Indiana University School of Medicine, Indianapolis, IN USA 1

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GWAS and Candidate Studies of MRI and Amyloid PET Phenotypes for Alzheimer's Disease Andrew J. Saykin Depts. of Radiology & Imaging Sciences and Medical & Molecular Genetics, Neurology & Psychiatry; Indiana University School of Medicine, Indianapolis, IN 46202 USA; and the Indiana Alzheimer Disease Center; email: asaykin@iupui.edu ADC Director Meeting, Boston, Acknowledgements & Disclosures National Institute on Aging ADNI U01 AG024904 & RC2 AG036535 R01 AG19771 & P30 AG10133 U01 AG032984, U24 AG21886, P30 AG010129, K01 AG030514 Natl. Inst. of Biomedical Imaging and Bioengineering Foundation for the NIH Anonymous Foundation (Challenge Grant) Gene Network Sciences, Merck, Pfizer (DNA ext.) Alzheimer s Association & Brin Wojcicki Foundation Sequencing of ADNI-GO/2 Saykin disclosures for related work: Siemens Healthcare, Welch-Allyn, Eli Lilly Overview Neuroimaging as an endophenotype Enhanced statistical power and proximity to biology Methodological issues in mapping between quantitative biomarker phenotypes and genetic data Emerging findings, challenges & future directions: Genome-wide whole brain analysis MRI phenotypes Candidate gene and pathway-based analyses Example: PiB PET New Florbetapir PET GWAS Ongoing work and new directions Exome and Whole Genome Sequencing Indianapolis, IN USA 1

Role of Gene Variation in Biomarker Phenotypes How do genes modify these curves? Modified from Trojanowski & Hampel Prog in Neurobiol 2011; 95:491-495; and Jack et al Lancet Neurology 2010; 9:119 28. Imaging, Biomarkers & Clinical Endophenotypes Gene Chip Other QT phenotypes: clinical, cognitive, fluid biomarker data ROI Brain-Genome Association Strategies Candidate Gene/SNP Biological Pathway Genome-wide Analysis Risacher et al 2010 Sloan et al 2010 Potkin et al 2009; Saykin et al 2010 Circuit Egan et al 2001 COMT Swaminathan et al 2010 PiB ROIs & amyloid pathway Potkin et al 2009 Mol Psych schizophrenia study Whole Brain 0 4 1 2 AD Saykin, 2011 Reiman et al PNAS 2009; Also Ho et al 2010 FTO Reiman et al 2008 cholesterol pathway genes Shen et al 2010 ROIs; Stein et al 2010 voxels Indianapolis, IN USA 2

Whole Brain & Genome-wide Analysis ROI-based Voxel-based Shen et al NeuroImage 53 (2010) 1051 1063 Stein et al NeuroImage 53 (2010) 1160 1174 New GWAS Loci for Brain Structure Nature Genetics, April 15, 2012 Hippocampal Volume: 12q14 & 12q24 Intracranial Volume (ICV): 6q22, 12q14/15, & 12q24, 17q21 Stein et al, n=21,151 ENIGMA Consortium including ADNI Bis et al, n=9,232 CHARGE Consortium; also ENIGMA/ADNI Ikram et al, n=8,175 CHARGE Consortium; also EGC Taal et al, n=10,768 EGC Consortium; also CHARGE [ 18 F]Florbetapir PET as Intermediate Phenotype: Neuropathological Validated for Imaging Amyloid JAMA Jan 19, 2011 FDA approval in 2012 Indianapolis, IN USA 3

Role of APOE in Early MCI: Florbetapir PET Risacher et al AAIC 2012 and submitted Role of APOE in Early MCI: Florbetapir PET Risacher et al AAIC 2012 and submitted Role of APOE in Early MCI: CSF Risacher et al AAIC 2012 and submitted Indianapolis, IN USA 4

Role of APOE in Early MCI: Structure Risacher et al AAIC 2012 and submitted Longitudinal GWAS on Adjusted Annual Percent Change in Hippocampal Volume APOE (Chr 19): rs429358 is the epsilon 4 allele marker TOMM40 (Chr 19): translocase of outer mitochondrial membrane 40 homolog (LD with APOE) CADH8 (Chr 16): cadherin 8, type 2; synaptic adhesion, axonal growth/guidance (no data in AD) Saykin et al Alzheimer s & Dementia (2010); 6:265 273 Increasing Focus on Biological Pathways Ramanan et al, Trends in Genetics, July 2012, Vol. 28, No. 7 Indianapolis, IN USA 5

Swaminathan et al, Brain Imaging & Behavior (2012) Amyloid Gene Pathway PET Study: [11C]PiB DHCR24 (seladin - selective AD indicator cholesterol synthesis pathway) Swaminathan et al, Brain Imaging & Behavior (2012) DOI 10.1007/s11682-011-9136-1 [ 18 F]Florbetapir GWAS Sample (ADNI-GO/2, N=555) HC (n=179) EMCI (n=190) LMCI (n=115) AD (n=71) Age (years) 76 68 (6 25) 71 04 (7 41) 75 61 (8 14) 75 87 (8 15) Gender (women, %) 87 (49%) 83 (44%) 41 (36%) 27 (38%) Education (years) 16 27 (2 72) 15 89 (2 65) 16 11 (2 90) 16 04 (2 87) APOE ε4 allele (present, %) 41 (23%) 77 (41%) 49 (43%) 45 (64%) CDR-SOB 0 07 (0 29) 1 22 (0 73) 1 73 (1 18) 5 63 (2 70) Mini Mental Status Examination 29 07 (1 25) 28 39 (1 52) 27 74 (1 84) 21 68 (4 24) Logical Memory Immediate Recall (WMS-R) Logical Memory Delayed Recall (WMS-R) 14 94 (3 36) 10 93 (2 81) 8 74 (4 35) 4 20 (3 10) 14 08 (3 64) 8 87 (1 73) 6 13 (4 38) 1 67 (2 50) Data are number (%) or mean (SD). CDR-SOB = Clinical Dementia Rating-Sum of Boxes. WMS-R = Wechsler Memory Scale-Revised. PET = positron emission tomography. Indianapolis, IN USA 6

Florbetapir GWAS Q-Q Plot GWAS of [ 18 F]Florbetapir PET Amyloid Burden HC 179, EMCI 190, LMCI 115, AD 71 Two significant loci explain 15% of variance in cortical Aβ levels (APOE: 10.7%; BCHE: 4.3%) Chromosome 19: APOE Region Indianapolis, IN USA 7

Influence of APOE Chromosome 3: BCHE Region Independent, genome-wide significant associations with serum BuChE activity Signal extends 800 kb upstream of BCHE Benyamin, et al., HMG, 2011 Australian population cohorts, N=8791 450 kb BCHE Region: Haplotype Blocks Indianapolis, IN USA 8

Influence of BCHE R Topography of rs509208 (BCHE) Influence on Florbetapir Uptake L Covariates: age, sex, diagnosis and APOE ԑ4 status p <.05, FWE corrected ADNI, N=555 Additive Effects of APOE and BCHE Indianapolis, IN USA 9

BuChE in Aβ plaque deposition Combining Imaging and Proteomic Biomarkers to Enhance Detection Integrating structural MRI and RBM plasma proteomic panel data significantly decreased classification errors Shen, Kim, Qi et al Lect Notes Comput Sci 2011;7012:27-34 Whole exome sequencing: rate of hippocampal change in extreme phenotype design K. Nho et al AAIC 2012 Developing Topics Session & submitted Indianapolis, IN USA 10

Future: Convergent -Omics Ramanan et al, Trends in Genetics, July 2012, Vol. 28, No. 7: dx.doi.org/10.1016/j.tig.2012.03.004 ADNI Genotyping Working Groups Indiana University Imaging Genomics Lab Andrew J. Saykin Li Shen Sungeun Kim Kwangsik Nho Vijay Ramanan Shannon Risacher Shanker Swaminathan NCRAD & Genetics Tatiana M. Foroud Kelley M. Faber Pfizer Genetics Bryan DeChairo Elyse Katz TGen Matt J. Huentelman David W. Craig Eric Reiman CHOP: Hakon Hakonarson UC Irvine: Steven G. Potkin Guia Guffanti Anita Lakatos Core Consultants (ADNI-2): Lars Bertram (Max Planck) Lindsay Farrer (BU) Robert Green (BU) Jason Moore (Dartmouth) Paul Thompson (UCLA) Indianapolis, IN USA 11