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Noyce, A. J.

Publications and source records attributed to Noyce, A. J..

4 recordsLinked to original sources

Screening performance of abbreviated versions of the UPSIT smell test

BackgroundHyposmia features in several neurodegenerative conditions, including Parkinsons disease (PD). The University of Pennsylvania Smell Identification Test (UPSIT) is a widely used screening tool for detecting hyposmia, but is time-consuming and expensive when used on a large scale.\n\nMethodsWe assessed shorter subsets of UPSIT items for their ability to detect hyposmia in 891 healthy participants from the PREDICT-PD study. Established shorter tests included Versions A and B of both the 4-item Pocket Smell Test (PST) and 12-item Brief Smell Identification Test (BSIT). Using a data-driven approach, we evaluated screening performances of 23,231,378 combinations of 1-7 smell items from the full UPSIT.\n\nResultsPST Versions A and B achieved sensitivity/specificity of 76.8%/64.9% and 86.6%/45.9% respectively, whilst BSIT Versions A and B achieved 83.1%/79.5% and 96.5%/51.8% for detecting hyposmia defined by the longer UPSIT. From the data-driven analysis, two optimised sets of 7 smells surpassed the screening performance of the 12 item BSITs (with validation sensitivity/specificities of 88.2%/85.4% and 100%/53.5%). A set of 4 smells (Menthol, Clove, Gingerbread and Orange) had higher sensitivity for hyposmia than PST-A, -B and even BSIT-A (with validation sensitivity 91.2%). The same 4 smells also featured amongst those most commonly misidentified by 44 individuals with PD compared to 891 PREDICT-PD controls and a screening test using these 4 smells would have identified all hyposmic patients with PD.\n\nConclusionUsing abbreviated smell tests could provide a cost-effective means of screening for hyposmia in large cohorts, allowing more targeted administration of the UPSIT or similar smell tests.

neuroscience

Parkinson disease age of onset GWAS: defining heritability, genetic loci and a-synuclein mechanisms

Increasing evidence supports an extensive and complex genetic contribution to Parkinsons disease (PD). Previous genome-wide association studies (GWAS) have shed light on the genetic basis of risk for this disease. However, the genetic determinants of PD age of onset are largely unknown. Here we performed an age of onset GWAS based on 28,568 PD cases. We estimated that the heritability of PD age of onset due to common genetic variation was ~0.11, lower than the overall heritability of risk for PD (~0.27) likely in part because of the subjective nature of this measure. We found two genome-wide significant association signals, one at SNCA and the other a protein-coding variant in TMEM175, both of which are known PD risk loci and a Bonferroni corrected significant effect at other known PD risk loci, INPP5F/BAG3, FAM47E/SCARB2, and MCCC1. In addition, we identified that GBA coding variant carriers had an earlier age of onset compared to non-carriers. Notably, SNCA, TMEM175, SCARB2, BAG3 and GBA have all been shown to either directly influence alpha-synuclein aggregation or are implicated in alpha-synuclein aggregation pathways. Remarkably, other well-established PD risk loci such as GCH1, MAPT and RAB7L1/NUCKS1 (PARK16) did not show a significant effect on age of onset of PD. While for some loci, this may be a measure of power, this is clearly not the case for the MAPT locus; thus genetic variability at this locus influences whether but not when an individual develops disease. We believe this is an important mechanistic and therapeutic distinction. Furthermore, these data support a model in which alpha-synuclein and lysosomal mechanisms impact not only PD risk but also age of disease onset and highlights that therapies that target alpha-synuclein aggregation are more likely to be disease-modifying than therapies targeting other pathways.

genetics

Parkinson’s disease genetics: identifying novel risk loci, providing causal insights and improving estimates of heritable risk

We performed the largest genome-wide association study of PD to date, involving the analysis of 7.8M SNPs in 37.7K cases, 18.6K UK Biobank proxy-cases, and 1.4M controls. We identified 90 independent genome-wide significant signals across 78 loci, including 38 independent risk signals in 37 novel loci. These variants explained 26-36% of the heritable risk of PD. Tests of causality within a Mendelian randomization framework identified putatively causal genes for 70 risk signals. Tissue expression enrichment analysis suggested that signatures of PD loci were heavily brain-enriched, consistent with specific neuronal cell types being implicated from single cell expression data. We found significant genetic correlations with brain volumes, smoking status, and educational attainment. In sum, these data provide the most comprehensive understanding of the genetic architecture of PD to date by revealing many additional PD risk loci, providing a biological context for these risk factors, and demonstrating that a considerable genetic component of this disease remains unidentified.

genetics

Tendency towards being a “Morning person” increases risk of Parkinson’s disease: evidence from Mendelian randomisation

BackgroundCircadian rhythm may play a role in neurodegenerative diseases such as Parkinsons disease (PD). Chronotype is the behavioural manifestation of circadian rhythm and Mendelian randomisation (MR) involves the use of genetic variants to explore causal effects of exposures on outcomes. This study aimed to explore a causal relationship between chronotype and coffee consumption on risk of PD.\n\nMethodsTwo-sample MR was undertaken using publicly available GWAS data. Associations between genetic instrumental variables (IV) and \"morning person\" (one extreme of chronotype) were obtained from the personal genetics company 23andMe, Inc., and UK Biobank, and consisted of the per-allele odds ratio of being a \"morning person\" for 15 independent variants. The per-allele difference in log-odds of PD for each variant was estimated from a recent meta-analysis. The inverse variance weight method was used to estimate an odds ratio (OR) for the effect of being a \"morning person\" on PD. Additional MR methods were used to check for bias in the IVW estimate, arising through violation of MR assumptions. The results were compared to analyses employing a genetic instrument of coffee consumption, because coffee consumption has been previously inversely linked to PD.\n\nFindingsBeing a \"morning person\" was causally linked with risk of PD (OR 1*27; 95% confidence interval 1*06-1*51; p=0*012). Sensitivity analyses did not suggest that invalid instruments were biasing the effect estimate and there was no evidence for a reverse causal relationship between liability for PD and chronotype. There was no robust evidence for a causal effect of high coffee consumption using IV analysis, but the effect was imprecisely estimated (OR 1*12; 95% CI 0*89-1*42; p=0*22).\n\nInterpretationWe observed causal evidence to support the notion that being a \"morning person\", a phenotype driven by the circadian clock, is associated with a higher risk of PD. Further work on the mechanisms is warranted and may lead to novel therapeutic targets.\n\nFundingNo specific funding source.

epidemiology