APOE e4 linked with MS-related cognitive impairment

There is a significant association between apolipoprotein E epsilon-4 allele (APOE e-4) carrier state and cognitive impairment in learning and memory in patients with multiple sclerosis, a new study suggests. The role of apolipoprotein E (APOE) polymorphism has been well recognized in other cognitive neurodegenerative disorders, such as Alzheimer disease, but its role in multiple sclerosis (MS) is less clear. In a study of 197 individuals age 23 to 77, 56 were APOE e4 allele carriers (28.4%) - a prevalence comparable to the general population — and 141 were non-carriers. The researchers performed neuropsychological tests investigating the four cognitive domains commonly impaired in MS and assessed the association of the presence of APOE [varepsilon]4 with cognition in MS. They found that measures of memory and learning on the selective reminding test were diminished in APOE e4 carriers versus noncarriers (p = 0.035). This continued to be significant when combined with 7/24 spatial recall test (OR, 2.3) and the paced auditory serial addition test (OR, 2.2), but not the word list generation test (OR, 1.3). The association between APOE e4 and cognitive deficits was strongest in the youngest MS patients in the study (age 31 to 40 years). “These results suggest a detrimental effect of the APOE [varepsilon]4 allele on cognition, particularly verbal learning and memory, in MS. They also illustrate the capability of cognitive testing to detect small differences between patient groups that clinically would have gone undetected. Formal cognitive testing in early stage MS may be warranted even without evidence of cognitive decline at bedside examination,” the researchers concluded. Their findings do not justify routine APOE genotyping in patients with MS, they added. Reference Shi, J. Zhao, C. et al. 2008, ‘APOE [varepsilon]4 allele is associated with cognitive impairment in patients with multiple sclerosis’ Neurology, vol. 70, PP. 185-190....