RT Journal Article
SR Electronic
T1 Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 271
OP 276
DO 10.1136/jnnp-2017-316882
VO 89
IS 3
A1 Eun-Jae Lee
A1 Mi-Sun Oh
A1 Jong S Kim
A1 Dae-Il Chang
A1 Jong-Ho Park
A1 Jae-Kwan Cha
A1 Ji Hoe Heo
A1 Sung-Il Sohn
A1 Dong-Eog Kim
A1 Hahn Young Kim
A1 Jei Kim
A1 Woo-Keun Seo
A1 Jun Lee
A1 Sang-Won Park
A1 Yun Joong Kim
A1 Byung-Chul Lee
A1 ,
YR 2018
UL http://jnnp.bmj.com/content/89/3/271.abstract
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.