Catechol-O-Methyltransferase Polymorphism Influences Outcome After Ischemic Stroke: A Prospective Double-Blind Study
Catechol-O-Methyltransferase Polymorphism Influences Outcome After Ischemic Stroke: A Prospective Double-Blind Study
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DOI：
10.1177/1545968313481282
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发表时间：
2013-07-01
影响因子：
4.2
通讯作者：
Schoenfeld, Ariel
中科院分区：
文献类型：
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作者：
Liepert, Joachim;Heller, Andreas;Schoenfeld, Ariel
背景探讨多巴胺代谢多态性是否影响缺血性脑卒中后神经康复的效果和预后。方法.对78例中度脑卒中患者进行Barthel指数（BI）和Rivermead运动功能评估（RMA）评估，（1）在他们进入神经科住院康复治疗后，（2）在康复治疗4周后，（3）在6个月后。检测了编码儿茶酚-O-甲基转移酶（COMT）基因的多态性。BI和RMA结果与COMT的遗传图谱进行了分析。结果在所有3个时间点，COMT瓦尔/瓦尔等位基因携带者在BI和RMA中显示出比COMT Met/Met携带者更好的结果。瓦尔/Met携带者的结果介于纯合子之间，提示存在基因-剂量关系。总之，BI和RMA结果高度相关。结论携带COMT瓦尔/瓦尔等位基因的脑卒中患者即使在康复初期也具有较高的运动功能和日常生活活动能力。所有患者组在康复期间的改善程度相似，表明物理治疗对所有多态性亚型均有效。
Background. To explore whether a polymorphism in dopamine metabolism influences the effectiveness of neurological rehabilitation and the outcome after ischemic stroke. Methods. The Barthel Index (BI) and the Rivermead Motor Assessment (RMA) were assessed in 78 moderately affected stroke patients (1) after they had entered a neurological inpatient rehabilitation, (2) after 4 weeks of rehabilitation therapy, and (3) 6 months later. Polymorphisms of the gene encoding catechol-O-methyltransferase (COMT) were determined. BI and RMA results were analyzed with respect to the genetic profiles of COMT. Results. Carriers of COMT Val/Val alleles showed better results in BI and RMA than COMT Met/Met carriers at all 3 time points. Val/Met carriers exhibited results in between the homozygotes, suggesting a gene-dose relationship. Altogether, BI and RMA results were highly correlated. Conclusion. Stroke patients with COMT Val/Val alleles had higher motor functions and abilities of activities of daily living even at the beginning of the rehabilitation period. All patient groups improved during the rehabilitation period to a similar degree, suggesting that physical therapy is comparably effective in all polymorphism subtypes.