APOE ε4 is associated with exacerbation of cognitive decline in patients with multiple sclerosis

Cogn Behav Neurol. 2011 Sep;24(3):128-33. doi: 10.1097/WNN.0b013e31823380b5.


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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Apolipoprotein E4 / genetics*
  • Cognition Disorders / complications
  • Cognition Disorders / genetics*
  • Cognition Disorders / psychology
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Genetic Predisposition to Disease / genetics*
  • Genotype
  • Heterozygote
  • Humans
  • Male
  • Memory
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / genetics*
  • Multiple Sclerosis / psychology
  • Neuropsychological Tests
  • Polymorphism, Genetic
  • Verbal Learning


  • Apolipoprotein E4