Genetic associations with mixed neuropathologies in the aging brainGenetic associations with mixed neuropathologies in the aging brain

Abstract

AbstractBackground““Mixed” neuropathologies (NPs) are common in aged brains. Classic Alzheimer’s disease neuropathologic change (ADNC) proteinopathies are amyloid‐β plaques and tau neurofibrillary tangles (NFTs). In addition, α‐synuclein and TDP‐43 are also key proteinaceous disease markers, and cerebrovascular diseases (CVDs) often coexist. Although the scientific problems regarding mixed NPs are increasingly recognized, genetic associations with mixed NPs have not been well‐investigated. In this study, we applied item response theory (IRT) to optimize the clustering and combination of mixed NPs and examined the genetic associations.MethodNP data were drawn from the National Alzheimer’s Coordinating Center (NACC) NP v10‐11 forms through the March 2022 data freeze, including Thal phase ratings (A score); Braak NFT stage (B score); CERAD neuritic plaque scores (C score); Lewy bodies (LBs); TDP‐43; hippocampal sclerosis (HS); cerebral amyloid angiopathy (CAA); infarct and lacunes; microinfarcts; atherosclerosis of the circle of Willis; and brain arteriolosclerosis. We determined dominant pathology patterns in 1,228 participants who had no missing data using a multidimensional graded response model within the IRT framework. The NACC NP data were linked to the U.S. Alzheimer’s Disease Research Centers genetic data provided by the Alzheimer’s Disease genetic Consortium.ResultFrom the leave one out cross validation simulation, the model fitness tests showed that the 4‐factor model had fewer differences from the data than the other models. As shown in Figure, the predominant NPs were TDP‐43 and HS for factor 1 (F1), CVDs other than CAA for factor 2 (F2), A, B, and C scores and CAA for factor 3 (F3), and LBs for factor 4 (F4). The TMEM106B locus was genome‐wide significant with F1 (TDP‐43/HS) and the APOE locus was genome‐wide significant with F3 (ADNC/CAA) after adjusted for age at death, sex, and other factor scores. The SDK1 and FMNL2 loci were not genome‐wide significant, but had noteworthy associations with F2 (CVDs).ConclusionOur new approach to create mixed NP scores could detect the TMEM106B and APOE loci as TDP‐43/HS related and ADNC related regions, respectively. Although previous studies reported SDK1 as an ADNC related gene, we showed that the gene may be associated with CVDs.