Changes of general cerebral symptoms in patients with traumatic brain injury and their dependence on the -675 4G/5G polymorphism in the plasminogen activator inhibitor-1 gene

Abstract

Traumatic brain injury (TBI) is the top place cause of fatality and disability in people of working age. World Health Organization reports more than 10 million cases of traumatic brain injury annually worldwide, of which 1.5 million are fatal. Control for stabilization of clinical course and resolution of patient neurologic state in acute period of TBI requires especially detailed study with involvement of individual schemes of patients` management. Diagnostic and prognostic significance of cerebral and meningeal symptoms, which are often inseparable, makes it necessary to monitor constantly this group of disorders and helps to suspect the development of brain secondary lesions and to determine further diagnostic and therapeutic tactics. The goal of our study is to evaluate the progression of changes in cerebral symptoms in patients with traumatic brain injury depending on the -675 4G/5G polymorphism in the plasminogen activator inhibitor gene. This article presents an evaluation analysis of the changes that concern cerebral and meningeal signs and symptoms in 200 patients with isolated TBI, and determines the interrelation of the changes with the -675 4G/5G polymorphism in the PAI-1 gene. All patients were treated according to the current recommendations. Examination of the nervous system and evaluation of the cerebral symptoms were performed on the 1 st , 7 th and 14 th day after the hospitalization. Patients with TBI were divided into 2 groups in accordance with the Glasgow Coma Scale state estimation. Group I (81 patients) included persons with mild traumatic brain injury: concussion and mild brain contusion; group II – 119 patients with severe TBI: severe brain contusion. In the process of the study, we have found an association between regressive course of cerebral and meningeal symptoms in patients with 4G/4G and 4G/5G genotypes for the studied polymorphism. It was suggested that regressive course of cerebral symptoms in TBI patients is induced by 4G allele and respectively 4G/4G and 4G/5G genotypes for the -675 4G/5G polymorphism in the PAI-1 gene.