Evidence map›Paper›PMID 34214981›Full record

ArticleJournal of neurosurgery2022

Somatic mosaicism in the MAPK pathway in sporadic brain arteriovenous malformation and association with phenotype.

Sen Gao, Jeffrey Nelson, Shantel Weinsheimer, Ethan A Winkler, Caleb Rutledge, Adib A Abla, Nalin Gupta, Joseph T Shieh, Daniel L Cooke, Steven W Hetts and 9 more

Open access · greenAbstract read
In one paragraph

Article in Journal of neurosurgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Translational relevance of animal models available on brain arteriovenous malformations, a systematic review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Pooled it
  2. Mutant KRAS in brain endothelial cells promotes vascular inflammation and impairs vascular integrity in brain arteriovenous malformation.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Article
  3. Towards precision medicine for brain arteriovenous malformations.The Journal of clinical investigation · 2026
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  20. Review of treatment and therapeutic targets in brain arteriovenous malformation.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 7 institutions in 1 country.

Sen GaoDepartments of1Anesthesia and Perioperative Care.
Jeffrey NelsonDepartments of1Anesthesia and Perioperative Care.
Shantel WeinsheimerDepartments of1Anesthesia and Perioperative Care.
Ethan A Winkler3Neurological Surgery.
Caleb Rutledge3Neurological Surgery.
Adib A Abla3Neurological Surgery.
Nalin Gupta3Neurological Surgery.
Joseph T Shieh4Institute for Human Genetics, University of California, San Francisco, California.
Daniel L Cooke5Radiology.
Steven W Hetts5Radiology.
Tarik Tihan6Pathology.
Christopher P Hess5Radiology.
Nerissa Ko7Neurology.
Brian P Walcott3Neurological Surgery.
Charles E McCulloch9Epidemiology and Biostatistics.
Michael T Lawton10Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
Hua SuDepartments of1Anesthesia and Perioperative Care.
Ludmila PawlikowskaDepartments of1Anesthesia and Perioperative Care.
Helen KimDepartments of1Anesthesia and Perioperative Care.
Neurological Surgery · USUniversity of California, San Francisco · USUniversity Radiology · USBarrow Neurological Institute · USCancer Research And Biostatistics · USNeurology, Inc · USPediatrics and Genetics · US

Funding

Uncover the Pathogenesis of Brain Arteriovenous MalformationR01NS027713 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SU, HUA · 1990 to 2023
$8.6M
PREDICTORS OF SPONTANEOUS CEREBRAL AVM HEMORRHAGER01NS034949 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KIM, HELEN · 1995 to 2017
$6.5M
Long-term outcomes in unruptured brain arteriovenous malformation patientsR01NS099268 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KIM, HELEN · 2017 to 2021
$3.1M
Reduction of Brain AVM Severity through Inhibition of Pathogenic AngiogenesisR01NS112819 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SU, HUA · 2020 to 2024
$2.9M
Somatic mutation detection in brain AVM by massively high-throughput sequencingR21NS070029 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PAWLIKOWSKA, LUDMILA · 2010 to 2011
$413k
NINDS NIH HHS R01 NS027713NINDS NIH HHS R01 NS034949NINDS NIH HHS R01 NS099268NINDS NIH HHS R01 NS112819NINDS NIH HHS R21 NS070029
6 · The paper itself

Abstract

objectiveSporadic brain arteriovenous malformation (BAVM) is a tangled vascular lesion characterized by direct artery-to-vein connections that can cause life-threatening intracerebral hemorrhage (ICH). Recently, somatic mutations in KRAS have been reported in sporadic BAVM, and mutations in other mitogen-activated protein kinase (MAPK) signaling pathway genes have been identified in other vascular malformations. The objectives of this study were to systematically evaluate somatic mutations in MAPK pathway genes in patients with sporadic BAVM lesions and to evaluate the association of somatic mutations with phenotypes of sporadic BAVM severity.

methodsThe authors performed whole-exome sequencing on paired lesion and blood DNA samples from 14 patients with sporadic BAVM, and 295 genes in the MAPK signaling pathway were evaluated to identify genes with somatic mutations in multiple patients with BAVM. Digital droplet polymerase chain reaction was used to validate KRAS G12V and G12D mutations and to assay an additional 56 BAVM samples.

resultsThe authors identified a total of 24 candidate BAVM-associated somatic variants in 11 MAPK pathway genes. The previously identified KRAS G12V and G12D mutations were the only recurrent mutations. Overall, somatic KRAS G12V was present in 14.5% of BAVM lesions and G12D was present in 31.9%. The authors did not detect a significant association between the presence or allelic burden of KRAS mutation and three BAVM phenotypes: lesion size (maximum diameter), age at diagnosis, and age at ICH.

conclusionsThe authors confirmed the high prevalence of somatic KRAS mutations in sporadic BAVM lesions and identified several candidate somatic variants in other MAPK pathway genes. These somatic variants may contribute to understanding of the etiology of sporadic BAVM and the clinical characteristics of patients with this condition.

Indexed as

MosaicismAdolescentAdultAgedAge of OnsetChildChild, PreschoolCohort StudiesDNAExome SequencingFemaleGenetic VariationHumansIntracranial Arteriovenous MalformationsIntracranial HemorrhagesMaleDNAKRAS protein, humanProto-Oncogene Proteins p21(ras)arteriovenous malformationcerebrovascular malformationgenotype-phenotype correlationintracerebral hemorrhageMAPK pathwaysomatic mutationvascular disorders

Identifiers

PMID34214981
PMCPMC8720328
OpenAlexW3177341751

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.