ApoE Epsilon4 Allele and Disease Duration Affect Verbal Learning in Mild Temporal Lobe Epilepsy
Antonio Gambardella
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorUmberto Aguglia
Regional Epilepsy Centre, Hospital of Reggio Calabria
Search for more papers by this authorRosanna Chifari
Clinic of Neurology, Hospital of Melegnano, Milan, Italy
Search for more papers by this authorAngelo Labate
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorIda Manna
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorPaolo Serra
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorNelide Romeo
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorGrazia Sibilia
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorEmilio LePiane
Regional Epilepsy Centre, Hospital of Reggio Calabria
Search for more papers by this authorAntonella La Russa
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorPatrizia Ventura
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorRita Cittadella
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorFrancesco Sasanelli
Clinic of Neurology, Hospital of Melegnano, Milan, Italy
Search for more papers by this authorEleonora Colosimo
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorUgo Leggio
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorMario Zappia
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorAldo Quattrone
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorAntonio Gambardella
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorUmberto Aguglia
Regional Epilepsy Centre, Hospital of Reggio Calabria
Search for more papers by this authorRosanna Chifari
Clinic of Neurology, Hospital of Melegnano, Milan, Italy
Search for more papers by this authorAngelo Labate
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorIda Manna
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorPaolo Serra
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorNelide Romeo
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorGrazia Sibilia
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorEmilio LePiane
Regional Epilepsy Centre, Hospital of Reggio Calabria
Search for more papers by this authorAntonella La Russa
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorPatrizia Ventura
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorRita Cittadella
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorFrancesco Sasanelli
Clinic of Neurology, Hospital of Melegnano, Milan, Italy
Search for more papers by this authorEleonora Colosimo
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorUgo Leggio
Institute of Neurology, School of Medicine, Catanzaro
Search for more papers by this authorMario Zappia
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorAldo Quattrone
Institute of Neurology, School of Medicine, Catanzaro
Institute of Neurological Sciences, National Research Council, Cosenza
Search for more papers by this authorAbstract
Summary: Purpose: To clarify the possible role of other factors including the ApoE ɛ4 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 ɛ4 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 ≥25.5 years (OR, 7.06; 95% CI, 1.67–29.85), especially if they carried the ɛ4 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 ɛ4 allele and point to the critical role of disease duration itself for cognitive impairment in TLE.
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