Catechol-O-Methyltransferase Genotypes and Parenting Influence on Long-Term Executive Functioning After Moderate to Severe Early Childhood Traumatic Brain Injury: An Exploratory Study

Dopamine-Related Genes Moderate the Association Between Family Environment and Executive Function Following Pediatric Traumatic Brain Injury: An Exploratory Study

OBJECTIVE

This study examined whether carrying dopamine-related "risk" genes-either the dopamine transporter (DAT1) 10-repeat allele or dopamine receptor-4 (DRD4) 7-repeat allele-moderated the association of family environment and executive function (EF) following traumatic brain injury (TBI) in early childhood.

METHODS

Caregivers of children with TBI or orthopedic injury (OI) completed the Behavior Rating Inventory of Executive Function (BRIEF) at postinjury visits. General linear models examined gene by environment interactions as moderators of the effects of TBI on EF at 12 months and 7 years postinjury.

RESULTS

At 12 months, we did not find any significant gene by environment interactions. At 7 years, we found a significant 3-way interaction among combined carrier status, level of permissive parenting, and injury type. For children exposed to more optimal parenting, carriers of DAT1 and/or DRD4 risk alleles with TBI showed significantly worse parent-reported EF than carriers with OI. In those with less optimal parenting, carriers and noncarriers with TBI, as well as carriers with OI, showed significantly worse parent-reported EF than noncarriers with OI, with medium to large effect sizes.

CONCLUSIONS

The findings highlight the importance of considering polygenetic and environmental factors in future studies of recovery following TBI and other injuries in childhood.

Inhibitory Control Mediates the Associations Between Parenting Practices and Depressive Symptoms in Adolescents: The Moderating Role of Catechol-O-Methyltransferase (COMT) Gene

Ample evidence suggested that parental responsiveness, demandingness, and autonomy granting protect adolescents from depressive symptoms. However, what is less well understood is how parenting practices reduce the risk of depressive symptoms. This study tested the protective effects of parenting practices and inhibitory control on depressive symptoms, along with the mediating role of inhibitory control and the moderating role of the COMT gene in linking parenting practices to depressive symptoms. The study utilized cross-sectional data from a community sample of Chinese Han adolescents (N = 943, M_age = 15.25 years, SD = 0.70 years; 51.9% girls). Results showed that parental responsiveness and autonomy granting promoted higher inhibitory control, which in turn was associated with lower depressive symptoms. Further, the mediation effects were moderated by the COMT gene. For adolescents with ValVal homozygotes, both responsiveness and autonomy granting were related to higher levels of inhibitory control, which reduced risk for depressive symptoms, but the mediation effects were not observed among Met allele carriers. The mediating role of inhibitory control did not hold in the parental demandingness model. Findings support the cognitive theory that inhibitory control is a proximal factor linking parenting practices to depressive symptoms exclusively in ValVal homozygotes. These results also suggested that differentiating different dimensions of parenting practices may help to further clarify the processes by which parenting practices eventuate depressive symptoms.

Epigenetic Effects on Pediatric Traumatic Brain Injury Recovery (EETR): An Observational, Prospective, Longitudinal Concurrent Cohort Study Protocol

Introduction: Unexplained heterogeneity in outcomes following pediatric traumatic brain injury (TBI) is one of the most critical barriers to the development of effective prognostic tools and therapeutics. The addition of personal biological factors to our prediction models may account for a significant portion of unexplained variance and advance the field toward precision rehabilitation medicine. The overarching goal of the Epigenetic Effects on Pediatric Traumatic Brain Injury Recovery (EETR) study is to investigate an epigenetic biomarker involved in both childhood adversity and postinjury neuroplasticity to better understand heterogeneity in neurobehavioral outcomes following pediatric TBI. Our primary hypothesis is that childhood adversity will be associated with worse neurobehavioral recovery in part through an epigenetically mediated reduction in brain-derived neurotrophic factor (BDNF) expression in response to TBI. Methods and analysis: EETR is an observational, prospective, longitudinal concurrent cohort study of children aged 3-18 years with either TBI (n = 200) or orthopedic injury (n = 100), recruited from the UPMC Children's Hospital of Pittsburgh. Participants complete study visits acutely and at 6 and 12 months postinjury. Blood and saliva biosamples are collected at all time points-and cerebrospinal fluid (CSF) when available acutely-for epigenetic and proteomic analysis of BDNF. Additional measures assess injury characteristics, pre- and postinjury child neurobehavioral functioning, childhood adversity, and potential covariates/confounders. Recruitment began in July 2017 and will occur for ~6 years, with data collection complete by mid-2023. Analyses will characterize BDNF DNA methylation and protein levels over the recovery period and investigate this novel biomarker as a potential biological mechanism underlying the known association between childhood adversity and worse neurobehavioral outcomes following pediatric TBI. Ethics and dissemination: The study received ethics approval from the University of Pittsburgh Institutional Review Board. Participants and their parents provide informed consent/assent. Research findings will be disseminated via local and international conference presentations and manuscripts submitted to peer-reviewed journals. Trial Registration: The study is registered with clinicaltrials.org (ClinicalTrials.gov Identifier: NCT04186429).

Genetic Influences on Behavioral Outcomes After Childhood TBI: A Novel Systems Biology-Informed Approach

Objectives: To test whether genetic associations with behavioral outcomes after early childhood traumatic brain injury (TBI) are enriched for biologic pathways underpinning neurocognitive and behavioral networks.

Design: Cross-sectional evaluation of the association of genetic factors with early (~ 6 months) and long-term (~ 7 years) post-TBI behavioral outcomes. We combined systems biology and genetic association testing methodologies to identify biologic pathways associated with neurocognitive and behavior outcomes after TBI. We then evaluated whether genes/single nucleotide polymorphism (SNPs) associated with these biologic pathways were more likely to demonstrate a relationship (i.e., enrichment) with short and long-term behavioral outcomes after early childhood TBI compared to genes/SNPs not associated with these biologic pathways.

Setting: Outpatient research setting.

Participants:140 children, ages 3–6:11 years at time of injury, admitted for a TBI or orthopedic injury (OI).

Interventions: Not Applicable.

Main Outcome Measures: Child behavior checklist total problems T score.

Results: Systems biology methodology identified neuronal systems and neurotransmitter signaling (Glutamate receptor, dopamine, serotonin, and calcium signaling), inflammatory response, cell death, immune systems, and brain development as important biologic pathways to neurocognitive and behavioral outcomes after TBI. At 6 months post injury, the group (TBI versus OI) by polymorphism interaction was significant when the aggregate signal from the highest ranked 40% of case gene associations was compared to the control set of genes. At ~ 7 years post injury, the selected polymorphisms had a significant main effect after controlling for injury type when the aggregate signal from the highest ranked 10% of the case genes were compared to the control set of genes

Conclusions: Findings demonstrate the promise of applying a genomics approach, informed by systems biology, to understanding behavioral recovery after pediatric TBI. A mixture of biologic pathways and processes are associated with behavioral recovery, specifically genes associated with cell death, inflammatory response, neurotransmitter signaling, and brain development. These results provide insights into the complex biology of TBI recovery.

Differences in Sensitivity to Environment Depending on Catechol-O-Methyltransferase (COMT) Gene? A Meta-analysis of Child and Adolescent Gene-by-Environment Studies

To date, several gene-by-environment (G×E) meta-analyses have been conducted to provide cumulative G×E evidence from previous inconsistent empirical studies; however, these meta-analyses have mainly focused on the serotonin transporter gene (5-HTTLPR). The present study aimed to conduct the first meta-analysis that tested whether and how an important dopaminergic gene-the catechol-O-methyltransferase (COMT) gene contributed to differences in child and adolescent environmental sensitivity. A total of 22 studies with 20,528 participants involving in various developmental outcomes (e.g., externalizing problems, emotional problems, cognitive development and social behaviors) met the inclusion criteria. The pooled effect size of environment-outcome associations in the Met-allele carriers (r = 0.11, 95% CI = [0.07, 0.15], p < .001) did not significantly differ from that in the Val/Val homozygotes (r = 0.14, 95% CI = [0.08, 0.20], p < 0.001) (Qcontrast (1) = 0.37, p = 0.54). The aggregated Liptak-Stouffer Z-score that combined the p-values of the COMT-environment interaction yield a nonsignificant result (p = 0.52). Moreover, outcome domain, sample age, ethnicity and assessment methods for the environment and the outcome did not moderate the effect sizes. Thus far, the COMT Val158Met polymorphism fails to explain the differences in sensitivity to environment. Future studies might incorporate more factors, such as polygenic effects of genetic pathways, epigenetics (EpiG) processing and sexual dimorphism, into the COMT-environment interaction equation.

The Moderating Effect of the Ankyrin Repeat and Kinase Domain Containing One Gene on the Association of Family Environment with Longitudinal Executive Function following Traumatic Brain Injury in Early Childhood: A Preliminary Study

This study examined whether the ankyrin repeat and kinase domain containing 1 gene (ANKK1) C/T single-nucleotide polymorphism (SNP) rs1800497 moderated the association of family environment with long-term executive function (EF) following traumatic injury in early childhood. Caregivers of children with traumatic brain injury (TBI) and children with orthopedic injury completed the Behavior Rating Inventory of Executive Function (BRIEF) at post-injury visits. DNA was collected to identify the rs1800497 genotype in the ANKK1 gene. General linear models examined gene-environment interactions as moderators of the effects of TBI on EF at two times post-injury (12 months and 7 years). At 12 months post-injury, analyses revealed a significant three-way interaction of genotype with level of permissive parenting and injury type. Post hoc analyses showed genetic effects were more pronounced for children with TBI from more positive family environments, such that children with TBI who were carriers of the risk allele (T-allele) had significantly poorer EF compared with non-carriers only when they were from more advantaged environments. At 7 years post-injury, analyses revealed a significant two-way interaction of genotype with level of authoritarian parenting. Post hoc analyses found that carriers of the risk allele had significantly poorer EF compared with non-carriers only when they were from more advantaged environments. These results suggest a gene-environment interaction involving the ANKK1 gene as a predictor of EF in a pediatric injury population. The findings highlight the importance of considering environmental influences in future genetic studies on recovery following TBI and other traumatic injuries in childhood.