Cramer SC et al. – Genetic factors, particularly the ApoE ε4 polymorphism, might contribute to variability in outcomes after stroke.Methods
- Genotypes were determined in 255 stroke patients who also received behavioral evaluations in the Glycine Antagonist In Neuroprotection (GAIN) clinical trials.
- The primary outcome measure was recovery during the first month post-stroke, as this is the time when neural repair is at a maximum and so when genetic influences might have their largest impact.
- Two secondary outcome measures at 3 months post-stroke were also examined.
- Genotype groups were similar acutely post-stroke.
- Presence of the ApoE ε 4 polymorphism was associated with significantly poorer recovery over the first month post-stroke (P = 0.023) and with a lower proportion of subjects with minimal or no disability (modified Rankin score 0–1, P = 0.01) at 3 months post-stroke.
- Indeed, those with this polymorphism were approximately half as likely to achieve minimal or no disability (18.2%) versus those with polymorphism absent (35.5%).
- Findings were confirmed in multivariate models.
- Results suggested possible effects from the val66met BDNF polymorphism and from the R0 mitochondrial DNA haplotype.