Causality between ischemic stroke and epilepsy based on Mendelian randomization
Neuroscience|更新时间:2026-01-09
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Causality between ischemic stroke and epilepsy based on Mendelian randomization
Journal of Army Medical UniversityVol. 46, Issue 20, Pages: 2276-2283(2024)
作者机构:
1.510006 广州,广州中医药大学针灸康复临床医学院
2.400037 重庆,陆军军医大学(第三军医大学)第二附属医院儿科
3.400037 重庆,陆军军医大学(第三军医大学)第二附属医院神经外科全军癫痫诊治中心
作者简介:
基金信息:
the General Program of National Natural Science Foundation of China(82171463);the Joint Medical Research Project for Young and Middle-Aged Top Talents of Chongqing Science and Technology Commission and Chongqing Health Commission(2024GDRC013)
Yun SHU, Qing YUAN, Zhifeng WU, et al. Causality between ischemic stroke and epilepsy based on Mendelian randomization[J]. Journal of Army Medical University, 2024, 46(20): 2276-2283.
DOI:
Yun SHU, Qing YUAN, Zhifeng WU, et al. Causality between ischemic stroke and epilepsy based on Mendelian randomization[J]. Journal of Army Medical University, 2024, 46(20): 2276-2283. DOI: 10.16016/j.2097-0927.202403006.
Causality between ischemic stroke and epilepsy based on Mendelian randomization
To explore the causal relationship between ischemic stroke and different types of epilepsy so as to provide genetic evidence for the risk of epilepsy after ischemic stroke.
Methods
2
Based on the summary data of genome-wide association study
Mendelian randomization (MR) analysis was performed with MR-Egger regression
weighted median and inverse-variance weighting. Sensitivity analysis was conducted by using MR-Egger regression test
MR-PRESSO test and leave-one-out method.
Results
2
Two-sample MR analysis showed that there was a causal relationship between ischemic stroke and the risk of epilepsy (
OR
=1.10
P
=0.036) and generalized epilepsy (
OR
=1.25
P
=0.001)
but no such relationship was observed with the risk of focal epilepsy (
OR
=1.06
P
=0.360). In addition
diastolic blood pressure (
OR
=1.12
P
=0.002) and BMI (
OR
=1.08
P
=0.015) also had a causal relationship with the risk of epilepsy. After adjusting confounding factors
multivariate MR analysis revealed that only ischemic stroke (
OR
=1.18
P
=3.770×10
-6
) and epilepsy risk had a causal relationship.
Conclusion
2
There is a causal relationship between ischemic stroke and the risk of generalized epilepsy
which can be used to stratify the risk of post-stroke epilepsy.
关键词
Keywords
references
KE B, LI C Y, SHANG H F. Sex hormones and risk of epilepsy: a bidirectional Mendelian randomization study[J]. Front Mol Neurosci, 2023, 16: 1153907. DOI: 10.3389/fnmol.2023.1153907.
VAN HEZIK-WESTER V, DE GROOT S, KANTERS T, et al . Burden of illness in people with medically refractory epilepsy who suffer from daily to weekly seizures: 12-month follow-up of participants in the EPISODE study[J ] . Front Neurol, 2022, 13: 1012486. DOI: 10.3389/fneur.2022.1012486.
WU S M, WU B, LIU M, et al . Stroke in China: advances and challenges in epidemiology, prevention, and management[J ] . Lancet Neurol, 2019, 18(4): 394-405. DOI: 10.1016/S1474-4 422(18)30500-3.
TRÖSCHER A R, GRUBER J, WAGNER J N, et al . Inflammation mediated epileptogenesis as possible mechanism underlying ischemic post-stroke epilepsy[J ] . Front Aging Neurosci, 2021, 13: 781174. DOI: 10.3389/fnagi.2021.781174.
MCDONALD T J W, HENRY-BARRON B J, FELTON E A, et al . Improving compliance in adults with epilepsy on a modified Atkins diet: a randomized trial[J ] . Seizure, 2018, 60: 132-138. DOI: 10.1016/j.seizure.2018.06.019.
RAZAZ N, TEDROFF K, VILLAMOR E, et al . Maternal body mass index in early pregnancy and risk of epilepsy in offspring[J ] . JAMA Neurol, 2017, 74(6): 668-676. DOI: 10.1001/jamaneurol.2016.6130.
STEFANIDOU M, HIMALI J J, DEVINSKY O, et al . Vascular risk factors as predictors of epilepsy in older age: the Framingham Heart Study[J ] . Epilepsia, 2022, 63(1): 237-243. DOI: 10.1111/epi.17108.
DOEGE C, LUEDDE M, KOSTEV K. Association between angiotensin receptor blocker therapy and incidence of epilepsy in patients with hypertension[J]. JAMA Neurol, 2022, 79(12): 1296-1302. DOI: 10.1001/jamaneurol.2022.3413.
RUSEK M, CZUCZWAR S J. A review of clinically significant drug-drug interactions involving angiotensin Ⅱ receptor antagonists and antiepileptic drugs[J]. Expert Opin Drug Metab Toxicol, 2020, 16(6): 507-515. DOI: 10.1080/17425255.2020.1763955.
ZHANG Z Z, WANG M M, YUAN S, et al . Alcohol, coffee,and milk intake in relation to epilepsy risk[J ] . Nutrients, 2022, 14(6): 1153. DOI: 10.3390/nu14061153.
ZENG Y J, CAO S, YANG H. Roles of gut microbiome in epilepsy risk: a Mendelian randomization study[J]. Front Microbiol, 2023, 14: 1115014. DOI: 10.3389/fmicb.2023.1115014.
MALIK R, CHAUHAN G, TRAYLOR M, et al . Multiancestry genome-wide association study of 520, 000 subjects identifies 32 loci associated with stroke and stroke subtypes[J ] . Nat Genet, 2018, 50(4): 524-537. DOI: 10.1038/s41588-018-0058-3.
YENGO L, SIDORENKO J, KEMPER K E, et al . Meta-analysis of genome-wide association studies for height and body mass index in~700000 individuals of European ancestry[J ] . Hum Mol Genet, 2018, 27(20): 3641-3649. DOI: 10.1093/hmg/ddy271.
International League Against Epilepsy Consortium on Complex Epilepsies. Genome-wide mega-analysis identifies 16 loci and highlights diverse biological mechanisms in the common epilepsies[J]. Nat Commun, 2018, 9(1): 5269. DOI: 10.1038/s41467-018-07524-z.
XIANG M M, WANG Y L, GAO Z Y, et al . Exploring causal correlations between inflammatory cytokines and systemic lupus erythematosus: a Mendelian randomization[J ] . Front Immunol, 2022, 13: 985729. DOI: 10.3389/fimmu.2022.985729.
PIERCE B L, AHSAN H, VANDERWEELE T J. Power and instrument strength requirements for Mendelian randomization studies using multiple genetic variants[J]. Int J Epidemiol, 2011, 40(3): 740-752. DOI: 10.1093/ije/dyq151.
BRION M J A, SHAKHBAZOV K, VISSCHER P M. Calculating statistical power in Mendelian randomization studies[J]. Int J Epidemiol, 2013, 42(5): 1497-1501. DOI: 10.1093/ije/dyt179.
BURGESS S, THOMPSON S G, CHD GENETICS COLLABORATION C R P. Avoiding bias from weak instruments in Mendelian randomization studies[J]. Int J Epidemiol, 2011, 40(3): 755-764. DOI: 10.1093/ije/dyr036.
PIERCE B L, BURGESS S. Efficient design for Mendelian randomization studies: subsample and 2-sample instrumental variable estimators[J]. Am J Epidemiol, 2013, 178(7): 1177-1184. DOI: 10.1093/aje/kwt084.
BURGESS S, THOMPSON S G. Interpreting findings from Mendelian randomization using the MR-Egger method[J]. Eur J Epidemiol, 2017, 32(5): 377-389. DOI: 10.1007/s10654-017-0255-x.
BOWDEN J, DAVEY SMITH G, BURGESS S. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression[J]. Int J Epidemiol, 2015, 44(2): 512-525. DOI: 10.1093/ije/dyv080.
BOWDEN J, DAVEY SMITH G, HAYCOCK P C, et al . Consistent estimation in Mendelian randomization with some invalid instruments using a weighted Median estimator[J ] . Genet Epidemiol, 2016, 40(4): 304-314. DOI: 10.1002/gepi.21965.
BURGESS S, ZUBER V, GKATZIONIS A, et al . Modal-based estimationvia heterogeneity-penalized weighting: model averaging for consistent and efficient estimation in Mendelian randomization when a plurality of candidate instruments are valid[J ] . Int J Epidemiol, 2018, 47(4): 1242-1254. DOI: 10.1093/ije/dyy080.
VERBANCK M, CHEN C Y, NEALE B, et al . Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases[J ] . Nat Genet, 2018, 50(5): 693-698. DOI: 10.1038/s41588-018-0099-7.
BEGHI E, CARPIO A, FORSG REN L, et al . Recommendation for a definition of acute symptomatic seizure[J ] . Epilepsia, 2010, 51(4): 671-675. DOI: 10.1111/j.1528-1167.2009.02285.x.
GALOVIC M, FERREIRA-ATUESTA C, ABRAIRA L, et al . Seizures and epilepsy after stroke: epidemiology, biomarkers and management[J ] . Drugs Aging, 2021, 38(4): 285-299. DOI: 10.1007/s40266-021-00837-7.
DORIA J W, FORGACS P B. Incidence, implications, and management of seizures following ischemic and hemorrhagic stroke[J]. Curr Neurol Neurosci Rep, 2019, 19(7): 37. DOI: 10.1007/s11910-019-0957-4.
Dziadkowiak E, Guzinski M, Chojdak-Lukasiewicz J, et al . Predictive factors in post-stroke epilepsy: Retrospective analysis[J ] . Adv Clin Exp Med, 2021, 30(1): 29-34. DOI: 10.17219/acem/128745.
Mullen S A, Berkovic S F. Genetic generalized epilepsies[J]. Epilepsia, 2018, 59(6): 1148-1153. DOI: 10.1111/epi.14042.
GESCHE J, BEIER C P. Drug resistance in idiopathic generalized epilepsies: Evidence and concepts[J]. Epilepsia, 2022, 63(12): 3007-3019. DOI: 10.17219/acem/128745.
SUZUKI T, KOIKE Y, ASHIKAWA K, et al . Genome-wide association study of epilepsy in a Japanese population identified an associated region at chromosome 12q24[J ] . Epilepsia, 2021, 62(6): 1391-1400. DOI: 10.1111/epi.16911.
MATTISKE T, LEE K, GECZ J, et al . Embryonic forebrain transcriptome of mice with polyalanine expansion mutations in the ARX homeobox gene[J ] . Hum Mol Genet, 2016, 25(24): 5433-5443. DOI: 10.1093/hmg/ddw360.
CHANG R S, LEUNG W C, VASSALLO M, et al . Antiepileptic drugs for the primary and secondary prevention of seizures after stroke[J ] . Cochrane Database Syst Rev, 2022, 2(2): CD005398. DOI: 10.1002/14651858.CD005398.pub4.
PUNIA V, HONOMICHL R, CHANDAN P, et al . Long-term continuation of anti-seizure medications after acute stroke[J ] . Ann Clin Transl Neurol, 2021, 8(9): 1857-1866. DOI: 10.1002/acn3.51440.
MAYERHOFER E, PARODI L, NARASIMHALU K, et al . Genetic variation supports a causal role for valproate in prevention of ischemic stroke[J ] . Int J Stroke, 2024, 19(1): 84-93. DOI: 10.1177/17474930231190259.
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