title: Catechol-O-methyltransferase polymorphism influences outcome after ischemic stroke: a prospective double-blind study.
abstract: BACKGROUND
  To explore whether a polymorphism in dopamine metabolism influences the effectiveness of neurological rehabilitation and the outcome after ischemic stroke.
  
  
  METHODS
  The Barthel Index (BI) and the Rivermead Motor Assessment (RMA) were assessed in 78 moderately affected stroke patients (1) after they had entered a neurological inpatient rehabilitation, (2) after 4 weeks of rehabilitation therapy, and (3) 6 months later. Polymorphisms of the gene encoding catechol-O-methyltransferase (COMT) were determined. BI and RMA results were analyzed with respect to the genetic profiles of COMT.
  
  
  RESULTS
  Carriers of COMT Val/Val alleles showed better results in BI and RMA than COMT Met/Met carriers at all 3 time points. Val/Met carriers exhibited results in between the homozygotes, suggesting a gene-dose relationship. Altogether, BI and RMA results were highly correlated.
  
  
  CONCLUSIONS
  Stroke patients with COMT Val/Val alleles had higher motor functions and abilities of activities of daily living even at the beginning of the rehabilitation period. All patient groups improved during the rehabilitation period to a similar degree, suggesting that physical therapy is comparably effective in all polymorphism subtypes.
authors.affiliation: Department of Neurorehabilitation, Kliniken Schmieder, Allensbach, Germany. j.liepert@kliniken-schmieder.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Liepert
authors.forename: Andreas
authors.initials: A
authors.lastname: Heller
authors.forename: Gusalija
authors.initials: G
authors.lastname: Behnisch
authors.forename: Ariel
authors.initials: A
authors.lastname: Schoenfeld
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D002545:Brain Ischemia / Q000150:complications; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D004311:Double-Blind Method; D005121:Extremities / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009788:Occupational Therapy; D010807:Physical Endurance; D026741:Physical Therapy Modalities; D011110:Polymorphism, Genetic / Q000235:genetics*; D011446:Prospective Studies; D055070:Resistance Training; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology / Q000235:genetics*; D000071939:Stroke Rehabilitation; D060726:Torso / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D002394:Catechol O-Methyltransferase
keywords: COMT polymorphism; genetics; rehabilitation; stroke