Impact of BDNF -196 G>A and BDNF -270 C>T polymorphisms on stroke rehabilitation outcome: sex and age differences.
BACKGROUND
Genetic factors, including gene polymorphisms, are promising in determining stroke rehabilitation outcome. Brain-derived neurotrophic factor (BDNF) is one of the most attractive because of its role in neuroplasticity and brain repair.


OBJECTIVE
The aim of present study was to assess the role of BDNF -196 G≯A (val66met) and -270 C≯T on clinical parameters and functional outcome in patients with ischemic and hemorrhagic stroke. Additional analyses according to sex and age (≤55 and ≯55 years) were performed.


METHODS
Three hundred thirty-eight patients (287 with ischemic and 51 with hemorrhagic stroke) were evaluated in terms of neurological deficit (National Institute of Heath Stroke Scale [NIHSS]), activities of daily living (Barthel Index [BI]), and everyday functionality (Rankin score [RS]) before and after rehabilitation. BDNF polymorphism genotyping was performed by polymerase chain reaction restriction fragment length polymorphism analysis.


RESULTS
In multivariative analysis, unfavorable outcome of stroke rehabilitation (RS ≥2) was associated with independent factors: ischemic stroke (odds ratio [OR], 2.59; 95% CI, 1.03-6.47), female gender (OR, 2.80; 95% CI, 1.39-5.64), depression (OR, 4.24; 95% CI, 1.45-12.35), falls (OR, 2.61; 95% CI, 1.16-5.87), and BDNF -196 GG polymorphism (OR, 2.18; 95% CI, 1.09-4.35). The differences of functional parameters measured with BI and RS on admission and at discharge are apparent only for comparisons between patients ≤55 and ≯55 years old carrying BDNF -196 GA+AA genotypes but not in those carrying -196 GG genotype; the differences were evident in women but not in men.


CONCLUSIONS
BDNF -196 G≯A polymorphism might affect functional outcome of stroke rehabilitation, but this hypothesis needs further verification.
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Dagmara
D
Mirowska-Guzel
2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Grazyna
G
Gromadzka
2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Tadeusz
T
Mendel
2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Barbara
B
Janus-Laszuk
2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Justyna
J
Dzierka
2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Iwona
I
Sarzynska-Dlugosz
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
Andrzej
A
Czlonkowski
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 2nd Department of Neurology, Rehabilitation Ward, Institute of Psychiatry and Neurology, Warsaw, Poland.
Anna
A
Czlonkowska
D000328:Adult; D000368:Aged; D000375:Aging; D000483:Alleles; D002545:Brain Ischemia / Q000150:complications / Q000534:rehabilitation; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics*; D004247:DNA / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011110:Polymorphism, Genetic / Q000235:genetics*; D012727:Sex Characteristics; D020521:Stroke / Q000145:classification / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D019208:Brain-Derived Neurotrophic Factor; D004247:DNA
age; brain-derived neurotrophic factor (BDNF); polymorphism; rehabilitation; stroke