Related Experiment Video
Updated: Jun 20, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Apolipoprotein genotype does not influence MS severity, cognition, or brain atrophy
A van der Walt1, J Stankovich, M Bahlo
1Royal Melbourne Hospital, Department of Neurology, Parkville, VIC, Australia. Anneke.vanderwalt@mh.org.au
Background:
The influence of APOE allelic heterogeneity on multiple sclerosis (MS) disease severity has been reported in multiple datasets with conflicting results. Several studies have reported an unfavorable association of APOE epsilon4 with more severe clinical disease course while, in contrast, APOE epsilon2 has been associated with a more benign disease course. In this study, we examine the influence of heterogeneity of the APOE gene on disease severity in a large, Australian, population-based MS cohort.
Methods:
Associations between APOE allele status, 2 promoter region single nucleotide polymorphisms (-219 G/T and +113 C/G), and 4 measures of disease severity were tested in 1,006 patients with relapsing-remitting MS and secondary progressive MS: 1) Multiple Sclerosis Severity Score; 2) Progression Index (Expanded Disability Status Scale/disease duration); 3) age at first symptom; and 4) interval between the first and second attack. The Symbol Digit Modalities Test was used as a single cognitive marker in 889 patients. Brain atrophy was measured in 792 patients using the intercaudate ratio. APOE epsilon4 and epsilon3 carriers were stratified by -219 G/T or +113 C/G to investigate haplotypic heterogeneity in the APOE gene region.
Results:
In this MS study, neither APOE allele status nor promoter region heterogeneity at positions -219 G/T or +113 C/G influenced the clinical disease severity, cognition, or cerebral atrophy.
Conclusions:
Allelic and haplotypic heterogeneity of the APOE gene region does not influence multiple sclerosis disease course in this well-defined Australian multiple sclerosis cohort.
Insights
Investigating the apolipoprotein E (APOE) gene in multiple sclerosis (MS) found no link between APOE variations and disease severity, cognition, or brain atrophy in an Australian cohort.
Area of Science:
- Neuroimmunology
- Genetics
- Epidemiology
Background:
- Conflicting reports exist on apolipoprotein E (APOE) allelic heterogeneity influencing multiple sclerosis (MS) severity.
- Some studies suggest APOE epsilon4 is linked to worse MS outcomes, while APOE epsilon2 may indicate a milder course.
- This study investigates APOE's role in MS disease severity within a large Australian population-based cohort.
Purpose of the Study:
- To examine the influence of APOE allelic and haplotypic heterogeneity on multiple sclerosis disease severity.
- To assess the impact of APOE variants on clinical outcomes, cognition, and brain atrophy in MS patients.
Main Methods:
- Analyzed 1,006 patients with relapsing-remitting and secondary progressive MS.
- Assessed disease severity using Multiple Sclerosis Severity Score, Progression Index, age at onset, and attack interval.
- Evaluated cognition with the Symbol Digit Modalities Test and brain atrophy via intercaudate ratio, stratifying APOE carriers by promoter polymorphisms.
Main Results:
- Neither APOE allele status nor promoter region single nucleotide polymorphisms (-219 G/T, +113 C/G) affected clinical MS severity.
- No significant influence was observed on cognitive function or cerebral atrophy measures.
- Haplotype analysis also revealed no association with disease course.
Conclusions:
- Allelic and haplotypic heterogeneity within the APOE gene region does not appear to influence the disease course of multiple sclerosis.
- Findings suggest APOE's genetic variations are not major determinants of MS severity in this Australian cohort.
Related Concept Videos
Alzheimer Disease ll: Pathophysiology
Multiple Sclerosis l: Introduction
Alzheimer Disease l: Introduction
Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
Alzheimer's Disease: Treatment
Pharmacogenomics: Identification of New Drug Targets
