Journal Club: Florbetapir imaging in cerebral amyloid angiopathy-related hemorrhages

Association between apolipoprotein E gene polymorphism and early MR findings in individuals with acute intracerebral hemorrhage: A retrospective cohort analysis

OBJECTIVE

The Apolipoprotein E (APOE) gene plays a significant role in the development and prognosis of intracerebral hemorrhage (ICH). Imaging features identified within 48 h of ICH onset, particularly on magnetic resonance imaging (MRI), are indicative of cerebral small vessel diseases (CSVD). Our study aimed to assess these imaging characteristics and investigate their association with the APOE gene among ICH patients.

METHODS

Clinical and imaging data from patients meeting specific inclusion and exclusion criteria from October 2021 to March 2022 were collected. MR signs or scores were evaluated following international accreditation standards and then analyzed in connection with the APOE allele genes.

RESULTS

In a cohort of 220 patients, ε2 was identified as an independent risk factor for the "multiple subcortical spots" sign (OR = 13.29, 95% CI 1.88-22.59). Furthermore, ε4 emerged as an independent risk factor for the presence of perivascular space (PVS) in the centrum semiovale (OR = 2.46, 95% CI 1.03-5.89) and basal ganglia (OR = 2.64, 95% CI 1.10-6.35), as well as for cerebral microbleeds (CMB) across all locations (OR = 2.38, 95% CI 1.15-6.97), lobar CMB (OR = 2.92, 95% CI 1.11-7.65), and deep CMB (OR = 2.29, 95% CI 1.12-8.67).

CONCLUSION

The association between APOE ɛ2 and ɛ4 alleles and the presence of "subcortical multiple spots," "PVS," and "CMB" indirectly implies the potential role of APOE gene-related pathological changes in the progression of ICH and small vessel pathology.