THE STUDY OF ASSOCIATIONS BETWEEN TNFα G308A GENE POLYMORPHISM AND CLINICAL-NEUROLOGICAL, NEUROIMAGING, HEMODYNAMIC CHARACTERISTICS AND COGNITIVE DYSFUNCTION IN PATIENTS WITH VASCULAR ENCEPHALOPATHY IN CHRONIC CEREBRAL ISCHEMIA
DOI:
https://doi.org/10.11603/mcch.2410-681X.2023.i3.14138Keywords:
vascular encephalopathy in chronic cerebral ischemia, tumor necrosis factor α (TNFα), TNFα gene G308A polymorphism, syndromic characteristics, neuroimaging changes in the brain, cognitive dysfunctionAbstract
Introduction. Tumor necrosis factor α (TNFα) is involved in neuroinflammation, which is an essential link in the pathogenesis of vascular encephalopathy in chronic cerebral ischemia (CCI), and polymorphism of the TNFα gene can significantly influence the susceptibility to the occurrence of diseases associated with neuroinflammation and determine them.
The aim of the study – to study probable associations of the G308A polymorphic variant of the TNFα gene with clinical-neurological, neuroimaging, hemodynamic characteristics and cognitive dysfunction in patients with CCI.
Research Methods. During 2021–2022, 145 patients with CCI that were undergoing treatment on the basis of the communal non-profit enterprise “Ternopil Regional Clinical Psychoneurological Hospital” were examined, of which 18 patients underwent molecular genetic research.; the control group consisted of 12 practically healthy individuals. Clinical and neurological examination was carried out according to a standard scheme; neuroimaging study of the brain was carried out using multislice computed tomography (MSCT) (devices from Asteion 4 Toshiba or Toshiba Aquilion TSX-101A/QC, Japan) or magnetic resonance imaging (MRI) (“Siemens Magnetom Аvanto” 1.5 Т, with advanced TIM technology, Germany); the state of cerebral blood flow was studied using transcranial duplex scanning of intracranial vessels and extracranial sections of brachiocephalic vessels using a Philips HDI device; cognitive function was assessed using the Montreal Cognitive Assessment (MOCA). A molecular genetic study of the G308A polymorphic variant of the TNFα gene was carried out in a molecular genetic laboratory of the State institution “Reference Center for Molecular Diagnostics of the Ministry of Health of Ukraine”, Kyiv. Statistical processing of the results was carried out using “STATISTICA 13.0”.
Results and Discussion. Analyzing the dependence of clinical neurological syndromes, neuroimaging, hemodynamic characteristics and cognitive dysfunction on the G308A polymorphic variant of the TNFα gene in patients with CCI, significant differences in the distribution of genotype frequencies were established only for neuroimaging changes (presence/absence of dilatation of subarachnoid spaces, χ2=8.33; p=0.016). Regarding the distribution of allele frequencies of the G308A polymorphic variant of the TNFα gene in patients with CCI, a significant predominance of allele A carriers was revealed among individuals with existing dilatation of the subarachnoid spaces in relation to individuals with present dilatation of the subarachnoid spaces (91.67 % against 8.33 %).
Conclusions. TNFα F G308A gene polymorphism affects structural changes in the brain in patients with CCI, which requires continued study involving a larger sample of individuals.
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