title: Apolipoprotein E polymorphisms and severity of cerebral palsy: a cross-sectional study in 255 children in Norway.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. espen.lien@ntnu.no
authors: Espen
authors: E
authors: Lien
authors: Guro L
authors: GL
authors: Andersen
authors: Yongde
authors: Y
authors: Bao
authors: Heather
authors: H
authors: Gordish-Dressman
authors: Jon S
authors: JS
authors: Skranes
authors: Torstein
authors: T
authors: Vik
authors: James A
authors: JA
authors: Blackman
mesh_terms: D000293:Adolescent; D053327:Apolipoprotein E4 / Q000235:genetics*; D001921:Brain / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000235:genetics* / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D004827:Epilepsy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005774:Gastrostomy / Q000706:statistics & numerical data; D005838:Genotype; D006801:Humans; D015994:Incidence; D008297:Male; D009048:Motor Skills; D009069:Movement Disorders / Q000453:epidemiology / Q000503:physiopathology; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011110:Polymorphism, Genetic; D011597:Psychomotor Performance; D012720:Severity of Illness Index
chemical_list: D053327:Apolipoprotein E4
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