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Published on: January 11, 2016
Apolipoprotein E polymorphisms and severity of cerebral palsy: a cross-sectional study in 255 children in Norway
Espen Lien1, Guro L Andersen, Yongde Bao
1Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. espen.lien@ntnu.no
Insights
The APOEε4 allele does not protect against cerebral palsy (CP) severity. Instead, this genotype was linked to increased risks of epilepsy and feeding tube dependence in children with CP.
Area of Science:
- Neuroscience
- Genetics
- Pediatrics
Background:
- The apolipoprotein E (ApoE) allele APOEε4 has been suggested to have a beneficial effect on neurodevelopment.
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, with varying severity.
Purpose of the Study:
- To investigate the association between the APOEε4 allele and the severity of cerebral palsy.
- To determine if APOEε4 has a protective effect on neurodevelopment in children with CP.
Main Methods:
- ApoE genotyping was performed on 255 children with CP.
- Gross Motor Function Classification System (GMFCS) was used to assess CP severity.
- Fine motor function, epilepsy, and gastrostomy tube feeding (GTF) were secondary outcome measures.
Main Results:
- No association was found between APOEε4 genotype and GMFCS levels.
- APOEε4 genotype was more frequent in children with epilepsy and/or requiring GTF.
- In unilateral CP, APOEε4 was linked to more severe fine motor impairment.
Conclusions:
- The hypothesis of a protective effect of APOEε4 on neurodevelopment in CP was not supported.
- Subgroup analyses suggest APOEε4 may have an adverse effect on the developing brain following injury.
Aim:
The aim of this study was to examine whether the presence of the apolipoprotein E (ApoE) allele APOEε4 is associated with less severe manifestations of cerebral palsy (CP), consistent with the suggested beneficial effect of this allele on neurodevelopment in children.
Method:
ApoE genotyping was performed on buccal epithelial cells from 255 children (141 males 114 females; mean age 12y, SD 2y 3mo, range 9-17y) recorded in the Cerebral Palsy Register of Norway. The main outcome measure of CP severity was the Gross Motor Function Classification System (GMFCS). Secondary outcome measures were fine motor function, epilepsy, and the need for gastrostomy tube feeding (GTF).
Results:
There was no association between the APOEε4 genotype and GMFCS levels (odds ratio [OR] 1.15; 95% confidence interval [CI] 0.66-1.99). However, the APOEε4 genotype was more often present among children with epilepsy (OR 2.2; 95% CI 1.1-4.2) and/or receiving GTF (OR 2.7; 95% CI 1.1-6.6). Among children with unilateral CP, the presence of APOEε4 was associated with more severe fine motor impairment (OR 2.6; 95% CI 1.3-6.9).
Interpretation:
Our main hypothesis that APOEε4 would have a protective effect on neurodevelopment was not supported. Instead, subgroup analyses suggested an adverse effect of the APOEε4 genotype on the developing brain after injury.
