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The impact of CBS polymorphisms on aneurysmal subarachnoid hemorrhage (aSAH) and its clinical sequelae is poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Blood samples from all patients enrolled in the CARAS (Cerebral Aneurysm Renin Angiotensin System) study were used for genetic evaluation. The CARAS study prospectively enrolled aSAH patients at 2 academic institutions in the United States from 2012 to 2015. Common <jats:italic>CBS<\/jats:italic> polymorphisms were detected using 5\u2032exonuclease genotyping assays. Analysis of associations between <jats:italic>CBS<\/jats:italic> polymorphisms and aSAH was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Samples from 149 aSAH patients and 50 controls were available for analysis. In multivariate logistic regression analysis, the insertion allele of the 844ins68 <jats:italic>CBS<\/jats:italic> insertion polymorphism showed a dominant effect on aSAH. The GG genotype of the <jats:italic>CBS<\/jats:italic> G\/A single nucleotide polymorphism (rs234706) was independently associated with unfavorable functional outcome (modified Rankin Scale Score 3\u20136) at discharge and last follow-up, but not clinical vasospasm or delayed cerebral ischemia (DCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The insertion allele of the 844ins68 <jats:italic>CBS<\/jats:italic> insertion polymorphism was independently associated with aSAH while the GG genotype of rs234706 was associated with an unfavorable outcome both at discharge and last follow-up. Increased CBS activity may exert its neuroprotective effects through alteration of H<jats:sub>2<\/jats:sub>S levels, and independent of clinical vasospasm and DCI.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.2.jns162933","type":"journal-article","created":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T13:59:10Z","timestamp":1501855150000},"page":"1771-1777","source":"Crossref","is-referenced-by-count":14,"title":["Association of cystathionine beta-synthase polymorphisms and aneurysmal subarachnoid hemorrhage"],"prefix":"10.3171","volume":"128","author":[{"given":"Philipp","family":"Hendrix","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg\/Saar, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Foreman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Harrigan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winfield S.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilesh A.","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Inova Health System, Falls Church;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert H.","family":"Lipsky","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Inova Health System, Falls Church;"},{"name":"Department of Molecular Neuroscience, George Mason University, Fairfax, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingkuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Molecular Neuroscience, George Mason University, Fairfax, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly C.","family":"Walters","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama;"},{"name":"Department of Molecular Neuroscience, George Mason University, Fairfax, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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