Chromosome 5 and Parkinson Disease
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European Journal of Human Genetics (2006) 14, 1106–1110 & 2006 Nature Publishing Group All rights reserved 1018-4813/06 $30.00 www.nature.com/ejhg ARTICLE Chromosome 5 and Parkinson disease Tatiana Foroud*,1, Nathan Pankratz1, Maria Martinez2 and the PROGENI/GSPD-European Consortium3 1Indiana University School of Medicine, Indianapolis, IN, USA; 2INSERM EMI00-06, 523 Place des Terrasses de l’Agora, Evry, France Parkinson disease (PD) is the second most common neurodegenerative disorder. Despite the identification of five causative genes, the majority of PD etiology is still unknown. A region on chromosome 5q is one of the few regions of the genome found linked in multiple studies of familial PD. Analyses were performed using genotypic data from two independent research studies to evaluate rigorously the evidence of linkage on chromosome 5. The combined sample consisting of 1238 affected individuals from 569 multiplex PD families were genotyped for a common set of 20 microsatellite markers spanning an 80 cM region on chromosome 5q. Two disease models were employed and model-free linkage analyses were performed to detect linkage to a PD susceptibility gene and also to detect linkage to a quantitative phenotype, age of onset of PD. There was little evidence of linkage using either a narrower or broader disease definition (lod o0.5). Analyses employing age of onset of PD as the phenotype produced a lod score of 1.8. These results in a very large sample of familial PD suggest that it is unlikely that a PD susceptibility gene is located on chromosome 5q. Evidence for a locus contributing to the age of onset of PD is modest at best (empirical P-value ¼ 0.07). European Journal of Human Genetics (2006) 14, 1106–1110. doi:10.1038/sj.ejhg.5201666; published online 31 May 2006 Keywords: Parkinson disease; chromosome 5; linkage analysis Introduction LRRK2, act in an autosomal dominant manner whereas the Parkinson disease (PD) is the second most common other three genes, PRKN, PINK1 and DJ1, are autosomal neurodegenerative disorder. There is wide variability in recessive in their mode of action. The majority of families the age of onset of disease, although the average age is with PD are not segregating a simple Mendelian form of approximately 60 years.1 PD is characterized by bradyki- disease. Rather, in many of these families, particularly nesia, resting tremor, muscular rigidity and postural those with multiple members with PD, it is expected that instability, as well as a clinically significant response to PD susceptibility genes may be interacting with each other treatment with levodopa.2 Recent studies have consistently or environmental factors, thereby increasing the risk of PD. found a significant genetic contribution to the risk of PD. Ongoing studies of multiplex PD pedigrees have provided Genetic analyses have identified five genes, which when evidence of linkage to several chromosomal regions. mutated can result in PD.3 Two of these genes, SNCA and Chromosome 5q is one of the few regions of the genome identified as a locus for PD susceptibility in multiple studies (Figure 1). Linkage to a PD susceptibility locus has *Correspondence: Dr T Foroud, Department of Medical and Molecular been detected using four different studies of multiplex PD Genetics (IB 130), Indiana University School of Medicine, 975 West Walnut Street, Indianapolis, IN 46202-5251, USA. Tel: þ 1 317 278 1291; families. In the PROGENI study, initial linkage analyses Fax: þ 1 317 278 1100; performed in a sample of 90 families with 96 affected E-mail: [email protected] sibling pairs meeting the narrow PD definition produced 3 For more details regarding PROGENI/GSPD-European Consortium see a maximum lod score of 1.6.4 Analyses in the GSPD- Appendix A. Received 14 February 2006; revised 26 April 2006; accepted 27 April 2006; European Consortium consisting of 199 families yielded a published online 31 May 2006 maximum lod score of 1.05 near the marker D5S471 using Chromosome 5 and Parkinson disease T Foroud et al 1107 45 years or younger, the typical criteria for early onset PD. Screening for mutations in known PD genes was not performed in all study samples. The majority of families (85%) consisted of a single pair of affected siblings. The PROGENI sample was primarily Caucasian (94%), although Hispanics (5%) also participated. The male-to-female ratio in this sample was 1.2. Appropriate written informed Figure 1 Evidence of linkage to chromosome 5q from four studies. consent approved by each individual institution’s Institu- The location of the markers used for fine mapping in this study are tional Review Board was completed. represented as dots below the ideogram. The GSPD-European Consortium sample consisted of 654 genotyped individuals (406 affected) from 199 multiplex PD pedigrees, ascertained through an index case a narrow disease definition. The evidence of linkage was with a definite diagnosis of PD. One hundred and eighty- greatest (lod ¼ 2.2) among those 115 families that did not eight pedigrees were ascertained from five European provide evidence of linkage to chromosome 2.5 A genome countries (France – 70, United Kingdom – 33, Netherlands screen in a sample of 51 Icelandic families resulted in a – 26, Germany – 30 and Italy – 29), and the remaining 11 maximum lod score of 1.6 on chromosome 5q near the pedigrees were recruited in the United States. Following a marker D5S666.6 The Duke PD study, using 174 families standardized neurological evaluation,5 subjects were clas- generated a maximum lod score of 1.5 on chromosome 5q sified as definite PD if the following criteria were near the marker D5S816.7 Further studies in these families met: presence of three of the four cardinal signs of PD also detected linkage to a gene that may contribute to PD age (bradykinesia, rigidity, rest tremor, asymmetry of signs at of onset in this same region of chromosome 5q.8 Clearly, the onset), at least 30% improvement with levodopa therapy evidence from each study individually is relatively modest; and absence of exclusion criteria (supranuclear gaze palsy, however, the convergence of linkage evidence from so many Babinski sign, cerebellar signs, dyspraxia, prominent and different studies suggests that a gene with moderate effect on early urinary symptoms, MMSE o24/30 within 2 years of PD risk may be located in this region of chromosome 5. onset). Probable PD was defined as three of the four To test rigorously whether a gene contributing to PD cardinal signs, or two of the four cardinal signs and at least susceptibility or PD age of onset is found on chromosome 30% improvement with levodopa therapy, and absence of 5q, a global genetics consortium was established between exclusion criteria. Age of onset information was available the PROGENI and GSPD-European Consortium studies. from 388 affected individuals. There was no difference in The goal of this consortium was to genotype a common set the subject’s age at participation, age at onset or clinical of markers across the region linked to PD susceptibility and symptoms between the six ascertainment sites.5 Thirteen test within an expanded sample of multiplex PD families percent of those with age of onset information in the whether a gene affecting the risk for PD was located on GSPD-European Consortium sample had an age of onset of chromosome 5. 45 years or younger, the typical criteria for early-onset PD. Screening for mutations in known PD genes was not performed in all study samples. The sample was nearly Methods exclusively Caucasian with an affected male-to-female Consortium samples ratio of 1.1. The PROGENI study samples were recruited through 59 Parkinson Study Group (PSG) sites located throughout Molecular genotyping and statistical analyses North America. The sample included 832 affected indivi- A common set of 20 equally spaced, microsatellite markers, duals with DNA from 379 multiplex PD families ascer- with an average intermarker density of 4.3 cM, was tained through a sibling pair reportedly affected with PD. genotyped across a 79 cM region of chromosome 5q23 All study participants completed a uniform clinical evalua- region. The PROGENI and GSPD-European Consortium tion (UPDRS;9) and a Diagnostic Checklist.4 The Diagnostic samples were genotyped in different laboratories using Checklist was developed with inclusion criteria consisting previously described methods.4,5 A CEPH control sample of clinical features highly associated with autopsy- (1347-02) was genotyped in both laboratories to assist in confirmed PD and exclusion criteria highly associated combining the two samples for joint analyses. with other non-PD pathological diagnoses.10,11 Responses A genome screen had been previously been completed in on the Diagnostic Checklist were used to classify study both the PROGENI and GSPD-European Consortium subjects as having verified PD or nonverified PD. Age of samples. Results from the screen had been used to verify onset information was available for 769 of the 832 sampled all family structures. The data from the 20 markers individuals. Twelve percent of those with age of onset genotyped as part of this study was evaluated for information in the PROGENI sample had an age of onset of Mendelian inheritance of marker alleles using the program European Journal of Human Genetics Chromosome 5 and Parkinson disease T Foroud et al 1108 Pedcheck.12 The distribution of the marker allele sizes and genetic analyses (see Table 1). To employ genotypic frequencies were reviewed in each sample and were found information from all available family members, those not to be significantly different. To further test for subtle genotyped family members which were not considered differences in allele frequencies within the GSPD-European affected within a particular model were coded as unknown. Consortium sample, given the varied origin of the families, A second series of analyses was also performed to assess the examination of the allele frequencies was performed based evidence of linkage for a gene contributing to the age of on the country of origin of the family.