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      Causal relationship between multiple sclerosis and cortical structure: a Mendelian randomization study

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          Abstract

          Background

          Observational studies have suggested an association between multiple sclerosis (MS) and cortical structure, but the results have been inconsistent.

          Objective

          We used two-sample Mendelian randomization (MR) to assess the causal relationship between MS and cortical structure.

          Methods

          MS data as the exposure trait, including 14,498 cases and 24,091 controls, were obtained from the International Multiple Sclerosis Genetics Consortium. Genome-wide association study (GWAS) data for cortical surface area (SAw/nw) and thickness (THw/nw) in 51,665 individuals of European ancestry were obtained from the ENIGMA Consortium. The inverse-variance weighted (IVW) method was used as the primary analysis for MR. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. Enrichment analysis was performed on MR analyses filtered by sensitivity analysis.

          Results

          After IVW and sensitivity analysis filtering, only six surviving MR results provided suggestive evidence supporting a causal relationship between MS and cortical structure, including lingual SAw ( p = .0342, beta (se) = 5.7127 (2.6969)), parahippocampal SAw ( p = .0224, beta (se) = 1.5577 (0.6822)), rostral middle frontal SAw ( p = .0154, beta (se) = − 9.0301 (3.7281)), cuneus THw ( p = .0418, beta (se) =  − 0.0020 (0.0010)), lateral orbitofrontal THw ( p = .0281, beta (se) = 0.0025 (0.0010)), and lateral orbitofrontal THnw ( p = .0417, beta (se) = 0.0029 (0.0014)). Enrichment analysis suggested that leukocyte cell-related pathways, JAK-STAT signaling pathway, NF-kappa B signaling pathway, cytokine-cytokine receptor interaction, and prolactin signaling pathway may be involved in the effect of MS on cortical morphology.

          Conclusion

          Our results provide evidence supporting a causal relationship between MS and cortical structure. Enrichment analysis suggests that the pathways mediating brain morphology abnormalities in MS patients are mainly related to immune and inflammation-driven pathways.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12967-024-04892-7.

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          Most cited references64

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          Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases

          Horizontal pleiotropy occurs when the variant has an effect on disease outside of its effect on the exposure in Mendelian randomization (MR). Violation of the ‘no horizontal pleiotropy’ assumption can cause severe bias in MR. We developed the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test to identify horizontal pleiotropic outliers in multi-instrument summary-level MR testing. We showed using simulations that MR-PRESSO is best suited when horizontal pleiotropy occurs in <50% of instruments. Next, we applied MR-PRESSO, along with several other MR tests to complex traits and diseases, and found that horizontal pleiotropy: (i) was detectable in over 48% of significant causal relationships in MR; (ii) introduced distortions in the causal estimates in MR that ranged on average from −131% to 201%; (iii) induced false positive causal relationships in up to 10% of relationships; and (iv) can be corrected in some but not all instances.
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            Mendelian Randomization Analysis With Multiple Genetic Variants Using Summarized Data

            Genome-wide association studies, which typically report regression coefficients summarizing the associations of many genetic variants with various traits, are potentially a powerful source of data for Mendelian randomization investigations. We demonstrate how such coefficients from multiple variants can be combined in a Mendelian randomization analysis to estimate the causal effect of a risk factor on an outcome. The bias and efficiency of estimates based on summarized data are compared to those based on individual-level data in simulation studies. We investigate the impact of gene–gene interactions, linkage disequilibrium, and ‘weak instruments’ on these estimates. Both an inverse-variance weighted average of variant-specific associations and a likelihood-based approach for summarized data give similar estimates and precision to the two-stage least squares method for individual-level data, even when there are gene–gene interactions. However, these summarized data methods overstate precision when variants are in linkage disequilibrium. If the P-value in a linear regression of the risk factor for each variant is less than , then weak instrument bias will be small. We use these methods to estimate the causal association of low-density lipoprotein cholesterol (LDL-C) on coronary artery disease using published data on five genetic variants. A 30% reduction in LDL-C is estimated to reduce coronary artery disease risk by 67% (95% CI: 54% to 76%). We conclude that Mendelian randomization investigations using summarized data from uncorrelated variants are similarly efficient to those using individual-level data, although the necessary assumptions cannot be so fully assessed.
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              Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).

              J. Kurtzke (1983)
              One method of evaluating the degree of neurologic impairment in MS has been the combination of grades (0 = normal to 5 or 6 = maximal impairment) within 8 Functional Systems (FS) and an overall Disability Status Scale (DSS) that had steps from 0 (normal) to 10 (death due to MS). A new Expanded Disability Status Scale (EDSS) is presented, with each of the former steps (1,2,3 . . . 9) now divided into two (1.0, 1.5, 2.0 . . . 9.5). The lower portion is obligatorily defined by Functional System grades. The FS are Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, and Other; the Sensory and Bowel & Bladder Systems have been revised. Patterns of FS and relations of FS by type and grade to the DSS are demonstrated.
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                Author and article information

                Contributors
                417734668@qq.com
                zhouhy@scu.edu.cn
                Journal
                J Transl Med
                J Transl Med
                Journal of Translational Medicine
                BioMed Central (London )
                1479-5876
                20 January 2024
                20 January 2024
                2024
                : 22
                : 83
                Affiliations
                GRID grid.412901.f, ISNI 0000 0004 1770 1022, Department of Neurology, , West China Hospital, Sichuan University, ; Guo Xuexiang #37, Chengdu, 610041 China
                Author information
                http://orcid.org/0000-0002-7637-1305
                Article
                4892
                10.1186/s12967-024-04892-7
                10800041
                38245759
                1b6f38cc-245a-4e60-9b24-0e73f45439b2
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 29 June 2023
                : 13 January 2024
                Funding
                Funded by: the Department of Science and Technology of Sichuan Province
                Award ID: 2022YFS0315
                Award Recipient :
                Funded by: the 1·3·5 project for disciplines of excellence – Clinical Research Incubation Project, West China Hospital, Sichuan University
                Award ID: 21HXFH041
                Award Recipient :
                Funded by: the National Natural Science Foundation of China
                Award ID: 82201494
                Award Recipient :
                Funded by: the Natural Science Foundation of Sichuan Province
                Award ID: 2022NSFSC1432
                Award Recipient :
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Medicine
                multiple sclerosis,cortical structure,mendelian randomization
                Medicine
                multiple sclerosis, cortical structure, mendelian randomization

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