School of Nursing and Midwifery, University of Dublin, Trinity College, Dublin, Ireland.
Department of Clinical Neurosciences, Salmaniya Medical Complex, Bahrain.
Asian J Psychiatr. 2019 Jan;39:135-142. doi: 10.1016/j.ajp.2018.12.019. Epub 2018 Dec 29.
The contribution of genetic factors such as the presence of ApoE allele e4 and its association with psychological consequences post stroke remains unknown within Middle-Eastern regions. This study examined the association of ApoE genotype with cognitive impairment and mood in stroke patients and compare with healthy older adults in Bahrain.
A prospective sample of n = 62 stroke patients (case group) and n = 53 healthy ageing individuals (control group) were eligible to participate in the study. A neuropsychological battery of cognitive assessments were conducted on all participants, and then stratified by cognitive function: no cognitive impairment, mild cognitive impairment and moderate to severe cognitive impairment. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS).
Most frequent ApoE genotype was e2/e3 in case (44%) and control groups (63%). ApoE allele e3 had the highest frequency for both groups with all stroke patients presenting with this allele and 86% for the control group (χ = 12.14, p < .0001). Stroke patients' non-carriers for ApoE allele e4 performed better on all cognitive measures but differences were not statistically significant (ns). Carriers of ApoE allele e2 in both groups had less mood symptoms compared to non-carriers.
ApoE genotype e3/e4 and e4/e4 was low in this Bahraini cohort explaining why there may been no significant associations found for this genotype variant with cognitive impairment. Further investigation of cognitive impairment and mood dysregulation with the different variants of the ApoE gene in general ageing and stroke populations is required from different ethno-cultural groups and geographical regions globally.
在中东地区,遗传因素(如存在载脂蛋白 E 等位基因 e4 及其与中风后心理后果的关联)对认知功能的影响仍不清楚。本研究旨在探讨载脂蛋白 E 基因型与巴林中风患者认知障碍和情绪的关系,并与健康老年人进行比较。
本前瞻性研究纳入了 62 名中风患者(病例组)和 53 名健康老年人(对照组)。所有参与者均接受了神经心理学认知评估,然后根据认知功能进行分层:无认知障碍、轻度认知障碍和中重度认知障碍。采用医院焦虑抑郁量表(HADS)评估焦虑和抑郁。
病例组和对照组最常见的载脂蛋白 E 基因型分别为 e2/e3(44%)和 e3/e3(63%)。载脂蛋白 E 等位基因 e3 在两组中的频率最高,所有中风患者均携带该等位基因,对照组中 86%的人携带该等位基因(χ 2 = 12.14,p < 0.0001)。两组中不携带载脂蛋白 E 等位基因 e4 的中风患者在所有认知测试中的表现均较好,但差异无统计学意义(ns)。两组中载脂蛋白 E 等位基因 e2 的携带者的情绪症状较非携带者少。
本研究中,巴林队列的载脂蛋白 E 基因型 e3/e4 和 e4/e4 频率较低,这可能解释了为什么该基因型与认知障碍之间没有显著关联。需要从不同的种族文化群体和地理区域进行进一步研究,以了解载脂蛋白 E 基因的不同变体与一般衰老和中风人群的认知障碍和情绪失调的关系。