Affiliations: Department of Pediatrics, University of Virginia,
Charlottesville, VA, USA | Department of Public Health Sciences, University of
Virginia, Charlottesville, VA, USA | Department of Microbiology, University of Virginia,
Charlottesville, VA, USA | Department of Orthopaedics, University of Virginia,
Charlottesville, VA, USA | Center for Public Health Genomics, University of
Virginia, Charlottesville, VA, USA
Note: [] Address for correspondence: James A. Blackman, MD, MPH, Kluge
Children's Rehabilitation Center, University of Virginia, 2270 Ivy Road,
Charlottesville, VA 22903, USA. Tel.: +1 434 924 0245; Fax: +1 434 924 2780;
E-mail: jab5u@virginia.edu
Abstract: Cerebral palsy is attributed to non-progressive disturbances in the
developing fetal or infant brain. The APOE ε4
allele has been associated with poor outcome after brain injury in adults but
may be protective among very young children. We conducted this study to explore
the hypothesis that the APOE ε4 is associated
with lowered severity of cerebral palsy. 158 individuals with CP and their
parents were genotyped for APOE. Mean age was 9.1 years; 54% were males.
61% were preterm at birth; 34% less than 30 weeks gestation. 30% of
the CP subjects had at least one ε4 allele. There
was a trend towards significance for subjects with at least one
ε4 allele assigned to the low severity group
(p = 0.11). The greater number of ε4 alleles, the more likely an individual was in the low severity CP
group (p = 0.12). Individuals with brain injury in the
perinatal period were almost 5 times more likely to be in the low severity
group (p < 0.01). Family analysis via the TDT supported a
protective effect of APOE ε4. Further study is
needed to confirm that, in contrast to adults, the APOE ε4
allele appears to confer protection and/or facilitate recovery
after brain injury in the fetus or newborn, particularly when that injury
occurs around term.
