|
1
|
Gagnon E, Daghlas I, Zagkos L, Sargurupremraj M, Georgakis MK, Anderson CD, Cronje HT, Burgess S, Arsenault BJ, Gill D. Mendelian Randomization Applied to Neurology: Promises and Challenges. Neurology 2024; 102:e209128. [PMID: 38261980 PMCID: PMC7615637 DOI: 10.1212/wnl.0000000000209128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/16/2023] [Indexed: 01/25/2024] Open
Abstract
The Mendelian randomization (MR) paradigm allows for causal inferences to be drawn using genetic data. In recent years, the expansion of well-powered publicly available genetic association data related to phenotypes such as brain tissue gene expression, brain imaging, and neurologic diseases offers exciting opportunities for the application of MR in the field of neurology. In this review, we discuss the basic principles of MR, its myriad applications to research in neurology, and potential pitfalls of injudicious applications. Throughout, we provide examples where MR-informed findings have shed light on long-standing epidemiologic controversies, provided insights into the pathophysiology of neurologic conditions, prioritized drug targets, and informed drug repurposing opportunities. With the ever-expanding availability of genome-wide association data, we project MR to become a key driver of progress in the field of neurology. It is therefore paramount that academics and clinicians within the field are familiar with the approach.
Collapse
Affiliation(s)
- Eloi Gagnon
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Iyas Daghlas
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Loukas Zagkos
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Muralidharan Sargurupremraj
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Marios K Georgakis
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Christopher D Anderson
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Helene T Cronje
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Stephen Burgess
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Benoit J Arsenault
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| | - Dipender Gill
- From the Quebec Heart and Lung Institute (E.G., B.J.A.), Laval University, Quebec, Canada; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (L.Z., D.G.), School of Public Health, Imperial College London, United Kingdom; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (M.S.), University of Texas Health Sciences Center, San Antonio; Broad Institute of MIT and Harvard (M.K.G., C.D.A.), Cambridge, MA; Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital, LMU Munich, Germany; Center for Genomic Medicine (C.D.A.), Massachusetts General Hospital; Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA; Department of Public Health (H.T.C.), Section of Epidemiology, University of Copenhagen, Denmark; MRC Biostatistics Unit (S.B.), and Cardiovascular Epidemiology Unit (S.B.), Department of Public Health and Primary Care, University of Cambridge, United Kingdom; and Department of Medicine (B.J.A.), Faculty of Medicine, Université Laval, Québec, Canada
| |
Collapse
|