May 7, 2004
The increased progression of multiple sclerosis (MS) in patients carrying the apolipoprotein E (APOE)-epsilon4 allele may be due to accelerated brain atrophy and more numerous T1-hypointense lesions (black holes), European researchers report in the April issue of the Annals of Neurology.
As senior investigator Dr. Franz Fazekas told Reuters Health, the "results provide further evidence for an impact of the APOE genotype on the course of MS -- which could be important for patient counseling -- and show that genetic effects can be substantiated and explored by sophisticated neuroimaging techniques."
Dr. Fazekas of Karl-Franzens University in Graz, Austria, and colleagues used magnetic resonance imaging (MRI) to study 99 MS patients.
Annual brain volume loss in the 22 APOE4 carriers was 5 times that of the other patients. Moreover, after a mean follow-up of 2.7 years, the ratio by percentage of black holes to T2 lesions rose significantly from 5.5 to 12.4 in these patients. In non-carriers, however, this ratio rose only from 5.0 to 5.7.
"The recognition of such genetic effects and mechanisms is important for our pathophysiologic understanding of the disease," Dr. Fazekas continued, "but even more so because it may impact on our decisions when and how to start treatment."
"For these reasons," he added, "future treatment trials of MS should also attempt to collect genetic information."
Ann Neurol 2004;55:563-569
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