APOE gene polymorphism alters cerebral oxygen saturation and quantitative EEG in early-stage traumatic brain injury

Yang, Baoxue; Liang, Xiaofang; Wu, Zhimin; Sun, Xiaochuan; Shi, Qin; Zhan, Yuan; Wei, Dan; Zheng, Dinghao; Xia, Yongzhi; Deng, Bo; Xie, Yizhen; Jiang, Li

doi:10.1016/j.clinph.2022.01.131

Cited by 3 publications

(9 citation statements)

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“…We also found that among TBI patients, APOE ε4 carriers had lower cerebral oxygen saturation than APOE ε4 non‐carriers 6 . Furthermore, compared to APOE ε4 non‐carriers, APOE ε4 carriers had a higher frequency of abnormal slow waves in the EEG at the early stage of TBI 7 . These results suggest that abnormal local cerebral oxygen and brain electrical activity may be related to the negative effect of APOE ε4 on the prognosis of patients with TBI.…”

Section: Introductionsupporting

confidence: 53%

“…The results of logistic regression analysis showed that APOE e4, hypoxia, and MTT >5.75 s were risk factors for the poor prognosis of TBI patients, which was also consistent with the findings of our previous study. 6,7,32 Therefore, APOE e4 carriers in the TBI group had not only a longer MTT and poorer rScO 2 but also a lower GOS compared to non-carriers.…”

Section: Discussionmentioning

confidence: 95%

“…In the TBI group, the mean GOS of APOE e4 carriers was significantly higher than that of APOE e4 noncarriers, suggesting that APOE e4 carriers were more likely to have worse outcomes than APOE e4 non-carriers after TBI, which is also consistent with our previous studies. 6,7,18,29 Previous studies have also shown that patients with poorer cerebral perfusion usually have a worse prognosis, while cerebral oxygen saturation was also reported to be related to prognosis after TBI. 16,19,30,31 However, the associations between cerebral perfusion, cerebral oxygen saturation, and TBI prognosis remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike APOE e2 and e3, APOE e4 showed negative effects on the balance of calcium and excited amino acids, inflammatory response, and apoptosis, which might cause impairment of blood-brain barrier (BBB) permeability. 6,7,18,19,33,34 Therefore, we speculate that APOE e4 leads to a disorder in cerebral perfusion and cerebral oxygen metabolism by impairing BBB permeability, which ultimately influences the prognosis of TBI.…”

Section: Discussionmentioning

confidence: 99%

“…6 Furthermore, compared to APOE e4 noncarriers, APOE e4 carriers had a higher frequency of abnormal slow waves in the EEG at the early stage of TBI. 7 These results suggest that abnormal local cerebral oxygen and brain electrical activity may be related to the negative effect of APOE e4 on the prognosis of patients with TBI. Both cerebral oxygen metabolism and brain electrical activity are closely associated with cerebral blood perfusion, which are also considered important indices for evaluating the condition of TBI patients.…”

Section: Introductionmentioning

confidence: 87%

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Effects of apolipoprotein E polymorphism on cerebral oxygen saturation, cerebral perfusion, and early prognosis after traumatic brain injury

Lin

Li²,

Sun

et al. 2023

Ann Clin Transl Neurol

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Objective To investigate the effects of the apolipoprotein E (APOE) gene on oxygen saturation and cerebral perfusion in the early stages of traumatic brain injury (TBI). Methods This study included 136 consecutive TBI patients and 51 healthy individuals. The APOE genotypes of all subjects were determined using quantitative fluorescence polymerase chain reaction (QF‐PCR). Regional cerebral oxygen saturation (rScO2) of patients with TBI and normal subjects was monitored using near‐infrared spectroscopy (NIRS). Computed tomography (CT) perfusion was used to obtain cerebral perfusion in patients with TBI and normal subjects. Results In the TBI group, the rScO2 of APOEε4 carriers (53.06 ± 6.87%) was significantly lower than that of non‐carriers (58.19 ± 5.83%, p < 0.05). Meanwhile, the MTT of APOEε4 carriers (6.75 ± 1.30 s) was significantly longer than that of non‐carriers (5.87 ± 1.00 s, p < 0.05). Furthermore, correlation analysis showed a negative correlation between rSCO2 and MTT in patients with TBI. Both the univariate and multifactorial logistic regression analyses revealed that APOE ε4, hypoxia, MTT >5.75 s, Marshall CT Class, and GCS were independent risk factors for early poor prognosis in patients with TBI. Conclusion Both cerebral perfusion and cerebral oxygen were significantly impaired after TBI, and low cerebral perfusion and hypoxia were related to poor prognosis of patients with TBI. Compared with APOE ε4 non‐carriers, APOE ε4 carriers not only had poorer cerebral perfusion and cerebral oxygen metabolism but also worse prognosis in the early stages of TBI. Furthermore, a negative correlation was observed between the rSCO2 and MTT levels. In addition, both CT perfusion scanning (CTP) and NIRS are reliable for monitoring the condition of patients with TBI in the neurological intensive care unit (NICU).

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Section: Introductionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

See 3 more Smart Citations

Effects of apolipoprotein E polymorphism on cerebral oxygen saturation, cerebral perfusion, and early prognosis after traumatic brain injury

Lin

Li²,

Sun

et al. 2023

Ann Clin Transl Neurol

Self Cite

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Quantitative Electroencephalography Objectivity and Reliability in the Diagnosis and Management of Traumatic Brain Injury: A Systematic Review

Amico,

Koberda

2023

Clin EEG Neurosci

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Background. Persons with a history of traumatic brain injury (TBI) may exhibit short- and long-term cognitive deficits as well as psychiatric symptoms. These symptoms often reflect functional anomalies in the brain that are not detected by standard neuroimaging. In this context, quantitative electroencephalography (qEEG) is more suitable to evaluate non-normative activity in a wide range of clinical settings. Method. We searched the literature using the “Medline” and “Web of Science” online databases. The search was concluded on February 23, 2023, and revised on July 12, 2023. It returned 134 results from Medline and 4 from Web of Science. We then applied the PRISMA method, which led to the selection of 31 articles, the most recent one published in March 2023. Results. The qEEG method can detect functional anomalies in the brain occurring immediately after and even years after injury, revealing in most cases abnormal power variability and increases in slow (delta and theta) versus decreases in fast (alpha, beta, and gamma) frequency activity. Moreover, other findings show that reduced beta coherence between frontoparietal regions is associated with slower processing speed in patients with recent mild TBI (mTBI). More recently, machine learning (ML) research has developed highly reliable models and algorithms for the detection of TBI, some of which are already integrated into commercial qEEG equipment. Conclusion. Accumulating evidence indicates that the qEEG method may improve the diagnosis and management of TBI, in many cases revealing long-term functional anomalies in the brain or even neuroanatomical insults that are not revealed by standard neuroimaging. While FDA clearance has been obtained only for some of the commercially available equipment, the qEEG method allows for systematic, cost-effective, non-invasive, and reliable investigations at emergency departments. Importantly, the automated implementation of intelligent algorithms based on multimodally acquired, clinically relevant measures may play a key role in increasing diagnosis reliability.

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The Rehabilitation Potential of Neurostimulation for Mild Traumatic Brain Injury in Animal and Human Studies

McNerney,

Gurkoff,

Beard

et al. 2023

Brain Sciences

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Neurostimulation carries high therapeutic potential, accompanied by an excellent safety profile. In this review, we argue that an arena in which these tools could provide breakthrough benefits is traumatic brain injury (TBI). TBI is a major health problem worldwide, with the majority of cases identified as mild TBI (mTBI). MTBI is of concern because it is a modifiable risk factor for dementia. A major challenge in studying mTBI is its inherent heterogeneity across a large feature space (e.g., etiology, age of injury, sex, treatment, initial health status, etc.). Parallel lines of research in human and rodent mTBI can be collated to take advantage of the full suite of neuroscience tools, from neuroimaging (electroencephalography: EEG; functional magnetic resonance imaging: fMRI; diffusion tensor imaging: DTI) to biochemical assays. Despite these attractive components and the need for effective treatments, there are at least two major challenges to implementation. First, there is insufficient understanding of how neurostimulation alters neural mechanisms. Second, there is insufficient understanding of how mTBI alters neural function. The goal of this review is to assemble interrelated but disparate areas of research to identify important gaps in knowledge impeding the implementation of neurostimulation.

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APOE gene polymorphism alters cerebral oxygen saturation and quantitative EEG in early-stage traumatic brain injury

Cited by 3 publications

References 37 publications

Effects of apolipoprotein E polymorphism on cerebral oxygen saturation, cerebral perfusion, and early prognosis after traumatic brain injury

Effects of apolipoprotein E polymorphism on cerebral oxygen saturation, cerebral perfusion, and early prognosis after traumatic brain injury

Quantitative Electroencephalography Objectivity and Reliability in the Diagnosis and Management of Traumatic Brain Injury: A Systematic Review

The Rehabilitation Potential of Neurostimulation for Mild Traumatic Brain Injury in Animal and Human Studies

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