More MS news articles for Sep 2001

Apolipoprotein E e4 is associated with rapid progression of multiple sclerosis

Neurology 2001;57:853-857
© 2001 American Academy of Neurology

F. Fazekas, MD;, S. Strasser–Fuchs, MD;, H. Kollegger, MD;, T. Berger, MD;, W. Kristoferitsch, MD;, H. Schmidt, MD;, C. Enzinger, MD;, M. Schiefermeier, PhD;, C. Schwarz, MD;, B. Kornek, MD;, M. Reindl, PhD;, K. Huber, MD;, R. Grass, MD;, G. Wimmer, MD;, K. Vass, MD;, K. H. Pfeiffer, PhD;, H. P. Hartung, MD; and R. Schmidt, MD

From the Department of Neurology (Drs. Fazekas, Strasser-Fuchs, Hartung, Enzinger, and R. Schmidt) and the Institute of Medical Biochemistry (Dr. H. Schmidt), Karl-Franzens University, Graz; Department of Neurology (Drs. Kolleger, Schiefermeier, Schwarz, Kornek, and Vass), University of Vienna; Department of Neurology (Drs. Berger and Reindl) and Institute of Biostatistics (Dr. Pfeiffer), Leopold-Franzens University, Innsbruck; the SMZ-Ost Donauspital (Drs. Kristoferitsch, Grass, and Wimmer), Vienna; and the Ludwig Boltzmann-Institute for Molecular-Genetic Laboratory Diagnostics (Dr. Huber), SMZ-Ost Donauspital, Vienna, Austria.

Address correspondence and reprint requests to Franz Fazekas, MD, Department of Neurology and MRI Center, Karl-Franzens University, Auenbruggerplatz 22, A-8036 Graz, Austria; e-mail:


The apolipoprotein E (APOE) polymorphism is known to impact on various neurologic disorders and has differential effects on the immune system and on CNS repair. Previous findings concerning a possible modulation of the clinical course of MS have been inconsistent, however.


In a cross-sectional study, the authors investigated 374 patients with clinically definite MS and a disease duration of at least 3 years and related their clinical and demographic findings to the allelic polymorphism of the APOE gene. The genotype distribution of patients with MS was compared with a cohort of 389 asymptomatic, randomly selected elderly volunteers.


The authors found no significant differences in the distribution of genotypes between patients with MS and controls. However, patients with MS with the e4 allele (n = 85) had a significantly higher progression index of disability (0.46 ± 0.4 versus 0.33 ± 0.26; p < 0.004) and a worse ranked MS severity score (5.1 ± 1.9 versus 5.7 ± 1.7; p = 0.05) than their non-e4 counterparts, despite significantly more frequent long-term immunotherapy in e4 carriers (74% versus 58%; p < 0.007). The annual relapse rate in e4 carriers (0.87 ± 0.56) was significantly higher than in patients with MS without an 4 allele (0.71 ± 0.47; p = 0.03).


These results suggest no effect of the APOE genotype on susceptibility to MS, but indicate an association of the APOE e4 allele with a more severe course of the disease.

Copyright © 2001 by AAN Enterprises, Inc.