gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Association of apolipoprotein E polymorphism with neurocognitive and psychosocial outcome after nonaneurysmal nontraumatic subarachnoid hemorrhage. A prospective five-year-long study

Meeting Abstract

  • corresponding author A. Alfieri - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • A. Schwarz - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • V. Unterhuber - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • M. Pircher - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • M. Campello - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • M. Broger - Neurosurgery, Gesundheitsbezirk Bozen, Südtirol, Italy
  • H. R. Widmer - Klinik für Neurochirurgie, Inselspital Bern, Switzerland

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 114

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Alfieri et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The aim of this study was to prospectively examine the long-term psychosocial and neuropsychological performances in patients suffering for nonaneurysmal nontraumatic SAH and to correlate the genetic presence of the APOE ε4 genotype to the outcome.

Methods: Cognitive and psychological skills were examined in thirty patients on a long-term basis (mean follow-up 59.8 months). These assessments included attention, memory, planning abilities, and depression. APO E genotype was determined in all patients by PCR from blood.

Results: Eleven patients were carriers of the APOE ε4 genotype (9 patients with genotype e4/e3 and two patients with genotype ε4/ε4). APOE ε4 and non-ε4 did not differ significantly with respect of age, years of education, type of SAH or any psychosocial measures. All patients showed a good recovery with full independence and without persisting neurological deficits. The APO ε4 group had, compared to the APO E non-ε4 group, however, a significant worse score in the depression measurement Beck Depression Inventory (BDI) with 22.1 (±6.3 SD) versus 14.1(±5.1 SD), respectively. At the follow-up the depression persists in the whole APO E ε4 group with statistical significance (p<0.05) compared to the non-ε4 group. There was moreover a significant correlation between the depression scores with BDI and performances on test of selective attention (D2 r: -0.39, p: 0.007). The selective attention D2 was impaired in the whole group for the first year of follow-up, with a good recovery after two years in the APO E non-ε4 carrier group and only after three years in the ε4-carrier cohort. Eight patients, all of the APO E ε4 group, did not return in the first year to their previous occupation. Five patients (16.7%) returned to part-time employment after the first year and to full-time within 3 years after the acute event. Two patients, also of the APO E ε4 group, did not return to their employment after five years.

Conclusions: These findings suggest that psychosocial and neuropsychological performances following nonaneurysmal SAH are related to the APOE genotypes, with significant consequences for the social and working life.