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携带 Met 等位基因与脑卒中后康复认知功能降低相关。

Met allele Is Associated With Lower Cognitive Function in Poststroke Rehabilitation.

机构信息

Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA.

Seventh People's Hospital of Shanghai University of TCM, Shanghai, PR China.

出版信息

Neurorehabil Neural Repair. 2020 Mar;34(3):247-259. doi: 10.1177/1545968320902127. Epub 2020 Feb 2.

Abstract

The identification of a genetic role for cognitive outcome could influence the design of individualized treatment in poststroke rehabilitation. The aim of this study is to determine whether brain-derived neurotrophic factor () Val66Met polymorphism is independently associated with poststroke functional outcome. A total of 775 stroke patients with genomic data were identified from the Partners HealthCare Biobank, which contains a large number of genotypes from Biobank's consented patients. Of 775 stroke patients who met the inclusion/exclusion criteria, 86 were enrolled. Functional outcomes were assessed using the Functional Independence Measure scores at the time of admission and discharge. Logistic and linear regression models adjusted for covariate variables, including age, sex, and medical conditions, were used to evaluate the association between Val66Met and functional outcome. We detected a significant correlation between Met alleles and lower cognitive function at discharge in both ischemic and hemorrhagic stroke patients. Genotyping findings confirmed that Met allele frequency was higher in contrast to Val/Val allele frequency in lower cognitive functional recovery. Furthermore, after adjusting for covariate variables, Met alleles were found to be associated with lower cognitive outcome [ = .003; odds ratio (OR) = 5.95 (1.81-19.52)] and recovery [ = .006; OR = 3.16 (1.4-7.15)], especially with lower problem solving, expression, and social recovery in all stroke patients. Met allele carriers exhibited impaired poststroke cognitive function. The BDNF genotype may be a useful predictor of cognitive function in inpatient poststroke rehabilitation.

摘要

认知结果的遗传作用的确定可能会影响中风后康复的个体化治疗设计。本研究旨在确定脑源性神经营养因子(BDNF)Val66Met 多态性是否与中风后功能结果独立相关。

从包含大量生物库患者基因型的合作伙伴医疗保健生物库中确定了 775 名具有基因组数据的中风患者。在符合纳入/排除标准的 775 名中风患者中,有 86 名入选。在入院和出院时使用功能独立性测量评分评估功能结果。使用调整协变量变量(包括年龄、性别和医疗条件)的逻辑和线性回归模型评估 Val66Met 与功能结果之间的关联。

我们发现在缺血性和出血性中风患者中,Met 等位基因与出院时认知功能较低之间存在显著相关性。基因分型结果证实,与 Val/Val 等位基因频率相比,较低认知功能恢复的 Met 等位基因频率更高。此外,在调整协变量变量后,Met 等位基因与较低的认知结果相关(=.003;优势比(OR)=5.95(1.81-19.52))和恢复(=.006;OR=3.16(1.4-7.15)),尤其是在所有中风患者中,解决问题、表达和社会恢复能力较低。Met 等位基因携带者表现出中风后认知功能受损。BDNF 基因型可能是住院中风后康复中认知功能的有用预测指标。

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