collapse
|
8
|
Mehan ND, Strauss KI. Combined age- and trauma-related proteomic changes in rat neocortex: a basis for brain vulnerability. Neurobiol Aging 2011; 33:1857-73. [PMID: 22088680 DOI: 10.1016/j.neurobiolaging.2011.09.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 09/17/2011] [Indexed: 11/16/2022]
Abstract
This proteomic study investigates the widely observed clinical phenomenon, that after comparable brain injuries, geriatric patients fare worse and recover less cognitive and neurologic function than younger victims. Utilizing a rat traumatic brain injury model, sham surgery or a neocortical contusion was induced in 3 age groups. Geriatric (21 months) rats performed worse on behavioral measures than young adults (12-16 weeks) and juveniles (5-6 weeks). Motor coordination and certain cognitive deficits showed age-dependence both before and after injury. Brain proteins were analyzed using silver-stained two-dimensional electrophoresis gels. Spot volume changes (>2-fold change, p<0.01) were identified between age and injury groups using computer-assisted densitometry. Sequences were determined by mass spectrometry of tryptic peptides. The 19 spots identified represented 13 different genes that fell into 4 general age- and injury-dependent expression patterns. Fifteen isoforms changed differentially with respect to both age and injury (p<0.05). Further investigations into the nature and function of these isoforms may yield insights into the vulnerability of older patients and resilience of younger patients in recovery after brain injuries.
Collapse
Affiliation(s)
- Neal D Mehan
- University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0517, USA
| | | |
Collapse
|
9
|
Guo ZD, Sun XC, Zhang JH. The role of apolipoprotein e in the pathological events following subarachnoid hemorrhage: a review. ACTA NEUROCHIRURGICA. SUPPLEMENT 2011; 110:5-7. [PMID: 21125436 DOI: 10.1007/978-3-7091-0356-2_1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Subarachnoid hemorrhage (SAH) strikes individuals with devastating neurological results. Traditional viewpoints do not explain all the differences that are usually found in clinical practice. The role of genetic predisposition in SAH has recently been investigated. Particular attention has been paid to the apolipoprotein E (apoE) genotype. APOE genotype is a major prognostic factor in patient outcome after spontaneous aneurysmal SAH. In patients with SAH, the expression of the apoE ε4 allele is associated with a higher risk of negative outcome and delayed ischemia. Evidence from experimental and clinical studies confirms that apoE plays an important role in the pathological events after SAH. This article reviews related research and surveys the links between the pathological events of SAH and apoE.
Collapse
Affiliation(s)
- Zong-Duo Guo
- Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | | | | |
Collapse
|