APOE ϵ4 Carriers Show Delayed Recovery of Verbal Memory and Smaller Entorhinal Volume in the First Year after Ischemic Stroke

Emilio Werden, Mohamed Salah Khlif, Laura J. Bird, Toby Cumming, Jennifer Bradshaw, Wasim Khan, Matthew Pase, Carolina Restrepo, Michele Veldsman, Natalia Egorova, Sheila K. Patel, Elie Gottlieb, Amy Brodtmann

Research output: Contribution to journalArticleResearchpeer-review

9 Citations (Scopus)


Background: The apolipoprotein E (APOE) gene ϵ4 allele is a risk factor for Alzheimer's disease and cardiovascular disease. However, its relationship with cognition and brain volume after stroke is not clear. Objective: We compared cognition and medial temporal lobe volumes in APOE ϵ4 carriers and non-carriers in the first year after ischemic stroke. Methods: We sampled 20 APOE ϵ4 carriers and 20 non-carriers from a larger cohort of 135 ischemic stroke participants in the longitudinal CANVAS study. Participants were matched on a range of demographic and stroke characteristics. We used linear mixed-effect models to compare cognitive domain z-scores (attention, processing speed, executive function, verbal and visual memory, language, visuospatial function) and regional medial temporal lobe volumes (hippocampal, entorhinal cortex) between groups at each time-point (3, 12-months post-stroke), and within groups across time-points. APOE gene single nucleotide polymorphisms (SNPs; rs7412, rs429358) were genotyped on venous blood. Results: APOE ϵ4 carriers and non-carriers did not differ on any demographic, clinical, or stroke variable. Carriers performed worse than non-carriers in verbal memory at 3 months post-stroke (p = 0.046), but were better in executive function at 12 months (p = 0.035). Carriers demonstrated a significant improvement in verbal memory (p = 0.012) and executive function (p = 0.015) between time-points. Non-carriers demonstrated a significant improvement in visual memory (p = 0.0005). Carriers had smaller bilateral entorhinal cortex volumes (p < 0.05), and larger right sided and contralesional hippocampal volumes, at both time-points (p < 0.05). Conclusion: APOE ϵ4 is associated with delayed recovery of verbal memory function and reduced entorhinal cortex volumes in the first year after ischemic stroke.

Original languageEnglish
Pages (from-to)245-259
Number of pages15
JournalJournal of Alzheimer's Disease
Issue number1
Publication statusPublished - 3 Sept 2019
Externally publishedYes


  • Apolipoproteins E
  • hippocampus
  • magnetic resonance imaging
  • memory
  • stroke

Cite this