ApoE epsilon4 allele and disease duration affect verbal learning in mild temporal lobe epilepsy.
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.
Gambardella
Antonio
A
Institute of Neurology, School of Medicine, Catanzaro, Italy.
Aguglia
Umberto
U
Chifari
Rosanna
R
Labate
Angelo
A
Manna
Ida
I
Serra
Paolo
P
Romeo
Nelide
N
Sibilia
Grazia
G
Lepiane
Emilio
E
Russa
Antonella La
AL
Ventura
Patrizia
P
Cittadella
Rita
R
Sasanelli
Francesco
F
Colosimo
Eleonora
E
Leggio
Ugo
U
Zappia
Mario
M
Quattrone
Aldo
A
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*
D053327:Apolipoprotein E4; D001057:Apolipoproteins E