(Stroke. 2000;31:1263.)
© 2000 American Heart Association, Inc.
Original Contributions |
Effect of the Apolipoprotein E 
4 Allele on White Matter Hyperintensities in Dementia
From the Divisions of Clinical Neurosciences (N.H., S.T., E.M.), Basic Neurosciences (M.Y.), and Neuroimaging Research (H.K.), Hyogo Institute for Aging Brain and Cognitive Disorders, Himeji, Japan.
Correspondence to Dr Nobutsugu Hirono, Division of Clinical Neuroscience, Hyogo Institute for Aging Brain and Cognitive Disorders, 520 Saisho-ko, Himeji, 670-0981, Japan. E-mail hirono{at}hiabcd.go.jp
Background and Purpose—The
clinical significance of the apoE 
4 allele in white matter
changes in patients with dementia has been a subject of debate. We
studied the association between the apoE 4 allele and white
matter hyperintensities (WMHs) before and after control for (1)
potential vascular risk factors and (2) the presence of lacunar
infarcts in patients with dementia.
Methods—The subjects were 131 patients with dementia who had
either Alzheimer’s disease or vascular dementia, or a
combination of these 2 types of dementia, with or without WMHs, lacunar
infarcts, or both. The association of the 4 allele with WMHs was
examined before and after control for age, sex, duration of symptoms,
education level, severity of dementia, presence of lacunar infarcts,
and potential vascular risk factors, including hypertension, diabetes
mellitus, lipid disorders, smoking habit, drinking habit, and cardiac
diseases.
Results—WMHs were observed in 73 (55.7%) of the patients.
Neither the number of apoE 4 alleles nor their presence was
significantly associated with WMHs before or after control for the
potential confounding factors. Multiple logistic regression
analyses revealed that age, the presence of hypertension, and
the presence of lacunar infarcts were independently associated with
WMHs.
Conclusions—The apoE 4 allele was not associated with WMHs
in patients with dementia. The fact that WMHs were significantly
associated with hypertension and lacunar infarcts may indicate an
ischemic origin of WMHs.
Key Words: apolipoproteins • dementia • hypertension • lacunar infarction • white matter
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