Relationship of medial temporal lobe atrophy, APOE genotype, and cognitive reserve in preclinical Alzheimer's disease.
Anja SoldanCorinne PettigrewYi LuMei-Cheng WangOla SelnesMarilyn AlbertTimothy BrownJ Tilak RatnanatherLaurent YounesMichael I Millernull nullPublished in: Human brain mapping (2015)
This study evaluated the utility of baseline and longitudinal magnetic resonance imaging (MRI) measures of medial temporal lobe brain regions collected when participants were cognitively normal and largely in middle age (mean age 57 years) to predict the time to onset of clinical symptoms associated with mild cognitive impairment (MCI). Furthermore, we examined whether the relationship between MRI measures and clinical symptom onset was modified by apolipoprotein E (ApoE) genotype and level of cognitive reserve (CR). MRI scans and measures of CR were obtained at baseline from 245 participants who had been followed for up to 18 years (mean follow-up 11 years). A composite score based on reading, vocabulary, and years of education was used as an index of CR. Cox regression models showed that lower baseline volume of the right hippocampus and smaller baseline thickness of the right entorhinal cortex predicted the time to symptom onset independently of CR and ApoE-ɛ4 genotype, which also predicted the onset of symptoms. The atrophy rates of bilateral entorhinal cortex and amygdala volumes were also associated with time to symptom onset, independent of CR, ApoE genotype, and baseline volume. Only one measure, the left entorhinal cortex baseline volume, interacted with CR, such that smaller volumes predicted symptom onset only in individuals with lower CR. These results suggest that MRI measures of medial temporal atrophy, ApoE-ɛ4 genotype, and the protective effects of higher CR all predict the time to onset of symptoms associated with MCI in a largely independent, additive manner during the preclinical phase of Alzheimer's disease.
Keyphrases
- cognitive decline
- mild cognitive impairment
- magnetic resonance imaging
- contrast enhanced
- functional connectivity
- high fat diet
- diffusion weighted imaging
- computed tomography
- healthcare
- resting state
- stem cells
- type diabetes
- magnetic resonance
- skeletal muscle
- sleep quality
- blood brain barrier
- cross sectional
- cognitive impairment
- cerebral ischemia
- brain injury
- subarachnoid hemorrhage