eprintid: 1559952 rev_number: 65 eprint_status: archive userid: 608 dir: disk0/01/55/99/52 datestamp: 2017-09-04 15:16:27 lastmod: 2021-12-01 23:40:50 status_changed: 2017-09-04 15:16:27 type: article metadata_visibility: show creators_name: Moss, DJH creators_name: Pardinas, AF creators_name: Langbehn, D creators_name: Lo, K creators_name: Leavitt, BR creators_name: Roos, R creators_name: Durr, A creators_name: Mead, S creators_name: Holmans, P creators_name: Jones, L creators_name: Tabrizi, SJ title: Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: DF9 divisions: FA5 divisions: D07 divisions: F84 divisions: F86 divisions: D13 divisions: G26 keywords: Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences & Neurology, AGE-OF-ONSET, CAG REPEAT, DNA, INSTABILITY, TRAITS, POWER, HD note: © 2017 Elsevier Ltd. All rights reserved. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: BACKGROUND: Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. METHODS: We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. FINDINGS: Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. INTERPRETATION: The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation. date: 2017-09 date_type: published publisher: ELSEVIER SCIENCE INC official_url: http://doi.org/10.1016/S1474-4422(17)30161-8 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green article_type_text: Article verified: verified_manual elements_id: 1299168 doi: 10.1016/S1474-4422(17)30161-8 lyricists_name: Cash, David lyricists_name: Fox, Nicholas lyricists_name: Gibbard, Clare lyricists_name: Hensman Moss, Davina lyricists_name: Malone, Ian lyricists_name: Mead, Simon lyricists_name: Owen, Gail lyricists_name: Read, Joy lyricists_name: Scahill, Rachael lyricists_name: Tabrizi, Sarah lyricists_name: Warner, Thomas lyricists_name: Wild, Edward lyricists_id: DMCAS28 lyricists_id: NCIFO25 lyricists_id: CRGIB31 lyricists_id: DHENS32 lyricists_id: IBMAL93 lyricists_id: SMEAD68 lyricists_id: GOWEN97 lyricists_id: JEREA20 lyricists_id: RSCAH26 lyricists_id: SJTAB21 lyricists_id: TTWAR25 lyricists_id: EJWIL36 actors_name: Tabrizi, Sarah actors_name: Laslett, David actors_id: SJTAB21 actors_id: DLASL34 actors_role: owner actors_role: impersonator full_text_status: public publication: Lancet Neurology volume: 16 number: 9 pagerange: 701-711 pages: 11 issn: 1474-4465 citation: Moss, DJH; Pardinas, AF; Langbehn, D; Lo, K; Leavitt, BR; Roos, R; Durr, A; ... Tabrizi, SJ; + view all <#> Moss, DJH; Pardinas, AF; Langbehn, D; Lo, K; Leavitt, BR; Roos, R; Durr, A; Mead, S; Holmans, P; Jones, L; Tabrizi, SJ; - view fewer <#> (2017) Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study. Lancet Neurology , 16 (9) pp. 701-711. 10.1016/S1474-4422(17)30161-8 <https://doi.org/10.1016/S1474-4422%2817%2930161-8>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/1559952/1/Tabrizi_Hensman%20Moss%20et%20al%202017%20LN%20Manuscript.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/1559952/11/Tabrizi_Hensman%20Moss%20et%20al%20Final%20Sup%20Info.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/1559952/16/Tabrizi_Complete%20supplementary%20tables%20to%20upload.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/1559952/23/Tabrizi_Manuscript%20figures.pdf