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Scientists Discover Brain Changes in Young Adults at Genetic Risk for Alzheimer's

  [ 129 votes ]   [ Discuss This Article ] • August 16, 2002

Decades before symptoms appear, scientists can detect abnormalities in the brains of healthy adults in their 20s and 30s who are at genetic risk for developing Alzheimer's disease, according to Eric Reiman, M.D., Scientific Director of the PET Center at Good Samaritan Regional Medical Center in Phoenix, Ariz. at the 8th International Conference on Alzheimer's Disease and Related Disorders.

Using a brain-imaging technique called positron emission tomography (PET), scientists were able to study young adults carrying the gene called apolipoprotein E, (ApoE), one of three common forms of a gene that codes production of a cholesterol carrying protein. The ApoE gene occurs in about one-fourth of the population, and individuals with ApoE have an increased risk - although not a certainty - of developing late-onset Alzheimer's disease. Late-onset Alzheimer's disease is the most common form of Alzheimer's, in which memory and thinking problems begin after the age of 60.

In the study, a dozen healthy young adults who carry ApoE were compared to 15 young adults who do not carry the gene. Clinical ratings and neuropsychological tests to assess the participants' memory and thinking, with PET imaging and powerful brain mapping software were used to map differences in brain activity between the ApoE carriers and noncarriers.

Although the young adults carrying the ApoE gene performed normally on the memory and thinking tests, Reiman and colleagues found that they had abnormally low brain activity in the same regions of the brain as patients with the clinical diagnosis of Alzheimer's disease.

"Young adults at risk of Alzheimer's disease have detectable brain abnormalities several decades before the possible onset of memory and thinking problems," said Reiman, who also serves as professor of psychiatry at the University of Arizona and director of the Arizona Alzheimer's Research Center. "Our findings underscore the possibility of finding treatments to prevent Alzheimer's disease at the earliest possible time and in the most effective way, and they reinforce the possibility of using PET to help establish the effectiveness of these prevention therapies without having to wait many years to determine whether or when treated individuals develop symptoms. Meanwhile, it is important to recognize that PET imaging technology should not be used to predict a person's risk for developing this terrible disorder."

Based on previous research, it is believed that the low brain activity found in patients clinically affected by Alzheimer's disease, and in cognitively normal people at genetic risk for the disorder, progress as the person ages. Studies led by Reiman and previously published in the New England Journal of Medicine and the Proceedings of the National Academy of Sciences found that 50- to 65-year-old carriers of the Apo£ gene had abnormally low brain activity in the same brain regions as clinically affected patients,. They also reported that this activity continues to decline over time, and that PET could efficiently test the potential of treatments to prevent Alzheimer's disease.

"I think it is very important to emphasize that APOE-£ is only one of many risks for Alzheimer's disease. Researchers have estimated there are a number of additional genes (not yet identified) that will both increase and decrease risk," explains Marilyn Albert, Ph.D., Professor of Psychiatry and Neurology, Harvard Medical School. "It is also clear there are environmental risk factors that influence the development of Alzheimer's disease. It is important to understand the impact of these risks on the brain so that we can understand how best to reduce risk for AD, and develop better treatments, and this study is part of that effort."

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