Biochemical Determinants of Cognitive Impairment Post-Stroke in a Bahraini Population

Background: Approximately one in three stroke patients have evidence of cognitive impairment resulting in increasing disability post-stroke. Many factors have been implicated in the pathogenesis of post-stroke cognitive impairment with a recent emphasis on genetic factors like Apolipoprotein E (ApoE), BACE-1 NEP and RAGE. The aim of this study is to determine the role of ApoE genotype, and serum concentrations of BACE, NEP and RAGE in the development of post-stroke cognitive impairment.

Methods: A case control study was conducted, in which demographic data, past medical history and a set of neuropsychological tests, including measures of global cognition, executive function, mood and metacognition, were obtained from medical reports and personal interviews. The ApoE genotype and the serum concentration of BACE-1, NEP and RAGE were also obtained for both groups. The results of aforementioned parameters were compared between two groups and statistical tests were done to determine the presence of any association between the biomarkers and post-stroke cognition.

Results:There were no statistical significant differences between the stroke and control groups regarding sociodemographic and clinical data, with the exception of the risk factor smoking (p

Conclusion: RAGE was found to be a predictor of post-stroke cognitive impairment in this study. However this finding should be confirmed using larger scale longitudinal studies with well-defined follow up samples to evaluate the pathogenesis of post-stroke cognitive dysfunction.