White matter lesions in Alzheimer patients are influenced by apolipoprotein E genotype

To analyse the influence of apolipoprotein E (APOE) genotype on the extent of white matter lesions (WMLs) in Alzheimer's disease (AD), we examined 60 AD patients with magnetic resonance imaging. The WMLs were rated visually in different brain regions. The patients with the APOE genotype epsilon 4/4 had more extensive WMLs in the deep white matter than patients with genotypes epsilon 3/3 and epsilon 3/4. There was a correlation with age for WMLs in the deep white matter in patients with the APOE epsilon 3/3 genotype. In patients carrying at least one epsilon 4 allele, the WMLs showed no age correlation. The results could imply that in APOE allele epsilon 4 carriers, the WMLs represent a pathological process related to the aetiology of the disease.