AIM Apolipoprotein E (APOE, protein; [ApoE, gene]) is a lipid transport protein abundantly present in brain cells. We investigated whether the APOE genotype is associated with cerebral palsy (CP) and whether patients with CP with comorbid conditions and more severe neurological deficits are likely to have a particular genotype. METHODIn a cross-sectional study, 243 individuals with spastic CP (135 males, 108 females; mean age at data collection 11 year ([SD 6y 7mo], 34% with hemiplegia, 37% with diplegia, 29% with triplegia ⁄ tetraplegia; 44% with mild motor involvement), 31% with moderate motor involvement, 25% with severe motor involvement, were compared with healthy individuals matched by age, race, and sex to analyse the association between APOE genotype and the incidence of CP. Associations between the APOE genotype and the incidence of comorbidities and neurological deficits were studied in the group with CP. RESULTSThe APOE 23 genotype was significantly more prevalent in the group with CP (11%) than the comparison group (5%) (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.01-7.66). The presence of the 2 allele raised the probability of having CP (OR 3.2; 95% CI 1.27-8.27). The presence of ApoE 4 was not significantly different among groups. No relation was found between APOE genotype and severity of neurological deficit or distribution of motor involvement. Four patients with CP presented the 44 genotype, and all exhibited epilepsy and microcephaly. Eleven of 12 individuals with CP and macrocephaly carried the 33 genotype.INTERPRETATION A higher prevalence of the APOE 2 genotype was found among those with CP. The association of microcephaly and epilepsy with the 44 genotype and the association of macrocephaly with 3 demand further investigation.The known causes of cerebral palsy (CP) are congenital, genetic, inflammatory, infectious, anoxic, traumatic, and metabolic.1 Recent advances in neonatal management and obstetric care have not resulted in a decline in CP in infants born at term.2 This has led to the study of other factors, including the possibility of a genetic influence in the pathophysiology of brain injury. Human apolipoprotein E (APOE, protein; [ApoE, gene]) plays a major physiological role in the regulation of overall lipid homeostasis and is important for neuronal repair. The gene for this protein has been located on chromosome 19, and there are three common isoforms, designated 2, 3, and 4. APOE is mainly synthesized by astrocytes, within which it is packaged with cholesterol and phospholipid to form lipidprotein complexes that are then released into the extracellular space. These complexes bind to APOE receptors on the surfaces of nerve cells, allowing them to be internalized and providing a mechanism for the maintenance and repair of cell membranes, neurotransmission, and brain response to hazards.Evidence also suggests that APOE plays an important role in modulating the systemic and central nervous inflammatory responses. 4 There are limited data about ApoE isoform-specific effects i...

No abstract

Objective: To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. Methods: Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. Results: The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. Conclusions: Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.