Dataset Information

Association between APOE ε2 and Aβ burden in patients with Alzheimer- and vascular-type cognitive impairment.

ABSTRACT:

Objective

To investigate the association between APOE genotype and β-amyloid (Aβ) burden, as measured by PET in patients with subcortical vascular cognitive impairment (SVCI) and those with Alzheimer disease-related cognitive impairment (ADCI).

Methods

This was a cross-sectional study of 310 patients with SVCI and 999 with ADCI. To evaluate the effects of APOE genotype or diagnostic group on Aβ positivity, we performed multivariate logistic regression analyses. Further distinctive underlying features of latent subgroups were examined by employing a latent class cluster analysis approach.

Results

In comparison with ε3 homozygotes, in the ADCI group, ε2 carriers showed a lower frequency of Aβ positivity (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.23-0.79), while in the SVCI group, ε2 carriers showed a higher frequency of Aβ positivity (OR 2.26, 95% CI 1.02-5.01). In particular, we observed an interaction effect of ε2 carrier status and diagnostic group on Aβ positivity (OR 5.12, 95% CI 1.93-13.56), in that relative to ε3 homozygotes, there were more Aβ-positive ε2 carriers in the SVCI group than in the ADCI group. We also identified latent subgroups of Aβ-positive APOE ε2 carriers with SVCI and Aβ-positive APOE ε4 carriers with ADCI.

Conclusions

Our findings suggest that APOE ε2 is distinctly associated with Aβ deposition in patients with SVCI and those with ADCI. Our findings further suggest that there is a distinctive subgroup of Aβ-positive APOE ε2 carriers with SVCI among patients with cognitive impairment.

SUBMITTER: Lee JS

PROVIDER: S-EPMC7682916 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Importance:There are conflicting results claiming that Alzheimer disease signature neurodegeneration may be more, less, or similarly advanced in individuals with ?-amyloid peptide (A?)-negative (A?-) suspected non-Alzheimer disease pathophysiology (SNAP) than in A?-positive (A?+) counterparts. Objective:To examine patterns of neurodegeneration in individuals with SNAP compared with their A?+ counterparts. Design, Setting, and Participants:A longitudinal cohort study was conducted among individuals with mild cognitive impairment (MCI) and cognitively normal individuals receiving care at Alzheimer's Disease Neuroimaging Initiative sites in the United States and Canada for a mean follow-up period of 30.5 months from August 1, 2005, to June 30, 2015. Several neurodegeneration biomarkers and longitudinal cognitive function were compared between patients with distinct SNAP (A?- and neurodegeneration-positive [A?-N+]) subtypes and their A?+N+ counterparts. Main Outcomes and Measures:Participants were classified according to the results of their florbetapir F-18 (A?) positron emission tomography and their Alzheimer disease-associated neurodegeneration status (temporoparietal glucose metabolism determined by fluorodeoxyglucose F 18 [FDG]-labeled positron emission tomography and/or hippocampal volume [HV] determined by magnetic resonance imaging: participants with subthreshold HV values were regarded as exhibiting hippocampal volume atrophy [HV+], while subthreshold mean FDG values were considered as FDG hypometabolism [FDG+]). Results:The study comprised 265 cognitively normal individuals (135 women and 130 men; mean [SD] age, 75.5 [6.7] years) and 522 patients with MCI (225 women and 297 men; mean [SD] age, 72.6 [7.8] years). A total of 469 individuals with MCI had data on neurodegeneration biomarkers; of these patients, 107 were A?-N+ (22.8%; 63 FDG+, 82 HV+, and 38 FDG+HV+) and 187 were A?+N+ (39.9%; 135 FDG+, 147 HV+, and 95 FDG+HV+ cases). A total of 209 cognitively normal participants had data on neurodegeneration biomarkers; of these, 52 were A?-N+ (24.9%; 30 FDG+, 33 HV+, and 11 FDG+HV+) and 37 were A?+N+ (17.7%; 22 FDG+, 26 HV+, and 11 FDG+HV+). Compared with their A?+ counterparts, all patients with MCI SNAP subtypes displayed better preservation of temporoparietal FDG metabolism (mean [SD] FDG: A?-N+, 1.25 [0.11] vs A?+N+, 1.19 [0.11]), less severe atrophy of the lateral temporal lobe, and lower mean (SD) cerebrospinal fluid levels of tau (59.2 [32.8] vs 111.3 [56.4]). In MCI with SNAP, sustained glucose metabolism and gray matter volume were associated with disproportionately low APOE ?4 (A?-N+, 18.7% vs A?+N+, 70.6%) and disproportionately high APOE ?2 (18.7% vs 4.8%) carrier prevalence. Slower cognitive decline and lower rates of progression to Alzheimer disease (A?-N+, 6.5% vs A?+N+, 32.6%) were also seen in patients with MCI with SNAP subtypes compared with their A?+ counterparts. In cognitively normal individuals, neurodegeneration biomarkers did not differ between A?-N+ and A?+N+ cases. Conclusions and Relevance:In MCI with SNAP, low APOE ?4 and high APOE ?2 carrier prevalence may account for differences in neurodegeneration patterns between A?-N+ and A?+N+ cases independent from the neuroimaging biomarker modality used to define neurodegeneration associated with Alzheimer disease.