title: Apolipoprotein E genotype and cerebral palsy.
abstract: OBJECTIVE
  Apolipoprotein E (APOE, protein; [ApoE, gene]) is a lipid transport protein abundantly present in brain cells. We investigated whether the APOE genotype is associated with cerebral palsy (CP) and whether patients with CP with comorbid conditions and more severe neurological deficits are likely to have a particular genotype.
  
  
  METHODS
  In a cross-sectional study, 243 individuals with spastic CP (135 males, 108 females; mean age at data collection 11 year ([SD 6y 7mo], 34% with hemiplegia, 37% with diplegia, 29% with triplegia/tetraplegia; 44% with mild motor involvement), 31% with moderate motor involvement, 25% with severe motor involvement, were compared with healthy individuals matched by age, race, and sex to analyse the association between APOE genotype and the incidence of CP. Associations between the APOE genotype and the incidence of comorbidities and neurological deficits were studied in the group with CP.
  
  
  RESULTS
  The APOE epsilon2epsilon3 genotype was significantly more prevalent in the group with CP (11%) than the comparison group (5%) (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.01-7.66). The presence of the epsilon2 allele raised the probability of having CP (OR 3.2; 95% CI 1.27-8.27). The presence of ApoE epsilon4 was not significantly different among groups. No relation was found between APOE genotype and severity of neurological deficit or distribution of motor involvement. Four patients with CP presented the epsilon4epsilon4 genotype, and all exhibited epilepsy and microcephaly. Eleven of 12 individuals with CP and macrocephaly carried the epsilon3epsilon3 genotype.
  
  
  CONCLUSIONS
  A higher prevalence of the APOE epsilon2 genotype was found among those with CP. The association of microcephaly and epilepsy with the epsilon4epsilon4 genotype and the association of macrocephaly with epsilon3 demand further investigation.
authors.affiliation: Neuropsychology Department, SARAH Network of Rehabilitation Hospitals, SMHS Quadra 501 CJ. A Trreo, Brasilia DF, Brazil. luciabraga@sarah.br
authors.forename: Lucia W
authors.initials: LW
authors.lastname: Braga
authors.forename: Eliana V M
authors.initials: EV
authors.lastname: Borigato
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Speck-Martins
authors.forename: Erica U
authors.initials: EU
authors.lastname: Imamura
authors.forename: Ana M Pedrosa
authors.initials: AM
authors.lastname: Gorges
authors.forename: Ana P
authors.initials: AP
authors.lastname: Izumi
authors.forename: Rizael C
authors.initials: RC
authors.lastname: Dantas
authors.forename: Luis G Nadal
authors.initials: LG
authors.lastname: Nunes
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D053329:Apolipoprotein E2 / Q000235:genetics*; D053318:Apolipoprotein E3 / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D002547:Cerebral Palsy / Q000453:epidemiology / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4