Apolipoprotein E type 4 allele and cerebral glucose metabolism in
relatives at risk for familial Alzheimer disease
Source: JAMA
1995 Mar;273(12):942-947.
Author: Small GW;Mazziotta JC;Collins MT;Baxter LR;Phelps ME;Mandelkern
MA;Kaplan A;La Rue A;Adamson CF;Chang L PubMed ID: 7884953
Abstract:
OBJECTIVE--Cerebral parietal hypometabolism and left-right
asymmetry occur early in the course of Alzheimer disease (AD), and the
apolipoprotein E type 4 allele (APOE epsilon 4) is a risk factor for
familial AD. To determine if APOE epsilon 4 is associated with lowered
brain function in nondemented relatives at risk for familial AD, we
studied 12 relatives with APOE epsilon 4 and 19 relatives without APOE
epsilon 4. We also compared them with seven patients with probable AD.
DESIGN--After grouping subjects according to diagnosis and genotype,
brain function measures were compared among groups. SETTING--University
medical center. PATIENTS--At risk subjects had mild memory complaints,
normal cognitive performance, and at least two relatives with AD.
Subjects with APOE epsilon 4 did not differ from those without APOE
epsilon 4 in mean age at examination (56.4 vs 55.5 years) or in
neuropsychological performance (mean Mini-Mental State Examination
score, 28.8 vs 29.3). MAIN OUTCOME MEASURES--Cerebral glucose metabolism
was measured using positron emission tomography and fludeoxyglucose F
18. RESULTS--Parietal metabolism was significantly lower and left-right
parietal asymmetry was significantly higher in at- risk subjects with
APOE epsilon 4 compared with those without APOE epsilon 4. Patients with
dementia had significantly lower parietal metabolism than did at-risk
subjects with APOE epsilon 4. CONCLUSIONS-- These results suggest that
the inheritance of APOE epsilon 4 is associated with reduced cerebral
parietal metabolism and increased asymmetry in non-demented relatives at
risk for probable AD. Longitudinal study will determine if glucose
metabolic measures provide a means to monitor experimental treatment
responses during the early phases of the disorder