BACKGROUND: To explore whether a polymorphism in dopamine metabolism influences the effectiveness of neurological rehabilitation and the outcome after ischemic stroke. METHODS: The Barthel Index (BI) and the Rivermead Motor Assessment (RMA) were assessed in 78 moderately affected stroke patients (1) after they had entered a neurological inpatient rehabilitation, (2) after 4 weeks of rehabilitation therapy, and (3) 6 months later. Polymorphisms of the gene encoding catechol-O-methyltransferase (COMT) were determined. BI and RMA results were analyzed with respect to the genetic profiles of COMT. RESULTS: Carriers of COMT Val/Val alleles showed better results in BI and RMA than COMT Met/Met carriers at all 3 time points. Val/Met carriers exhibited results in between the homozygotes, suggesting a gene-dose relationship. Altogether, BI and RMA results were highly correlated. CONCLUSION:Stroke patients with COMT Val/Val alleles had higher motor functions and abilities of activities of daily living even at the beginning of the rehabilitation period. All patient groups improved during the rehabilitation period to a similar degree, suggesting that physical therapy is comparably effective in all polymorphism subtypes.
RCT Entities:
BACKGROUND: To explore whether a polymorphism in dopamine metabolism influences the effectiveness of neurological rehabilitation and the outcome after ischemic stroke. METHODS: The Barthel Index (BI) and the Rivermead Motor Assessment (RMA) were assessed in 78 moderately affected strokepatients (1) after they had entered a neurological inpatient rehabilitation, (2) after 4 weeks of rehabilitation therapy, and (3) 6 months later. Polymorphisms of the gene encoding catechol-O-methyltransferase (COMT) were determined. BI and RMA results were analyzed with respect to the genetic profiles of COMT. RESULTS: Carriers of COMTVal/Val alleles showed better results in BI and RMA than COMTMet/Met carriers at all 3 time points. Val/Met carriers exhibited results in between the homozygotes, suggesting a gene-dose relationship. Altogether, BI and RMA results were highly correlated. CONCLUSION:Strokepatients with COMTVal/Val alleles had higher motor functions and abilities of activities of daily living even at the beginning of the rehabilitation period. All patient groups improved during the rehabilitation period to a similar degree, suggesting that physical therapy is comparably effective in all polymorphism subtypes.
Authors: Jane M Maguire; Steve Bevan; Tara M Stanne; Erik Lorenzen; Israel Fernandez-Cadenas; Graeme J Hankey; Jordi Jimenez-Conde; Katarina Jood; Jin-Moo Lee; Robin Lemmens; Christopher Levi; Bo Norrving; Kristiina Rannikmae; Natalia Rost; Jonathan Rosand; Peter M Rothwell; Rodney Scott; Daniel Strbian; Jonathan Sturm; Cathie Sudlow; Matthew Traylor; Vincent Thijs; Turgut Tatlisumak; Tadeusz Wieloch; Daniel Woo; Bradford B Worrall; Christina Jern; Arne Lindgren Journal: Eur Stroke J Date: 2017-04-19