Mei Feng, Wu Yanfeng, Ding Guibing, Pan Fenghua, Chen Liang, Wu Jin
Department of Psychology, Nanjing Brain Hospital Affiliated to Nanjing Medical University.
Department of Neurology, the Second Affiliated Hospital of Nanjing Medical University, China.
J Pak Med Assoc. 2018 Jun;68(7):888-892.
To investigate the association of methylenetetrahydrofolate reductase gene 677C>T polymorphism with post-stroke depression risk and antidepressant treatment response in Han Chinese.
This cross-sectional study was conducted at the Department of Neurology and Neurosurgery, the Second Affiliated Hospital of Nanjing Medical University and Nanjing Brain Hospital, China, between February 2010 and December 2014. It comprised patients who had experienced first-episode acute stroke. Psychological assessment was performed at day 7, 1 month, 3 months and 6 months after stroke. Post-stroke depression patients were characterised by clinical response to anti-depressive pharmacological treatment measured by intra-individual changes based on the 17-item Hamilton rating scale for depression scores.
Of the total 292 patients, 11(3.76%) were lost during 6-month follow-up. Our final analysis comprised 106(36.3%) post-stroke depression patients and 175(59.93%) post-stroke depression-free patients. The 677T allele and 677C/T genotype of methylenetetrahydrofolate reductase gene 677C>T polymorphism, which were over-represented in depression patients and were respectively associated with 1.82-fold (p=0.001) and 3.65-fold (p<0.001) increased risk of post-stroke depression relative to the 677C allele and 677C/C genotype. No significant association was observed between this polymorphism and treatment response (p>0.05).
Mutation of methylenetetrahydrofolate reductase gene 677C>T polymorphism was found to be significantly associated with the increased risk of post-stroke depression, but not with treatment response..
探讨亚甲基四氢叶酸还原酶基因677C>T多态性与汉族人群中风后抑郁风险及抗抑郁治疗反应之间的关联。
本横断面研究于2010年2月至2014年12月在中国南京医科大学第二附属医院神经内科及神经外科以及南京脑科医院进行。研究对象为首次发生急性中风的患者。在中风后第7天、1个月、3个月和6个月进行心理评估。中风后抑郁患者的特征是根据基于17项汉密尔顿抑郁量表评分的个体内变化来衡量对抗抑郁药物治疗的临床反应。
在总共292例患者中，11例（3.76%）在6个月的随访期间失访。我们的最终分析包括106例（36.3%）中风后抑郁患者和175例（59.93%）无中风后抑郁患者。亚甲基四氢叶酸还原酶基因677C>T多态性的677T等位基因和677C/T基因型在抑郁患者中过度表达，相对于677C等位基因和677C/C基因型，分别与中风后抑郁风险增加1.82倍（p=0.001）和3.65倍（p<0.001）相关。未观察到该多态性与治疗反应之间存在显著关联（p>0.05）。
发现亚甲基四氢叶酸还原酶基因677C>T多态性的突变与中风后抑郁风险增加显著相关，但与治疗反应无关。
