Abstract
Post-stroke cognitive impairment (PSCI) is a clinical outcome in around 30% of post-stroke survivors. BDNF is a major gene in this regard. It is regulated by circadian rhythm. The circadian genes are correlated with stroke timings at molecular level. However, studies suggesting the role of these on susceptibility to PSCI are limited. We aim here to determine: (a) genetic risk variants in circadian clock genes, BDNF and (b) dysregulation in expression level of CLOCK, BMAL1, and BDNF that may be associated with PSCI. BDNF (rs6265G/A, rs56164415C/T), CLOCK (rs1801260T/C, rs4580704G/C), and CRY2 (rs2292912C/G) genes variants were genotyped among 119 post-stroke survivors and 292 controls from Eastern part of India. In addition, we analyzed their gene expression in Peripheral blood Mononuclear cells (PBMC) from 15 PSCI cases and 12 controls. The mRNA data for BDNF was further validated by its plasma level through ELISA (n = 38). Among the studied variants, only rs4580704/CLOCK showed an overall association with PSCI (P = 0.001) and lower Bengali Mini-Mental State Examination (BMSE) score. Its ‘C’ allele showed a correlation with attention deficiency. The language and memory impairments showed association with rs6265/BDNF, while the ‘CC’ genotype of rs2292912/CRY2 negatively influenced language and executive function. A significant decrease in gene expression for CLOCK and BDNF in PBMC (influenced by specific genotypes) of PSCI patients was observed than controls. Unlike Pro-BDNF, plasma-level mBDNF was also lower in them. Our results suggest the genetic variants in CLOCK, CRY2, and BDNF as risk factors for PSCI among eastern Indians. At the same time, a lowering expression of CLOCK and BDNF genes in PSCI patients than controls describes their transcriptional dysregulation as underlying mechanism for post-stroke cognitive decline.
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The data that support the findings of this study are available from the corresponding author upon request.
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Acknowledgements
The authors are thankful to the patients, family members, and healthy individuals who participated in the study.
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The study has been supported by Post-Doctoral fellowship grants from the Department of Science & Technology, Govt. of India, under Cognitive Science Research Initiative Program to first author DS [DST/CSRI-PDF/2021/12 & DST/CSRI/PDF-21/2018] and the second author AB [DST/CSRI-P/2017/22].
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DS, ID, and AB were responsible for the concept, study design, experimental work, and manuscript preparation. SM, PM, PM, and GP had put effort in data analysis (both clinical and genetic) and manuscript preparation. KC did the statistical analysis. AB, BKR, and TKB evaluated patients and blood collections as being clinical collaborates. While, SPH provided the instrumentation facility in S. N. Pradhan Center for Neurosciences, University of Calcutta and provide his input for manuscript preparation. All authors read the draft, provided their inputs, and agreed on the final version of the manuscript.
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Sadhukhan, D., Biswas, A., Mishra, S. et al. Genetic Variations and Altered Blood mRNA Level of Circadian Genes and BDNF as Risk Factors of Post-Stroke Cognitive Impairment Among Eastern Indians. Neuromol Med 25, 586–595 (2023). https://doi.org/10.1007/s12017-023-08761-2
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DOI: https://doi.org/10.1007/s12017-023-08761-2