COMMENTARY

Monthly Summaries of Nursing Research: December, 2008

January 05, 2009

Genetic Variations of the Serotonin Transporter Gene Are Significantly Associated With Development of Post-Stroke Depression

Kohen R, Cain KC, Mitchell PH, et al. Association of serotonin transporter gene polymorphisms with poststroke depression. Arch Gen Psychiatry. 2008;65:1296-302.

Post-stroke depression (PSD) is thought to affect approximately 33% of stroke survivors. While the precise etiology of PSD is unknown, it is likely multifactorial, and may be linked, like non comorbid depression and other mental illnesses, to polymorphisms of the serotonin transporter gene (SERT). A team of researchers examined whether variations of the serotonin transporter gene (specifically the 5-HTTLPR, STin2 VNTR, and rs25531 polymorphisms) are associated with PSD in stroke survivors.

In a case-control study, a convenience sample of 75 stroke survivors with PSD and 75 nondepressed stroke survivors provided blood or saliva samples for DNA extraction and genotyping. Logistic regression analyses were then performed comparing depressed and non-depressed stroke survivors by their SERT polymorphisms, controlling for age, sex, and stroke severity scores (National Institutes of Health Stroke Scale). Results of these analyses demonstrated that individuals with the 5-HTTLPR s/s genotype had 3-fold higher odds of PSD compared with l/l or l/xl genotype carriers (odds ratio [OR] 3.1; P ≤ .045). Participants with the STin2 9/12 or 12/12 genotype had 4-fold higher odds of PSD compared with STin2 10/10 genotype carriers (OR 4.1; P ≤ .01). An association of rs25531 with PSD was not shown. From the results, it was determined that the 5-HTTLPR and the STin2 VNTR, but not the rs25531, polymorphisms of SERT are associated with PSD in stroke survivors.

This gives further evidence of a role of SERT polymorphisms in mediating resilience to biopsychosocial stress and represents the first study to characterize an association of SERT polymorphisms in PSD. Identifying the biomarkers associated with increased odds of PSD provide a critical first step toward identifying those at risk of developing this illness as well as the development of possible preventive therapeutics.

Abstract

All studies reported here are supported by funding from the National Institute of Nursing Research.

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