Hellstrøm Torgeir, Andelic Nada, de Lange Ann-Marie G, Helseth Eirik, Eiklid Kristin, Westlye Lars T
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway.
Research Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, 0318 Oslo, Norway.
J Clin Med. 2021 Jan 22;10(3):418. doi: 10.3390/jcm10030418.
Apolipoprotein E (APOE) ɛ4 is associated with poor outcome following moderate to severe traumatic brain injury (TBI). There is a lack of studies investigating the influence of APOE ɛ4 on intracranial pathology following mild traumatic brain injury (MTBI). This study explores the association between APOE ɛ4 and MRI measures of brain age prediction, brain morphometry, and diffusion tensor imaging (DTI).
Patients aged 16 to 65 with acute MTBI admitted to the trauma center were included. Multimodal MRI was performed 12 months after injury and associated with APOE ɛ4 status. Corrections for multiple comparisons were done using false discovery rate (FDR).
Of included patients, 123 patients had available APOE, volumetric, and DTI data of sufficient quality. There were no differences between APOE ɛ4 carriers (39%) and non-carriers in demographic and clinical data. Age prediction revealed high accuracy both for the DTI-based and the brain morphometry based model. Group comparisons revealed no significant differences in brain-age gap between ɛ4 carriers and non-carriers, and no significant differences in conventional measures of brain morphometry and volumes. Compared to non-carriers, APOE ɛ4 carriers showed lower fractional anisotropy (FA) in the hippocampal part of the cingulum bundle, which did not remain significant after FDR adjustment.
APOE ɛ4 carriers might be vulnerable to reduced neuronal integrity in the cingulum. Larger cohort studies are warranted to replicate this finding.
载脂蛋白E（APOE）ε4与中重度创伤性脑损伤（TBI）后的不良预后相关。目前缺乏关于APOE ε4对轻度创伤性脑损伤（MTBI）后颅内病理影响的研究。本研究探讨APOE ε4与脑年龄预测、脑形态测量和扩散张量成像（DTI）的MRI测量之间的关联。
纳入创伤中心收治的16至65岁急性MTBI患者。伤后12个月进行多模态MRI检查，并与APOE ε4状态相关联。采用错误发现率（FDR）进行多重比较校正。
纳入的患者中，123例患者有质量足够的APOE、容积和DTI数据。APOE ε4携带者（39%）和非携带者在人口统计学和临床数据方面无差异。年龄预测显示基于DTI和基于脑形态测量的模型都具有较高的准确性。组间比较显示，ε4携带者和非携带者之间的脑年龄差距无显著差异，脑形态测量和容积的传统测量指标也无显著差异。与非携带者相比，APOE ε4携带者扣带束海马部分的分数各向异性（FA）较低，经FDR校正后无统计学意义。
APOE ε4携带者可能易患扣带中神经元完整性降低。需要更大规模的队列研究来重复这一发现。
