title: Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis.
abstract: BACKGROUND
  Cognitive impairment may occur at any time during the course of multiple sclerosis (MS), and it is often a major cause of disability in patients with the disease. The APOE-epsilon4 allele is the major known genetic risk factor for late onset familial and sporadic Alzheimer's Disease (AD), and it seems to be implicated in cognitive decline in normal elderly persons.
  
  
  OBJECTIVE
  To investigate the clinical and genetic variables that can be associated with the cognitive decline in patients with MS.
  
  
  METHODS
  Five-hundred and three patients with clinically definite MS underwent a battery of neuropsychological tests and, according to the number of failed tests, were divided into cognitively normal and impaired. All patients were genotyped for APOE gene polymorphisms.
  
  
  RESULTS
  Fifty-six percent of MS patients showed, to different extents, cognitive impairment. Cognitive decline was predominant in men and was associated with disease duration, Kurtzke Expanded Disability Status Scale (EDSS) score, a low level of education, and, interestingly, the epsilon4 allele of the APOE gene. By contrast, cognitive impairment in women was independent of any investigated variable.
  
  
  CONCLUSIONS
  The findings demonstrate that clinical and genetic factors play a role in men affected by MS developing cognitive impairment.
authors.affiliation: Institute of Neuropsychiatry, University of Palermo, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Savettieri
authors.forename: Demetrio
authors.initials: D
authors.lastname: Messina
authors.forename: Virginia
authors.initials: V
authors.lastname: Andreoli
authors.forename: Simona
authors.initials: S
authors.lastname: Bonavita
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.forename: Rita
authors.initials: R
authors.lastname: Cittadella
authors.forename: Deborah
authors.initials: D
authors.lastname: Farina
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Fazio
authors.forename: Paolo
authors.initials: P
authors.lastname: Girlanda
authors.forename: Francesco
authors.initials: F
authors.lastname: Le Pira
authors.forename: Maria
authors.initials: M
authors.lastname: Liguori
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lugaresi
authors.forename: Ugo
authors.initials: U
authors.lastname: Nocentini
authors.forename: Arturo
authors.initials: A
authors.lastname: Reggio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salemi
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Tedeschi
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Paola
authors.initials: P
authors.lastname: Valentino
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001057:Apolipoproteins E / Q000235:genetics; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000209:etiology / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000235:genetics*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D016017:Odds Ratio; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012727:Sex Characteristics
chemical_list: D001057:Apolipoproteins E; D012333:RNA, Messenger