Document Detail

Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans.
MedLine Citation:
PMID:  19251191     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: To address the mechanisms by which apoE polymorphism affects functional outcome after intracerebral hemorrhage in humans, we tested the hypothesis that the presence of the APOE4 allele results in amplified inflammatory responses and increased cerebral edema.
METHODS: We prospectively enrolled and collected data on 21 adult patients consecutively admitted to Duke University Hospital with supratentorial intracerebral hematoma including hemorrhage volume, midline shift, modified Rankin Score, Glasgow Outcome Score, and APOE genotype. Hemorrhage size (cm(3)) and midline shift (mm), at the level of the thalamus, were measured by computed tomography within 36 hours of admission. Rankin and Glasgow Scores were determined at discharge. Student's t-test was used to analyze hemorrhage size, midline shift, and Glasgow Outcome Score and logistical regression were used to measure allele affect on modified Rankin Score. When analyzing modified Rankin Score, patients were grouped by favorable outcome (0-2) or unfavorable (3-6).
RESULTS: Out of 21 patients, 11 possessed at least 1 APOE4 allele (APOE4+). There was no difference in hemorrhage volume (25.8 v 38.3 mm for APOE4- v APOE4+, respectively) between the groups, but there was a significant difference in midline shift (P = .04, 0.7 v 4 mm). Functional outcomes were worse for the patients possessing at least 1 APOE4 allele (P = .04)
CONCLUSION: The presence of APOE4 is associated with poor functional outcomes in humans after intracerebral hemorrhage. Our data suggest that the mechanism for this may be increased cerebral edema and not larger hematoma volume.
Michael L James; Robert Blessing; Ellen Bennett; Daniel T Laskowitz
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  18     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-03-02     Completed Date:  2009-06-29     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-9     Citation Subset:  IM    
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MeSH Terms
Apolipoprotein E4 / genetics,  metabolism
Apolipoproteins E / genetics*,  metabolism
Brain / metabolism,  pathology,  physiopathology
Brain Edema / genetics*,  metabolism,  physiopathology
Cerebral Hemorrhage / genetics*,  metabolism,  physiopathology
DNA Mutational Analysis
Genetic Predisposition to Disease / genetics*
Genetic Testing
Middle Aged
Outcome Assessment (Health Care) / methods
Polymorphism, Genetic / genetics
Severity of Illness Index
Tomography, X-Ray Computed
Grant Support
L30 GM086132/GM/NIGMS NIH HHS; L30 GM086132-01/GM/NIGMS NIH HHS; T32 GM008600/GM/NIGMS NIH HHS; T32 GM008600-13/GM/NIGMS NIH HHS
Reg. No./Substance:
0/Apolipoprotein E4; 0/Apolipoproteins E

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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