OBJECTIVES: Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5-HTT) and serotonin 2a receptor (5-HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population. METHODS: In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5-HTT gene-linked promoter region (5-HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5-HTR2a 1438A/G, and 5-HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene-gene interactions were investigated by using the generalized multifactor dimensionality reduction method. RESULTS: PSEI was present in 37 (13.4%) patients. The 5-HTT gene-linked promoter region s/s genotype was independently associated with PSEI. No associations with STin2 VNTR and 5-HTR2a genes were found, and no significant gene-gene interactions were identified. CONCLUSIONS: Stroke patients with 5-HTTLPR s allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology.
OBJECTIVES:Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5-HTT) and serotonin 2a receptor (5-HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population. METHODS: In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5-HTT gene-linked promoter region (5-HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5-HTR2a1438A/G, and 5-HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene-gene interactions were investigated by using the generalized multifactor dimensionality reduction method. RESULTS: PSEI was present in 37 (13.4%) patients. The 5-HTT gene-linked promoter region s/s genotype was independently associated with PSEI. No associations with STin2 VNTR and 5-HTR2a genes were found, and no significant gene-gene interactions were identified. CONCLUSIONS:Strokepatients with 5-HTTLPR s allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology.