To investigate the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism on the recovery after subcortical stroke, using the modified Rankin Scale (mRS).
Subcortical stroke patients with copies of BDNF Val66Met polymorphism (n=7) were compared to their controls (n=7) without a copy of BDNF Val66Met polymorphism after matching for initial severity, location and type of stroke. The mRS scores at 1 and 3 months after discharge from the neurorehabilitation unit were compared between the groups.
A repeated measures ANOVA for mRS revealed significant interaction between time and group (F(2, 24) =37.2, p<0.001) and a significant effect of time (F(2, 24)=10.8, p<0.001), thereby reflecting significant differences between the Met allele (+) group and the Met allele (-) group. There was a significant difference in mRS scores at 3 months post-discharge between the two groups (p=0.01) although no difference was evident in mRS scores at 1 month post-discharge between the two groups. There were significant improvements between mRS scores on admission and mRS scores at 1 month post-discharge (p=0.02), and between mRS scores at 1 month post-discharge and mRS scores at 3 months post-discharge (p=0.004) in the Met allele (-) group.
BDNF Val66Met polymorphism may be associated with worse functional outcome in Korean patients with subcortical stroke. Therefore, BDNF Val66Met polymorphism should be considered as an important prognostic factor for recovery and responses to rehabilitation therapies after stroke in Korean patients. There is a need for developing different rehabilitation strategies for the population with BDNF Val66Met polymorphism. Further studies assessing different outcomes for various functional domains of stroke recovery are needed to clarify the role of BDNF Val66Met polymorphism.
Citations
Method: The protocol for HAT consisted of consecutive 10 days in which a child and his/her caregiver were held in 1.3 atm hyperbaric air chamber for 60 minutes per one day. Nine children with cerebral palsy underwent 99mTc-HMPAO single-photon emission computed tomography (SPECT) before and after HAT. The change of regional cerebral blood flow (rCBF) was evaluated by subtraction analysis using statistical parametric mapping.
Results: Average gestational age and birth weights were 34.0⁑5.1 months, and 2.3⁑1.2 kg, respectively. Two spastic quadriplegics, four spastic diplegics, two spastic hemiplegics, and one ataxic child were enrolled. In 3 out of 9 children, rCBF change was demonstrated; increased perfusion in right cerebellar hemisphere in child with diffuse brain atrophy and increased perfusion in diffuse cerebral cortex in child with left frontal leukoencephalopathy and decreased perfusion of right frontal cortex in child with right frontal leukoencephalopathy.
Conclusion: These findings suggest that HAT may recruit less excitable neurons that was of functionally silent in motor cortex, previously. However, increased rCBF following HAT protocol could not be ruled out whether the result of learning effects or HAT. (J Korean Acad Rehab Med 2003; 27: 335-339)
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