gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Apolipoprotein E genotype and the risk of myelopathy in patients with chronic spinal cord compression – a prospective evaluation

Der Einfluss des Apolipoprotein E-Genotyps auf das Myelopathie-Risiko bei Patienten mit chronischer Rückenmarkskompression

Meeting Abstract

  • corresponding author M. Setzer - Klinik für Neurochirurgie, J.W. Goethe Universität, Frankfurt/M.
  • G. Marquardt - Klinik für Neurochirurgie, J.W. Goethe Universität, Frankfurt/M.
  • E. Hermann - Klinik für Neurochirurgie, J.W. Goethe Universität, Frankfurt/M.
  • V. Seifert - Klinik für Neurochirurgie, J.W. Goethe Universität, Frankfurt/M.

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 12.196

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc413.shtml

Published: May 8, 2006

© 2006 Setzer et al.
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Outline

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Objective: Recent studies demonstrated that the Apolipoprotein E (APOE) polymorphism influences the recovery of brain injury and that relationship exists between the occurrence (Alzheimer disease) and outcome of patients with neurological diseases (eg. subarachnoid hemorrhage, traumatic brain injury, intracerebral hemorrhage, spinal cord injury) and the possession of the e4 allele. The aim of this study was to test if there is an increased risk for the development of myelopathy in patients with homo- or heterozygous e4 genotype.

Methods: 91 consecutive patients with chronic spinal cord compression due to tumor or degenerative disease of the spine were included in this study (59 men; 32 women). The age ranged from 21 to 86 years. The mean age was 58,1±14,3 years. Patient characteristics and radiographic variables were recorded prospectively. APOE genotyping was carried out by isolation of DNA from venous blood samples. APOE genotypes were determined by polymerase chain reaction followed by restriction enzyme digestion and polyacrylamide gel electrophoresis of digested fragments. Univariate association between categorical variables was tested using the chi square test. A backward stepwise method was used to construct a multivariate logistic regression model in relation to the occurrence of myelopathy as the dependent variable.

Results: The following distribution of APOE genotypes was found: e2/e2: 1 patient; e2/e3: 9 patients; e2/e4:1 patient; e3/e3: 56 patients; e3/ e4: 22 patients; e4/ e4: 2 patients. Univariate analysis showed that patients with chronic spinal cord compression and homo- or heterozygous allele e4 are more likely to develop myelopathy than patients without allele e4 (88 % vs. 47%, p<0,001). The effect remained significant in a binary logistic regression model (OR 9,4; 95% CI 2,4 to 36,0; p<0,001).

Conclusions: Our findings confirm that the APOE e4 allele increases the risk for the development of myelopathy in patients with chronic spinal cord compression.