Apolipoprotein E polymorphism and acute ischemic stroke: a diffusion- and perfusion-weighted magnetic resonance imaging study.
Diffusion- and perfusion-weighted magnetic resonance imaging (MRI) was used to study the putative effects of apolipoprotein E (ApoE) polymorphism in stroke. Thirty-one patients with acute stroke, comparative for age and gender were scanned, nine of whom were ApoE allele epsilon 4 carriers. Initially, less than 24 hours from the onset of stroke, the epsilon 4 carriers had significantly smaller volumes of hypoperfusion on relative cerebral blood volume map (P = 0.001), and smaller infarct volumes (P = 0.008) compared with the noncarriers. By day 8, this difference in the infarct volumes had disappeared, suggesting relatively enhanced infarct growth. On average, the total infarct volume increased 145% of the initial infarct volume in the epsilon 4 carriers, and 84% in the noncarriers. There were strong correlations between the imaging findings and clinical status initially and with the outcome 3 months after the stroke in the epsilon 4 noncarriers, but, with a single exception at acute phase, a lack thereof in the epsilon 4 carriers. These patterns were virtually similar in a subgroup of patients with middle cerebral artery stroke. These data support the hypothesis of increased general vulnerability of the brain in the epsilon 4 carriers. Thus, the effects of ApoE polymorphism should be accounted for when interpreting diffusion- and perfusion-weighted MRI studies, particularly if predicting lesion growth.
Liu
Yawu
Y
Department of Clinical Radiology, Kuopio University Hospital, Finland.
Laakso
Mikko P
MP
Karonen
Jari O
JO
Vanninen
Ritva L
RL
Nuutinen
Juho
J
Soimakallio
Seppo
S
Aronen
Hannu J
HJ
D000208:Acute Disease; D000368:Aged; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006579:Heterozygote; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics* / Q000503:physiopathology
D053327:Apolipoprotein E4; D001057:Apolipoproteins E