Age of onset of mesial temporal lobe epilepsy with hippocampal sclerosis: the effect of apolipoprotein E and febrile seizures

作者：Leal Barbara; Chaves Joao; Carvalho Claudia; Bettencourt Andreia; Freitas Joel; Lopes Joao; Ramalheira Joao; Costa Paulo P; Mendonca Denisa; Silva Antonio M^*; Silva Berta M

来源：International Journal of Neuroscience, 2017, 127(9): 800-804.

DOI：10.1080/00207454.2016.1264396

• Epilepsy
• febrile seizures
• ApoE
• hippocampus

Purpose: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is the most frequent pharmaco-resistant epilepsy. It has been associated with febrile seizures (FS) in childhood. Its aetiology remains unclear but genetic factors are involved. Apolipoprotein E (ApoE) is the main lipoprotein secreted in brain. It has a critical immunomodulatory function, influences neurotransmission and it is involved in repairing damaged neurons. ApoE E4 is an isoform of ApoE with altered protein function, previously associated with refractoriness and early onset epilepsy. This study was undertaken to determine if ApoE isoforms are risk factors for MTLE-HS and influence clinical characteristics.Methods: A group of 188 MTLE-HS patients (101 F, 87M, mean age = 44.7 +/- 11.6years, 100 with FS antecedents) was studied and compared with a group of 342 healthy individuals in a case-control genetic association study. Data were analysed with Pearson Chi-squared Test or Student's t test, as appropriated.Results: No differences in ApoE E4 allelic frequencies between MTLE-HS patients and controls or between MTLE-HS subgroups were observed. Nevertheless, ApoE E4 carriers had an earlier MTLE-HS onset (11.0 +/- 7.9years in ApoE E4 carriers vs. 14.4 +/- 11.2years in ApoE E4 non-carriers p < 0.05). Additionally, we observed that MTLE-HS patients with FS antecedents had a statistically significant early disease onset (11.5 +/- 8.7years in FS+ vs. 16.0 +/- 12.1years in FS-, p < 0.01).Conclusions: Our data show that ApoE E4 and FS may not participate directly in etiopathogenic mechanisms of MTLE-HS but could hasten the disease development in predisposed individuals.

• 出版日期2017