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Influence of Angiotensin-Converting Enzyme Polymorphism on Neuropsychological Subacute Performance in Moderate and Severe Traumatic Brain Injury

Received November 5, 2004; revised February 15, 2005; accepted March 11, 2005. From the Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain; the August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona Spain; the Department of Animal Biology, University of Barcelona, Barcelona, Spain; the Department of Neurosurgery and Neurotraumatology Intensive Care Unit, Vall d'Hebron University Hospital, Autonomous University of Barcelona (UAB), Barcelona, Spain. Address correspondence to Dr. Ariza, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, IDIBAPS C/Casanova, 143 08036 Barcelona; marizago7{at}docd4.ub.edu (E-mail).

Traumatic brain injury (TBI) frequently results in cerebrovascular lesions that may increase secondary damage and cause neuropsychological impairment. Previous studies suggest an association among the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE), cardiovascular disease, and cognitive performance. Clinical and experimental studies have demonstrated the beneficial effects of ACE inhibitor treatment on vascular injury, hypertension, brain ischemia, and cognitive functioning. In a sample of 73 moderate and severe TBI patients, the authors assessed whether cognitive sequelae differed in relation to the ACE I/D polymorphism. D allele carrier patients performed worse than those with I/I polymorphism on tests involving attention and processing speed. Findings suggest that the physiopathological changes associated with TBI may have greater consequences in ACE D allele carriers.

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