Genes and outcome after aneurysmal subarachnoid haemorrhage

Y M Ruigrok, A J C Slooter, A Bardoel, C J M Frijns, G J E Rinkel, C Wijmenga

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33 Citations (Scopus)


OBJECTIVES: Initial and secondary ischaemia are important determinants of outcome after subarachnoid haemorrhage (SAH). Cerebral ischaemia is a potent stimulus for expression of genes that may influence recovery.We investigated whether functional polymorphisms in the apolipoprotein E (APOE), insulin-like growth factor-1 (IGF-1), tumor necrosis factor-A (TNF-A), interleukin-1A (IL-1A), interleukin-1B (IL-1B), and interleukin-6 (IL-6) genes are related with outcome after aneurysmal SAH.

METHODS: Genotyping of the polymorphisms was performed in a consecutive series of 167 patients with aneurysmal SAH. The risk of a poor outcome was analysed with logistic regression with adjustment for prognostic factors for outcome after SAH, using the homozygotes for the wild type alleles as a reference.

RESULTS: Patients carrying any IGF-1 non-wild type allele had a lower risk of a poor outcome (OR 0.4, 95% CI 0.2-1.0), while carriers of the TNF-A non-wild type allele had a higher risk (OR 2.3, 95% CI 1.0-5.4). We could not demonstrate an association with outcome for APOE (APOE epsilon4 OR 0.4, 95% CI 0.1-1.2; APOE epsilon2 OR 0.7, 95% CI 0.2-2.4), IL-1A (OR 1.8, 95% CI 0.8-4.0), IL-1B (OR 0.7, 95% CI 0.3-1.5) and IL-6 (OR 0.7, 95% CI 0.3-1.8) polymorphisms.

CONCLUSIONS: Variation in some genes that are expressed after cerebral ischaemia may partly explain the large differences in outcome between patients with aneurysmal SAH. SAH patients homozygote for the IGF-1 wild type allele or carriers of the TNF-A non-wild type allele have a higher risk of poor outcome. Additional studies in other populations are needed to assess the generalisability of our results.

Original languageEnglish
Pages (from-to)417-422
Number of pages6
JournalJournal of Neurology
Issue number4
Publication statusPublished - Apr 2005


  • Aged
  • Apolipoproteins E/genetics
  • Female
  • Gene Expression Regulation/physiology
  • Gene Frequency
  • Genotype
  • Glasgow Outcome Scale
  • Humans
  • Insulin-Like Growth Factor I/genetics
  • Male
  • Middle Aged
  • Odds Ratio
  • Outcome Assessment, Health Care
  • Polymorphism, Genetic
  • Prognosis
  • Retrospective Studies
  • Risk
  • Subarachnoid Hemorrhage/epidemiology
  • Tumor Necrosis Factor-alpha/genetics


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