Patterns of Brain Activation in People at Risk for Alzheimer's Disease
Open accessAbstract
BACKGROUND: The epsilon4 allele of the apolipoprotein E gene (APOE) is the chief known genetic risk factor for Alzheimer's disease, the most common cause of dementia late in life. To determine the relation between brain responses to tasks requiring memory and the genetic risk of Alzheimer's disease, we performed APOE genotyping and functional magnetic resonance imaging (MRI) of the brain in older persons with intact cognition. METHODS: We studied 30 subjects (age, 47 to 82 years) who were neurologically normal, of whom 16 were carriers of the APOE epsilon4 allele and 14 were homozygous for the APOE epsilon3 allele. The mean age and level of education were similar in the two groups. Patterns of brain activation during functional MRI scanning were determined while subjects memorized and recalled unrelated pairs of words and while subjects rested between such periods. Memory was reassessed in 14 subjects two years later. RESULTS: Both the magnitude and the extent of brain activation during memory-activation tasks in regions affected by Alzheimer's disease, including the left hippocampal, parietal, and prefrontal regions, were greater among the carriers of the APOE epsilon4 allele than among the carriers of the APOE epsilon3 allele. During periods of recall, the carriers of the APOE epsilon4 allele had a greater average increase in signal intensity in the hippocampal region (1.03 percent vs. 0.62 percent, P<0.001) and a greater mean (+/-SD) number of activated regions throughout the brain (15.9+/-6.2 vs. 9.4+/-5.5, P=0.005) than did carriers of the APOE epsilon3 allele. Longitudinal assessment after two years indicated that the degree of base-line brain activation correlated with degree of decline in memory. CONCLUSIONS: Patterns of brain activation during tasks requiring memory differ depending on the genetic risk of Alzheimer's disease and may predict a subsequent decline in memory.
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Previous studies have already linked APOE4 to increased (hyper-)metabolism in young individuals.
“However, previous studies have already linked APOE4 to increased (hyper-)metabolism in young individuals.”
From APOE4 Increases Energy Metabolism in APOE-Isogenic iPSC-Derived Neurons (2024) · cites this paper as [46]
The introduction (p. 451) says PET studies found deficits, not increases, in resting glucose metabolism among middle-aged APOE4 carriers. The Results report greater task-related fMRI activation in participants aged 47–82, which is not evidence of hypermetabolism in young individuals. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredStudies in young adults, before the onset of a pathology, showed that APOE4 carriers display hypermetabolism and hyperactivity in distinct brain regions, such as the hippocampus, entorhinal cortex, and cortical regions.
“Studies in young adults, before the onset of a pathology, showed that APOE4 carriers display hypermetabolism and hyperactivity in distinct brain regions, such as the hippocampus, entorhinal cortex, and cortical regions [44,45,46].”
From APOE4 Increases Energy Metabolism in APOE-Isogenic iPSC-Derived Neurons (2024) · cites this paper as [46]
The Results and Discussion report greater memory-task activation in APOE e4 carriers in hippocampal and cortical regions. But the studied participants were 47–82 years old, not young adults; the study measured functional MRI activation, not hypermetabolism, and does not identify increased activation in the entorhinal cortex. The paper's background discussion instead describes glucose-metabolism deficits in middle-aged carriers (p. 451). (LLM, conf=0.89)
Experimental — accuracy not yet measuredHealthy young and middle-aged adult apoE4 carriers show increased hippocampal activation during encoding task performance.
“and increased hippocampal activation during encoding task performance [179–181]”
From Apolipoprotein E4, inhibitory network dysfunction, and Alzheimer’s disease (2019) · cites this paper as [180]
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Self-citation
- Authors
- Bookheimer, S. Y., Strojwas, M. H., Cohen, M. S., Saunders, A. M., Pericak-Vance, M. A., Mazziotta, J. C., & Small, G. W.
- Affiliations
- University of California, Los Angeles (US)
- Neurology, Inc (US)
- Duke Medical Center (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2000-08-17
- Volume
- 343
- Issue
- 7
- Pages
- 450-456
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2831477
- OpenAlex
- W2060629467
- Cited by
- 1,328
- References
- 35
- Citations by year
- 2026: 27 · 2025: 20 · 2024: 33 · 2023: 42 · 2022: 31 · 2021: 40 · 2020: 33 · 2019: 37 · 2018: 42 · 2017: 38 · 2016: 37 · 2015: 59 · 2014: 58 · 2013: 67 · 2012: 53
- FWCI
- 29.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- Ahmanson Foundation
- National Institute on Aging (AG-13308, P50AG005128, R01AG013308, P60AG011268, P30AG010123, U24AG021886)
- National Institute of Mental Health (MH52453, R01MH052453)
- National Institute of Neurological Disorders and Stroke (P01NS026630, R01NS031153)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Keywords
- Alzheimer's disease, APOE ε4, apolipoprotein E, genetic risk, brain activation, memory, hippocampus, memory decline, older adults, functional MRI, APOE genotyping, prefrontal cortex, parietal cortex
- MeSH terms
- Aged, Aged, 80 and over, Alleles, Alzheimer Disease, Apolipoproteins E, Brain, Brain Mapping, Female, Heterozygote, Hippocampus, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Memory, Middle Aged, Neuropsychological Tests, Apolipoprotein E3, Apolipoprotein E4
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