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Polymorphismus des „brain derived neurotrophic factor“ und Erholung nach Schlaganfall

Polymorphism of brain derived neurotrophic factor and recovery of functions after ischemic stroke

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Zusammenfassung

Hintergrund

Die Funktionsrestitution nach einem Schlaganfall wird von vielen Faktoren beeinflusst. Insbesondere das Alter des Patienten, die initiale Ausprägung der Symptomatik, das Vorhandensein kognitiver oder neuropsychologischer Defizite zählen dazu. In dieser Studie wurde untersucht, ob ein Polymorphismus im für den „brain derived neurotrophic factor“ (BDNF) kodierenden Gen Einfluss auf die Verbesserung von motorischen Funktionen und Alltagsaktivitäten nimmt.

Methoden

Patienten mit subakutem ischämischem Hirninfarkt (n = 67) wurden zu Beginn einer stationären neurologischen Rehabilitation, nach 4-wöchiger Behandlung und 6 Monate später mittels Barthel-Index (BI) und Rivermead Motor Assessment (RMA) untersucht. Je nach BDNF-Polymorphismus im Codon 66 erfolgte die Einteilung in Gruppen (Valin [Val]/Valin, Val/Methionin[Met] oder Met/Met).

Ergebnisse

Die 3 Gruppen (Val/Val, n = 34 Patienten; Val/Met, n = 26; Met/Met, n = 7) wiesen im BI und im RMA sowohl nach 4 Wochen als auch nach 6 Monaten eine signifikante Verbesserung zum jeweils vorhergehenden Untersuchungsergebnis auf. BI und RMA waren hoch miteinander korreliert. Es gab keinen Unterschied in Bezug auf den BDNF-Polymorphismus.

Diskussion

Nach Hirninfarkt kommt es über mindestens 6 Monate zu kontinuierlichen Verbesserungen der motorischen Funktionen und der Alltagsfunktionen. Der BDNF-Polymorphismus beeinflusste diese Entwicklung nicht.

Summary

Background

After ischemic stroke, many factors influence the restitution of functions. In particular they include the patient age, the initial stroke severity and the presence of cognitive and neuropsychological deficits. In this study we investigated whether a polymorphism in the gene encoding for brain derived neurotrophic factor (BDNF) influences improvements of motor functions and everyday activities.

Methods

Patients with subacute ischemic stroke (n = 67) were examined at the beginning of an inpatient neurological rehabilitation, after 4 weeks of treatment and after 6 months. The Barthel index (BI) and the Rivermead motor assessment (RMA) were used to measure motor functions and everyday activities. Patients were allocated to three groups (valine [Val]/valine, val/methionine [Met] and Met/Met) depending on the BDNF polymorphism at codon 66.

Results

The 3 groups (Val/Val, n = 34 patients, Val/Met, n = 26 and Met/Met, n = 7) showed significant improvements in BI and RMA after 4 weeks and after 6 months as compared to the preceding measurements. The BI and RMA were positively correlated. The three groups did not differ with respect to the extent of improvement.

Conclusion

After ischemic stroke, motor functions and everyday activities improved continuously over a period of at least 6 months. The BDNF polymorphism did not influence this development.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Liepert, A. Heller, G. Behnisch und A. Schoenfeld geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Abteilung für Neurorehabilitation, Kliniken Schmieder, Zum Tafelholz 8, 78476, Allensbach, Deutschland

    J. Liepert MD, A. Heller MD & A. Schoenfeld MD

  2. Abteilung für Verhaltensneurologie, Leibniz Institut für Neurobiologie, Magdeburg, Deutschland

    G. Behnisch MD & A. Schoenfeld MD

  3. Neurologische Klinik, Otto-von-Guericke Universität, Magdeburg, Deutschland

    A. Schoenfeld MD

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  1. J. Liepert MD
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  2. A. Heller MD
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  3. G. Behnisch MD
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  4. A. Schoenfeld MD
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Correspondence to J. Liepert MD.

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Liepert, J., Heller, A., Behnisch, G. et al. Polymorphismus des „brain derived neurotrophic factor“ und Erholung nach Schlaganfall. Nervenarzt 86, 1255–1260 (2015). https://doi.org/10.1007/s00115-015-4325-6

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  • DOI: https://doi.org/10.1007/s00115-015-4325-6

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