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. Silliman
  • Bradford 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

25 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
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

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