Reduced Posterior Cingulate Mitochondrial Activity in Expired Young Adult Carriers of the APOE ε4 Allele, the Major Late-Onset Alzheimer's Susceptibility Gene
Open accessAbstract
In vivo PET imaging studies of young-adult carriers of the apolipoprotein E ε4 allele (APOEε4), the major Alzheimer's disease (AD) susceptibility gene, have demonstrated declines in glucose metabolism in brain areas later vulnerable to AD, such as posterior cingulate cortex, decades before the possible onset of symptoms. We have previously shown in postmortem studies that such metabolic declines in AD are associated with brain regional mitochondrial dysfunction. To determine whether young adult at-risk individuals demonstrate similar mitochondrial functional decline, we histochemically assessed postmortem tissues from the posterior cingulate cortex of young-adult carriers and noncarriers of APOEε4. At-risk ε4 carriers had lower mitochondrial cytochrome oxidase activity than noncarriers in posterior cingulate cortex, particularly within the superficial cortical lamina, a pattern similar to that seen in AD patients. Except for one 34 year-old ε4 homozygote, the ε4 carriers did not have increased soluble amyloid-β, histologic amyloid-β, or tau pathology in this same region. This functional biomarker may prove useful in early detection and tracking of AD and indicates that mitochondrial mechanisms may contribute to the predisposition to AD before any evidence of amyloid or tau pathology.
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Mitochondrial dysfunction is involved in early AD pathology.
“APOE4 carriers show mitochondrial dysfunction in brain areas associated with AD even before the onset of amyloid or tau pathology or cognitive changes, indicating that mitochondrial dysfunction is involved in early AD pathology [31].”
From APOE4 Increases Energy Metabolism in APOE-Isogenic iPSC-Derived Neurons (2024) · cites this paper as [31]
The Abstract reports reduced mitochondrial cytochrome oxidase activity in young APOE ε4 carriers’ posterior cingulate cortex, generally without detectable amyloid or tau pathology. But it identifies one carrier who did have both, and says mitochondrial mechanisms *may contribute* to AD predisposition; it does not establish that dysfunction is involved in early AD pathology. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAPOE4 carriers show mitochondrial dysfunction in brain areas associated with AD even before the onset of amyloid or tau pathology or cognitive changes.
“APOE4 carriers show mitochondrial dysfunction in brain areas associated with AD even before the onset of amyloid or tau pathology or cognitive changes, indicating that mitochondrial dysfunction is involved in early AD pathology [31].”
From APOE4 Increases Energy Metabolism in APOE-Isogenic iPSC-Derived Neurons (2024) · cites this paper as [31]
The Abstract and Introduction report reduced mitochondrial cytochrome oxidase activity in young-adult APOE ε4 carriers in the posterior cingulate cortex, an AD-vulnerable region. The claim is broader than the evidence: the study measured mitochondrial activity in that region only, and the Results report one carrier who already had amyloid and tau pathology. The Abstract places the finding decades before possible symptom onset but does not establish the absence of cognitive changes in each donor. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn nondemented apoE4 carriers, mitochondrial complex IV activity is decreased in cortical regions susceptible to Alzheimer's disease.
“in nondemented apoE4 carriers, the activity of mitochondrial complex IV is decreased in cortical regions susceptible to AD [32]”
From Neuronal Apolipoprotein E4 Expression Results in Proteome-Wide Alterations and Compromises Bioenergetic Capacity by Disrupting Mitochondrial Function (2019) · cites this paper as [32]
The Results report significantly lower cytochrome oxidase (mitochondrial complex IV) activity in young-adult APOE ε4 carriers than in noncarriers, but the measurements were from the posterior cingulate cortex. The Discussion says further studies are needed to determine whether the reduction extends beyond that region, so the claim's plural “cortical regions” is broader than this study establishes. Page numbers are unavailable in our copy. (LLM, conf=0.89)
Experimental — accuracy not yet measuredDecrease in mitochondrial respiratory complex IV activity was observed in autopsy brains from young ApoE4 carriers.
“a decrease in mitochondrial respiratory complex IV activity was observed in autopsy brains from young ApoE4 carriers [74]”
From Apoe4 and Alzheimer’s Disease Pathogenesis—Mitochondrial Deregulation and Targeted Therapeutic Strategies (2023) · cites this paper as [74]
For many subjects with suspected AD or increased risk, what are currently considered downstream biomarker changes potentially precede upstream biomarker changes.
“Our hypothesis, therefore, can accommodate a growing realization that for many subjects with suspected AD, or who have an increased risk of developing AD, what are currently considered downstream biomarker changes potentially precede upstream biomarker changes [206-213].”
From The Alzheimer’s disease mitochondrial cascade hypothesis: progress and perspectives (2014) · cites this paper as [208]
In most young adult APOE4 carriers evaluated, COX activity was low even in the absence of fibrillar Aβ.
“In most of the young adult APOE4 carriers evaluated by this study COX activity was low even in the absence of fibrillar Aβ.”
From Brain aging, Alzheimer's disease, and mitochondria (2011) · cites this paper as [133]
Young adult APOE4 carriers have an increased AD risk and lower posterior cingulate COX activities than young adult non-APOE4 carriers.
“Young adult APOE4 carriers, who also have an increased AD risk, have lower posterior cingulate COX activities than young adult non-APOE4 carriers [133].”
From Brain aging, Alzheimer's disease, and mitochondria (2011) · cites this paper as [133]
Mitochondrial dysfunction has been suggested to occur early in the progression to AD and continues into later stages of AD.
“Mitochondrial dysfunction has been suggested to occur early in the progression to AD and continues into later stages of AD31–34.”
From Large-scale proteomic analysis of human brain identifies proteins associated with cognitive trajectory in advanced age (2019) · cites this paper as [32]
In a study of expired young-adult APOE4 carriers vs. non-APOE4 carriers, young-adult participants in both groups did not have amyloid or tangle deposition in the posterior cingulate cortex (PCC); yet APOE4 carriers showed reduced mitochondrial activity in PCC neurons, as measured by cytochrome oxidase levels.
“In that study, young-adult participants in both groups did not have amyloid or tangle deposition in the posterior cingulate cortex (PCC); yet, APOE4 carriers, i.e., those at greater risk for developing AD, showed reduced mitochondrial activity in PCC neurons, as measured by cytochrome oxidase levels”
From Large-scale proteomic analysis of human brain identifies proteins associated with cognitive trajectory in advanced age (2019) · cites this paper as [32]
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- Authors
- Valla, J., Yaari, R., Wolf, A. B., Kusne, Y., Beach, T. G., Roher, A. E., Corneveaux, J. J., Huentelman, M. J., Caselli, R. J., & Reiman, E. M.
- Affiliations
- Barrow Neurological Institute (US)
- University of Arizona (US)
- Banner Sun Health Research Institute (US)
- Translational Genomics Research Institute (US)
- Mayo Clinic in Arizona (US)
- Corresponding author
- Valla, Jon
- ORCID
- Venue
- Journal of Alzheimer s Disease
- Publisher
- SAGE Publications
- Published
- 2010-09-28
- Volume
- 22
- Issue
- 1
- Pages
- 307-313
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- PMC
- PMC3124564
- OpenAlex
- W1529577194
- Cited by
- 150
- References
- 34
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 10 · 2020: 9 · 2019: 11 · 2018: 6 · 2017: 14 · 2016: 12 · 2015: 6 · 2014: 13 · 2013: 15 · 2012: 17
- FWCI
- 9.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P30-AG-19610, R01-AG 19795, R01AG019795, R01AG031581, P30AG019610)
- National Institute of Neurological Disorders and Stroke (R01NS059873)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Keywords
- APOE ε4, Alzheimer's disease
- MeSH terms
- Adolescent, Adult, Alleles, Alzheimer Disease, Electron Transport Complex IV, Female, Gyrus Cinguli, Genetic Carrier Screening, Humans, Male, Mitochondria, Genetic Predisposition to Disease, Apolipoprotein E4, Young Adult
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