Background and Purpose-White matter hyperintensities (WMH) on brain magnetic resonance imaging are typical signs of cerebral small vessel disease and may indicate various preclinical, age-related neurological disorders, such as stroke. Though WMH are highly heritable, known common variants explain a small proportion of the WMH variance. The contribution of low-frequency/rare coding variants to WMH burden has not been explored. Methods-In the discovery sample we recruited 20 719 stroke/dementia-free adults from 13 population-based cohort studies within the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, among which 17 790 were of European ancestry and 2929 of African ancestry. We genotyped these participants at ≈250 000 mostly exonic variants with Illumina HumanExome BeadChip arrays. We performed ethnicity-specific linear regression on rank-normalized WMH in each study separately, which were then combined in meta-analyses to test for association with single variants and genes aggregating the effects of putatively functional low-frequency/rare variants. We then sought replication of the top findings in 1192 adults (European ancestry) with whole exome/genome sequencing data from 2 independent studies. Results-At 17q25, we confirmed the association of multiple common variants in TRIM65, FBF1, and ACOX1 (P<6×10−7). We also identified a novel association with 2 low-frequency nonsynonymous variants in MRPL38 (lead, rs34136221; PEA=4.5×10−8) partially independent of known common signal (PEA(conditional)=1.4×10−3). We further identified a locus at 2q33 containing common variants in NBEAL1, CARF, and WDR12 (lead, rs2351524; Pall=1.9×10−10). Although our novel findings were not replicated because of limited power and possible differences in study design, meta-analysis of the discovery and replication samples yielded stronger association for the 2 low-frequency MRPL38 variants (Prs34136221=2.8×10−8). Conclusions-Both common and low-frequency/rare functional variants influence WMH. Larger replication and experimental follow-up are essential to confirm our findings and uncover the biological causal mechanisms of age-related WMH.
Bibliographical noteFunding Information:
This study was supported in part through the National Institute of Neurological Disorders and Stroke grant R01NS087541 and the National Institute on Aging (NIA) grant U01AG049506. Infrastructure for the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium was supported in part by the National Heart, Lung, and Blood Institute grant R01HL105756 and for the neuroCHARGE working group through the NIA grant R01AG033193. Drs Deary and Bastin are receiving funding from Age UK (Disconnected Mind programme) and the Medical Research Council (MR/K026992/1 and MR/M01311/1). Dr Grabe has funding from the Federal Ministry of Education and Research, the German Research Foundation, the DAMP Foundation, and Fresenius Medical Care. Dr Niessen received funding from the Netherlands Organization for Scientific Research. Dr Schmidt has funding from the Austrian Science Fund. Funding for each participating cohort is reported in the online-only Data Supplement.
© 2018 American Heart Association, Inc.
- Cerebral small vessel disease
- Magnetic resonance imaging
- White matter