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Vol 32 No.4 September 2015


HUBUNGAN KADAR BETA SEKRETASE, BETA-AMILOID, DAN HIDROKSINONENAL PLASMA DENGAN GANGGUAN KOGNITIF PASCASTROKE ISKEMIK
Yuliarni Syafrita,* Yanwirasti,** M Hasan Machfoed,*** Darwin Amir*

THE ASSOCIATION OF PLASMA LEVELS OF BETA SECRETASE, BETA-AMYLOID, AND HYDROXINONENAL WITH COGNITIVE IMPAIRMENT POST ISCHEMIC STROKE

ABSTRACT

Introduction: The level of beta-amyloid (Aβ) in the cerebrospinal fluid (CSS) can be used as a marker to detect cognitive impairment. Since CSS retrieval technique is invasive, it is necessary to find relatively easy, cheap, and reliable markers.

Aims:
To determine the association of the plasma levels of beta-secretase (BACE-1), beta-amiloid (Aβ), and 4-hydroxynonenal (4-HNE) with cognitive function after stroke events.


Methods:
This study was an observational case-control study. Eighty four patients with ischemic stroke and 42 normal control subjects were enrolled, from March to December 2013 at Neurology Clinic of M. Djamil Hospital, Padang. Cognitive function was assessed using Montreal Cognitive Assessment Indonesian version (MoCA-Ina) test and plasma levels of BACE-1, Aβ40, Aβ42, and 4-HNE were measured. Regression statistical analysis was used to determine the most dominant factors related to the occurrence of impaired cognitive function after stroke event. Data was analyzed by T, Kruskal-wallis, Mann-Whitney, and Chi-square tests.


Results:
There was a significant association between cognitive impairment after stroke with high plasma levels of BACE1 (p=0.004, OR=4.714), low levels of Aβ40 (p<0.001, OR=14.80) and Aβ42 (p=0.017, OR=3.44). In multivariate analysis, low plasma level of Aβ40, high level of BACE-1, and low level of Aβ42 were variables strongly related with cognitive impairment after ischemic stroke subsequently based on the strength of correlation.


Discussion:
Low level of Aβ40, high level of BACE-1, and low level of Aβ42 were associated with the incidence of impaired
cognitive function after ischemic stroke.


Keywords:
Beta-amyloid, beta-secretase, cognitive function, ischemic stroke.


ABSTRAK

Pendahuluan: Kadar beta-amiloid (Aβ) di cairan serebrospinal (CSS) dapat dijadikan sebagai penanda telah terjadinya gangguan kognitif, namun teknik pengambilan CSS adalah invasif, sehingga perlu dicari penanda yang relatif mudah, murah, dan dapat dipercaya.

Tujuan:
Untuk mengetahui hubungan kadar beta sekretase (BACE-1), Aβ, dan 4-hidroksinonenal (4-HNE) plasma dengan fungsi kognitif pascastroke iskemik.

Metode: Penelitian ini bersifat observasional komparatif dengan disain kasus kontrol di RS Dr. M. Djamil, Padang selama periode Maret–Desember 2013. Fungsi kognitif diperiksa 3 bulan pascastroke dengan test MoCA-Ina dan pemeriksaan kadar BACE1-1, Aβ40, Aβ42, dan 4-HNE plasma. Analisis regresi statitistik digunakan untuk menetapkan faktor mana yang paling dominan hubungannya dengan terjadinya gangguan fungsi kognitif pascastroke iskemik. Data dianalisis dengan uji t, Kruskal-Wallis, Mann-Whitney, dan Chi-square.

Hasil: Dari 84 subyek pascastroke iskemik dan 42 subyek normal sebagai kontrol, ditemukan hubungan yang bermakna antara gangguan kognitif pascastroke dengan tingginya kadar BACE=1 (p=0,004, RO=4,714), rendahnya kadar Aβ40 (p<0,001, OR=14,80), dan rendahnya kadar Aβ42 (p=0,017, RO=3,44). Pada analisis multivariat, didapatkan rendahnya kadar Aβ40, tingginya kadar BACE-1, dan rendahnya kadar Aβ42 plasma sebagai urutan kekuatan variabel yang berhubungan dengan terjadinya gangguan kognitif pascastroke iskemik.

Diskusi:
Rendahnya kadar Aβ40, Aβ42, dan tingginya kadar BACE-1 plasma berhubungan dengan kejadian gangguan fungsi kognitif pascastroke iskemik.

Kata kunci:
Beta-amiloid, beta sekretase, fungsi kognitif, stroke iskemik.

---------------------------------------------------------------------------------------------------------------
*Bagian Neurologi FK Universitas Andalas, Padang, **Bagian Anatomi FK Universitas Andalas, Padang, ***Bagian Neurologi FK Universitas Airlangga, Surabaya.

Korespondensi: ysyafrita@yahoo.com


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Vol 32 No.4 September 2015


  Terakreditasi DIKTI Nomor: 12/M/Kp/II/15

 

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