Apolipoprotein E Genotype Contributes to Motor Progression in Parkinson's Disease

Background Emerging evidence indicates that the apolipoprotein E (APOE) epsilon 4 exacerbates alpha-synuclein pathology. Objective To determine whether APOE epsilon 4 contributes to motor progression in early Parkinson's disease (PD). Methods Longitudinal data were obtained from 384 patients with PD divided into APOE epsilon 4 carriers (n = 85) and noncarriers (n = 299) in the Parkinson's Progression Marker Initiative. Participants underwent yearly motor assessments over a mean follow-up period of 78.9 months. Repeated measures and linear mixed models were used to test the effects of APOE epsilon 4. Results The motor progression was significantly more rapid in patients with PD carrying APOE epsilon 4 than in noncarriers (beta = 0.283, P = 0.026, 95% confidence interval: 0.033-0.532). Through subgroup analysis, we found that the effect of APOE epsilon 4 was significant only in patients with high amyloid beta burden (beta = 0.761, P < 0.001, 95% confidence interval: 0.0356-1.167). Conclusions APOE epsilon 4 may be associated with rapid motor progression in PD. (c) 2021 International Parkinson and Movement Disorder Society