The following is a summary of the “Cholesterol pathway biomarkers are associated with neuropsychological measures in multiple sclerosis,” published in the January 2023 issue of Multiple Sclerosis and Related Disorders by Siddiqui, et al.

Neurodegeneration is connected to the prevalence of cognitive impairment (CI) in people living with multiple sclerosis (PwMS). Disruption of the blood-brain barrier, lesions, and neurodegeneration are all linked to the cholesterol pathway biomarkers (CPB) in MS (MS). CPB may have an effect on CI. There were 163 people in total, including 74 with relapsing-remitting MS (RR-MS), 48 with progressive MS (P-MS), and 41 with healthy controls (HC). The Beck Depression Inventory-Fast Screen, the Paced Auditory Serial Addition Test-3, the Symbol Digit Modalities Test, the Timed 25-Foot Walk, and the Nine-Hole Peg Test were the physical and cognitive tests administered. 

Total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), and apolipoproteins (Apo) ApoA-I, ApoA-II, ApoB, ApoC-II, and ApoE were all measured as part of the CPB panel. Age, sex, body mass index, years of education, HC versus RR-MS versus P-MS status, CPB, and an HC versus RR-MS versus P-MS status CPB interaction term were included as predictors in regression analyses evaluating disability and cognitive assessments. Symbol Digit Modalities Test (SDMT) was associated with the interaction terms for HDL-C (p = 0.045), ApoA-I (p = 0.032), ApoB (p = 0.032), TC/HDL-C (p = 0.013), and ApoB/ApoA-I (p = 0.008) ratios. 

CPB associations of SDMT were not abrogated upon adjusting for brain parenchymal volume. NHPT performance was associated with the interaction terms for TC (p = 0.047), LDL-C (P = 0.017), ApoB (p = 0.001), HDL-C (P = 0.035), ApoA-I (P = 0.032), ApoC-II (P = 0.049) and ApoE (P = 0.037), TC/HDL-C (P < 0.001), and ApoB/ApoA-I ratios (P < 0.001).

SDMT and NHPT in MS are linked to the LDL/HDL ratio. The results are in line with the idea that CPB could play a part in CI.