The effect of ApoE ε4 on longitudinal brain region-specific glucose metabolism in patients with mild cognitive impairment: a FDG-PET study
Open accessAbstract
While the ApoE ε4 allele is a known risk factor for mild cognitive impairment (MCI) and Alzheimer's disease, brain region specific effects remain elusive. In this study, we investigate whether the ApoE ε4 allele exhibits brain region specific effects in longitudinal glucose uptake among patients with MCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Preprocessed FDG PET images, MRIs, and demographic information were downloaded from the ADNI database. An iterative reblurred Van Cittertiteration method was used for partial volume correction (PVC) on all PET images. Structural MRIs were used for PET spatial normalization and region of interest (ROI) definition in standard space. Longitudinal changes in ROI FDG standardized uptake value ratio (SUVR) relative to cerebellum in 24 ApoE ε4 carriers and 24 age-matched ApoE ε4 non-carriers were measured for up to 84-months (median 72 months, SD = 11.2 months) and compared using a generalized linear mixed effects model controlling for gender, education, baseline age, and follow-up period. Additionally, voxelwise analysis was performed by implementing a paired t-test comparing matched baseline and 72 month FDG SUVR images in ApoE carriers and non-carriers separately. Results with PVC were compared with ones from non-PVC based analysis. After applying PVC, the superior fontal, parietal, lateral temporal, medial temporal, caudate, thalamus, and post-cingulate, and amygdala regions had greater longitudinal decreases in FDG uptake in ApoE ε4 carriers with MCI compared to non-carriers with MCI. Similar forebrain and limbic clusters were found through voxelwise analysis. Compared to the PVC based analysis, fewer significant ApoE-associated regions and clusters were found in the non-PVC based PET analysis. Our findings suggest that the ApoE ε4 genotype is associated with a longitudinal decline in glucose uptake in 8 forebrain and limbic brain regions in the context of MCI. In conclusion, this 84-months longitudinal FDG PET study demonstrates a novel ApoE ε4-associated brain-region specific glucose metabolism pattern in patients with MCI. Partial volume correction improved FDG PET quantification.
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Regional metabolic deficits closely mirror mitochondrial bioenergetic decline, suggesting cerebral hypometabolism represents an in vivo biomarker of mitochondrial dysfunction rather than an isolated process.
“These regional metabolic deficits closely mirror mitochondrial bioenergetic decline, suggesting that cerebral hypometabolism represents an in vivo biomarker of mitochondrial dysfunction rather than an isolated process [66, 68].”
From Toward a Unified Framework in Molecular Neurobiology of Alzheimer’s Disease: Revisiting the Pathophysiological Hypotheses (2026) · cites this paper as [68]
The Conclusion (page unavailable) reports regional declines in FDG uptake in ApoE ε4 carriers with mild cognitive impairment, supporting the regional hypometabolism component. Neither it nor the retrieved Introduction and Discussion passages reports mitochondrial bioenergetic decline or establishes hypometabolism as a biomarker of mitochondrial dysfunction (searched: mitochondrial bioenergetic decline, mitochondrial dysfunction, oxidative phosphorylation). (LLM, conf=0.84)
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- Authors
- Paranjpe, M. D., Chen, X., Liu, M., Paranjpe, I., Leal, J. P., Wang, R., Pomper, M. G., Wong, D. F., Benzinger, T. L. S., & Zhou, Y.
- Affiliations
- Johns Hopkins University (US)
- Peking University First Hospital (CN)
- Icahn School of Medicine at Mount Sinai (US)
- Washington University in St. Louis (US)
- Corresponding author
- Zhou, Yun
- ORCID
- Venue
- NeuroImage: Clinical
- Publisher
- Elsevier BV
- Published
- 2019
- Volume
- 22
- Pages
- 101795
- ISSN
- 2213-1582 (ISSN-L)
- PMC
- PMC6449776
- OpenAlex
- W2927152915
- Cited by
- 51
- References
- 7
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 5 · 2019: 3
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- NeuroImage Clinical (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health
- National Institute on Aging
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- APOE ε4, mild cognitive impairment, brain glucose metabolism, partial volume correction, Alzheimer's disease risk, amygdala, medial temporal lobe
- MeSH terms
- Aged, Aged, 80 and over, Apolipoproteins E, Brain, Female, Glucose, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Fluorodeoxyglucose F18, Positron-Emission Tomography, Apolipoprotein E4, Neuroimaging, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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