Brain arteriovenous malformations (AVMs) are an important cause of intracranial hemorrhage (ICH) in young adults. The etiology and pathogenesis of AVMs are not well understood. Treatment is invasive and controversy remains over the clinical management of unruptured AVMs. Previous work by our group has identified genes associated with AVM and new ICH in the clinical course. However, the determinants of new ICH may differ from those that influence poor outcome from a hemorrhagic event or treatment-related injury. Identification of genetic predictors of functional outcome after brain injury may help facilitate risk prediction for better management of AVM patients and advance understanding of hemorrhagic diseases of the brain. The overall goal of this research proposal is to better understand the pathogenesis of brain AVMs and the underlying genetic susceptibility to adverse outcomes. Specifically, my goals are to identify genetic predictors of outcome measured by the modified Rankin scale after 1) brain injury from ICH or 2) invasive treatment in brain AVM patients, using a candidate gene approach. Thirdly, we will address methodological issues of population stratification, i.e., genetic confounding by race/ethnicity, which is a potential problem for all genetic association studies conducted in multiethnic populations. These objectives will be completed in a carefully characterized, actively followed cohort of existing and new AVM cases from the UCSF Brain AVM Study Project and healthy controls. The candidate is a PhD trained cardiovascular genetic epidemiologist dedicated to a career in patient-oriented stroke research focusing on hemorrhagic diseases of the brain. This application proposes a comprehensive 5-year plan to develop the candidate into an independent stroke researcher, including clinical training, such as attendance in stroke clinics and operating room to observe stroke patient treatment, advanced training in statistical methods and bioinformatics, and hands on laboratory training in high throughput genotyping techniques. The candidate's long-term objective is to become an independent leader in stroke genetics research by combining skills in epidemiology, biostatistics, genetics, and neurology. The Mentored Patient-Oriented Career Development Award and the advanced training milieu at UCSF will ensure the candidate's success in these endeavors.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Mentored Patient-Oriented Research Career Development Award (K23)
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NST-2 Subcommittee (NST)
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Moy, Claudia S
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University of California San Francisco
Schools of Medicine
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Weinsheimer, Shantel; Bendjilali, Nasrine; Nelson, Jeffrey et al. (2016) Genome-wide association study of sporadic brain arteriovenous malformations. J Neurol Neurosurg Psychiatry 87:916-23
Bendjilali, Nasrine; Nelson, Jeffrey; Weinsheimer, Shantel et al. (2014) Common variants on 9p21.3 are associated with brain arteriovenous malformations with accompanying arterial aneurysms. J Neurol Neurosurg Psychiatry 85:1280-3
Kim, Helen; Al-Shahi Salman, Rustam; McCulloch, Charles E et al. (2014) Untreated brain arteriovenous malformation: patient-level meta-analysis of hemorrhage predictors. Neurology 83:590-7
Bendjilali, Nasrine; Kim, Helen; Weinsheimer, Shantel et al. (2013) A genome-wide investigation of copy number variation in patients with sporadic brain arteriovenous malformation. PLoS One 8:e71434
Guo, Yi; Saunders, Tara; Su, Hua et al. (2012) Silent intralesional microhemorrhage as a risk factor for brain arteriovenous malformation rupture. Stroke 43:1240-6
Westbroek, Erick M; Pawlikowska, Ludmila; Lawton, Michael T et al. (2012) Brain-derived neurotrophic factor Val66Met polymorphism predicts worse functional outcome after surgery in patients with unruptured brain arteriovenous malformation. Stroke 43:2255-7
Kim, Helen; Pourmohamad, Tony; Westbroek, Erick M et al. (2012) Evaluating performance of the spetzler-martin supplemented model in selecting patients with brain arteriovenous malformation for surgery. Stroke 43:2497-9
Weinsheimer, Shantel; Brettman, Ari D; Pawlikowska, Ludmila et al. (2012) G Protein-Coupled Receptor 124 (GPR124) Gene Polymorphisms and Risk of Brain Arteriovenous Malformation. Transl Stroke Res 3:418-27
Mikhak, Bahar; Weinsheimer, Shantel; Pawlikowska, Ludmila et al. (2011) Angiopoietin-like 4 (ANGPTL4) gene polymorphisms and risk of brain arteriovenous malformations. Cerebrovasc Dis 31:338-45
Kim, Helen; Su, Hua; Weinsheimer, Shantel et al. (2011) Brain arteriovenous malformation pathogenesis: a response-to-injury paradigm. Acta Neurochir Suppl 111:83-92

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