Abstract

BackgroundCerebrovascular disease is the third leading cause of death in the United States, and about one-fourth of cerebrovascular deaths are attributed to ruptured intracranial aneurysms (IA). Epidemiological evidence suggests that IAs cluster in families, and are therefore probably genetic. Identification of individuals at risk for developing IAs by genetic tests will allow concentration of diagnostic imaging on high-risk individuals. We used model-free linkage analysis based on allele sharing with a two-stage design for a genome-wide scan to identify chromosomal regions that may harbor IA loci.MethodsWe previously estimated sibling relative risk in the Finnish population at between 9 and 16, and proceeded with a genome-wide scan for loci predisposing to IA. In 85 Finnish families with two or more affected members, 48 affected sibling pairs (ASPs) were available for our genetic study. Power calculations indicated that 48 ASPs were adequate to identify chromosomal regions likely to harbor predisposing genes and that a liberal stage I lod score threshold of 0.8 provided a reasonable balance between detection of false positive regions and failure to detect real loci with moderate effect.ResultsSeven chromosomal regions exceeded the stage I lod score threshold of 0.8 and five exceeded 1.0. The most significant region, on chromosome 19q, had a maximum multipoint lod score (MLS) of 2.6.ConclusionsOur study provides evidence for the locations of genes predisposing to IA. Further studies are necessary to elucidate the genes and their role in the pathophysiology of IA, and to design genetic tests.

Highlights

  • Cerebrovascular disease is the third leading cause of death in the United States, and about one-fourth of cerebrovascular deaths are attributed to ruptured intracranial aneurysms (IA)

  • About 90% of subarachnoid hemorrhage (SAH) cases are caused by a ruptured IA [1]

  • Simple tests for genetic risk factors would permit the identification of individuals at high risk for development and rupture of aneurysms, allowing diagnostic effort to be concentrated on a smaller group that is at higher risk

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Summary

Introduction

Cerebrovascular disease is the third leading cause of death in the United States, and about one-fourth of cerebrovascular deaths are attributed to ruptured intracranial aneurysms (IA). Identification of individuals at risk for developing IAs by genetic tests will allow concentration of diagnostic imaging on high-risk individuals. There is substantial debate regarding the cost-benefit ratio of population screening [4,5,6,7,8] Restricting screening to those individuals at high risk both for developing IA and for rupture would improve the cost-benefit ratio. Characterization of environmental and genetic risk factors would allow reduction of risk through behavior modification, and significantly improve detection. Simple tests for genetic risk factors would permit the identification of individuals at high risk for development and rupture of aneurysms, allowing diagnostic effort to be concentrated on a smaller group that is at higher risk

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