• Vidar Stenset, Dag Hofoss, Lisbeth Johnsen, Audun Elnaes Berstad, Anne Negaard, Anders Skinningsrud, Leif Gjerstad, and Tormod Fladby.
• Department of Neurology, Akershus University Hospital, Lørenskog, Norway. vidar.stenset@medisin.uio.no
• J Neuroimaging. 2011 Apr 1; 21 (2): e78-82.

BackgroundWhite matter lesions (WMLs) are age-related manifestations of ischemic cerebrovascular disease and increase the risk for Alzheimer's disease (AD). The apolipoprotein E (ApoE) ɛ4 allele is a risk factor for late onset AD and has been related to low cerebrospinal fluid (CSF) Aβ42 levels and to cerebrovascular disease. The present study analyzed the relationship between WMLs, ApoE-ɛ4 genotype, and low CSF Aβ42.MethodsA total of 235 memory clinic attenders were stratified in 3 groups according to WML load. WMLs were rated on axial T2 magnetic resonance imaging images. Group 1 had no or only small amounts of periventricular (PV) or subcortical (SC) WMLs, WML group 2 had high amounts of PV WMLs and low amounts of SC WMLs, and WML group 3 had high amounts of both PV and SC WMLs. In each WML group, ApoE-ɛ4 genotype was used in logistic regression as a predictor for low CSF Aβ42 (cutoff≤450 ng/L).ResultsThe odds ratio (OR) of having low CSF Aβ42 was significantly increased in the presence of ApoE-ɛ4 only in WML group 3 (OR 3.69, P=.009).ConclusionA high WML load may interact with the ApoE-ɛ4 genotype and increase the risk for reduced CSF Aβ42 in patients attending a memory clinic.Copyright © 2009 by the American Society of Neuroimaging.

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