Effect of apolipoprotein ϵ4 genotype on severity and cognitive impairment in relapsing-remitting and progressive forms of MS

Abstract

Depending on the nature of the disease, multiple sclerosis (MS) occurs with a variety of symptoms, including cognitive impairment. Some studies have shown that MS patients carrying the APOE4 gene are more prone to brain atrophy and cognitive impairment, while other studies do not support the hypothesis of a major risk factor for APOE4 for cognitive impairment. In this study, we aim to evaluate the relationship between apolipoprotein E gene alleles and cognitive disorders in MS patients in East Azerbaijan province, Iran. Methods Patients with Relapsing-Remitting MS (RRMS) participated in this study. Cognitive tests were performed by MACFIMS test. MACFIMS is a valid internationally approved test for the cognitive impairment of patients with multiple sclerosis, the Persian version of which has been validated and approved. After genotyping, patients were divided into ApoE4 positive and negative groups, then cognitive findings were compared. Gender subgroup analysis was also performed. Results 71 patients with a mean age of 31.43 ± 8.75 participated in this study. Eleven of the 17 patients (64.70%) in the ApoE4-positive group had at least one abnormal test, whereas in the ApoE4-negative group 16 out of 54 (29.62%). Impairment of the PASAT test as well as the mean score of the BVMT-R test was associated with ApoE4. The mean EDSS score of the ApoE4 group was negative 1.21 ± 1.25, while in the ApoE4 positive group it was 1.29 ± 1.29 (p = 0.91). Of 17 ApoE4 positive patients, 15 patients (88.23%) were female and 2 patients (11.76%) were male. The results of the gender-specific subgroup analysis was not associated with ApoE4.