PT - JOURNAL ARTICLE AU - Eun-Jae Lee AU - Mi-Sun Oh AU - Jong S Kim AU - Dae-Il Chang AU - Jong-Ho Park AU - Jae-Kwan Cha AU - Ji Hoe Heo AU - Sung-Il Sohn AU - Dong-Eog Kim AU - Hahn Young Kim AU - Jei Kim AU - Woo-Keun Seo AU - Jun Lee AU - Sang-Won Park AU - Yun Joong Kim AU - Byung-Chul Lee ED - , TI - Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use AID - 10.1136/jnnp-2017-316882 DP - 2018 Mar 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - 271--276 VI - 89 IP - 3 4099 - http://jnnp.bmj.com/content/89/3/271.short 4100 - http://jnnp.bmj.com/content/89/3/271.full SO - J Neurol Neurosurg Psychiatry2018 Mar 01; 89 AB - 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.