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Gong L, Xu R, Liu D, Lan L, Zhang B, Zhang C. The Specific Impact of Apolipoprotein E Epsilon 2 on Cognition and Brain Function in Cognitively Normal Elders and Mild Cognitive Impairment Patients. Front Aging Neurosci 2020; 11:374. [PMID: 32226373 PMCID: PMC7081769 DOI: 10.3389/fnagi.2019.00374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/19/2019] [Indexed: 12/17/2022] Open
Abstract
Variants in the apolipoprotein E (APOE) gene play an important role in the development of Alzheimer’s disease (AD). Specifically, the APOE ε4 allele is an established genetic risk factor for AD, while the APOE ε2 allele is a protective factor against AD. However, the mechanism underlying this impact of APOE genotype on the pathogenesis of AD remain unclear. This study sought to investigate the influence of APOE genotype on cognition and neuroimaging features in cognitively normal (CN) elderly individuals and patients with mild cognitive impairment (MCI). A total of 177 participants were selected from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, including 101 MCI patients and 76 CN individuals. A 2 × 3 (consisting of two groups and three APOE genotypes) analysis of covariance was carried out to measure the influences of diagnosis and APOE genotype on cognition and brain features, assessed based on global functional connectivity density (gFCD) and hippocampal volume. In addition, a mediation analysis was carried out to investigate the indirect influence of neuroimaging features on the relationship between APOE genotype and cognitive performance in the MCI group. This analysis revealed that APOE genotype had an influence on brain function in the bilateral precentral gyrus, right thalamus, and posterior cingulate cortex (PCC). In addition, an interactive influence between diagnosis and APOE genotype was found on general cognition, immediate memory, executive function, hippocampal volume, and gFCD in the right dorsolateral prefrontal cortex and medial prefrontal cortex (MPFC). Finally, this mediation analysis revealed that hippocampal volume and gFCD in the thalamus may mediate the relationship between APOE genotype and cognitive performance in the MCI group. Taken together, our findings provide novel insights into the neural mechanisms underlying the genetically guided pathogenic mechanisms of AD.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Lin Lan
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Chuantao Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Chai YL, Yeo HKH, Wang J, Hilal S, Ikram MK, Venketasubramanian N, Wong BS, Chen CLH. Apolipoprotein ɛ4 is Associated with Dementia and Cognitive Impairment Predominantly Due to Alzheimer's Disease and Not with Vascular Cognitive Impairment: A Singapore-Based Cohort. J Alzheimers Dis 2016; 51:1111-8. [PMID: 26923016 DOI: 10.3233/jad-150902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVE While the association for apolipoprotein ɛ4 allele (APOE4) with Alzheimer's disease (AD) has been consistently confirmed, the association with vascular cognitive impairment (VCI) is unclear. We therefore explored the relationship of APOE with both AD and cerebrovascular disease (CeVD) by examining the prevalence of APOE4 in AD, AD with CeVD and vascular dementia (VaD), as well as in cognitive impairment no dementia (CIND) with and without CeVD. METHODS We performed a case-control study with subjects recruited from memory clinics and the community. All subjects underwent standardized brain neuroimaging, clinical and neuropsychological assessments, following which they were classified using research criteria. RESULTS A total of 411 subjects; 92 controls with no cognitive impairment (NCI), 77 CIND without CeVD, 87 CIND with CeVD, 55 AD without CeVD, 68 AD with CeVD, and 32 VaD patients were recruited. Compared to NCI (16.3%), the prevalence of APOE4 carriers was significantly higher only in CIND (37.7%) and AD in the absence of CeVD (45.5%), but not in the three subgroups of VCI, namely CIND with CeVD (20.7%), AD with CeVD (27.9%) and VaD (25.0%). Logistic regression analyses also showed that APOE4 carriers were more likely to have CIND without CeVD (Odds Ratio [OR]: 3.34; 95% Confidence Interval [CI]: 1.59-7.03) and AD without CeVD (OR: 7.21; 95% CI: 2.74-18.98), but no such association was observed in the VCI subgroups. CONCLUSION APOE4 is significantly associated with dementia and CIND due to AD pathology, but not with VCI.
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Affiliation(s)
- Yuek Ling Chai
- Memory Ageing and Cognition Centre (MACC), National University Health System, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hazel Kai-Hui Yeo
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiehao Wang
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Saima Hilal
- Memory Ageing and Cognition Centre (MACC), National University Health System, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mohammad Kamran Ikram
- Memory Ageing and Cognition Centre (MACC), National University Health System, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore.,Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory Ageing and Cognition Centre (MACC), National University Health System, Singapore.,Raffles Neuroscience Centre, Raffles Hospital, Singapore
| | - Boon-Seng Wong
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christopher Li-Hsian Chen
- Memory Ageing and Cognition Centre (MACC), National University Health System, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Apostolo J, Holland C, O'Connell MDL, Feeney J, Tabares-Seisdedos R, Tadros G, Campos E, Santos N, Robertson DA, Marcucci M, Varela-Nieto I, Crespo-Facorro B, Vieta E, Navarro-Pardo E, Selva-Vera G, Balanzá-Martínez V, Cano A. Mild cognitive decline. A position statement of the Cognitive Decline Group of the European Innovation Partnership for Active and Healthy Ageing (EIPAHA). Maturitas 2015; 83:83-93. [PMID: 26520249 DOI: 10.1016/j.maturitas.2015.10.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is a term used to describe a level of decline in cognition which is seen as an intermediate stage between normal ageing and dementia, and which many consider to be a prodromal stage of neurodegeneration that may become dementia. That is, it is perceived as a high risk level of cognitive change. The increasing burden of dementia in our society, but also our increasing understanding of its risk factors and potential interventions, require diligent management of MCI in order to find strategies that produce effective prevention of dementia. AIM To update knowledge regarding mild cognitive impairment, and to bring together and appraise evidence about the main features of clinical interest: definitions, prevalence and stability, risk factors, screening, and management and intervention. METHODS Literature review and consensus of expert opinion. RESULTS AND CONCLUSION MCI describes a level of impairment in which deteriorating cognitive functions still allow for reasonable independent living, including some compensatory strategies. While there is evidence for some early risk factors, there is still a need to more precisely delineate and distinguish early manifestations of frank dementia from cognitive impairment that is less likely to progress to dementia, and furthermore to develop improved prospective evidence for positive response to intervention. An important limitation derives from the scarcity of studies that take MCI as an endpoint. Strategies for effective management suffer from the same limitation, since most studies have focused on dementia. Behavioural changes may represent the most cost-effective approach.
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Affiliation(s)
- Joao Apostolo
- Portugal Centre for Evidence Based Practice, Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal.
| | - Carol Holland
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK.
| | | | - Joanne Feeney
- Centre for Public Health, Queen's University Belfast, United Kingdom.
| | - Rafael Tabares-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - George Tadros
- Birmingham & Solihull Mental Health Foundation Trust, Old Age Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham, UK.
| | - Elzbieta Campos
- Portugal Centre for Evidence Based Practice, Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal.
| | - Nadine Santos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal.
| | | | - Maura Marcucci
- Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico & Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Isabel Varela-Nieto
- Institute for Biomedical Research, CSIC-UAM and IdiPAZ-CIBERER, Madrid 28029, Spain.
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University of Cantabria, Marqués de Valdecilla Hospital, Santander, Spain; IDIVAL, Santander, Spain; CIBERSAM, Madrid, Spain.
| | - Eduard Vieta
- Barcelona Bipolar Disorders Programme, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain.
| | | | - Gabriel Selva-Vera
- Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Vicent Balanzá-Martínez
- Department of Medicine, La Fe University and Polytechnic Hospital, CIBERSAM, University of Valencia, Valencia, Spain.
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain; Service of Obstetrics and Gynecology, INCLIVA, Valencia, Spain.
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