Artikel
Association of apolipoprotein E polymorphism with neurocognitive and psychosocial outcome after nonaneurysmal nontraumatic subarachnoid hemorrhage. A prospective five-year-long study
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: The aim of this study was to prospectively examine the long-term psychosocial and neuropsychological performances in patients suffering for nonaneurysmal nontraumatic SAH and to correlate the genetic presence of the APOE ε4 genotype to the outcome.
Methods: Cognitive and psychological skills were examined in thirty patients on a long-term basis (mean follow-up 59.8 months). These assessments included attention, memory, planning abilities, and depression. APO E genotype was determined in all patients by PCR from blood.
Results: Eleven patients were carriers of the APOE ε4 genotype (9 patients with genotype e4/e3 and two patients with genotype ε4/ε4). APOE ε4 and non-ε4 did not differ significantly with respect of age, years of education, type of SAH or any psychosocial measures. All patients showed a good recovery with full independence and without persisting neurological deficits. The APO ε4 group had, compared to the APO E non-ε4 group, however, a significant worse score in the depression measurement Beck Depression Inventory (BDI) with 22.1 (±6.3 SD) versus 14.1(±5.1 SD), respectively. At the follow-up the depression persists in the whole APO E ε4 group with statistical significance (p<0.05) compared to the non-ε4 group. There was moreover a significant correlation between the depression scores with BDI and performances on test of selective attention (D2 r: -0.39, p: 0.007). The selective attention D2 was impaired in the whole group for the first year of follow-up, with a good recovery after two years in the APO E non-ε4 carrier group and only after three years in the ε4-carrier cohort. Eight patients, all of the APO E ε4 group, did not return in the first year to their previous occupation. Five patients (16.7%) returned to part-time employment after the first year and to full-time within 3 years after the acute event. Two patients, also of the APO E ε4 group, did not return to their employment after five years.
Conclusions: These findings suggest that psychosocial and neuropsychological performances following nonaneurysmal SAH are related to the APOE genotypes, with significant consequences for the social and working life.