Polygenic liability for anxiety in association with comorbid anxiety in multiple sclerosis

Author:

Kowalec Kaarina12ORCID,Harder Arvid2,Dolovich Casandra3,Fitzgerald Kathryn C.4ORCID,Salter Amber5ORCID,Lu Yi2,Bernstein Charles N.3,Bolton James M.6,Cutter Gary7,Fisk John D.8,Gelernter Joel910,Graff Lesley A.11,Hägg Sara2,Hitchon Carol A.12,Levey Daniel F.910,Lublin Fred D.13,McKay Kyla A.14ORCID,Patten Scott15,Patki Amit7,Stein Murray B.616,Tiwari Hemant K.7,Wolinsky Jerry S.17ORCID,Marrie Ruth A.318

Affiliation:

1. Rady Faculty of Health Sciences University of Manitoba Winnipeg Canada

2. Department of Medical Epidemiology & Biostatistics Karolinska Institutet Solna Sweden

3. Department of Internal Medicine Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Canada

4. Department of Neurology Johns Hopkins School of Medicine Baltimore Maryland USA

5. Department of Neurology UT Southwestern Dallas Texas USA

6. Department of Psychiatry Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Canada

7. Department of Biostatistics University of Alabama at Birmingham Birmingham Alabama USA

8. Nova Scotia Health and Departments of Psychiatry, Psychology & Neuroscience, and Medicine Dalhousie University Halifax Nova Scotia Canada

9. Department of Psychiatry Yale University, School of Medicine New Haven Connecticut USA

10. Department of Psychiatry VA Connecticut Healthcare System New Haven Connecticut USA

11. Department of Clinical Health Psychology Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Canada

12. Department of Rheumatology Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Canada

13. Icahn School of Medicine at Mount Sinai New York New York USA

14. Department of Clinical Neuroscience Karolinska Institutet Solna Sweden

15. Department of Community Health Sciences Cumming School of Medicine, University of Calgary Calgary Canada

16. Department of Psychiatry University of California San Diego La Jolla California USA

17. Department of Neurology McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth) Houston Texas USA

18. Department of Community Health Sciences Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Canada

Abstract

AbstractObjectiveComorbid anxiety occurs often in MS and is associated with disability progression. Polygenic scores offer a possible means of anxiety risk prediction but often have not been validated outside the original discovery population. We aimed to investigate the association between the Generalized Anxiety Disorder 2‐item scale polygenic score with anxiety in MS.MethodsUsing a case–control design, participants from Canadian, UK Biobank, and United States cohorts were grouped into cases (MS/comorbid anxiety) or controls (MS/no anxiety, anxiety/no immune disease or healthy). We used multiple anxiety measures: current symptoms, lifetime interview‐diagnosed, and lifetime self‐report physician‐diagnosed. The polygenic score was computed for current anxiety symptoms using summary statistics from a previous genome‐wide association study and was tested using regression.ResultsA total of 71,343 individuals of European genetic ancestry were used: Canada (n = 334; 212 MS), UK Biobank (n = 70,431; 1,390 MS), and the USA (n = 578 MS). Meta‐analyses identified that in MS, each 1‐SD increase in the polygenic score was associated with ~50% increased odds of comorbid moderate anxious symptoms compared to those with less than moderate anxious symptoms (OR: 1.47, 95% CI: 1.09–1.99). We found a similar direction of effects in the other measures. MS had a similar anxiety genetic burden compared to people with anxiety as the index disease.InterpretationHigher genetic burden for anxiety was associated with significantly increased odds of moderate anxious symptoms in MS of European genetic ancestry which did not differ from those with anxiety and no comorbid immune disease. This study suggests a genetic basis for anxiety in MS.

Funder

National Institute of Mental Health

Canadian Institutes of Health Research

University of Manitoba

U.S. Department of Veterans Affairs

Vetenskapsrådet

Publisher

Wiley

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