Are genetic factors important in the aetiology of leukoaraiosis? Results from a memory clinic population.
OBJECTIVE
To discover whether polymorphism in either the apolipoprotein E (ApoE) or angiotensin-converting enzyme (ACE) genes is associated with leukoaraiosis, white matter lesions visible on neuroimaging of the brain, which is commonly seen in dementia as well as some normal elderly subjects.


METHODS
Prospective study of consecutive patients attending our memory disorders clinic, to examine the relationship between leukoaraiosis and polymorphism of the ApoE and ACE genes.


METHODS
Memory disorders clinic in Bristol, UK.


METHODS
182 patients attending the memory disorders clinic for investigation of possible dementia of whom 75% were suffering from dementia, 20% from memory impairment but no dementia and in 5% of whom a dementing illness was thought to be unlikely; 38% of all patients had visible white matter lesions and 16% had cerebral infarcts.


METHODS
Patients and/or carers who agreed to participate in the study had their ACE and ApoE genotype determined and their brain CT/MRI scans were assessed by a neuroradiologist, blind to the result of the genotyping, for the presence or absence of white matter low attenuation.


RESULTS
There was a significant association between white matter lesions and the DD genotype (p < 0.05), but not the ApoE genotype. However, this relationship with the DD genotype was only significant for patients with a previous infarct.


CONCLUSIONS
Homozygosity of ACE gene deletion polymorphism is a risk factor for white matter lesions when it is associated with cerebral infarction. This suggests that it may be possible to identify subjects who are at greater risk of developing white matter lesions and are at risk of cognitive impairment and possibly dementia.
Royal Bournemouth Hospital, UK.
K
K
Amar
S
S
MacGowan
G
G
Wilcock
T
T
Lewis
M
M
Scott
D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000235:genetics* / Q000473:pathology; D002544:Cerebral Infarction / Q000235:genetics / Q000473:pathology; D005838:Genotype; D006801:Humans; D008569:Memory Disorders / Q000473:pathology; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic
D001057:Apolipoproteins E; D007703:Peptidyl-Dipeptidase A