Deficient Liver Biosynthesis of Docosahexaenoic Acid Correlates with Cognitive Impairment in Alzheimer's Disease
Open accessAbstract
Reduced brain levels of docosahexaenoic acid (C22:6n-3), a neurotrophic and neuroprotective fatty acid, may contribute to cognitive decline in Alzheimer's disease. Here, we investigated whether the liver enzyme system that provides docosahexaenoic acid to the brain is dysfunctional in this disease. Docosahexaenoic acid levels were reduced in temporal cortex, mid-frontal cortex and cerebellum of subjects with Alzheimer's disease, compared to control subjects (P = 0.007). Mini Mental State Examination (MMSE) scores positively correlated with docosahexaenoic/α-linolenic ratios in temporal cortex (P = 0.005) and mid-frontal cortex (P = 0.018), but not cerebellum. Similarly, liver docosahexaenoic acid content was lower in Alzheimer's disease patients than control subjects (P = 0.011). Liver docosahexaenoic/α-linolenic ratios correlated positively with MMSE scores (r = 0.78; P<0.0001), and negatively with global deterioration scale grades (P = 0.013). Docosahexaenoic acid precursors, including tetracosahexaenoic acid (C24:6n-3), were elevated in liver of Alzheimer's disease patients (P = 0.041), whereas expression of peroxisomal d-bifunctional protein, which catalyzes the conversion of tetracosahexaenoic acid into docosahexaenoic acid, was reduced (P = 0.048). Other genes involved in docosahexaenoic acid metabolism were not affected. The results indicate that a deficit in d-bifunctional protein activity impairs docosahexaenoic acid biosynthesis in liver of Alzheimer's disease patients, lessening the flux of this neuroprotective fatty acid to the brain.
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Metabolomic biomarkers such as reduced docosahexaenoic acid (DHA) and elevated homocysteine have demonstrated clinical utility.
“Despite variability introduced by diet and comorbid conditions, metabolomic biomarkers such as reduced docosahexaenoic acid (DHA) and elevated homocysteine have demonstrated clinical utility133,194, 195, 196, 197, 198, 199.”
From Artificial intelligence-driven multi-omics approaches in Alzheimer's disease: Progress, challenges, and future directions (2025) · cites this paper as [133]
The Results (page unavailable) report lower DHA levels in Alzheimer’s disease patients and an association between liver DHA measures and cognitive scores. The Discussion (page unavailable) describes peripheral lipid biomarkers as a prospect for discovery, not as having demonstrated clinical utility. This paper does not address elevated homocysteine. (LLM, conf=0.86)
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- Authors
- Astarita, G., Jung, K.-M., Berchtold, N. C., Nguyen, V. Q., Gillen, D. L., Head, E., Cotman, C. W., & Piomelli, D.
- Affiliations
- University of Rome Tor Vergata (IT)
- University of California, Irvine (US)
- University of Kentucky (US)
- Corresponding author
- Piomelli, Daniele
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2010-09-08
- Volume
- 5
- Issue
- 9
- Pages
- e12538
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC2935886
- OpenAlex
- W1993630867
- Cited by
- 218
- References
- 42
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 17 · 2023: 9 · 2022: 15 · 2021: 19 · 2020: 16 · 2019: 15 · 2018: 9 · 2017: 18 · 2016: 19 · 2015: 21 · 2014: 14 · 2013: 14 · 2012: 11
- FWCI
- 11.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UKnowledge (University of Kentucky) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Funders
- Michael J. Fox Foundation for Parkinson's Research (05-901, 211002, P30 AG19610)
- Agilent Foundation
- Arizona Department of Health Services (P30 AG19610, P50 AG016573, 05-901, 211002, Contract 211002)
- Arizona Biomedical Research Commission (P30 AG19610, 05–901, 211002)
- University of California, Irvine (P50AG016573)
- National Institute on Aging (211002, P01AG000538, P30-AG-19610, AG-016573, P01 AG00538, AG-19610, AG 00538, P50AG016573, P30AG019610, 05-901)
- National Institute on Drug Abuse (R01DA012447)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- docosahexaenoic acid, Alzheimer's disease, cognitive impairment, omega-3 fatty acids, temporal cortex, cerebellum
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Brain, Cognition, Docosahexaenoic Acids, Female, Humans, Liver, Male, Neuropsychological Tests, Case-Control Studies
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