Factors associated with post-stroke anger proneness in ischaemic stroke patients

Background and purpose: Factors related to post- stroke anger proneness (PSAP) are poorly studied. The aim of the present study was to determine the frequency of, and the factors related to, PSAP in the acute stage of stroke. Serotonin transporter protein genes and monoamine oxidase A (MAO-A) gene polymorphisms were also examined.

Methods: A total of 508 patients with acute IS were screened for PSAP at admission after stroke, using the modified Spielberger Trait Anger Scale. Blood samples were collected from each participant for DNA extraction and genotyping. The promoter of serotonin transporter protein (5-HTTLPR), the variable number of tandem repeat polymorphisms within intron 2 (VNTR STin2), and the 30-bp functional VNTR polymorphism in the promoter region of the MAO-A gene (MAOA-uVNTR) were genotyped.

Results: Post- stroke anger proneness was present in 15.1% of patients at admission. The factors related to PSAP were diabetes mellitus (P < 0.05), previous stroke (P < 0.01), motor and sensory dysfunction (P < 0.01), National Institutes of Health Stroke Scale (NIHSS) at admission (P < 0.01), and MAO-A gene polymorphism (P < 0.05). Multiple logistic regression analyses showed that previous stroke (95% CI: 1.33-4.25, P < 0.01), NIHSS at admission (95% CI: 1.09-1.26, P < 0.01), and low MAO-A activity (95% CI: 1.19-3.47, P = 0.01) were the factors related to PSAP.

Conclusions: Our results show that PSAP is relatively prevalent and that previous stroke, neurological dysfunction and the MAO-A gene are involved in the development of PSAP.