Epigenomics of Patient Outcomes after SAH

This project was focused on understanding the pathophysiology following aneurysmal subarachnoid hemorrhage (aSAH). DNA methylation is a key mechanism for regulation of gene expression and function in the adult brain and appears to play an important role in neuroprotection during ischemic events in the brain. Delayed cerebral ischemia (DCI), occurring during the acute phase following aSAH, is a major contributor to the complications that later develop; however, the pathophysiology of DCI and the development of complications is not known. We hypothesize that characterizing the methylome representing the CNS environment post aSAH will clarify the pathophysiology associated with DCI and patient outcomes. The aims of this project focused on the daily genome-wide methylomic changes that occur in DNA representing the CNS for the first 14 days after aSAH, as well as in peripheral blood in a subset of partcipants, and determining if this methylomic data impacts DCI and the development of complications after aSAH.]]>
Inclusion and exclusion criteria for participants were: New (within 5 days) diagnosis of aSAH verified via cerebral angiogram; Hunt and Hess grade <2 and/or Fisher grade <3 to ensure subjects have a degree of hemorrhage sufficient for detecting the impact of genes and biomarkers on outcomes of interest; ≥ 18 years of age; External ventricular drainage of CSF as standard of care; Able to read∕speak English because most of our outcome measures are only validated for English speaking subjects; No history of previous neurological disorders to control for potential confounding variables that may interfere with neurophysiologic processes of recovery affecting the measurement of biomarkers. ]]>