title: APOE-epsilon4 is not associated with cognitive impairment in relapsing-remitting multiple sclerosis.
abstract: The objective of this article was to assess the association between apolipoprotein E (APOE)-epsilon4 and cognitive impairment (CI) in relapsing-remitting multiple sclerosis (RRMS). The APOE genotype was assessed in 85 RRMS cases (58 females, mean age 43 +/- 8.4 years, mean disease duration 15.8 +/- 9.6 years, mean Expanded Disability Status Scale (EDSS) 1.7 +/- 1.0). Cognitive functioning was evaluated in the whole sample using Rao's Brief Repeatable Battery (BRB). Performance on each test was assessed by applying the normative values for the Italian population. In a subgroup of 50 patients, a brain magnetic resonance (MR) study was performed including measurement of T2 lesion volumes (T2LV), neocortical volume (NCV) and normalized brain volume (NBV). The relationship between APOE genotype, CI and MR variables was assessed through univariate and multivariate logistic regression models. CI, most commonly involving complex attention and verbal memory tasks, was found in 28 cases (33%). We identified a total of 19 epsilon4carriers (22.4%), who did not differ from non-carriers regarding clinical and demographic characteristics. The presence of the epsilon4 genotype was associated with neither CI (p = 0.28) nor impairment on each neuropsychological test (p > 0.32; corrected for age, gender, disease duration, EDSS, depression and fatigue). The APOE genotype and CI were also not related in the subgroup of younger patients (age < 45 years; p > 0.9). Moreover, CI was related to higher T2LV (p = 0.008) and lower NCV (p = 0.006). In conclusion, in our sample CI was associated with higher subcortical damage and cortical atrophy but not with APOE-epsilon4 genotype. The role of APOE-epsilon4 as a possible biomarker in multiple sclerosis is still questionable.
authors: Department of Neurology, University of Florence, Florence, Italy. portilio@tin.it
authors: Emilio
authors: E
authors: Portaccio
authors: Benedetta
authors: B
authors: Goretti
authors: Valentina
authors: V
authors: Zipoli
authors: Benedetta
authors: B
authors: Nacmias
authors: Maria Laura
authors: ML
authors: Stromillo
authors: Maria Letizia
authors: ML
authors: Bartolozzi
authors: Gianfranco
authors: G
authors: Siracusa
authors: Leonello
authors: L
authors: Guidi
authors: Antonio
authors: A
authors: Federico
authors: Sandro
authors: S
authors: Sorbi
authors: Nicola
authors: N
authors: De Stefano
authors: Maria Pia
authors: MP
authors: Amato
mesh_terms: D000328:Adult; D053327:Apolipoprotein E4 / Q000235:genetics*; D001288:Attention; D001921:Brain / Q000473:pathology; D003071:Cognition; D003072:Cognition Disorders / Q000235:genetics* / Q000473:pathology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000235:genetics* / Q000473:pathology / Q000523:psychology*; D009483:Neuropsychological Tests; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D053327:Apolipoprotein E4