Background: Late posttraumatic seizures are a common complication of moderate and severe traumatic brain injury. Inheritance of the apolipoprotein E (APOE) epsilon4 allele is associated with increased risk of Alzheimer disease, progression to disability in multiple sclerosis, and poor outcome after traumatic brain injury.
Objective: To determine whether inheritance of APOE epsilon4 is associated with increased risk of developing late posttraumatic seizures.
Design: Prospective study.
Setting: Neurosurgical service at an urban level I trauma center.Patients Patients admitted with a diagnosis of moderate and severe traumatic brain injury were enrolled.
Methods: Six months after injury, patients were contacted to determine functional outcome (according to the Glasgow Outcome Scale-Expanded [GOS-E]) and the presence of late posttraumatic seizures. Genotype at the APOE locus was determined by restriction fragment length polymorphism analysis.
Results: DNA and outcome information was obtained from 106 subjects. Six months after injury, 31 (29%) had a poor outcome (GOS-E score, 1-4), 47 (44%) had an intermediate outcome (GOS-E score, 5-6), and 28 (26%) had a favorable outcome (GOS-E score, 7-8). Twenty-one patients (20%) had at least 1 late posttraumatic seizure. The relative risk of late posttraumatic seizures for patients with the epsilon4 allele was 2.41 (95% confidence interval, 1.15-5.07; P =.03). In this cohort, inheritance of APOE epsilon4 was not associated with an unfavorable GOS-E score 6 (P =.47).
Conclusions: Inheritance of the APOE epsilon4 allele is associated with increased risk of late posttraumatic seizures. In this cohort, this risk appears to be independent of an effect of epsilon4 on functional outcome. A better understanding of the molecular role of APOE in neurodegenerative diseases may be helpful in developing antiepileptogenic therapies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/archneur.60.6.818 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A systematic review and meta-analysis on the impact of early vs. delayed pharmacological thromboprophylaxis in patients with traumatic brain injury.
J Clin Neurosci
December 2024
Department of Internal Medicine, Akhtar Saeed Medical College, Lahore, Pakistan.
Article Synopsis
- Traumatic brain injury (TBI) is linked to serious health issues like venous thromboembolism and higher death rates, making early post-traumatic prophylaxis (PTP) important for patient recovery.
- A systematic review analyzed data from 20 studies with over 87,000 patients, revealing that early PTP significantly cuts the risks of VTE, DVT, PE, and overall mortality compared to later administration.
- The results emphasize the effectiveness of early pharmacologic thromboprophylaxis in improving outcomes for TBI patients, although the timing of administration (within 48 hours) is particularly critical for achieving statistical significance.
Combined ultrasound imaging/neurophysiological evaluation for surgical planning in upper limb traumatic nerve injuries with concomitant vascular damage: Two emblematic cases and a review of litterature.
Ann Chir Plast Esthet
December 2024
Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care - University of Palermo, Palermo, Italy.
Article Synopsis
- Traumatic injuries of the upper limb often result in both nerve and vascular damage due to the close proximity of major vessels and nerves, and timely diagnosis of complications like pseudoaneurysms is crucial.
- A study reviewed cases of upper limb trauma over two years, utilizing a combined ultrasound imaging and neurophysiological approach to assess nerve injuries, including two specific late-onset vascular complication cases.
- The findings highlight the enhanced diagnostic accuracy achieved when combining electrophysiology with ultrasonography for assessing nerve injuries, suggesting the need for more extensive studies to validate these promising results.
A longitudinal study of healthcare workers' mental health during Western Australia's unique policy response to COVID-19.
BJPsych Open
December 2024
School of Population Health, Curtin University, Australia; Curtin enAble Institute, Perth, Australia; and Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Australia.
Article Synopsis
- - Western Australia effectively managed COVID-19 public health measures, but healthcare staff still faced significant mental health risks, particularly during the pandemic's early years.
- - A study involving 183 healthcare workers found stable rates of post-traumatic stress, depression, and anxiety over time, but those with initially lower symptoms experienced greater increases, while those with higher symptoms saw smaller declines—a phenomenon described as a "catch-up" effect.
- - Key risk factors for psychological symptom changes included workplace stress, sleep problems, and trauma exposure, while supportive workplace and social networks helped protect mental health, indicating a need for improvements in systemic support for healthcare professionals.
Understanding psychological symptoms among Chinese college students during the COVID-19 Omicron pandemic: Findings from a national cross-sectional survey in 2023.
Compr Psychoneuroendocrinol
November 2024
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Article Synopsis
- The study surveyed 4,254 Chinese students during the Omicron pandemic to evaluate their mental health, focusing on symptoms of depression, anxiety, and PTSD along with their social support networks.
- Key protective factors against mental health issues included regular exercise and strong social support, while risk factors involved excessive alcohol use, comorbidities, Omicron infection, and irregular sleep patterns.
- The findings highlight the heightened vulnerability of students during the pandemic, emphasizing the need for better social support and healthier lifestyle habits to improve their mental well-being.
Long-Term Cerebellar Consequences of Post-traumatic Brain Injury Assessed by MRI With Diffusion Tensor Imaging.
Neurosurgery
November 2024
AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care Medicine, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
Background And Objectives: Post-traumatic brain injury (TBI) lesions, which combine brain atrophy and white matter injuries, can lead to progressive post-traumatic encephalopathy. However, the specific involvement of the cerebellum, which participates in cognitive, executive, and sensory functions, has been little studied. The aim of this work was to explore the long-term cerebellar consequences of severe TBI.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!