College of Nursing The Research Institute of Nursing Science Seoul National University Seoul South Korea.
College of Nursing Keimyung University Daegu South Korea.
Brain Behav. 2018 Jan 11;8(2):e00892. doi: 10.1002/brb3.892. eCollection 2018 Feb.
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.
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.
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).
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.
情绪功能障碍是脑卒中患者的常见表现。尽管已有报告称 5-羟色胺能系统参与了脑卒中后情绪功能障碍（poststroke emotional dysfunction，PSED）的发病机制，但 5-羟色胺合成限速酶色氨酸羟化酶 2（tryptophan hydroxylase 2，TPH2）基因在 PSED 发病机制中的作用尚不清楚。
对先前采集并储存在-70°C 冰箱中的 383 例脑卒中患者的基因组 DNA 进行 rs4641528 和 rs10879355 基因分型。在脑卒中后 3 个月时，研究了这 2 个基因与脑卒中后抑郁（poststroke depression，PSD）、脑卒中后情感失禁（poststroke emotional incontinence，PSEI）和脑卒中后易激惹（poststroke anger proneness，PSAP）之间的潜在关联。
在 383 例患者中，69 例（18%）患有 PSD，41 例（11%）患有 PSEI，93 例（24%）患有 PSAP。rs4641528 基因型频率在 PSD 患者和无 PSD 患者之间存在显著差异，在 PSEI 患者和无 PSEI 患者之间也存在显著差异，但在 PSAP 患者和无 PSAP 患者之间无显著差异。多因素 logistic 回归分析显示，PSD 与入院时美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分（95%可信区间：1.047-1.230，<.01）、3 个月时改良 Rankin 量表评分（95%可信区间：0.135-0.848，<.05）和 rs4641528 C 等位基因（95%可信区间：1.039-5.631，<.05）有关，而 PSEI 仅与入院时 NIHSS 评分（95%可信区间：1.053-1.259，<.01）和 rs4641528 C 等位基因（95%可信区间：1.029-11.678，<.05）有关。
本研究结果提示，rs4641528 C 等位基因可能在韩国脑卒中患者 PSD 和 PSEI 的发病机制中起作用，但与 PSAP 无关。
