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Polsinelli AJ, Logan PE, Lane KA, Manchella MK, Nemes S, Sanjay AB, Gao S, Apostolova LG. APOE ε4 carrier status and sex differentiate rates of cognitive decline in early- and late-onset Alzheimer's disease. Alzheimers Dement 2023; 19:1983-1993. [PMID: 36394443 PMCID: PMC10182251 DOI: 10.1002/alz.12831] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/19/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND We studied the effect of apolipoprotein E (APOE) ε4 status and sex on rates of cognitive decline in early- (EO) and late- (LO) onset Alzheimer's disease (AD). METHOD We ran mixed-effects models with longitudinal cognitive measures as dependent variables, and sex, APOE ε4 carrier status, and interaction terms as predictor variables in 998 EOAD and 2562 LOAD participants from the National Alzheimer's Coordinating Center. RESULTS APOE ε4 carriers showed accelerated cognitive decline relative to non-carriers in both EOAD and LOAD, although the patterns of specific cognitive domains that were affected differed. Female participants showed accelerated cognitive decline relative to male participants in EOAD only. The effect of APOE ε4 was greater in EOAD for executive functioning (p < 0.0001) and greater in LOAD for language (p < 0.0001). CONCLUSION We found APOE ε4 effects on cognitive decline in both EOAD and LOAD and female sex in EOAD only. The specific patterns and magnitude of decline are distinct between the two disease variants. HIGHLIGHTS Apolipoprotein E (APOE) ε4 carrier status and sex differentiate rates of cognitive decline in early-onset (EO) and late-onset (LO) Alzheimer's disease (AD). APOE ε4 in EOAD accelerated decline in memory, executive, and processing speed domains. Female sex in EOAD accelerated decline in language, memory, and global cognition. The effect of APOE ε4 was stronger for language in LOAD and for executive function in EOAD. Sex effects on language and executive function decline differed between EOAD and LOAD.
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Affiliation(s)
- Angelina J. Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
| | - Paige E. Logan
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
| | - Kathleen A. Lane
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mohit K. Manchella
- Department of Chemistry, University of Southern Indiana Evansville, Indiana, USA
| | - Sára Nemes
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Sujuan Gao
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
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Qian J, Betensky RA, Hyman BT, Serrano-Pozo A. Association of APOE Genotype With Heterogeneity of Cognitive Decline Rate in Alzheimer Disease. Neurology 2021; 96:e2414-e2428. [PMID: 33771840 PMCID: PMC8166439 DOI: 10.1212/wnl.0000000000011883] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/12/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To test the hypothesis that the APOE genotype is a significant driver of heterogeneity in Alzheimer disease (AD) clinical progression, which could have important implications for clinical trial design and interpretation. Methods We applied novel reverse-time longitudinal models to analyze the trajectories of Clinical Dementia Rating Sum of Boxes (CDR-SOB) and Mini-Mental State Examination (MMSE) scores—2 common outcome measures in AD clinical trials—in 1,102 autopsy-proven AD cases (moderate/frequent neuritic plaques and Braak tangle stage III or greater) from the National Alzheimer's Coordinating Center Neuropathology database resembling participants with mild to moderate AD in therapeutic clinical trials. Results APOE ε4 carriers exhibited ≈1.5 times faster CDR-SOB increase than APOE ε3/ε3 carriers (2.12 points per year vs 1.44 points per year) and ≈1.3 times faster increase than APOE ε2 carriers (1.65 points per year), whereas APOE ε2 vs APOE ε3/ε3 difference was not statistically significant. APOE ε4 carriers had ≈1.1 times faster MMSE decline than APOE ε3/ε3 carriers (−3.45 vs −3.03 points per year) and ≈1.4 times faster decline than APOE ε2 carriers (−2.43 points per year), whereas APOE ε2 carriers had ≈1.2 times slower decline than APOE ε3/ε3 carriers (−2.43 vs −3.03 points per year). These findings remained largely unchanged after controlling for the effect of AD neuropathologic changes on the rate of cognitive decline and for the presence and severity of comorbid pathologies. Conclusion Compared to the APOE ε3/ε3 reference genotype, the APOE ε2 and ε4 alleles have opposite (slowing and accelerating, respectively) effects on the rate of cognitive decline, which are clinically relevant and largely independent of the differential APOE allele effects on AD and comorbid pathologies. Thus, APOE genotype contributes to the heterogeneity in rate of clinical progression in AD.
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Affiliation(s)
- Jing Qian
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Rebecca A Betensky
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Bradley T Hyman
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Alberto Serrano-Pozo
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA.
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Katzourou I, Leonenko G, Ivanov D, Meggy A, Marshall R, Sims R, Williams J, Holmans P, Escott-Price V. Cognitive Decline in Alzheimer's Disease Is Not Associated with APOE. J Alzheimers Dis 2021; 84:141-149. [PMID: 34487047 DOI: 10.3233/jad-210685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The rate of cognitive decline in Alzheimer's disease (AD) has been found to vary widely between individuals, with numerous factors driving this heterogeneity. OBJECTIVE This study aimed to compute a measure of cognitive decline in patients with AD based on clinical information and to utilize this measure to explore the genetic architecture of cognitive decline in AD. METHODS An in-house cohort of 616 individuals, hereby termed the Cardiff Genetic Resource for AD, as well as a subset of 577 individuals from the publicly available ADNI dataset, that have been assessed at multiple timepoints, were used in this study. Measures of cognitive decline were computed using various mixed effect linear models of Mini-Mental State Examination (MMSE). After an optimal model was selected, a metric of cognitive decline for each individual was estimated as the random slope derived from this model. This metric was subsequently used for testing the association of cognitive decline with apolipoprotein E (APOE) genotype. RESULTS No association was found between the number of APOEɛ2 or ɛ4 alleles and the rate of cognitive decline in either of the datasets examined. CONCLUSION Further exploration is required to uncover possible genetic variants that affect the rate of decline in patients with AD.
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Affiliation(s)
| | - Ganna Leonenko
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Dobril Ivanov
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Alun Meggy
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Rachel Marshall
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Julie Williams
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Peter Holmans
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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Zhu Y, Gong L, He C, Wang Q, Ren Q, Xie C. Default Mode Network Connectivity Moderates the Relationship Between the APOE Genotype and Cognition and Individualizes Identification Across the Alzheimer's Disease Spectrum. J Alzheimers Dis 2020; 70:843-860. [PMID: 31282419 DOI: 10.3233/jad-190254] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although previous studies have investigated the effects of the apolipoprotein E (APOE) ɛ4 genotype on the default mode network (DMN) in the Alzheimer's disease (AD) spectrum, it is still unclear how the APOE genotype regulates the DMN and subsequently affects cognitive decline in the AD spectrum. One hundred sixty-nine subjects with resting-state functional magnetic resonance imaging data and neuropsychological test scores were selected from the Alzheimer's Disease Neuroimaging Initiative. The main effects and interaction of the APOE genotype and disease status on the DMN were explored. A moderation analysis was performed to investigate the relationship among the APOE genotype, DMN connectivity, and cognition. Additionally, the pair-wised DMN connectivity was used to classify AD spectrum, and the classification accuracy was validated. Compared to APOEɛ4 non-carriers, APOEɛ4 carriers showed the opposite trajectory of DMN connectivity across the AD spectrum. Specifically, the strengths in the posterior cingulate cortex (PCC) connecting with the right precuneus, insular, and fusiform area (FFA) were positively correlated with Mini-Mental State Examination (MMSE) scores in APOEɛ4 non-carriers but not in APOEɛ4 carriers. Furthermore, PCC-right FFA connectivity could moderate the effects of the APOE genotype on MMSE scores across the disease groups. More importantly, using a receiver operating characteristic analysis, these altered connectivities yielded strong classification powers in a pathological stage-dependent manner in the AD spectrum. These findings first identified the intrinsic DMN connectivity moderating the effect of the APOE genotype on cognition and provided a pathological stage-dependent neuroimaging biomarker for early differentiation of the AD spectrum.
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Affiliation(s)
- Yao Zhu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Liang Gong
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Cancan He
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Qing Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Qingguo Ren
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
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Rauchmann BS, Schneider-Axmann T, Alexopoulos P, Perneczky R. CSF soluble TREM2 as a measure of immune response along the Alzheimer's disease continuum. Neurobiol Aging 2018; 74:182-190. [PMID: 30458365 DOI: 10.1016/j.neurobiolaging.2018.10.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/28/2018] [Accepted: 10/17/2018] [Indexed: 01/25/2023]
Abstract
TREM2 was suggested to be an important regulator of microglia during neurodegeneration, but previous studies report conflicting results in relation to soluble TREM2 (sTREM2) in cerebrospinal fluid (CSF) when using clinical criteria to classify Alzheimer's disease (AD). The present study explores sTREM2 CSF levels and their associations with other biomarkers and cognitive measures in a prospective AD cohort. Based on the available CSF biomarker information, 497 subjects were classified according to the 2018 National Institute on Aging-Alzheimer's Association research framework guidelines, which group biomarkers into those of amyloid-β deposition, tau pathology, and neurodegeneration. CSF sTREM2 concentrations were associated with markers of neurodegeneration and fibrillar tau pathology, but not amyloidosis; sTREM2 concentrations were increased in total tau-positive versus -negative individuals; sTREM2 was not related to cognitive and other biomarker changes over time; and sTREM2 concentrations increased over time in total tau-positive versus -negative individuals with AD pathophysiology. The present study provides evidence in support of sTREM2 in CSF as a marker of neuroinflammation across the spectrum of early clinical AD. sTREM2 is linked to neuronal injury and may therefore offer complementary information relevant for diagnostic purposes and novel treatment approaches targeting the immune system in AD.
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Affiliation(s)
- Boris-Stephan Rauchmann
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece; Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
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Groot C, Sudre CH, Barkhof F, Teunissen CE, van Berckel BNM, Seo SW, Ourselin S, Scheltens P, Cardoso MJ, van der Flier WM, Ossenkoppele R. Clinical phenotype, atrophy, and small vessel disease in APOEε2 carriers with Alzheimer disease. Neurology 2018; 91:e1851-e1859. [PMID: 30341156 DOI: 10.1212/wnl.0000000000006503] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To examine the clinical phenotype, gray matter atrophy patterns, and small vessel disease in patients who developed prodromal or probable Alzheimer disease dementia, despite carrying the protective APOEε2 allele. METHODS We included 36 β-amyloid-positive (by CSF or PET) APOEε2 carriers (all ε2/ε3) with mild cognitive impairment or dementia due to Alzheimer disease who were matched for age and diagnosis (ratio 1:2) to APOEε3 homozygotes and APOEε4 carriers (70% ε3/ε4 and 30% ε4/ε4). We assessed neuropsychological performance across 4 cognitive domains (memory, attention, executive, and language functions), performed voxelwise and region of interest analyses of gray matter atrophy on T1-weighted MRI, used fluid-attenuated inversion recovery images to automatically quantify white matter hyperintensity volumes, and assessed T2*-weighted images to identify microbleeds. Differences in cognitive domain scores, atrophy, and white matter hyperintensities between ε2 carriers, ε3 homozygotes, and ε4 carriers were assessed using analysis of variance analyses, and Pearson χ2 tests were used to examine differences in prevalence of microbleeds. RESULTS We found that ε2 carriers performed worse on nonmemory domains compared to both ε3 homozygotes and ε4 carriers but better on memory compared to ε4 carriers. Voxelwise T1-weighted MRI analyses showed asymmetric (left > right) temporoparietal-predominant atrophy with subtly less involvement of medial-temporal structures in ε2 carriers compared to ε4 carriers. Finally, ε2 carriers had larger total white matter hyperintensity volumes compared to ε4 carriers (mean 10.4 vs 7.3 mL) and a higher prevalence of microbleeds compared to ε3 homozygotes (37.5% vs 18.3%). CONCLUSION APOEε2 carriers who develop Alzheimer disease despite carrying the protective allele display a nonamnestic clinical phenotype with more severe small vessel disease.
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Affiliation(s)
- Colin Groot
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden.
| | - Carole H Sudre
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Frederik Barkhof
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Charlotte E Teunissen
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Bart N M van Berckel
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Sang Won Seo
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Sébastien Ourselin
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Philip Scheltens
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - M Jorge Cardoso
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Wiesje M van der Flier
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Rik Ossenkoppele
- From the Departments of Neurology and Alzheimer Center (C.G., P.S., W.M.v.d.F., R.O.), Radiology and Nuclear Medicine (C.G., F.B., B.N.M.v.B., R.O.), Neurochemistry Lab and Biobank (C.E.T.), and Clinical Chemistry, Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Neuroscience Campus Amsterdam, the Netherlands; Dementia Research Centre (C.H.S., S.O., M.J.C.), Department of Neurodegenerative Disease, UCL Institute of Neurology, Centre for Medical Image Computing (C.H.S., S.O., M.J.C.), and Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; Department of Neurology (S.W.S.), Sungkyunkwan University School of Medicine, and Neuroscience Center (S.W.S.), Samsung Medical Center; Department of Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
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Meta-Analysis of the Relationship between the APOE Gene and the Onset of Parkinson's Disease Dementia. PARKINSONS DISEASE 2018; 2018:9497147. [PMID: 30405900 PMCID: PMC6204165 DOI: 10.1155/2018/9497147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/17/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022]
Abstract
Purpose To clarify the relationship between certain genotypes or alleles of the APOE gene and the onset risk of Parkinson's disease dementia (PDD). Methods The PubMed, Cochrane, Embase, CBM, CNKI, and Wanfang databases were searched to identify all case-control studies and cohort studies published before October 30, 2017, that investigated the association between the APOE gene and the onset of PDD. Manual information retrieval was also performed. All studies that met the quality requirements were included in a meta-analysis performed using RevMan 5.3 software. Results The meta-analysis included 17 studies, with a total of 820 patients in the PDD group and 1,922 in the non-PDD group. The influence of the APOE gene on PDD onset was analyzed from three aspects: five genotypes vs. ε3/3, ε2+/ε4+ vs. ε3/3, and ε4+ vs. ε4-. The risk factors for PDD may include the genotypes ε3/4 (OR 1.47, 95% CI 1.14-1.89) and ε4/4 (OR 2.93, 95% CI 1.20-7.14). In patients with PDD, there was no significant difference in the distribution of ε2+ vs. ε3/3 (OR 1.35, 95% CI 0.97-1.87, P=0.07). The risk of PDD was 1.61 times greater in ε4+ compared with ε3/3 (OR 1.61, 95% CI 1.24-2.08, P=0.0003). As the results indicated that ε2+ did not play a role as a risk factor or a protective factor, we divided the population into ε4+ and ε4- for the meta-analysis and found that, among patients with Parkinson's disease, the dementia risk of those with ε4+ was 1.72 times greater than that of those with ε4- (OR 1.72, 95% CI 1.41-2.10, P < 0.00001). Subgroup analysis in accordance with different geographical regions revealed that ε4+ was a risk factor for PDD in people from all regions. Conclusions Among the APOE genotypes, ε2+ is neither a risk factor nor a protective factor for PDD, while ε4+ is a risk factor for PDD. The present results are applicable to Asian, European, and American patients with Parkinson's disease. Regarding the single APOE genotypes, ε3/4 and ε4/4 may be risk factors for PDD; however, further studies with large sample sizes are needed to verify this.
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8
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Chen J, Shu H, Wang Z, Liu D, Shi Y, Xu L, Zhang Z. Protective effect of APOE epsilon 2 on intrinsic functional connectivity of the entorhinal cortex is associated with better episodic memory in elderly individuals with risk factors for Alzheimer's disease. Oncotarget 2018; 7:58789-58801. [PMID: 27542235 PMCID: PMC5312276 DOI: 10.18632/oncotarget.11289] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/11/2016] [Indexed: 01/23/2023] Open
Abstract
The apolipoprotein E (APOE) ε4 allele associates with accelerating the conversion from amnestic mild cognitive impairment (aMCI) to Alzheimer's disease (AD), whereas the protectiveAPOEε2 allele appears to be against the disease. Moreover, entorhinal cortex (ERC) is one of the earliest brain regions of AD pathology that disrupts the formation of episodic memory. To investigate the effects of APOE ε2 and ε4alleles on functional connectivity (FC) of ERC and cognition in aMCI. Methods The FC analyses of ERC were performed in 83 aMCI (9 ε2-carrier, 44 ε3ε3, and 30 ε4-carrier) and 88 healthy controls (HC, 15 ε2-carrier, 40 ε3ε3, and 33 ε4-carrier). Multiple linear regression model was performed between the altered ERC connectivities and cognition. In the ERC network, aMCI with ε4-carriers showed decreased FC in the bilateral middle temporal gyrus (MTG), right precuneus, and right precentral gyrus (PreCG), while ε2-carriers showed increased FC in these regions (except the right PreCG) compared to HC. The altered FC between ERC and right MTG correlated with episodic memory performance in aMCI carried ε2 and ε4 alleles. These results suggest that the effects ofAPOEon the ERC network are closely linked to the role of this gene on AD risk, which aMCI with ε4-carriers can accelerate the pathological progression of network-based mechanisms while ε2-carriers may play a protective role in contributing to a compensatory mechanism. It further suggests that APOE can appear to directly affect the ERC-MTG neural pathway associated with the impairment of episodic memory in aMCI.
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Affiliation(s)
- Jiu Chen
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Duan Liu
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Yongmei Shi
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Lin Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, Chinese Academy of Sciences, Kunming Institute of Zoology, Kunming, Yunnan, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China.,Department of Psychology, Xinxiang Medical University, Xinxiang, Henan, China
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9
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Piskunowicz MT, Linkowska K, Gołota S, Grzybowski T, Kędziora-Kornatowska K, Borkowska A. The Association of Apolipoprotein E Gene Polymorphism With Cognitive Performance in Nondemented Polish Adults Aged 55 to 75. Int J Aging Hum Dev 2017; 87:124-140. [PMID: 28844148 DOI: 10.1177/0091415017724548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The ε4 allele of the apolipoprotein E (APOE) gene is known as a risk factor for dementia. How APOE ε polymorphism affects cognitive performance in nondemented aging subjects remains less clear. In this study, the relationship between APOE status and cognitive performance across various cognitive domains in adults aged 55 to 75 years ( n = 74) without dementia was investigated. E4 carriers ( n = 11) performed worse versus noncarriers on forward Digit Span and delayed recall of the Rey-Osterrieth complex figure. General linear model analysis revealed a small but significant main effect of ε4 on Rey-Osterrieth complex figure delayed recall. Comparing ε2 carriers, ε3 homozygotes, and ε4 carriers, ε3/ε3 performed significantly better on Trail Making Test part B and derived score Trail Making Test B-A. The findings support the relation between the APOE ε polymorphism and visual memory, short-term auditory memory, visuospatial attention, and executive functions in an aging sample without dementia.
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Affiliation(s)
| | - Katarzyna Linkowska
- 1 Collegium Medicum, 49604 Uniwersytet Mikolaja Kopernika , Bydgoszcz, Poland
| | - Szymon Gołota
- 1 Collegium Medicum, 49604 Uniwersytet Mikolaja Kopernika , Bydgoszcz, Poland
| | - Tomasz Grzybowski
- 1 Collegium Medicum, 49604 Uniwersytet Mikolaja Kopernika , Bydgoszcz, Poland
| | | | - Alina Borkowska
- 1 Collegium Medicum, 49604 Uniwersytet Mikolaja Kopernika , Bydgoszcz, Poland
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10
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Gong L, Shu H, He C, Ye Q, Bai F, Xie C, Zhang Z. Convergent and divergent effects of apolipoprotein E ε4 and ε2 alleles on amygdala functional networks in nondemented older adults. Neurobiol Aging 2017; 54:31-39. [DOI: 10.1016/j.neurobiolaging.2017.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 02/11/2017] [Accepted: 02/16/2017] [Indexed: 12/13/2022]
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11
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Robb C, Udeh-Momoh C, Wagenpfeil S, Schöpe J, Alexopoulos P, Perneczky R. Biomarkers and Functional Decline in Prodromal Alzheimer’s Disease. J Alzheimers Dis 2017; 58:69-78. [DOI: 10.3233/jad-161162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Catherine Robb
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK
| | - Chinedu Udeh-Momoh
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK
- MRC Centre for Synaptic Plasticity, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Universität des Saarlandes, Campus Homburg, Germany
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Universität des Saarlandes, Campus Homburg, Germany
| | - Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Psychiatry, University of Patras, Rion Patras, Greece
| | - Robert Perneczky
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
- West London Mental Health NHS Trust, London, UK
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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12
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Associations between APOE polymorphisms and seven diseases with cognitive impairment including Alzheimer's disease, frontotemporal dementia, and dementia with Lewy bodies in southeast China. Psychiatr Genet 2017; 26:124-31. [PMID: 26981880 PMCID: PMC4890824 DOI: 10.1097/ypg.0000000000000126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Supplemental Digital Content is available in the text. Objective To explore the effect of APOE polymorphisms on patients with cognitive impairments in The Chinese Han population. Materials and methods A total of 1027 cases with Alzheimer’s disease (AD), 40 cases with vascular dementia (VaD), 28 cases with behavioral variant frontotemporal dementia (bvFTD), 54 cases with semantic dementia (SD), 44 cases with dementia with Lewy bodies (DLB), 583 cases with mild cognitive impairment (MCI), and 32 cases with vascular cognitive impairment no dementia (VCIND) were recruited consecutively from memory disorders clinics in Huashan Hospital between January 2010 and December 2014. The 1149 cognitively normal controls were recruited from the community epidemiologic investigations. The APOE genotypes were determined using the TaqMan assay. Results The distribution of genotype and allele frequencies of APOE differed significantly between control and AD or MCI, with ε4 increasing the risk of AD and MCI in a dose-dependent pattern and ε2 decreasing the risk of AD, but not the risk of MCI. As for VaD, significant differences in the APOE genotype distribution were found compared with the controls. E4/4 increased the risk of VaD and ε4 increased the risk of VCIND in women. The allele distribution differed between bvFTD and controls, but genotype and allele frequencies of APOE did not affect the risk of bvFTD, SD, and DLB. Conclusion In The Chinese Han population, APOE ε4 increased the risk of AD and MCI in a dose-dependent manner and ε2 decreased the risk of AD as reported previously. APOEε4 might increase risk in VaD and female patients with VCIND, but no effects of APOE on bvFTD, DLB, and SD were found.
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13
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Yuan B, Xie C, Shu H, Liao W, Wang Z, Liu D, Zhang Z. Differential Effects of APOE Genotypes on the Anterior and Posterior Subnetworks of Default Mode Network in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2016; 54:1409-1423. [DOI: 10.3233/jad-160353] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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14
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Lindbergh CA, Dishman RK, Miller LS. Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:129-59. [PMID: 27393566 DOI: 10.1007/s11065-016-9321-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/12/2016] [Indexed: 02/07/2023]
Abstract
Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N = 62,260). Random effects models yielded a large overall summary effect size (Hedges' g = 0.76, 95 % confidence interval: 0.68 - 0.83, p < .001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g = 0.78, 95 % confidence interval: 0.69 - 0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.
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Affiliation(s)
- Cutter A Lindbergh
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, GA, 30602, USA
| | - L Stephen Miller
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.,Bio-Imaging Research Center, Paul D. Coverdell Center, University of Georgia, Athens, GA, 30602, USA
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15
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Abstract
Genetic characterization of individuals at risk of Alzheimer's disease (AD), i.e. people having amyloid deposits in the brain without symptoms, people suffering from subjective cognitive decline (SCD) or mild cognitive impairment (MCI), has spurred the interests of researchers. However, their pre-dementia genetic profile remains mostly unexplored. In this study, we reviewed the loci related to phenotypes of AD, MCI and SCD from literature and performed the first meta-analyses evaluating the role of apolipoprotein E (APOE) in the risk of conversion from a healthy status to MCI and SCD. For AD dementia risk, an increased number of loci have been identified; to date, 28 genes have been associated with Late Onset AD. In MCI syndrome, APOE is confirmed as a pheno-conversion factor leading from MCI to AD, and clusterin is a promising candidate. Additionally, our meta-analyses revealed APOE as genetic risk factor to convert from a healthy status to MCI [OR = 1.849 (1.587-2.153); P = 2.80 × 10-15] and to a lesser extent from healthy status to SCD [OR = 1.151 (1.015-1.304); P = 0.028]. Thus, we believe that genetic studies in longitudinal SCD and MCI series may provide new therapeutic targets and improve the existing knowledge of AD. This type of studies must be completed on healthy subjects to better understand the natural disease resistance to brain insults and neurodegeneration.
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16
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Serrano-Pozo A, Qian J, Monsell SE, Betensky RA, Hyman BT. APOEε2 is associated with milder clinical and pathological Alzheimer disease. Ann Neurol 2015; 77:917-29. [PMID: 25623662 DOI: 10.1002/ana.24369] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/19/2015] [Accepted: 06/06/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The Alzheimer disease (AD) APOEε4 risk allele associates with an earlier age at onset and increased amyloid-β deposition, whereas the protective APOEε2 allele delays the onset and appears to prevent amyloid-β deposition. Yet the clinical and pathological effects of APOEε2 remain uncertain because of its relative rarity. We investigated the effects of APOEε2 and ε4 alleles on AD pathology and cognition in a large US data set of well-characterized AD patients. METHODS We studied individuals from the National Alzheimer's Coordinating Center autopsy cohort across the entire clinicopathological continuum of AD. Multivariate models were built to examine the associations between APOE alleles and AD neuropathological changes, using the APOEε3/ε3 group as comparator. Mediation analysis was used to estimate the direct and indirect effects of APOE alleles on AD pathology and cognition (Clinical Dementia Rating Sum of Boxes and Mini-Mental State Examination). RESULTS Compared to APOEε3/ε3, APOEε2 is independently associated with lower Braak neurofibrillary tangle (NFT) stages and possibly fewer neuritic plaques, but has no direct effect on cerebral amyloid angiopathy (CAA) severity, whereas APOEε4 is associated with more neuritic plaques and CAA, but has no independent effect on Braak NFT stage. Unadjusted analyses showed marked differences among APOE genotypes with respect to cognitive performance (ε2 > ε3 > ε4). Mediation analysis suggests that this is largely explained through effects on pathology. INTERPRETATION Even when adjusted for age at onset, symptom duration, and other demographic variables, APOEε2 is associated with milder AD pathology and less severe antemortem cognitive impairment compared to APOEε3 and ε4 alleles, suggesting a relative neuroprotective effect of APOEε2 in AD.
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Affiliation(s)
- Alberto Serrano-Pozo
- Department of Neurology, Massachusetts General Hospital, Boston, MA.,Massachusetts Alzheimer Disease Research Center, Charlestown, MA.,Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Jing Qian
- Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA
| | - Sarah E Monsell
- National Alzheimer's Coordinating Center and Department of Epidemiology, University of Washington, Seattle, WA
| | - Rebecca A Betensky
- Massachusetts Alzheimer Disease Research Center, Charlestown, MA.,Department of Biostatistics, Harvard School of Public Health, Boston, MA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA.,Massachusetts Alzheimer Disease Research Center, Charlestown, MA
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17
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Weiner MW, Veitch DP, Aisen PS, Beckett LA, Cairns NJ, Cedarbaum J, Green RC, Harvey D, Jack CR, Jagust W, Luthman J, Morris JC, Petersen RC, Saykin AJ, Shaw L, Shen L, Schwarz A, Toga AW, Trojanowski JQ. 2014 Update of the Alzheimer's Disease Neuroimaging Initiative: A review of papers published since its inception. Alzheimers Dement 2015; 11:e1-120. [PMID: 26073027 PMCID: PMC5469297 DOI: 10.1016/j.jalz.2014.11.001] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/18/2013] [Indexed: 01/18/2023]
Abstract
The Alzheimer's Disease Neuroimaging Initiative (ADNI) is an ongoing, longitudinal, multicenter study designed to develop clinical, imaging, genetic, and biochemical biomarkers for the early detection and tracking of Alzheimer's disease (AD). The initial study, ADNI-1, enrolled 400 subjects with early mild cognitive impairment (MCI), 200 with early AD, and 200 cognitively normal elderly controls. ADNI-1 was extended by a 2-year Grand Opportunities grant in 2009 and by a competitive renewal, ADNI-2, which enrolled an additional 550 participants and will run until 2015. This article reviews all papers published since the inception of the initiative and summarizes the results to the end of 2013. The major accomplishments of ADNI have been as follows: (1) the development of standardized methods for clinical tests, magnetic resonance imaging (MRI), positron emission tomography (PET), and cerebrospinal fluid (CSF) biomarkers in a multicenter setting; (2) elucidation of the patterns and rates of change of imaging and CSF biomarker measurements in control subjects, MCI patients, and AD patients. CSF biomarkers are largely consistent with disease trajectories predicted by β-amyloid cascade (Hardy, J Alzheimer's Dis 2006;9(Suppl 3):151-3) and tau-mediated neurodegeneration hypotheses for AD, whereas brain atrophy and hypometabolism levels show predicted patterns but exhibit differing rates of change depending on region and disease severity; (3) the assessment of alternative methods of diagnostic categorization. Currently, the best classifiers select and combine optimum features from multiple modalities, including MRI, [(18)F]-fluorodeoxyglucose-PET, amyloid PET, CSF biomarkers, and clinical tests; (4) the development of blood biomarkers for AD as potentially noninvasive and low-cost alternatives to CSF biomarkers for AD diagnosis and the assessment of α-syn as an additional biomarker; (5) the development of methods for the early detection of AD. CSF biomarkers, β-amyloid 42 and tau, as well as amyloid PET may reflect the earliest steps in AD pathology in mildly symptomatic or even nonsymptomatic subjects and are leading candidates for the detection of AD in its preclinical stages; (6) the improvement of clinical trial efficiency through the identification of subjects most likely to undergo imminent future clinical decline and the use of more sensitive outcome measures to reduce sample sizes. Multimodal methods incorporating APOE status and longitudinal MRI proved most highly predictive of future decline. Refinements of clinical tests used as outcome measures such as clinical dementia rating-sum of boxes further reduced sample sizes; (7) the pioneering of genome-wide association studies that leverage quantitative imaging and biomarker phenotypes, including longitudinal data, to confirm recently identified loci, CR1, CLU, and PICALM and to identify novel AD risk loci; (8) worldwide impact through the establishment of ADNI-like programs in Japan, Australia, Argentina, Taiwan, China, Korea, Europe, and Italy; (9) understanding the biology and pathobiology of normal aging, MCI, and AD through integration of ADNI biomarker and clinical data to stimulate research that will resolve controversies about competing hypotheses on the etiopathogenesis of AD, thereby advancing efforts to find disease-modifying drugs for AD; and (10) the establishment of infrastructure to allow sharing of all raw and processed data without embargo to interested scientific investigators throughout the world.
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Affiliation(s)
- Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
| | - Dallas P Veitch
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Paul S Aisen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Laurel A Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Nigel J Cairns
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jesse Cedarbaum
- Neurology Early Clinical Development, Biogen Idec, Cambridge, MA, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - William Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Johan Luthman
- Neuroscience Clinical Development, Neuroscience & General Medicine Product Creation Unit, Eisai Inc., Philadelphia, PA, USA
| | - John C Morris
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | | | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Li Shen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Adam Schwarz
- Tailored Therapeutics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Arthur W Toga
- Laboratory of Neuroimaging, Institute of Neuroimaging and Informatics, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - John Q Trojanowski
- Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Udall Parkinson's Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Wu P, Li HL, Liu ZJ, Tao QQ, Xu M, Guo QH, Hong Z, Sun YM. Associations between apolipoprotein E gene polymorphisms and Alzheimer's disease risk in a large Chinese Han population. Clin Interv Aging 2015; 10:371-8. [PMID: 25673977 PMCID: PMC4321568 DOI: 10.2147/cia.s73396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective Apolipoprotein E gene (APOE) polymorphisms contributing to the risk of sporadic Alzheimer’s disease (AD) have been identified for decades, but it has not been investigated in large AD samples of Chinese Han population. Methods We performed a cross-sectional study to explore the effect of APOE polymorphisms on sporadic AD in 875 sporadic AD patients and 1,195 cognitive normal controls of Chinese Han. Genotyping of APOE was determined by multiplex amplification refractory mutation system polymerase chain reaction. Results APOE ε3ε4 and ε4ε4 genotypes increased AD risk with dosage effect. The odds ratio (OR) of ε3ε4 was 1.89 and the OR of ε4ε4 was 15.64 compared with that of ε3ε3 in all the subjects. E2ε3 genotype decreased AD risk in all the subjects (OR=0.64), female subgroup (OR=0.57), and late-onset AD subgroup (OR=0.60). However, neither ε2ε2 nor ε2ε4 affected AD risk. About the age at onset (AAO), the influence of APOE ε4 was only exhibited in late-onset AD subgroup, with 1 year lower in ε4-positive ones than negative ones. Further analysis did not show the dosage effect of ε4 pertinent to AAO, though the AAO of ε4ε4 patients decreased by 2 years. E2 did not affect the AAO of AD. Conclusion APOE ε4 is a strong risk factor of AD risk in Chinese Han population, and APOE ε4ε4 genotype might be related to the AAO of late-onset AD.
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Affiliation(s)
- Ping Wu
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China ; PET Center, Department of Nuclear Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Hong-Lei Li
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Zhi-Jun Liu
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Qing-Qing Tao
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Miao Xu
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Qi-Hao Guo
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Zhen Hong
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
| | - Yi-Min Sun
- Department of Neurology and Institute of Neurology, Fudan University, Shanghai, People's Republic of China
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Ogata S, Hayashi C, Sugiura K, Hayakawa K. Association between subjective memory complaints and impaired higher-level functional capacity in people aged 60 years or older. Arch Gerontol Geriatr 2014; 60:201-5. [PMID: 25465503 DOI: 10.1016/j.archger.2014.10.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 09/24/2014] [Accepted: 10/29/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We aimed to investigate the association between subjective memory complaints and higher-level functional capacity in either people with long-term care needs or those who require help to maintain functional capacity. METHODS We conducted a cross-sectional study among participants aged 60 years or older. We measured subjective memory complaints, higher-level functional capacity, and depressive symptoms, and then estimated odds ratios (ORs) by multiple logistic analysis. Subjective memory complaints were used as the predictor variable, higher-level functional capacity as the outcome variable, and age, depressive symptoms, medical history of diabetes and hypertension, frequency of going out, falling within a year, and body mass index as possible confounders. We assessed higher-level functional capacity using the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence score ≤5 as a cut-off (which is associated with higher one-year mortality rates). RESULTS We conducted analyses using 501 people aged 60 years or older. Among women, subjective memory complaints were associated with impaired higher-level functional capacity after adjustment for age and depressive symptoms (OR=3.36; 95% confidence interval [CI], 1.59-7.08). Among the men, subjective memory complaints were not significantly associated with impaired higher-level functional capacity after adjustment for age and depressive symptoms (OR=1.91; 95% CI, 0.88-4.12). CONCLUSIONS Subjective memory complaints among women can indicate impaired higher-level functional capacity and may suggest higher one-year mortality rates.
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Affiliation(s)
- Soshiro Ogata
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Japan.
| | - Chisato Hayashi
- Department of Public Health Nursing, Graduated School of Nursing, Osaka City University, Japan
| | | | - Kazuo Hayakawa
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Japan
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Shen L, Thompson PM, Potkin SG, Bertram L, Farrer LA, Foroud TM, Green RC, Hu X, Huentelman MJ, Kim S, Kauwe JSK, Li Q, Liu E, Macciardi F, Moore JH, Munsie L, Nho K, Ramanan VK, Risacher SL, Stone DJ, Swaminathan S, Toga AW, Weiner MW, Saykin AJ. Genetic analysis of quantitative phenotypes in AD and MCI: imaging, cognition and biomarkers. Brain Imaging Behav 2014; 8:183-207. [PMID: 24092460 PMCID: PMC3976843 DOI: 10.1007/s11682-013-9262-z] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The Genetics Core of the Alzheimer's Disease Neuroimaging Initiative (ADNI), formally established in 2009, aims to provide resources and facilitate research related to genetic predictors of multidimensional Alzheimer's disease (AD)-related phenotypes. Here, we provide a systematic review of genetic studies published between 2009 and 2012 where either ADNI APOE genotype or genome-wide association study (GWAS) data were used. We review and synthesize ADNI genetic associations with disease status or quantitative disease endophenotypes including structural and functional neuroimaging, fluid biomarker assays, and cognitive performance. We also discuss the diverse analytical strategies used in these studies, including univariate and multivariate analysis, meta-analysis, pathway analysis, and interaction and network analysis. Finally, we perform pathway and network enrichment analyses of these ADNI genetic associations to highlight key mechanisms that may drive disease onset and trajectory. Major ADNI findings included all the top 10 AD genes and several of these (e.g., APOE, BIN1, CLU, CR1, and PICALM) were corroborated by ADNI imaging, fluid and cognitive phenotypes. ADNI imaging genetics studies discovered novel findings (e.g., FRMD6) that were later replicated on different data sets. Several other genes (e.g., APOC1, FTO, GRIN2B, MAGI2, and TOMM40) were associated with multiple ADNI phenotypes, warranting further investigation on other data sets. The broad availability and wide scope of ADNI genetic and phenotypic data has advanced our understanding of the genetic basis of AD and has nominated novel targets for future studies employing next-generation sequencing and convergent multi-omics approaches, and for clinical drug and biomarker development.
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Affiliation(s)
- Li Shen
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Paul M. Thompson
- Imaging Genetics Center, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095 USA
| | - Steven G. Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617 USA
| | - Lars Bertram
- Neuropsychiatric Genetics Group, Max-Planck Institute for Molecular Genetics, Berlin, Germany
| | - Lindsay A. Farrer
- Biomedical Genetics L320, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118 USA
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Robert C. Green
- Division of Genetics and Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115 USA
| | - Xiaolan Hu
- Clinical Genetics, Exploratory Clinical & Translational Research, Bristol-Myers Squibbs, Pennington, NJ 08534 USA
| | - Matthew J. Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ 85004 USA
| | - Sungeun Kim
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - John S. K. Kauwe
- Departments of Biology, Neuroscience, Brigham Young University, 675 WIDB, Provo, UT 84602 USA
| | - Qingqin Li
- Department of Neuroscience Biomarkers, Janssen Research and Development, LLC, Raritan, NJ 08869 USA
| | - Enchi Liu
- Biomarker Discovery, Janssen Alzheimer Immunotherapy Research and Development, LLC, South San Francisco, CA 94080 USA
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617 USA
- Department of Sciences and Biomedical Technologies, University of Milan, Segrate, MI Italy
| | - Jason H. Moore
- Department of Genetics, Computational Genetics Laboratory, Dartmouth Medical School, Lebanon, NH 03756 USA
| | - Leanne Munsie
- Tailored Therapeutics, Eli Lilly and Company, Indianapolis, IN 46285 USA
| | - Kwangsik Nho
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Vijay K. Ramanan
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Shannon L. Risacher
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - David J. Stone
- Merck Research Laboratories, 770 Sumneytown Pike, WP53B-120, West Point, PA 19486 USA
| | - Shanker Swaminathan
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095 USA
| | - Michael W. Weiner
- Departments of Radiology, Medicine and Psychiatry, UC San Francisco, San Francisco, CA 94143 USA
| | - Andrew J. Saykin
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - for the Alzheimer’s Disease Neuroimaging Initiative
- Center for Neuroimaging and Indiana Alzheimer’s Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W 16th Street, Suite 4100, Indianapolis, IN 46202 USA
- Imaging Genetics Center, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095 USA
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617 USA
- Neuropsychiatric Genetics Group, Max-Planck Institute for Molecular Genetics, Berlin, Germany
- Biomedical Genetics L320, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118 USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Division of Genetics and Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115 USA
- Clinical Genetics, Exploratory Clinical & Translational Research, Bristol-Myers Squibbs, Pennington, NJ 08534 USA
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ 85004 USA
- Departments of Biology, Neuroscience, Brigham Young University, 675 WIDB, Provo, UT 84602 USA
- Department of Neuroscience Biomarkers, Janssen Research and Development, LLC, Raritan, NJ 08869 USA
- Biomarker Discovery, Janssen Alzheimer Immunotherapy Research and Development, LLC, South San Francisco, CA 94080 USA
- Department of Sciences and Biomedical Technologies, University of Milan, Segrate, MI Italy
- Department of Genetics, Computational Genetics Laboratory, Dartmouth Medical School, Lebanon, NH 03756 USA
- Tailored Therapeutics, Eli Lilly and Company, Indianapolis, IN 46285 USA
- Merck Research Laboratories, 770 Sumneytown Pike, WP53B-120, West Point, PA 19486 USA
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095 USA
- Departments of Radiology, Medicine and Psychiatry, UC San Francisco, San Francisco, CA 94143 USA
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APOE moderates the association between lifestyle activities and cognitive performance: evidence of genetic plasticity in aging. J Int Neuropsychol Soc 2014; 20:478-86. [PMID: 24867440 PMCID: PMC4096557 DOI: 10.1017/s1355617714000356] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The current study examined independent and interactive effects between Apolipoprotein E (APOE) genotype and two types of cognitively-stimulating lifestyle activities (CSLA)-integrated information processing (CSLA-II) and novel information processing (CSLA-NI)-on concurrent and longitudinal changes in cognition. Three-wave data across 6 years of follow-up from the Victoria Longitudinal Study (n=278; ages 55-94) and linear mixed model analyses were used to characterize the effects of APOE genotype and participation in CSLA-II and CSLA-NI in four cognitive domains. Significant CSLA effects on cognition were observed. More frequent participation in challenging activities (i.e., CSLA-NI) was associated with higher baseline scores on word recall, fact recall, vocabulary and verbal fluency. Conversely, higher participation in less cognitively-challenging activities (i.e., CSLA-II) was associated with lower scores on fact recall and verbal fluency. No longitudinal CSLA-cognition effects were found. Two significant genetic effects were observed. First, APOE moderated CSLA-II and CSLA-NI associations with baseline verbal fluency and fact recall scores. Second, APOE non-ɛ4 carriers' baseline performance were more likely to be moderated by CSLA participation, compared to APOE-ɛ4 carriers. Our findings suggest APOE may be a "plasticity" gene that makes individuals more or less amenable to the influence of protective factors such as CSLA.
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Regal P, Nair B, Hetherington E. Apolipoprotein E ε4 is superior to apolipoprotein E ε2 in predicting cognitive scores over 30 months. Clin Interv Aging 2013; 8:1461-5. [PMID: 24204131 PMCID: PMC3817103 DOI: 10.2147/cia.s47485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this study was to compare apolipoprotein E ε4 (Apo E ε4) and apolipoprotein E ε2 (Apo E ε2) as predictors of cognitive and functional trajectories over 30 months. Methods This prospective cohort study included 287 community-dwelling memory clinic patients with dementia, mild cognitive impairment, or no cognitive impairment. The Addenbrooke Cognitive Examination, Mini-Mental State Examination, Montreal Cognitive Assessment, Delirium Index, and Nottingham Instrumental Activities of Daily Living tests were administered to each subject. Results One hundred and nine subjects (40%) carried Apo E ε4 and 48 (16.7%) carried Apo E ε2. One hundred and nine ε4-positive subjects differed significantly from 178 ε4-negative subjects in 19/52 comparisons (36.5%), whereas 46 Apo E ε2-positive subjects had 0/52 significant differences from 239 ε2-negative subjects (P < 0.0001). The variables most affected by ε4 were the Delirium Index and Mini-Mental State Examination. Instrumental Activities of Daily Living score and residence were unrelated to Apo E ε4 or ε2. Conclusion Apo E ε4 positivity predicted four cognitive scores measured every 6 months over 30 months. Apo E ε2 scores predicted none of 52 comparisons.
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Affiliation(s)
- Paul Regal
- Geriatric Medicine and Gerontology, University of Newcastle, Callaghan, NSW, Australia
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Weiner MW, Veitch DP, Aisen PS, Beckett LA, Cairns NJ, Green RC, Harvey D, Jack CR, Jagust W, Liu E, Morris JC, Petersen RC, Saykin AJ, Schmidt ME, Shaw L, Shen L, Siuciak JA, Soares H, Toga AW, Trojanowski JQ. The Alzheimer's Disease Neuroimaging Initiative: a review of papers published since its inception. Alzheimers Dement 2013; 9:e111-94. [PMID: 23932184 DOI: 10.1016/j.jalz.2013.05.1769] [Citation(s) in RCA: 298] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/18/2013] [Indexed: 01/19/2023]
Abstract
The Alzheimer's Disease Neuroimaging Initiative (ADNI) is an ongoing, longitudinal, multicenter study designed to develop clinical, imaging, genetic, and biochemical biomarkers for the early detection and tracking of Alzheimer's disease (AD). The study aimed to enroll 400 subjects with early mild cognitive impairment (MCI), 200 subjects with early AD, and 200 normal control subjects; $67 million funding was provided by both the public and private sectors, including the National Institute on Aging, 13 pharmaceutical companies, and 2 foundations that provided support through the Foundation for the National Institutes of Health. This article reviews all papers published since the inception of the initiative and summarizes the results as of February 2011. The major accomplishments of ADNI have been as follows: (1) the development of standardized methods for clinical tests, magnetic resonance imaging (MRI), positron emission tomography (PET), and cerebrospinal fluid (CSF) biomarkers in a multicenter setting; (2) elucidation of the patterns and rates of change of imaging and CSF biomarker measurements in control subjects, MCI patients, and AD patients. CSF biomarkers are consistent with disease trajectories predicted by β-amyloid cascade (Hardy, J Alzheimers Dis 2006;9(Suppl 3):151-3) and tau-mediated neurodegeneration hypotheses for AD, whereas brain atrophy and hypometabolism levels show predicted patterns but exhibit differing rates of change depending on region and disease severity; (3) the assessment of alternative methods of diagnostic categorization. Currently, the best classifiers combine optimum features from multiple modalities, including MRI, [(18)F]-fluorodeoxyglucose-PET, CSF biomarkers, and clinical tests; (4) the development of methods for the early detection of AD. CSF biomarkers, β-amyloid 42 and tau, as well as amyloid PET may reflect the earliest steps in AD pathology in mildly symptomatic or even nonsymptomatic subjects, and are leading candidates for the detection of AD in its preclinical stages; (5) the improvement of clinical trial efficiency through the identification of subjects most likely to undergo imminent future clinical decline and the use of more sensitive outcome measures to reduce sample sizes. Baseline cognitive and/or MRI measures generally predicted future decline better than other modalities, whereas MRI measures of change were shown to be the most efficient outcome measures; (6) the confirmation of the AD risk loci CLU, CR1, and PICALM and the identification of novel candidate risk loci; (7) worldwide impact through the establishment of ADNI-like programs in Europe, Asia, and Australia; (8) understanding the biology and pathobiology of normal aging, MCI, and AD through integration of ADNI biomarker data with clinical data from ADNI to stimulate research that will resolve controversies about competing hypotheses on the etiopathogenesis of AD, thereby advancing efforts to find disease-modifying drugs for AD; and (9) the establishment of infrastructure to allow sharing of all raw and processed data without embargo to interested scientific investigators throughout the world. The ADNI study was extended by a 2-year Grand Opportunities grant in 2009 and a renewal of ADNI (ADNI-2) in October 2010 through to 2016, with enrollment of an additional 550 participants.
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Affiliation(s)
- Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.
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