title: ApoE epsilon4 allele and disease duration affect verbal learning in mild temporal lobe epilepsy.
abstract: OBJECTIVE
  To clarify the possible role of other factors including the ApoE epsilon4 allele for memory decline in temporal lobe epilepsy (TLE).
  
  
  METHODS
  We conducted a neuropsychological and molecular study in 138 consecutive patients (78 female patients; mean age, 50.2 years, SD +/- 17.9; range, 14 to 87 years) with mild nonlesional TLE, who rarely or never had seizures at long-term follow-up. The mean age at seizure onset was 33.0 years (SD, +/-21.7), and the mean duration of epilepsy was 17.1 years (SD, +/-15.7).
  
  
  RESULTS
  Thirty-four (25%) of 138 patients had test scores indicating verbal learning deficit (VLD). The presence of an ApoE epsilon4 allele was associated with an increased risk of VLD (OR, 4.18; 95% CI, 1.66-10.55). The effect of the ApoE genotype was independent of both the age at epilepsy onset and disease duration as well as of a low educational level, which were separately associated with VLD (p values = 0.045, 0.001, and 0.001, respectively). A significant linear trend (p = 0.005) was seen in the relation between disease duration and cognitive impairment, with the highest risk being in patients with an epilepsy duration > or =25.5 years (OR, 7.06; 95% CI, 1.67-29.85), especially if they carried the epsilon4 allele (OR, 32.29; 95% CI, 5.23-195.72).
  
  
  CONCLUSIONS
  These results provide evidence for an alteration in cognitive performance as a function of the presence of the ApoE epsilon4 allele and point to the critical role of disease duration itself for cognitive impairment in TLE.
authors.affiliation: Institute of Neurology, School of Medicine, Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambardella
authors.forename: Umberto
authors.initials: U
authors.lastname: Aguglia
authors.forename: Rosanna
authors.initials: R
authors.lastname: Chifari
authors.forename: Angelo
authors.initials: A
authors.lastname: Labate
authors.forename: Ida
authors.initials: I
authors.lastname: Manna
authors.forename: Paolo
authors.initials: P
authors.lastname: Serra
authors.forename: Nelide
authors.initials: N
authors.lastname: Romeo
authors.forename: Grazia
authors.initials: G
authors.lastname: Sibilia
authors.forename: Emilio
authors.initials: E
authors.lastname: Lepiane
authors.forename: Antonella La
authors.initials: AL
authors.lastname: Russa
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ventura
authors.forename: Rita
authors.initials: R
authors.lastname: Cittadella
authors.forename: Francesco
authors.initials: F
authors.lastname: Sasanelli
authors.forename: Eleonora
authors.initials: E
authors.lastname: Colosimo
authors.forename: Ugo
authors.initials: U
authors.lastname: Leggio
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000235:genetics; D004522:Educational Status; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014706:Verbal Learning / Q000502:physiology*
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E