Accelerated Evolution of Brain Atrophy and "Black Holes" in MS Patients with APOE-ε4

Department of Neurology, Karl-Franzens University, Graz, Austria.
Annals of Neurology (Impact Factor: 9.98). 04/2004; 55(4):563-9. DOI: 10.1002/ana.20027
Source: PubMed


Apolipoprotein E (APOE)-epsilon4 has been associated with an unfavorable course of multiple sclerosis (MS). The mechanisms responsible for this are unclear, although cross-sectional MRI demonstrated a higher extent of "black holes" (BHs) in such patients. Here, we have studied the impact of the APOE genotype on both the longitudinal evolution of focal (BH ratio) and global (brain volume change [BVC]) brain tissue damage. Ninety-nine MS patients underwent ApoE genotyping, clinical examination, and magnetic resonance imaging at baseline and after 2.7 +/- 1.1 years to assess lesion load (LL) and BVC. In APOE-epsilon4 patients, the annual reduction in brain volume was fivefold higher (-0.65 +/- 0.61%) than in those without APOE-epsilon4 (-0.13 +/- 0.36%; p = 0.0001). At baseline, T(2) LL and T(1) LL were non-significantly higher in epsilon4 carriers, despite a shorter disease duration and absence of significant clinical differences. During follow-up, T(1) LL increased from 1.2 +/- 2.3 ccm to 1.7 +/- 2.7 ccm in the epsilon4 group, although T(2) LL did not change, leading to a significantly higher increase in the BH ratio [(T(1) LL/T(2) LL) x 100] from 5.5 to 12.4% (p = 0.005). BH ratio remained almost constant in non-epsilon4 patients (5.0 vs 5.7%). Accelerated brain tissue loss and a higher proportion of lesions evolving into BH therefore provide magnetic resonance imaging evidence for more pronounced tissue destruction in MS patients with APOE-epsilon4.

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    • "These results are in variance to the animal studies in whichAMD severity has been found to be associated with ApoE4 expressing aged mice which were subjected to high fat cholesterol. Even the major complex diseases such as atherosclerosis, Alzheimer’s disease, and stroke, are characterized by strong association betweenAPOE4allele and disease (Kalaria, 1997; Weller and Nicoll, 2003; Enzinger et al., 2004). "
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    Full-text · Article · Jul 2014 · Frontiers in Aging Neuroscience
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    • "Neuroimaging data revealed that accelerated brain-tissue loss and a higher proportion of lesions evolving into " black holes " in MS patients with APOE-ε4. In another investigation Enzinger et al. demonstrated that the annual decrease in brain volume in APOE-ε4 carriers is five-fold higher than non-ε4-carriers [47]. As mentioned earlier, the probability of developing MS in individuals with ε3ε4 genotype is about 2.4 times more than individuals Table 1 The frequency of MS type among males and females. "
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    ABSTRACT: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system. Evidences linking apolipoprotein E (APOE) to myelin repair, neuronal plasticity, and cerebral inflammatory processes suggest that it may be relevant in MS. The main goal of this study was to determine whether the APOE genotypes and alleles are associated with MS patients. In total, 147 MS cases and 168 control subjects from Iranian population were genotyped for APOE gene using PCR-RFLP method. The frequency of APOE-ε2ε3 genotype was significantly higher in controls than cases (14.3% vs. 6.1%, P=0.009, OR=0.39) whereas APOE-ε3ε4 genotype frequency was significantly higher in cases compared with controls (8.2% vs. 3.6%, P=0.03, OR=2.4). APOE-ε2 allele frequency in cases was significantly lower than that of controls (4.4% vs. 8.0%, P=0.03, OR=0.52). Also male controls were significantly more likely to have APOE-ε2 allele (7.8% vs. 1%, P=0.01, OR=0.11). APOE-ε4 allele frequency in cases was significantly higher than control group (4.8% versus 2.1%, P=0.03, OR=2.35). It seems that individuals carrying APOE-ε4 allele and/or APOE-ε3ε4 genotype develop MS two times more than non-carriers. Also APOE-ε2ε3 genotype or APOE-ε2 allele may have a protective role against MS development in Iranian population. Further investigation would be warranted to understand the role of APOE alleles and genotypes and risk of MS.
    Full-text · Article · Jun 2012 · Journal of the neurological sciences
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    • "Neuroimaging data demonstrated accelerated brain-tissue loss and a higher proportion of lesions evolving into “black holes” in MS patients with APOE ε4. The annual reduction in brain volume in APOE ε4 carriers is five-fold higher than non-ε4-carriers [104]. There are also indications that the APOE ε4 allele is related to more severe progression of MS, as measured by MRI markers [105]. "
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