title: APOE ε4 is associated with exacerbation of cognitive decline in patients with multiple sclerosis.
abstract: BACKGROUND
  : In previous studies we and others have demonstrated an association with apolipoprotein (APOE) ε4 genotype and the presence of cognitive deficits in multiple sclerosis (MS). In this follow-up study, we have assessed whether APOE ε4 status exacerbates progression of cognitive deficits in MS.
  
  
  METHODS
  : A total of 197 patients with MS were assessed for APOE genotype, and baseline cognitive performance was measured using a standardized battery of tests. One hundred seventy patients (86.3%) were clinically followed up for 1 year and were assessed for progression of cognitive deficits.
  
  
  RESULTS
  : The APOE ε4 allele was present in 24.7% of patients. During 1-year follow-up, significant progression of cognitive deficits was found in APOE ε4 carriers (P=0.001) after logistic regression analysis controlling for sex, ethnicity, age, education, disease duration, severity, and subtype.
  
  
  CONCLUSIONS
  : APOE ε4 carriers with MS have worsening progression of cognitive deficits than noncarriers. APOE ε4 carrier status predicts cognitive decline in verbal learning and memory.
authors.affiliation: Division of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. jiong.shi@chw.edu
authors.forename: Jiong
authors.initials: J
authors.lastname: Shi
authors.forename: Jiang-Long
authors.initials: JL
authors.lastname: Tu
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Gale
authors.forename: Leslie
authors.initials: L
authors.lastname: Baxter
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Vollmer
authors.forename: Denise I
authors.initials: DI
authors.lastname: Campagnolo
authors.forename: Tuula M
authors.initials: TM
authors.lastname: Tyry
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhuang
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Kuniyoshi
mesh_terms: D000328:Adult; D000368:Aged; D053327:Apolipoprotein E4 / Q000235:genetics*; D003072:Cognition Disorders / Q000150:complications / Q000235:genetics* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005838:Genotype; D006579:Heterozygote; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000235:genetics* / Q000523:psychology; D009483:Neuropsychological Tests; D011110:Polymorphism, Genetic; D014706:Verbal Learning
chemical_list: D053327:Apolipoprotein E4