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Genes and outcome after aneurysmal subarachnoid haemorrhage

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Abstract

Objectives

Initial and secondary ischaemia are important determinants of outcome after subarachnoid haemorrhage (SAH). Cerebral ischaemia is a potent stimulus for expression of genes that may influence recovery.We investigated whether functional polymorphisms in the apolipoprotein E (APOE), insulin–like growth factor-1 (IGF–1), tumor necrosis factor-A (TNF–A), interleukin-1A (IL–1A), interleukin-1B (IL–1B), and interleukin-6 (IL–6) genes are related with outcome after aneurysmal SAH.

Methods

Genotyping of the polymorphisms was performed in a consecutive series of 167 patients with aneurysmal SAH. The risk of a poor outcome was analysed with logistic regression with adjustment for prognostic factors for outcome after SAH, using the homozygotes for the wild type alleles as a reference.

Results

Patients carrying any IGF–1 non–wild type allele had a lower risk of a poor outcome (OR 0.4, 95% CI 0.2–1.0), while carriers of the TNF–A non–wild type allele had a higher risk (OR 2.3, 95% CI 1.0–5.4). We could not demonstrate an association with outcome for APOE (APOEε4 OR 0.4, 95% CI 0.1–1.2; APOE ε2 OR 0.7, 95% CI 0.2–2.4), IL–1A (OR 1.8, 95% CI 0.8–4.0), IL–1B (OR 0.7, 95% CI 0.3–1.5) and IL–6 (OR 0.7, 95% CI 0.3–1.8) polymorphisms.

Conclusions

Variation in some genes that are expressed after cerebral ischaemia may partly explain the large differences in outcome between patients with aneurysmal SAH. SAH patients homozygote for the IGF–1 wild type allele or carriers of the TNF–A non–wild type allele have a higher risk of poor outcome. Additional studies in other populations are needed to assess the generalisability of our results.

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Authors and Affiliations

  1. Dept. of Neurology, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, 85500, 3500 GA Utrecht, The Netherlands

    Y. M. Ruigrok M.D., A. J. C. Slooter MD, C. J. M. Frijns MD & G. J. E. Rinkel MD

  2. Dept. of Biomedical Genetics, University Medical Centre, Utrecht, the Netherlands

    A. Bardoel & C. Wijmenga PhD

Authors
  1. Y. M. Ruigrok M.D.
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  2. A. J. C. Slooter MD
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  3. A. Bardoel
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  4. C. J. M. Frijns MD
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  5. G. J. E. Rinkel MD
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  6. C. Wijmenga PhD
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Correspondence to Y. M. Ruigrok M.D..

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Ruigrok, Y.M., Slooter, A.J.C., Bardoel, A. et al. Genes and outcome after aneurysmal subarachnoid haemorrhage. J Neurol 252, 417–422 (2005). https://doi.org/10.1007/s00415-005-0661-y

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  • DOI: https://doi.org/10.1007/s00415-005-0661-y

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