Poststroke emotional disturbances and a tryptophan hydroxylase 2 gene polymorphism.

OBJECTIVES

Emotional dysfunction is a common finding in stroke patients. Despite reports on serotonergic involvement in the etiology of poststroke emotional dysfunction (PSED), the role of serotonin synthesizing tryptophan hydroxylase 2 (TPH2) genes in the development of PSED remains unclear.

METHODS

Genotyping of rs4641528 and rs10879355 was performed from genomic DNA of 383 stroke patients collected previously and stored at -70°C. Potential associations between 2 genes and poststroke depression (PSD), poststroke emotional incontinence (PSEI), and poststroke anger proneness (PSAP) were investigated 3 months poststroke.

RESULTS

Among the 383 patients, 69 (18%) had PSD, 41 (11%) had PSEI, and 93 (24%) had PSAP. The rs4641528 genotype frequencies differed significantly between patients with and without either PSD or PSEI, although no significant differences were found between the patients with and without PSAP. In multiple logistic regression analysis, PSD was related to the National Institutes of Health Stroke Scale (NIHSS) score at admission (95% confidence interval [CI]: 1.047-1.230, <.01), modified Rankin scale score at 3 months (95% CI: 0.135-0.848, <.05), and rs4641528 C allele (95% CI: 1.039-5.631, <.05), whereas PSEI was associated only with the NIHSS score at admission (95% CI: 1.053-1.259, <.01) and the rs4641528 C allele (95% CI: 1.029-11.678, <.05).

CONCLUSIONS

Our findings suggest that the rs4641528 C allele may play a role in the pathogenesis of PSD and PSEI but not PSAP in Korean stroke patients.