title: White matter lesion load increases the risk of low CSF Aβ42 in apolipoprotein E-ɛ4 carriers attending a memory clinic.
abstract: BACKGROUND
  White matter lesions (WMLs) are age-related manifestations of ischemic cerebrovascular disease and increase the risk for Alzheimer's disease (AD). The apolipoprotein E (ApoE) ɛ4 allele is a risk factor for late onset AD and has been related to low cerebrospinal fluid (CSF) Aβ42 levels and to cerebrovascular disease. The present study analyzed the relationship between WMLs, ApoE-ɛ4 genotype, and low CSF Aβ42.
  
  
  METHODS
  A total of 235 memory clinic attenders were stratified in 3 groups according to WML load. WMLs were rated on axial T2 magnetic resonance imaging images. Group 1 had no or only small amounts of periventricular (PV) or subcortical (SC) WMLs, WML group 2 had high amounts of PV WMLs and low amounts of SC WMLs, and WML group 3 had high amounts of both PV and SC WMLs. In each WML group, ApoE-ɛ4 genotype was used in logistic regression as a predictor for low CSF Aβ42 (cutoff≤450 ng/L).
  
  
  RESULTS
  The odds ratio (OR) of having low CSF Aβ42 was significantly increased in the presence of ApoE-ɛ4 only in WML group 3 (OR 3.69, P=.009).
  
  
  CONCLUSIONS
  A high WML load may interact with the ApoE-ɛ4 genotype and increase the risk for reduced CSF Aβ42 in patients attending a memory clinic.
authors.affiliation: Department of Neurology, Akershus University Hospital, Lørenskog, Norway. vidar.stenset@medisin.uio.no
authors.forename: Vidar
authors.initials: V
authors.lastname: Stenset
authors.forename: Dag
authors.initials: D
authors.lastname: Hofoss
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Johnsen
authors.forename: Audun Elnaes
authors.initials: AE
authors.lastname: Berstad
authors.forename: Anne
authors.initials: A
authors.lastname: Negaard
authors.forename: Anders
authors.initials: A
authors.lastname: Skinningsrud
authors.forename: Leif
authors.initials: L
authors.lastname: Gjerstad
authors.forename: Tormod
authors.initials: T
authors.lastname: Fladby
mesh_terms: D000368:Aged; D000483:Alleles; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid* / Q000235:genetics*; D000704:Analysis of Variance; D053327:Apolipoprotein E4 / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D056784:Leukoencephalopathies / Q000134:cerebrospinal fluid* / Q000235:genetics*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000134:cerebrospinal fluid* / Q000235:genetics*; D012307:Risk Factors
chemical_list: D016229:Amyloid beta-Peptides; D053327:Apolipoprotein E4