Is Edema Zone Volume Associated With Ki-67 Index in Glioblastoma Patients?

Introduction Despite all the progress with genetic mapping and multimodal treatment, the prognosis of Glioblastoma multiforme (GBM) remains poor, with median overall survival (OS) of only 12 to 15 months. Several studies showed correlations between glioblastoma clinic and prognosis factors; however, it doesn`t occur with tumor radiological features. The purpose of this study is to determine possible correlations between the volumetric analysis of glioblastoma compartments and the proliferation index represented by Ki-67. Methods We performed a retrospective analysis of MRI studies of 70 patients with glioblastoma multiforme acquired up to one week before surgery. The tumor compartments were divided into enhancing zone; edema zone and tumor total zone. Each compartment was submitted to volumetric analysis using Horos Project software. A linear regression model was used to assess correlations between the ki-67 index and the volume of each compartment with a p-value of 0.05. Results The male/female ratio in our study was 1.7:1, at a mean age of 60.7 ± 14.6 years. Tumor predominant location was the temporal lobe with 25% of cases and cystic morphology was present in 17%. The median of Ki-67 was 40%. The average tumor compartment volume was 40 cm3 for the contrast-enhancing zone, 62 cm3for the edema zone, and 103 cm3 for the total tumor volume. A significant association between the Ki-67 index and edema zone volume (p=0.02) was found.  Conclusion Volumetric analysis of the glioblastoma edema zone by MRI allows for predicting tumor aggressiveness through correlation with the Ki-67 index.

Alpha-synuclein A53T mutation is not frequent on a sample of Brazilian Parkinson's disease patients.

INTRODUCTION: The pathogenesis of Parkinson's disease (PD) involves both genetic susceptibility and environmental factors, with focus on the mutation in the alpha-synuclein gene (SNCA).Objective To analyse the polymorphism SNCA-A53T in patients with familial PD (FPD) and sporadic PD (SPD). METHOD: A total of 294 individuals were studied, regardless of sex and with mixed ethnicity. The study group with 154 patients with PD, and the control group included 140 individuals without PD. The genotyping of SNCA-A53T was performed by PCR/RFLP. Significance level was p < 0.05. RESULTS: Among all patients, 37 (24%) had FPD and 117 (75.9%) had SPD. The absence of SNCA-A53T mutation was observed in all individuals. CONCLUSION: SPD is notably observed in patients. However, the SNCA-A53T mutation was absent in all individuals, which does not differ controls from patients. This fact should be confirmed in a Brazilian study case with a more numerous and older population.

Alpha-synuclein A53T mutation is not frequent on a sample of Brazilian Parkinson’s disease patients / Mutação A53T da alfa-sinucleína não é frequente em amostra de população brasileira com doença de Parkinson

Introduction The pathogenesis of Parkinson’s disease (PD) involves both genetic susceptibility and environmental factors, with focus on the mutation in the alpha-synuclein gene (SNCA).Objective To analyse the polymorphism SNCA-A53T in patients with familial PD (FPD) and sporadic PD (SPD).Method A total of 294 individuals were studied, regardless of sex and with mixed ethnicity. The study group with 154 patients with PD, and the control group included 140 individuals without PD. The genotyping of SNCA-A53T was performed by PCR/RFLP. Significance level was p < 0.05.Results Among all patients, 37 (24%) had FPD and 117 (75.9%) had SPD. The absence of SNCA-A53T mutation was observed in all individuals.Conclusion SPD is notably observed in patients. However, the SNCA-A53T mutation was absent in all individuals, which does not differ controls from patients. This fact should be confirmed in a Brazilian study case with a more numerous and older population.

Introdução A patogênese da doença de Parkinson (DP) envolve fatores ambientais e suscetibilidade genética, destacando-se a mutação de alfa-sinucleína (SNCA.)Objetivos Analisar a variante genética SNCA-A53T em pacientes com DP familiar (DPF) e DP esporádica (DPE).Método Foram estudados 294 indivíduos, independente de sexo, com etnia miscigenada, sendo 154 com DP e 140 sem a doença (grupo controle). A genotipagem de SNCA-A53T foi realizada por PCR/RFLP. Nível de significância para p < 0,05.Resultados Entre os pacientes, 37(24%) tinham DPF e 117 (75,9%) DPE. A ausência da mutação SNCA-A53T em todos os indivíduos.Conclusão DPE é destacada entre os pacientes, no entanto a mutação SNCA-A53T ausente em todos os indivíduos, não diferenciando os grupo controle e pacientes, o que deve ser confirmado em população brasileira, considerando uma ampla casuística, além da ancestralidade.

Impact of genetic variants of apolipoprotein E on lipid profile in patients with Parkinson's disease.

The pathogenesis of Parkinson's disease (PD) seems to involve genetic susceptibility to neurodegeneration. APOE gene has been considered a risk factor for PD. This study aimed to evaluate the association of APOE polymorphism with PD and its influence on lipid profile. We studied 232 PD patients (PD) and 169 individuals without the disease. The studied polymorphism was analyzed by PCR/RFLP. The Fisher's exact test, chi-square, ANOVA, and t-test (P < 0.05) were applied. The APOE3/3 genotype was prevalent in PD patients and Controls (P = 0.713) followed by APOE3/4 (P = 0.772). Both groups showed recommended values for lipid profile, with increase in the values of total cholesterol and LDLc, as well as decreased values of triglycerides in PD patients compared with Controls (P < 0.05 for all of them). Increased levels of HDLc, in PD patients, were associated with the APOE3/3 versus APOE-/4 genotypes (P = 0.012). The APOE polymorphism does not distinguish PD patients from Controls, as opposed to the lipid profile alone or in association with APOE. Furthermore, a relationship between increase of HDLc levels and APOE3 in homozygous was found in PD patients only.

Exposure to pesticides and heterozygote genotype of GSTP1-Alw26I are associated to Parkinson's disease.

OBJECTIVE: This study aimed to analyze the frequency of GSTP1-Alw26I polymorphism and to estimate its association with toxic substances in Parkinson's disease (PD). METHODS: A study group with 154 patients - subdivided into familial and sporadic PD groups - and 158 elderly individuals without the disease (control group) were evaluated. GSTP1-Alw26I polymorphism was analyzed by polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP). RESULTS: Patients were significantly more exposed to pesticides compared with the control group (p=0.0004), and the heterozygote genotype associated to exposure to pesticides also prevailed in patients (p=0.0001). Wild homozygote genotype was related to tobacco use (p=0.043) and alcoholism (p=0.033) in familial PD patients. CONCLUSION: Exposure to pesticides is associated to PD, whose effect can be enhanced when combined with the heterozygote genotype of GSTP1-Alw26I. Also, large genetic and environmental studies considering tobacco use, alcoholism, GSTP1 and PD are necessary to confirm our findings.

Exposure to pesticides and heterozygote genotype of GSTP1-Alw26I are associated to Parkinson's disease / Exposição a pesticidas e genótipo heterozigoto de GSTP1-Alw26I associam-se à doença de Parkinson

Objective This study aimed to analyze the frequency of GSTP1-Alw26I polymorphism and to estimate its association with toxic substances in Parkinson's disease (PD). Methods A study group with 154 patients - subdivided into familial and sporadic PD groups - and 158 elderly individuals without the disease (control group) were evaluated. GSTP1-Alw26I polymorphism was analyzed by polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP). Results Patients were significantly more exposed to pesticides compared with the control group (p=0.0004), and the heterozygote genotype associated to exposure to pesticides also prevailed in patients (p=0.0001). Wild homozygote genotype was related to tobacco use (p=0.043) and alcoholism (p=0.033) in familial PD patients. Conclusion Exposure to pesticides is associated to PD, whose effect can be enhanced when combined with the heterozygote genotype of GSTP1-Alw26I. Also, large genetic and environmental studies considering tobacco use, alcoholism, GSTP1 and PD are necessary to confirm our findings. .

Objetivo Analisar a frequência do polimorfismo GSTP1-Alw26I, assim como estimar sua associação com substâncias tóxicas na doença de Parkinson (DP). Métodos A casuística avaliada foi composta por um grupo de estudo, com 154 pacientes, subdivididos em DP familial e esporádica, e outro com 158 idosos sem a doença (grupo controle). O polimorfismo GSTP1-Alw26I foi analisado por reação em cadeia da polimerase/polimorfismo de comprimento do fragmento de restrição (PCR/RFLP). Resultados Os pacientes foram significativamente mais expostos a pesticidas, comparados com o grupo controle (p=0,0004), e o genótipo heterozigoto associado a exposição a pesticidas também prevaleceu nos pacientes (p=0,0001). O genótipo homozigoto selvagem apresentou relação com tabagismo (p=0,043) e etilismo (p=0,033) em pacientes com DP familial. Desse modo, a exposição a pesticidas está associada à DP, cujo efeito pode ser potencializado quando combinado ao genótipo heterozigoto de GSTP1-Alw26I. Estudos genético-ambientais envolvendo tabagismo, etilismo, GSTP1 e DP devem ser realizados em casuísticas numerosas, confirmando essa associação. .

Malformações arteriovenosas encefálicas: aspectos morfológicos, clínicos e operatórios. Revisão da literatura / Intracranial arteriovenous malformation. A literature review

É feita revisão da literatura sobre malformações arteriovenosas(MAV)encefálicas. MAV são anomalias morfológicas neurovasculares caracterizadas por comunicação direta entre artérias e veias , sem interposição do leito capilar, portanto sem resistência ao fluxo sanguíneo. Morfologicamente, MAV possuem três componentes distintos:aferências, nidus e eferências.As aferências incluem vasos originados de quaisquer artérias intra ou extracranianas que nutrem as MAV.O nidus corresponde a um enovelado complexo de artérias e veias anormais,unidas por uma ou mais fístulas além de calcificações e aneurismas intranidais. As eferências constituem as drenagens venosas, que podem ser superficial,profunda ou mista.Acidentes vasculares encefálicos(AVE)hemorrágicos são as manifestações mais comuns,ocorrendo em aproximadamente 50 por cento dos casos.O tratamento de MAV pode ser microcirurgia,embolização endovascular,radiocirúrgico estereotáxico,conservador ou multidisciplinar.Ressecção cirúrgica completa de MAV é considerada a melhor opção de tratamento,eliminando risco de futura hemorragia.Apesar do desenvolvimento tecnológico na área de neurocirurgia endovascular nas últimas décadas, a fisiopatologia de MAV e sua história natural ainda não estão bem esclarecidas.O tratamento representa um grande desafio.Acreditamos que estudos sobre complexidade arquitetônica e hemodinâmica de MAV são necessários a fim de estabelecer fatores de risco e prognósticos,melhorando os resultados do tratamento.

Clinical application of magnetic resonance in acute traumatic brain injury.

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

Clinical application of magnetic resonance in acute traumatic brain injury

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8 percent) males and 21 (38.2 percent) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1 percent and by MRI in 3.6 percent of the patients; subdural hematoma by CT in 10.9 percent and MRI in 36.4 percent; diffuse axonal injury (DAI) by CT in 1.8 percent and MRI in 50.9 percent; cortical contusions by CT in 9.1 percent and MRI in 41.8 percent; subarachnoid hemorrhage by CT in 18.2 percent and MRI in 41.8 percent. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

PROPÓSITO: Avaliar a aplicação clínica da ressonância magnética (RM) em pacientes vítimas de traumatismo craniencefálico (TCE) agudo, na identificação do tipo, número, gravidade e correlação clínica-radiológica. MÉTODO: Foram estudados prospectivamente 55 pacientes vítimas de TCE agudo fechado (0-5 dias), por TC e RM, sendo 34 do sexo masculino e 21 do feminino. RESULTADOS: Houve diferença estatisticamente significante (teste McNemar): fraturas de crânio foram detectadas em 29,1 por cento pacientes na TC e 3,6 por cento pela RM; hematoma subdural 10,9 por cento na TC e 36,4 por cento pela RM; lesão axonal difusa (LAD) 1,8 por cento pela TC e 50,9 por cento na RM; contusões corticais 9,1 por cento na TC e 41,8 por cento pela RM, hemorragia subaracnóidea 18,2 por cento na TC e 41,8 por cento pela RM. CONCLUSÃO: A RM foi superior à TC na identificação da LAD, hemorragia subaracnóidea, contusões corticais e hematoma subdural agudo, porém inferior no diagnóstico de fraturas. A detecção de LAD pela RM foi associada com maior gravidade do TCE agudo.

Glutathione S-transferase variants increase susceptibility for late-onset Alzheimer's disease: association study and relationship with apolipoprotein E epsilon4 allele.

BACKGROUND: Several factors participate in the pathogenesis of Alzheimer's disease (AD), including free radicals, which when out of balance with their antioxidant capacity contribute to the oxidative stress process and neuronal death. The glutathione S-transferase (GST) polymorphisms are associated with the organism detoxification capacity and can help with the identification of sub-groups that present susceptibility to the development of AD. The aim of this study was to analyze the association of GSTs, including GSTP1, GSTT1 and GSTM1 and apolipoprotein E (apoE) with AD and the distribution of these polymorphisms in the first-degree relatives of patients. METHODS: For this, 41 patients with AD, 24 elderly without cognitive deficits (control group), 109 relatives of patients with AD and 41 relatives of controls were studied. A sample of peripheral blood was drawn for leukocyte DNA extraction. The genetic polymorphisms were analyzed by PCR-RFLP. RESULTS: There was a significantly higher frequency of the 4 allele in the patients (0.21) and in their relatives (0.25) when compared to controls (0.04; p=0.01) and their relatives (0.03; p<0.0001). The V allele of the GSTP1 polymorphism was higher in patients compared to controls (0.35 and 0.19, respectively; p=0.04). In contrast, the presence of the GSTT1 polymorphism prevailed in controls (79%) and their relatives. CONCLUSIONS: The V allele may be a risk factor for AD, mainly in the presence of the apoE 4 allele, while the presence of GSTT1 may indicate protection against the disease.

Avaliação clínica evolutiva de pacientes pós - primeiro Acidente Vascular Encefálico e seus cuidadores / Clinical evolution assessment of patients after first stroke and their caregivers

Atualmente, o Acidente Vascular Encefálico (AVE) é uma das principais causas de morte e incapacidade, com graves conseqüências para o paciente, seus cuidadores e sociedade. Objetivos: Avaliar a independência funcional, evolução clínica e a caracterização dos pacientes que sofreram o primeiro episódio de Acidente Vascular Encefálico, e traçar o perfil dos cuidadores destes pacientes. Método: Pesquisa descritiva, realizada nas instituições hospitalares e domicílios na cidade São José do Rio Preto, utilizando como instrumento de seleção a escala de Barthel com índice <= a 40 e entrevista semi estruturada aplicada aos cuidadores.Resultados: Dos 22 pacientes, 54,55% eram do sexo masculino e, entre os cuidadores, 81,82% eram do sexo feminino. Quanto a independência funcional, 86,4% dos pacientes eram totalmente dependentes de seus cuidadores (Índice de Barthel entre 0 e 20). As complicações clínicas mais freqüentes foram: 26,46%pneumonia, 26,46% úlcera de pressão e 23,53% infecção do trato urinário. Quanto ao índice de sobrevida, 45,45% dos pacientes foram a óbito nos 60 dias pós-Acidente Vascular Encefálico. Conclusão: Os resultados demonstraram que a maioria dos pacientes que sofreram o primeiro episódio de ave eram do sexo masculino, dependentes dos seus cuidadores (sexo feminino). Apresentaram complicações clínicas e 45,45% morreram após 60 dias, depois do primeiro AVE.

Currently, stroke is considered one of the main causes of death and impairments with serious consequences for the patient, their caregivers and society. Objectives: To assess the functional independence, clinical evolution and characteristics of patients who had suffered the first stroke, and to outline their caregivers´profile. Method: Descriptive research performed at hospital settings and at the patient’s home in the city of São José do Rio Preto, using as selection instrument Barthel ´s scale d” to 40, and a semi-structure interview applied to the caregivers. Results: Out of the 22 patients, 54. 55% were male, and among the caregivers, 81.82% were female. According to the functional independence, 86.4% were completely dependent of their caregivers (Barthel´s scale between 0 and 20) The most frequent clinical complications were: 26. 46% pneumonia; 26. 46% pressure ulcer; and 23.53% urinary tract infection. According to the survival rate, 45.45% of the patients died in the following 60 days after the stroke. Conclusion: The results showed that most of patients after the first stroke were males, dependent of their caregivers (female sex). They presented clinical complications, and 45.45% died in the following 60 days after the first stroke.

Contribuição da ressonância magnética encefálica no traumatismo craniencefálico fechado / The value of magnetic ressonance imaging in closed head injury evaluation

O manuseio clínico do trauma craniencefálico(TCE) representa ainda um dos problemas mais complexos e prevalentes encontrados nas emergências modernas. Os custos financeiros do tratamento da grande quantidade de pacientes traumatizados a cada ano são alarmamntes. O TCE, caracteristicamente, transforma indivíduos jovens e produtivos em dependentes que, frequentemente, requerem décadas de cuidado especializado e de alto custo. O principal objetivo do radiologista no diagnóstico de neurotraumatologia é prover informação diagnóstica crucial ao gerenciamento clínico com a finalidade de limitar a morbidade e mortalidade. O uso adequado dos métodos diagnósticos disponíveis é essencial para minimizar custos e melhorar o resultado do tratamento instituído ao paciente traumatizado. Neste artigo de revisão tentamos sumarizar a situação atual do disgnóstico por imagem de pacientes com TCE e damos ênfase à ressonância magnética comparada à tomografia computadorizada.

Urban prevalence of epilepsy: populational study in São José do Rio Preto, a medium-sized city in Brazil.

UNLABELLED: The aim of this study was to determine the prevalence of epilepsy in the urban population of São José do Rio Preto. This is a medium-sized city of 336000 inhabitants, located in the northwest of the state of São Paulo, Brazil. METHOD: A cross-sectional epidemiological investigation with a randomized sample was performed in two phases, a screening phase and a confirmation of the diagnosis phase. The gold standard was a clinical investigation and neurological examination. The chi-square test was used in analysis of the results and p-value value < 0.05 was considered significant. Prevalence was calculated with 95% confidence interval. RESULTS: The study sample size was 17293 individuals, with distributions of gender, age, and race similar to the general population. The prevalence per 1000 inhabitants of epilepsy was 18.6, of these 8.2 were active, defined as at least one seizure within the last two years. The prevalence per 1000 inhabitants for the age groups (years) was 4.9 (04), 11.7 (514), 20.3 (1564) and 32.8 (65 or over). CONCLUSION: Prevalence of both accumulated and active epilepsy was elevated, comparable to other developing nations, in particular those of Latin America. However, the prevalence of epilepsy in childhood was low, whilst in aged individuals it was high similar to industrialized nations.

Urban prevalence of epilepsy: populational study in São José do Rio Preto, a medium-sized city in Brazil

ANTECEDENTES: O objetivo deste estudo foi determinar a prevalência da epilepsia na população urbana de São José do Rio Preto, com 336000 habitantes, localizada no noroeste do Estado de São Paulo/ Brasil. MÉTODO: O estudo populacional, tipo corte transversal, em amostra aleatória, constituiuse de uma fase de rastreamento, mediante um questionário. O padrão ouro para confirmação diagnóstica foi a história clínica e o exame neurológico. Os testes do c2 e intervalo de confiança de 95% (IC95%) foram usados para análise dos resultados, tendo sido considerados significantes os de valor p< 0,05. RESULTADOS: A amostra estudada foi de 17293 pessoas, cuja distribuição quanto ao sexo, à faixa etária e à raça foram semelhantes à da população em geral. A prevalência de epilepsia por 1000 hab. foi 18,6, sendo 8,2 para ativa considerandose, pelo menos, uma crise no período dos últimos 2 anos. A prevalência na faixa etária de 0 a 4 anos foi 4,9, de 5 a 14, 11,7; de 15 a 64, 20,3; e acima dos 65 anos foi 32,8. CONCLUSÃO: As prevalências de epilepsia acumulada e ativa foram elevadas, semelhantes às dos países em desenvolvimento, em particular, aos da América Latina. A prevalência de epilepsia na infância foi baixa, enquanto que nos idosos foi elevada, semelhantes às observadas em países desenvolvidos. Estes resultados são relevantes no planejamento de medidas sanitárias, adequação ao tratamento da população, considerando a alta prevalência encontrada, para minimizar o impacto da epilepsia na população.

Influence of the polymorphism of apolipoprotein E in cerebral vascular disease.

UNLABELLED: The genetic heterogeneity of apolipoprotein E (apo E) has been associated with lipid profile and atherothrombotic stroke, however this association remains inconclusive. OBJECTIVE: To evaluate the relationship between the isoforms of apo E and atherothrombotic stroke, by ascertaining the frequency of its alleles and genotypes associated with the lipid profile in patients with stroke. METHOD: A total of 207 individuals were divided into two groups, consisting of 107 patients with stroke and 100 individuals without clinical symptoms of the disease. Blood samples were taken from patients and controls for molecular investigation of the apo E (epsilon2, epsilon3 and epsilon4 alleles) for the analysis of the lipid profile. RESULTS: The epsilon3 allele was the most common and its prevalence was significantly higher in patients (0.93) compared to the controls (0.86; p=0.024). The epsilon2 allele was rarely seen specifically in patients (0.02 versus 0.05 in controls, p=0.191). The epsilon4 allele was not associated with stroke showing a reduced frequency in patients (0.05) when compared to controls (0.09; p=0.011). Although higher average levels of lipid profile were found in patients when compared to controls, with statistical significance for the values of total cholesterol (TC) (203.6 mg/dL +/- 57.98 and 181.9 mg/dL +/- 68.47 respectively; p=0.003) and low-density lipoprotein cholesterol (LDLc) (131.4mg/dL +/- 52.60 and 116 mg/dL +/- 56.38, respectively; p=0.014), these were independent of the presence of the epsilon4 allele. In control group the higher TC and LDLc values occurred in the absence of the epsilon4 allele, confirming the conflicting effect of the alleles of apo E on the plasmatic lipids and atherothrombotic stroke. CONCLUSION: The isoforms of apo E cannot be regarded as an isolated risk factor for stroke and do not show association with lipid profile in this study.

Influence of the polymorphism of apolipoprotein E in cerebral vascular disease

The genetic heterogeneity of apolipoprotein E (apo E) has been associated with lipid profile and atherothrombotic stroke, however this association remains inconclusive. OBJECTIVE: To evaluate the relationship between the isoforms of apo E and atherothrombotic stroke, by ascertaining the frequency of its alleles and genotypes associated with the lipid profile in patients with stroke. METHOD: A total of 207 individuals were divided into two groups, consisting of 107 patients with stroke and 100 individuals without clinical symptoms of the disease. Blood samples were taken from patients and controls for molecular investigation of the apo E (epsilon2, epsilon3 and epsilon4 alleles) for the analysis of the lipid profile. RESULTS: The epsilon3 allele was the most common and its prevalence was significantly higher in patients (0.93) compared to the controls (0.86; p=0.024). The epsilon2 allele was rarely seen specifically in patients (0.02 versus 0.05 in controls, p=0.191). The epsilon4 allele was not associated with stroke showing a reduced frequency in patients (0.05) when compared to controls (0.09; p=0.011). Although higher average levels of lipid profile were found in patients when compared to controls, with statistical significance for the values of total cholesterol (TC) (203.6mg/dL±57.98 and 181.9mg/dL±68.47 respectively; p=0.003) and low-density lipoprotein cholesterol (LDLc) (131.4mg/dL±52.60 and 116mg/dL±56.38, respectively; p=0.014), these were independent of the presence of the epsilon4 allele. In control group the higher TC and LDLc values occurred in the absence of the epsilon4 allele, confirming the conflicting effect of the alleles of apo E on the plasmatic lipids and atherothrombotic stroke. CONCLUSION: The isoforms of apo E cannot be regarded as an isolated risk factor for stroke and do not show association with lipid profile in this study