17p12 Influences Hematoma Volume and Outcome in Spontaneous Intracerebral Hemorrhage

Sandro Marini, William J. Devan, Farid Radmanesh, Laura Miyares, Timothy Poterba, Björn M. Hansen, Bo Norrving, Jordi Jimenez-Conde, Eva Giralt-Steinhauer, Roberto Elosua, Elisa Cuadrado-Godia, Carolina Soriano, Jaume Roquer, Christina E. Kourkoulis, Alison M. Ayres, Kristin Schwab, David L. Tirschwell, Magdy Selim, Devin L. Brown, Scott L. SillimanBradford B. Worrall, James F. Meschia, Chelsea S. Kidwell, Joan Montaner, Israel Fernandez-Cadenas, Pilar Delgado, Steven M. Greenberg, Arne Lindgren, Charles Matouk, Kevin N. Sheth, Daniel Woo, Christopher D. Anderson, Jonathan Rosand, Guido J. Falcone

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background and Purpose-Hematoma volume is an important determinant of clinical outcome in spontaneous intracerebral hemorrhage (ICH). We performed a genome-wide association study (GWAS) of hematoma volume with the aim of identifying novel biological pathways involved in the pathophysiology of primary brain injury in ICH. Methods-We conducted a 2-stage (discovery and replication) case-only genome-wide association study in patients with ICH of European ancestry. We utilized the admission head computed tomography to calculate hematoma volume via semiautomated computer-Assisted technique. After quality control and imputation, 7 million genetic variants were available for association testing with ICH volume, which was performed separately in lobar and nonlobar ICH cases using linear regression. Signals with P<5×10 - 8 were pursued in replication and tested for association with admission Glasgow coma scale and 3-month post-ICH dichotomized (0-2 versus 3-6) modified Rankin Scale using ordinal and logistic regression, respectively. Results-The discovery phase included 394 ICH cases (228 lobar and 166 nonlobar) and identified 2 susceptibility loci: A genomic region on 22q13 encompassing PARVB (top single-nucleotide polymorphism rs9614326: β, 1.84; SE, 0.32; P=4.4×10 -8 ) for lobar ICH volume and an intergenic region overlying numerous copy number variants on 17p12 (top single-nucleotide polymorphism rs11655160: β, 0.95; SE, 0.17; P=4.3×10 -8 ) for nonlobar ICH volume. The replication included 240 ICH cases (71 lobar and 169 nonlobar) and corroborated the association for 17p12 (P=0.04; meta-Analysis P=2.5×10 -9 ; heterogeneity, P=0.16) but not for 22q13 (P=0.49). In multivariable analysis, rs11655160 was also associated with lower admission Glasgow coma scale (odds ratio, 0.17; P=0.004) and increased risk of poor 3-month modified Rankin Scale (odds ratio, 1.94; P=0.045). Conclusions-We identified 17p12 as a novel susceptibility risk locus for hematoma volume, clinical severity, and functional outcome in nonlobar ICH. Replication in other ethnicities and follow-up translational studies are needed to elucidate the mechanism mediating the observed association.

Original languageEnglish (US)
Pages (from-to)1618-1625
Number of pages8
JournalStroke
Volume49
Issue number7
DOIs
StatePublished - Jul 1 2018

Keywords

  • cerebral hemorrhage
  • genetics
  • genome-wide association study
  • humans
  • neuroimaging

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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