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Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use

Authors
 Eun-Jae Lee  ;  Mi-Sun Oh  ;  Jong S Kim  ;  Dae-Il Chang  ;  Jong-Ho Park  ;  Jae-Kwan Cha  ;  Ji Hoe Heo  ;  Sung-Il Sohn  ;  Dong-Eog Kim  ;  Hahn Young Kim  ;  Jei Kim  ;  Woo-Keun Seo  ;  Jun Lee  ;  Sang-Won Park  ;  Yun Joong Kim  ;  Byung-Chul Lee 
Citation
 JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol.89(3) : 271-276, 2018 
Journal Title
 JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY 
ISSN
 0022-3050 
Issue Date
2018
Keywords
depression ; gene ; motor recovery ; serotonin ; stroke
Abstract
OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) putatively improve neurological recovery after stroke. We aimed to investigate whether serotonin transporter (SERT) gene polymorphisms are related to the responsiveness to SSRIs in the poststroke neurological recovery. METHODS: This was a post hoc analysis of the EMOTION study (ClinicalTrials.gov NCT01278498), a randomised, placebo-controlled, double-blind trial examining the efficacy of escitalopram on emotional and neurological disturbances after acute stroke. Patients with no/minimal disability initially (modified Rankin Scale (mRS) 0-1) were excluded. Of the participants, 301 underwent genetic studies of the STin2 (a variable number tandem repeat (VNTR) in intron 2) (STin2 12/10 and STin2 12/12 genotypes) and 5-HTTLPR (a variable-length repeat in the promoter region) polymorphisms of SERT. We explored whether neurological function (National Institutes of Health Stroke Scale (NIHSS) score and mRS) at 3 months would differ according to SERT polymorphisms within each treatment arm (escitalopram and placebo). RESULTS: Among the escitalopram users (n=159), neurological function in subjects with STin2 12/10 (n=29) improved significantly more than that in STin2 12/12 carriers (n=130) at 3 months. After adjusting for age, initial NIHSS and depression, STin2 12/10 independently predicted a good clinical outcome (mRS 0-1) (OR 2.99, 95% CI 1.04 to 8.58) at 3 months. However, differences between STin2 polymorphisms were not shown in the placebo group (n=142). 5-HTTLPR polymorphisms were not associated with neurological recovery in any treatment group. CONCLUSION: STin2 VNTR polymorphisms may be associated with poststroke neurological recovery after SSRI therapy. Further studies are needed to identify the role of serotonin in neurological recovery after stroke.
Full Text
https://jnnp.bmj.com/content/89/3/271.long
DOI
10.1136/jnnp-2017-316882
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169502
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