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Genetic vulnerability and adverse mental health outcomes following mild traumatic brain injury: a meta-analysis of CENTER-TBI and TRACK-TBI cohorts

Post-traumatic stress disorder (PTSD) and depression are common after mild traumatic brain injury (mTBI), but their biological drivers are uncertain. We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of...

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Published in:EClinicalMedicine 2024-12, Vol.78, p.102956, Article 102956
Main Authors: Levey, Daniel F., Sun, Xiaoying, Menon, David K., Ackerlund, Cecilia, Amrein, Krisztina, Andreassen, Lasse, Antoni, Anna, Azzolini, Maria Luisa, Bartels, Ronald, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Beretta, Luigi, Brazinova, Alexandra, Brorsson, Camilla, Caccioppola, Alessio, Calvi, Maria Rosa, Carbonara, Marco, Dawes, Helen, De Keyser, Véronique, Dixit, Abhishek, Donoghue, Emma, Ercole, Ari, Fabricius, Martin, Feigin, Valery L., Gao, Guoyi, Gruen, Russell L., Helseth, Eirik, Hutchinson, Peter J., Jacobs, Bram, Jiang, Ji-yao, Jones, Kelly, Kowark, Ana, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Lejeune, Aurelie, Levi, Leon, Maegele, Marc, McMahon, Catherine, Misset, Benoit, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Payen, Jean-François, Persona, Paolo, Piippo-Karjalainen, Anna, Ples, Horia, Helmrich, Isabel Retel, Rosenthal, Guy, Sandor, Janos, Schäfer, Nadine, Schoonman, Guus, Singh, Ranjit D., Skandsen, Toril, Sorinola, Abayomi, Stewart, William, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Trapani, Tony, van der Jagt, Mathieu, Van der Steen, Gregory, van Dijck, Jeroen T.J.M., van Erp, Inge A., Van Hecke, Wim, Vyvere, Thijs Vande, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, von Steinbüchel, Nicole, Ylén, Peter, Badjatia, Neeraj, Boase, Kim, Chesnut, Randall, Corrigan, John, Diaz-Arrastia, Ramon, Ellenbogen, Richard, Feeser, Venkata, Ferguson, Adam R., Giacino, Joseph, Gonzalez, Luis, Grandhi, Ramesh, Hemphill, Claude, Hotz, Gillian, Huie, Russell, Levin, Harvey, Madden, Christopher, McAllister, Thomas, Nelson, Lindsay, Nolan, Amber, Okonkwo, David, Puccio, Ava, Ben Rodgers, Richard, Sander, Angelle, Temkin, Nancy, Toga, Arthur, Vassar, Mary
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container_title EClinicalMedicine
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creator Levey, Daniel F.
Sun, Xiaoying
Menon, David K.
Ackerlund, Cecilia
Amrein, Krisztina
Andreassen, Lasse
Antoni, Anna
Azzolini, Maria Luisa
Bartels, Ronald
Bellander, Bo-Michael
Belli, Antonio
Benali, Habib
Beretta, Luigi
Brazinova, Alexandra
Brorsson, Camilla
Caccioppola, Alessio
Calvi, Maria Rosa
Carbonara, Marco
Dawes, Helen
De Keyser, Véronique
Dixit, Abhishek
Donoghue, Emma
Ercole, Ari
Fabricius, Martin
Feigin, Valery L.
Gao, Guoyi
Gruen, Russell L.
Helseth, Eirik
Hutchinson, Peter J.
Jacobs, Bram
Jiang, Ji-yao
Jones, Kelly
Kowark, Ana
Lanyon, Linda
Laureys, Steven
Lecky, Fiona
Lejeune, Aurelie
Levi, Leon
Maegele, Marc
McMahon, Catherine
Misset, Benoit
Murray, Lynnette
Negru, Ancuta
Nelson, David
Newcombe, Virginia
Payen, Jean-François
Persona, Paolo
Piippo-Karjalainen, Anna
Ples, Horia
Helmrich, Isabel Retel
Rosenthal, Guy
Sandor, Janos
Schäfer, Nadine
Schoonman, Guus
Singh, Ranjit D.
Skandsen, Toril
Sorinola, Abayomi
Stewart, William
Tenovuo, Olli
Thomas, Matt
Tibboel, Dick
Trapani, Tony
van der Jagt, Mathieu
Van der Steen, Gregory
van Dijck, Jeroen T.J.M.
van Erp, Inge A.
Van Hecke, Wim
Vyvere, Thijs Vande
Vega, Emmanuel
Vik, Anne
Vilcinis, Rimantas
Volovici, Victor
von Steinbüchel, Nicole
Ylén, Peter
Badjatia, Neeraj
Boase, Kim
Chesnut, Randall
Corrigan, John
Diaz-Arrastia, Ramon
Ellenbogen, Richard
Feeser, Venkata
Ferguson, Adam R.
Giacino, Joseph
Gonzalez, Luis
Grandhi, Ramesh
Hemphill, Claude
Hotz, Gillian
Huie, Russell
Levin, Harvey
Madden, Christopher
McAllister, Thomas
Nelson, Lindsay
Nolan, Amber
Okonkwo, David
Puccio, Ava
Ben Rodgers, Richard
Sander, Angelle
Temkin, Nancy
Toga, Arthur
Vassar, Mary
description Post-traumatic stress disorder (PTSD) and depression are common after mild traumatic brain injury (mTBI), but their biological drivers are uncertain. We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of cognate TBI-related phenotypes. Meta-analyses were conducted using data from two multicenter, prospective observational cohort studies of patients with mTBI: the CENTER-TBI study (ClinicalTrials.gov ID NCT02210221) in Europe (December 2014–December 2017) and the TRACK-TBI study in the US (March 2014–July 2018). In both cohorts, the most common causes of injury were road traffic accidents and falls. Primary outcomes, specifically probable PTSD and depression, were defined at 6 months post-injury using scores ≥33 on the PTSD Checklist-5 and ≥15 on the Patient Health Questionnaire-9, respectively. We calculated PTSD-PRS and MDD-PRS for patients aged ≥17 years who had a Glasgow Coma Scale score of 13–15 upon hospital arrival and assessed their association with PTSD and depression following TBI. We also evaluated the transferability of the findings in a cohort of African Americans. Overall, 11.8% (219/1869) and 6.7% (124/1869) patients were classified as having probable PTSD and depression, respectively. The PTSD-PRS was significantly associated with higher adjusted odds of PTSD in both cohorts, with a pooled odds ratio (OR) of 1.55 [95% confidence interval (CI) 1.30–1.84, p 
doi_str_mv 10.1016/j.eclinm.2024.102956
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Sun, Xiaoying ; Menon, David K. ; Ackerlund, Cecilia ; Amrein, Krisztina ; Andreassen, Lasse ; Antoni, Anna ; Azzolini, Maria Luisa ; Bartels, Ronald ; Bellander, Bo-Michael ; Belli, Antonio ; Benali, Habib ; Beretta, Luigi ; Brazinova, Alexandra ; Brorsson, Camilla ; Caccioppola, Alessio ; Calvi, Maria Rosa ; Carbonara, Marco ; Dawes, Helen ; De Keyser, Véronique ; Dixit, Abhishek ; Donoghue, Emma ; Ercole, Ari ; Fabricius, Martin ; Feigin, Valery L. ; Gao, Guoyi ; Gruen, Russell L. ; Helseth, Eirik ; Hutchinson, Peter J. ; Jacobs, Bram ; Jiang, Ji-yao ; Jones, Kelly ; Kowark, Ana ; Lanyon, Linda ; Laureys, Steven ; Lecky, Fiona ; Lejeune, Aurelie ; Levi, Leon ; Maegele, Marc ; McMahon, Catherine ; Misset, Benoit ; Murray, Lynnette ; Negru, Ancuta ; Nelson, David ; Newcombe, Virginia ; Payen, Jean-François ; Persona, Paolo ; Piippo-Karjalainen, Anna ; Ples, Horia ; Helmrich, Isabel Retel ; Rosenthal, Guy ; Sandor, Janos ; Schäfer, Nadine ; Schoonman, Guus ; Singh, Ranjit D. ; Skandsen, Toril ; Sorinola, Abayomi ; Stewart, William ; Tenovuo, Olli ; Thomas, Matt ; Tibboel, Dick ; Trapani, Tony ; van der Jagt, Mathieu ; Van der Steen, Gregory ; van Dijck, Jeroen T.J.M. ; van Erp, Inge A. ; Van Hecke, Wim ; Vyvere, Thijs Vande ; Vega, Emmanuel ; Vik, Anne ; Vilcinis, Rimantas ; Volovici, Victor ; von Steinbüchel, Nicole ; Ylén, Peter ; Badjatia, Neeraj ; Boase, Kim ; Chesnut, Randall ; Corrigan, John ; Diaz-Arrastia, Ramon ; Ellenbogen, Richard ; Feeser, Venkata ; Ferguson, Adam R. ; Giacino, Joseph ; Gonzalez, Luis ; Grandhi, Ramesh ; Hemphill, Claude ; Hotz, Gillian ; Huie, Russell ; Levin, Harvey ; Madden, Christopher ; McAllister, Thomas ; Nelson, Lindsay ; Nolan, Amber ; Okonkwo, David ; Puccio, Ava ; Ben Rodgers, Richard ; Sander, Angelle ; Temkin, Nancy ; Toga, Arthur ; Vassar, Mary</creator><creatorcontrib>Levey, Daniel F. ; Sun, Xiaoying ; Menon, David K. ; Ackerlund, Cecilia ; Amrein, Krisztina ; Andreassen, Lasse ; Antoni, Anna ; Azzolini, Maria Luisa ; Bartels, Ronald ; Bellander, Bo-Michael ; Belli, Antonio ; Benali, Habib ; Beretta, Luigi ; Brazinova, Alexandra ; Brorsson, Camilla ; Caccioppola, Alessio ; Calvi, Maria Rosa ; Carbonara, Marco ; Dawes, Helen ; De Keyser, Véronique ; Dixit, Abhishek ; Donoghue, Emma ; Ercole, Ari ; Fabricius, Martin ; Feigin, Valery L. ; Gao, Guoyi ; Gruen, Russell L. ; Helseth, Eirik ; Hutchinson, Peter J. ; Jacobs, Bram ; Jiang, Ji-yao ; Jones, Kelly ; Kowark, Ana ; Lanyon, Linda ; Laureys, Steven ; Lecky, Fiona ; Lejeune, Aurelie ; Levi, Leon ; Maegele, Marc ; McMahon, Catherine ; Misset, Benoit ; Murray, Lynnette ; Negru, Ancuta ; Nelson, David ; Newcombe, Virginia ; Payen, Jean-François ; Persona, Paolo ; Piippo-Karjalainen, Anna ; Ples, Horia ; Helmrich, Isabel Retel ; Rosenthal, Guy ; Sandor, Janos ; Schäfer, Nadine ; Schoonman, Guus ; Singh, Ranjit D. ; Skandsen, Toril ; Sorinola, Abayomi ; Stewart, William ; Tenovuo, Olli ; Thomas, Matt ; Tibboel, Dick ; Trapani, Tony ; van der Jagt, Mathieu ; Van der Steen, Gregory ; van Dijck, Jeroen T.J.M. ; van Erp, Inge A. ; Van Hecke, Wim ; Vyvere, Thijs Vande ; Vega, Emmanuel ; Vik, Anne ; Vilcinis, Rimantas ; Volovici, Victor ; von Steinbüchel, Nicole ; Ylén, Peter ; Badjatia, Neeraj ; Boase, Kim ; Chesnut, Randall ; Corrigan, John ; Diaz-Arrastia, Ramon ; Ellenbogen, Richard ; Feeser, Venkata ; Ferguson, Adam R. ; Giacino, Joseph ; Gonzalez, Luis ; Grandhi, Ramesh ; Hemphill, Claude ; Hotz, Gillian ; Huie, Russell ; Levin, Harvey ; Madden, Christopher ; McAllister, Thomas ; Nelson, Lindsay ; Nolan, Amber ; Okonkwo, David ; Puccio, Ava ; Ben Rodgers, Richard ; Sander, Angelle ; Temkin, Nancy ; Toga, Arthur ; Vassar, Mary ; The Genetic Associations In Neurotrauma (GAIN) Consortium (with contribution from the CENTER-TBI and TRACK-TBI studies) ; Genetic Associations In Neurotrauma (GAIN) Consortium (with contribution from the CENTER-TBI and TRACK-TBI studies)</creatorcontrib><description>Post-traumatic stress disorder (PTSD) and depression are common after mild traumatic brain injury (mTBI), but their biological drivers are uncertain. We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of cognate TBI-related phenotypes. Meta-analyses were conducted using data from two multicenter, prospective observational cohort studies of patients with mTBI: the CENTER-TBI study (ClinicalTrials.gov ID NCT02210221) in Europe (December 2014–December 2017) and the TRACK-TBI study in the US (March 2014–July 2018). In both cohorts, the most common causes of injury were road traffic accidents and falls. Primary outcomes, specifically probable PTSD and depression, were defined at 6 months post-injury using scores ≥33 on the PTSD Checklist-5 and ≥15 on the Patient Health Questionnaire-9, respectively. We calculated PTSD-PRS and MDD-PRS for patients aged ≥17 years who had a Glasgow Coma Scale score of 13–15 upon hospital arrival and assessed their association with PTSD and depression following TBI. We also evaluated the transferability of the findings in a cohort of African Americans. Overall, 11.8% (219/1869) and 6.7% (124/1869) patients were classified as having probable PTSD and depression, respectively. The PTSD-PRS was significantly associated with higher adjusted odds of PTSD in both cohorts, with a pooled odds ratio (OR) of 1.55 [95% confidence interval (CI) 1.30–1.84, p &lt; 0.001, I2 = 20.8%]. Although the MDD-PRS increased the risk of depression after TBI, it did not reach significance in the individual cohorts. However, in a combined analysis, the risk was significantly elevated with a pooled OR of 1.26 [95% CI 1.03–1.53, p = 0.02, I2 = 0%]. The addition of PRSs improved the proportion of outcome variance explained in the two study cohorts from 19.5% and 30.3% to 21.6% and 34.0% for PTSD; and from 11.0% and 22.5% to 12.8% and 22.6% for depression. Patients in the highest cognate PRS quintile had increased odds of 3.16 [95% CI 1.80–5.55] and 2.03 [95% CI 1.04–3.94] of developing PTSD or depression compared to the lowest quintile, respectively. Associations of PRSs with PTSD and depression following TBI are not disorder-specific. However, the overlap between MDD-PRS and depression following TBI is less robust compared to PTSD-PRS and PTSD. PRSs could improve risk prediction, and permit enrichment for interventional trials. This study was supported by funding by an FP7 grant from the European Union, Hannelore Kohl Stiftung, Integra LifeSciences Corporation, NeuroTrauma Sciences, US National Institutes of Health, US Department of Defense, National Football League Advisory Board, US Department of Energy, and One Mind.</description><identifier>ISSN: 2589-5370</identifier><identifier>EISSN: 2589-5370</identifier><identifier>DOI: 10.1016/j.eclinm.2024.102956</identifier><identifier>PMID: 39720422</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Depression ; Mental health ; Polygenic risk score ; Post-traumatic stress disorder ; Traumatic brain injury</subject><ispartof>EClinicalMedicine, 2024-12, Vol.78, p.102956, Article 102956</ispartof><rights>2024 The Authors</rights><rights>2024 The Authors.</rights><rights>2024 The Authors 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We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of cognate TBI-related phenotypes. Meta-analyses were conducted using data from two multicenter, prospective observational cohort studies of patients with mTBI: the CENTER-TBI study (ClinicalTrials.gov ID NCT02210221) in Europe (December 2014–December 2017) and the TRACK-TBI study in the US (March 2014–July 2018). In both cohorts, the most common causes of injury were road traffic accidents and falls. Primary outcomes, specifically probable PTSD and depression, were defined at 6 months post-injury using scores ≥33 on the PTSD Checklist-5 and ≥15 on the Patient Health Questionnaire-9, respectively. We calculated PTSD-PRS and MDD-PRS for patients aged ≥17 years who had a Glasgow Coma Scale score of 13–15 upon hospital arrival and assessed their association with PTSD and depression following TBI. We also evaluated the transferability of the findings in a cohort of African Americans. Overall, 11.8% (219/1869) and 6.7% (124/1869) patients were classified as having probable PTSD and depression, respectively. The PTSD-PRS was significantly associated with higher adjusted odds of PTSD in both cohorts, with a pooled odds ratio (OR) of 1.55 [95% confidence interval (CI) 1.30–1.84, p &lt; 0.001, I2 = 20.8%]. Although the MDD-PRS increased the risk of depression after TBI, it did not reach significance in the individual cohorts. However, in a combined analysis, the risk was significantly elevated with a pooled OR of 1.26 [95% CI 1.03–1.53, p = 0.02, I2 = 0%]. The addition of PRSs improved the proportion of outcome variance explained in the two study cohorts from 19.5% and 30.3% to 21.6% and 34.0% for PTSD; and from 11.0% and 22.5% to 12.8% and 22.6% for depression. Patients in the highest cognate PRS quintile had increased odds of 3.16 [95% CI 1.80–5.55] and 2.03 [95% CI 1.04–3.94] of developing PTSD or depression compared to the lowest quintile, respectively. Associations of PRSs with PTSD and depression following TBI are not disorder-specific. However, the overlap between MDD-PRS and depression following TBI is less robust compared to PTSD-PRS and PTSD. PRSs could improve risk prediction, and permit enrichment for interventional trials. This study was supported by funding by an FP7 grant from the European Union, Hannelore Kohl Stiftung, Integra LifeSciences Corporation, NeuroTrauma Sciences, US National Institutes of Health, US Department of Defense, National Football League Advisory Board, US Department of Energy, and One Mind.</description><subject>Depression</subject><subject>Mental health</subject><subject>Polygenic risk score</subject><subject>Post-traumatic stress disorder</subject><subject>Traumatic brain injury</subject><issn>2589-5370</issn><issn>2589-5370</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9Uc1uEzEQXiEQrUrfACEfuWw69m72hwOoRGmpqECqwtmatWcbR1672N6gPAcvzCYpVblw8ozn-xn7y7K3HGYceHWxmZGyxg0zAaKcrkQ7r15kp2LetPm8qOHls_okO49xAwACyqat4HV2UrT11Ahxmv2-JkfJKLYdraOAnbEm7Rg6zVBvKURiA7mElq0JbVozPyblB4qs99b6X8bds8FYzVLAccC9UhfQOGbcZgy7DwwnfsIcHdpdNJH5ni2W31bLu3z1-ebgs7q7XHw9dMqvfUjxTfaqRxvp_PE8y35cLVeLL_nt9-ubxeVtrkRbp1xjwZUmELxroJ2XRCga1epK9G3foCi16KhSHDoA4tDwvhAFIlIBVU1lUZxln466D2M3kFbTOwNa-RDMgGEnPRr578SZtbz3W8l5VdVwUHj_qBD8z5FikoOJiqxFR36MsuBlC_W0XD1ByyNUBR9joP7Jh4PcZyo38pip3Gcqj5lOtHfPd3wi_U1wAnw8Amj6qa2hIKMy5BRpE0glqb35v8Mf7o22tQ</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Levey, Daniel F.</creator><creator>Sun, Xiaoying</creator><creator>Menon, David K.</creator><creator>Ackerlund, Cecilia</creator><creator>Amrein, Krisztina</creator><creator>Andreassen, 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- Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>EClinicalMedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Levey, Daniel F.</au><au>Sun, Xiaoying</au><au>Menon, David K.</au><au>Ackerlund, Cecilia</au><au>Amrein, Krisztina</au><au>Andreassen, Lasse</au><au>Antoni, Anna</au><au>Azzolini, Maria Luisa</au><au>Bartels, Ronald</au><au>Bellander, Bo-Michael</au><au>Belli, Antonio</au><au>Benali, Habib</au><au>Beretta, Luigi</au><au>Brazinova, Alexandra</au><au>Brorsson, Camilla</au><au>Caccioppola, Alessio</au><au>Calvi, Maria Rosa</au><au>Carbonara, Marco</au><au>Dawes, Helen</au><au>De Keyser, Véronique</au><au>Dixit, Abhishek</au><au>Donoghue, Emma</au><au>Ercole, Ari</au><au>Fabricius, Martin</au><au>Feigin, Valery L.</au><au>Gao, Guoyi</au><au>Gruen, Russell L.</au><au>Helseth, Eirik</au><au>Hutchinson, Peter J.</au><au>Jacobs, Bram</au><au>Jiang, Ji-yao</au><au>Jones, Kelly</au><au>Kowark, Ana</au><au>Lanyon, Linda</au><au>Laureys, Steven</au><au>Lecky, Fiona</au><au>Lejeune, Aurelie</au><au>Levi, Leon</au><au>Maegele, Marc</au><au>McMahon, Catherine</au><au>Misset, Benoit</au><au>Murray, Lynnette</au><au>Negru, Ancuta</au><au>Nelson, David</au><au>Newcombe, Virginia</au><au>Payen, Jean-François</au><au>Persona, Paolo</au><au>Piippo-Karjalainen, Anna</au><au>Ples, Horia</au><au>Helmrich, Isabel Retel</au><au>Rosenthal, Guy</au><au>Sandor, Janos</au><au>Schäfer, Nadine</au><au>Schoonman, Guus</au><au>Singh, Ranjit D.</au><au>Skandsen, Toril</au><au>Sorinola, Abayomi</au><au>Stewart, William</au><au>Tenovuo, Olli</au><au>Thomas, Matt</au><au>Tibboel, Dick</au><au>Trapani, Tony</au><au>van der Jagt, Mathieu</au><au>Van der Steen, Gregory</au><au>van Dijck, Jeroen T.J.M.</au><au>van Erp, Inge A.</au><au>Van Hecke, Wim</au><au>Vyvere, Thijs Vande</au><au>Vega, Emmanuel</au><au>Vik, Anne</au><au>Vilcinis, Rimantas</au><au>Volovici, Victor</au><au>von Steinbüchel, Nicole</au><au>Ylén, Peter</au><au>Badjatia, Neeraj</au><au>Boase, Kim</au><au>Chesnut, Randall</au><au>Corrigan, John</au><au>Diaz-Arrastia, Ramon</au><au>Ellenbogen, Richard</au><au>Feeser, Venkata</au><au>Ferguson, Adam R.</au><au>Giacino, Joseph</au><au>Gonzalez, Luis</au><au>Grandhi, Ramesh</au><au>Hemphill, Claude</au><au>Hotz, Gillian</au><au>Huie, Russell</au><au>Levin, Harvey</au><au>Madden, Christopher</au><au>McAllister, Thomas</au><au>Nelson, Lindsay</au><au>Nolan, Amber</au><au>Okonkwo, David</au><au>Puccio, Ava</au><au>Ben Rodgers, Richard</au><au>Sander, Angelle</au><au>Temkin, Nancy</au><au>Toga, Arthur</au><au>Vassar, Mary</au><aucorp>The Genetic Associations In Neurotrauma (GAIN) Consortium (with contribution from the CENTER-TBI and TRACK-TBI studies)</aucorp><aucorp>Genetic Associations In Neurotrauma (GAIN) Consortium (with contribution from the CENTER-TBI and TRACK-TBI studies)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Genetic vulnerability and adverse mental health outcomes following mild traumatic brain injury: a meta-analysis of CENTER-TBI and TRACK-TBI cohorts</atitle><jtitle>EClinicalMedicine</jtitle><addtitle>EClinicalMedicine</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>78</volume><spage>102956</spage><pages>102956-</pages><artnum>102956</artnum><issn>2589-5370</issn><eissn>2589-5370</eissn><abstract>Post-traumatic stress disorder (PTSD) and depression are common after mild traumatic brain injury (mTBI), but their biological drivers are uncertain. We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of cognate TBI-related phenotypes. Meta-analyses were conducted using data from two multicenter, prospective observational cohort studies of patients with mTBI: the CENTER-TBI study (ClinicalTrials.gov ID NCT02210221) in Europe (December 2014–December 2017) and the TRACK-TBI study in the US (March 2014–July 2018). In both cohorts, the most common causes of injury were road traffic accidents and falls. Primary outcomes, specifically probable PTSD and depression, were defined at 6 months post-injury using scores ≥33 on the PTSD Checklist-5 and ≥15 on the Patient Health Questionnaire-9, respectively. We calculated PTSD-PRS and MDD-PRS for patients aged ≥17 years who had a Glasgow Coma Scale score of 13–15 upon hospital arrival and assessed their association with PTSD and depression following TBI. We also evaluated the transferability of the findings in a cohort of African Americans. Overall, 11.8% (219/1869) and 6.7% (124/1869) patients were classified as having probable PTSD and depression, respectively. The PTSD-PRS was significantly associated with higher adjusted odds of PTSD in both cohorts, with a pooled odds ratio (OR) of 1.55 [95% confidence interval (CI) 1.30–1.84, p &lt; 0.001, I2 = 20.8%]. Although the MDD-PRS increased the risk of depression after TBI, it did not reach significance in the individual cohorts. However, in a combined analysis, the risk was significantly elevated with a pooled OR of 1.26 [95% CI 1.03–1.53, p = 0.02, I2 = 0%]. The addition of PRSs improved the proportion of outcome variance explained in the two study cohorts from 19.5% and 30.3% to 21.6% and 34.0% for PTSD; and from 11.0% and 22.5% to 12.8% and 22.6% for depression. Patients in the highest cognate PRS quintile had increased odds of 3.16 [95% CI 1.80–5.55] and 2.03 [95% CI 1.04–3.94] of developing PTSD or depression compared to the lowest quintile, respectively. Associations of PRSs with PTSD and depression following TBI are not disorder-specific. However, the overlap between MDD-PRS and depression following TBI is less robust compared to PTSD-PRS and PTSD. PRSs could improve risk prediction, and permit enrichment for interventional trials. This study was supported by funding by an FP7 grant from the European Union, Hannelore Kohl Stiftung, Integra LifeSciences Corporation, NeuroTrauma Sciences, US National Institutes of Health, US Department of Defense, National Football League Advisory Board, US Department of Energy, and One Mind.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>39720422</pmid><doi>10.1016/j.eclinm.2024.102956</doi><orcidid>https://orcid.org/0000-0003-1612-1264</orcidid><orcidid>https://orcid.org/0000-0002-1014-9138</orcidid><orcidid>https://orcid.org/0000-0003-2090-8780</orcidid><oa>free_for_read</oa></addata></record>
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subjects Depression
Mental health
Polygenic risk score
Post-traumatic stress disorder
Traumatic brain injury
title Genetic vulnerability and adverse mental health outcomes following mild traumatic brain injury: a meta-analysis of CENTER-TBI and TRACK-TBI cohorts
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