To discover common genetic variants associated with poststroke outcomes using a genome-wide association (GWA) study.
The study comprised 6,165 patients with ischemic stroke from 12 studies in Europe, the United States, and Australia included in the GISCOME (Genetics of Ischaemic Stroke Functional Outcome) network. The primary outcome was modified Rankin Scale score after 60 to 190 days, evaluated as 2 dichotomous variables (0–2 vs 3–6 and 0–1 vs 2–6) and subsequently as an ordinal variable. GWA analyses were performed in each study independently and results were meta-analyzed. Analyses were adjusted for age, sex, stroke severity (baseline NIH Stroke Scale score), and ancestry. The significance level was p < 5 × 10 −8.
We identified one genetic variant associated with functional outcome with genome-wide significance (modified Rankin Scale scores 0–2 vs 3–6, p = 5.3 × 10 −9). This intronic variant (rs1842681) in the LOC105372028 gene is a previously reported trans-expression quantitative trait locus for PPP1R21, which encodes a regulatory subunit of protein phosphatase 1. This ubiquitous phosphatase is implicated in brain functions such as brain plasticity. Several variants detected in this study demonstrated suggestive association with outcome ( p < 10 −5), some of which are within or near genes with experimental evidence of influence on ischemic stroke volume and/or brain recovery (e.g., NTN4, TEK, and PTCH1).
In this large GWA study on functional outcome after ischemic stroke, we report one significant variant and several variants with suggestive association to outcome 3 months after stroke onset with plausible mechanistic links to poststroke recovery. Future replication studies and exploration of potential functional mechanisms for identified genetic variants are warranted.
Swedish governmental funding under the ?Avtal om L?karutbildning och Medicinsk Forskning, ALF?, 2017-2018.
(1) Swedish stroke association(2) the Foundation of F?rs & Frosta?one of Sparbanken Sk?ne?s ownership Foundations
Book entitled: Stroke Essentials for Primary Care, Alway, David; Cole, John Walden (Eds., 2009, Springer, ISBN: 978-1-934115-01-5
American Heart Association/Bayer Pharmaceuticals Cole Role: PI Grant #17IBDG33700328 The Genetics and Biomarkers of Small Vessel Stroke.
Data safety monitoring board, AC Immune, Trial of vaccine for Alzheimer's disease, Commercial Stroke Prevention in Atrial Fibrillation, Bayer, Commercial
Commercial entity, honoraria for lecturing at a scientific symposium on anticoagulation for atrial fibrillation at European Stroke Conference, 2018, sponsored by Bayer. Commercial entity, honoraria for participating in a panel discussion on atrial fibrillation registries for theheart.org, sponsored by Medscape.
Currently Circulation, Associate Editor International journal of Stroke, consulting editor The Lancet, Editorial consultant The Lancet Neurology, Editorial consultant Stroke, Editorial board member Cerebrovascular Diseases, Editorial Advisory Board member
DSMB member for CATCH trial: A Multicenter, Open-Label, Phase 2a Proof-of-Concept Study to Evaluate the Administration of CN-105 in Participants with Acute Supratentorial Intracerebral Hemorrhage; sponsored by AegisCN
NIH/NINDS R01NS084028 (PI), R01NS085419 (PI), R01NS094692 (PI), R21AG05533301 (PI), U24NS107230 (PI).
Foundation for Barnes-Jewish Hospital (Landau Fund, Lillian Strauss Fund)
I have received travel expenses and/or honoraira for lectures or educational activities not funded by industry
Expert External Reviewer - Stroke and Neurology Service, The Alfred Hospital, Melbourne. 2012
NHMRC Practitioner Fellowship 2013-21 ongoing NHMRC Project, Program and Partnership Grants 2000-2021 ongoing
(1) Frontiers in Neurology (Review editor, Stroke), 2017- (2) Current Genetic Medicine Reports (Section editor, Cardiovascular Genetics), 2017
1. NIH P30DK072488,Co-Director, 2011 - 2020 2. NIH U01NS069208, Co-Investigator, 2010 - 2015 3. NIH R01NS073346, Co-Investigator, 2011 ? 2015 4. NIH R01NS086905, Co-Investigator, 2016 ? 2020 5. NIH R01NS100178, MPI, 2017-2022 6. NIH R01NS105150, MPI, 2017-2022 7. NIH U01MH1D8148, Co-Investigator, 2015 - 2020 8. NIH R01HL121007, PI, 2014-18 9. Regeneron Pharmaceutical, PI, 2015 - 2020 10. NIH R0HL1136574, Co-Investigator, 2015 - 2021
(1) Stroke, Assistant Editor, 2010 - current; (2) Current Treatment Options in Cardiovascular Medicine, Section Editor, 2014 - 2017. (3) Continuum - Cerebrovascular Issue Editor, 2018
NIH/NINDS R01NS082285 (PI), 2013 -current NIH/NINDS R01NS086905 (PI), 2015 - current
Bayer - Executive Committee of ARRIVE Trial - 2006 onwards Servier - Executive Committee of PERFORM trial - 2005 -2010 Pfizer - IDMC if Rocket-AF Trial - 2006 - 2009 Biotronic - Executive Committee of device trial - 2005 - 2011
I don't keep a record. Certainly had travel expenses paid by Sanofi-Aventis, Servier, Astra-Zeneca and Bayer in past. However, nothing relevant to this manuscript.
Stroke, Section Editor, 2013- European Stroke Journal, Editorial board member, 2016-
(1) The Helsinki University Central Hospital (HUCH) governmental subsidiary (EVO) funds for clinical research, minor role, 2015-2018. (2) The Finnish Medical Foundation, funds for clinical research 2014-2016
(1) Cancer Research UK Brain cancer Centre of Excellence (Co-I), ?3 Million 2018-2023 (2) Health Data Research UK Scottish Substantive Site Award (PI), ?5 million, 2018-2023 (3) Health Data Research UK: UKRI/Rutherford HRDUK Fellowships (PI), ?1.2 million, 2018-2021 (4) UK MRC and Wellcome Trust: UK Biobank programme renewal, ?35 million, 2010-2017 (co-I) (5) UK MRC, Dementias Platform UK programme grant, ?12 million, 2014-2019 (co-I) (6) UK MRC, Wellcome Trust, British Heart Foundation: UK Biobank imaging study, ?43 million, 2013-2022 (co-I) (7) European Union Innovative Medicines Initiative Horizon 2020 programme, ROADMAP (real world outcomes in Alzheimer's Disease), 8 million euros (about 50% EU, 50% EFPIA pharma company partners), 2016-2018 (co-I) (8) UK MRC: Mental Health Data Pathfinder Award (co-I), 2018-2021, ?1.3 million (9) MRC: Environment-wide association studies (co-I), 2017-2020, ?471K
(1) British Heart Foundation, 2012-2017, RESTART trial of antiplatelet treatment in ICH ( co-I)
(1) Bayer advisory board (2) Pfizer/BMS advisory board (3) Medtronic advisory board
(1) Medtronic (2) Boehringer Ingelheim (3) Pfizer (4) Bayer (5) Astra Zeneca
Acta Neurologica Belgica, Associate Editor, ongoing Stroke Editorial board member, ongoing European Journal of Emergency Medicine, Editorial Board member, until 2018 European Stroke Journal, Editorial Board member, ongoing International Journal of Stroke, Editorial board member, ongoing Frontiers in Neurology, Associate Editor, ongoing
Medtronic, Inc., Pfizer Inc., AstraZeneca, Boehringer Ingelheim, Astra Zeneca
Congress traveling and accommodation costs (none commercial): European Stroke Organisation University of Donau (Austria) Internal Medicine Society of Greece Thrombolysis and Thrombectomy in Acute Stroke Treatment Conference 2nd Stroke Academy Meeting, Istanbul, Turkey WSO Regional Conference - Caucasia Challenges in Stroke Meeting, Belgrade, Serbia
Stroke, 2000-2006, 2010-2016 Current Vascular Pharmacology, 2002- Stroke Research and Treatment, 2009- BMC Journal of Experimental and Translational Stroke Medicine, 2009-2015 Frontiers in Stroke, 2010- European Stroke Journal, 2016- Therapeutic Advances in Neurological Disroders, 2017- No compensation was received for any of the above editorial duties
1. New Therapeutic Uses (method to prevent brain edema and reperfusion injury), PCT/FI2004/000070. Inventors: Lindsberg PJ, Karjalainen-Lindsberg M-L, Tatlisumak T, Strbian D. Applicant: Licentia Oy. Application date: February 13, 2003. Publication 7/2003, Application number: 20030224. 2. Thrombolytic compositions (method to prevent postthrombolytic hemorrhage formation), PCT/FI2004/000071. Inventors: Lindsberg PJ, Karjalainen- Lindsberg M-L, Tatlisumak T, Strbian D, Kovanen P. Applicant: Licentia Oy. Application date: February 13, 2003. Publication: 3/2003. Application number: 20030225.
Helsinki University Central Hospital Research Funds, PI University of Gothenburg Research Funds, PI Sahlgrenska University Hospital Research Funds, PI National Stroke Research Institute of Australia
Neurology: Associate Editor 1 July 2009 - September 2015; Deputy Editor October 2015 - present Seminars in Neurology Editorial Board 2006-2014
AegisCN, LLC/Duke Clinical Research Institute - Serving as a site for phase II clinical trial titled
NINDS/NIH ? U24 NS107222 (co-Principal Investigator) 2018-2023 NIH/NCATS ? U54 TR002586 (co-Principal Investigator KL2) 2018-2023 NINDS/NIH - R21 NS106480 (Principal Investigator) 2018-2020 NINDS/NIH - R01 NS 069763 (co-investigator) 2010-2017 NINDS/NIH ? U-01 NS069208 (co-Principal Investigator) 2010-2015 NHGRI/NIH ? U-01 HG005160 (co-Principal Investigator) 2009-2014
University of Virginia - CENTERS OF EXCELLENCE CLINICAL RESEARCH GRANT SUPPORT - The UVA BRAIN AND AORTIC ANEURYSM SCREENING (BAAS) study - Principal Investigator 10/13-4/17
(1)Astra Zeneca (2)Bristol-Myers Squibb (3)Boehringer Ingelheim (4)Sanofi (5)Pfizer (6)Bayer (7)Reneuron
(1)Astra Zeneca, speaker honoraria (2)Bristol-Myers Squibb, speaker honoraria (3)Boehringer Ingelheim, speaker honoraria (4)Sanofi, speaker honoraria (5)Pfizer, speaker honoraria, travel (6)Bayer, speaker honoraria
(1) The Sahlgrenska Academy and the Sahlgrenska University, ALFGBG-148861, PI, 2011-2014 (2) The Swedish Medical Research Council, K2014-64X-14605-12- 5, PI, 2014-2018
(1) The Swedish Heart Lung Foundation (2) The Swedish Stroke Foundation
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
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