Claire Donnellan
Trinity College Dublin, Ireland
Title: Psychological comorbidity and biological factors post stroke in a Middle-Eastern cohort
Biography
Biography: Claire Donnellan
Abstract
Introduction: The link between psychological comorbidity and biological factors has been well recognized for many conditions; however, less evidence is reported in the context of stroke. The aim of the study was to examine psychological comorbidity and biological correlates post- stroke in a Middle Eastern cohort.
Method: A prospective stroke sample of n=50 patients (case group) and n=50 healthy ageing individuals (control group) were recruited from the largest Medical Complex in Bahrain. A neuropsychological battery of assessments (including global, executive and meta- cognition and mood), were conducted on all participants. Blood samples were taken for ApoE and other biomarkers levels to determine clinical characteristics.
Results: Total metacognition scores were significantly associated with both anxiety (r=.47, p=.001) and depression (r=.54, p<.0001). Global cognition (r=.32, p<.01) but not executive function, was significantly associated with depression only. Metacognition remained a statistically significant correlate with depression (beta=.42, p<.0001) and anxiety (beta=.51, p<.0001) after adjusting for education and global cognition. The most frequent ApoE genotype was É›2/3 in both cases (44%) and control groups (63%). No statistical significant association was found by cognitive impairment stratification and ApoE genotype for either case or control groups. ApoE genotype É›2/4 had worse cognitive function (χ2 (3)=8.29, p<.05) in the control group. A statistical significant difference was found between ApoE genotype and total anxiety scores in that ApoE genotype É›3/3 were highly anxious in the case group (χ2 (2)=6.77, p<.05).
Discussion: Metacognition is a better determinant of mood symptoms after stroke, especially in regions where illiteracy levels are high in older populations. The presence of ApoE genotype ɛ4/3 and ɛ4/4 was low to non-existent in this sample explaining no significant associations with cognitive impairment. Further examination of mood dysregulation and ApoE genotype polymorphism may be warranted post-stroke.