Correlation between genetic polymorphisms and stroke recovery
European Journal of Neurology,  Clinical Article

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.

Results
  • 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.

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