Variants in the APOE gene region may explain ethnic differences in the association of Alzheimer’s disease (AD) with ε4. Ethnic differences in allele frequencies for three APOE region SNPs (single nucleotide polymorphisms) were identified and tested for association in 19,398 East Asians (EastA), including Koreans and Japanese, 15,836 European ancestry (EuroA) individuals, and 4985 African Americans, and with brain imaging measures of cortical atrophy in sub-samples of Koreans and EuroAs. Among ε4/ε4 individuals, AD risk increased substantially in a dose-dependent manner with the number of APOE promoter SNP rs405509 T alleles in EastAs (TT: OR (odds ratio) = 27.02, p = 8.80 × 10⁻⁹⁴; GT: OR = 15.87, p = 2.62 × 10⁻⁹) and EuroAs (TT: OR = 18.13, p = 2.69 × 10⁻¹⁰⁸; GT: OR = 12.63, p = 3.44 × 10⁻⁶⁴), and rs405509-T homozygotes had a younger onset and more severe cortical atrophy than those with G-allele. Functional experiments using APOE promoter fragments demonstrated that TT lowered APOE expression in human brain and serum. The modifying effect of rs405509 genotype explained much of the ethnic variability in the AD/ε4 association, and increasing APOE expression might lower AD risk among ε4 homozygotes.

Oligomeric amyloid-ß is a major toxic species associated with Alzheimer’s disease pathogenesis. Methods used to measure oligomeric amyloid-β in the blood have increased in number in recent years. The Multimer Detection System-Oligomeric Amyloid-β (MDS-OAβ) is a specific method to measure oligomerization tendencies in the blood. The objective of this study was to determine the association between amyloid-ß oligomerization in the plasma and structural changes of the brain. We studied 162 subjects composed of 92 community-based normal healthy subjects, 17 with subjective cognitive decline, 14 with mild cognitive impairment and 39 with Alzheimer’s disease dementia. All subjects underwent MDS-OAβ and three-dimensional T1 magnetic resonance imaging. To determine the structural changes of the brain that are statistically correlated with MDS-OAβ level, we used voxel-based morphometry with corrections for age and total intracranial volume covariates. We found brain volume reduction in the bilateral temporal, amygdala, parahippocampal and lower parietal lobe and left cingulate and precuneus regions (family-wise error, p < 0.05). Reduction was also found in white matter in proximity to the left temporal and bilateral lower parietal lobes and posterior corpus callosum (family-wise error, p < 0.05). Brain volume increment was not observed in any regions within grey or white matter. Findings suggest that substantial correlation exists between amyloid ß oligomerization in the blood and brain volume reduction in the form of Alzheimer’s disease despite of uncertainty in the casual relationship.

Diagnosing and treating dementia, including mild cognitive impairment (MCI), is challenging due to diverse disease types and overlapping symptoms. Early MCI detection is vital as it can precede dementia, yet distinguishing it from later stage dementia is intricate due to subtle symptoms. The primary objective of this study is to adopt a complex network perspective to unravel the underlying pathophysiological mechanisms of dementia-related disorders. Leveraging the extensive availability of electroencephalogram (EEG) data, our study focuses on the meticulous identification and analysis of EEG-based brain functional network (BFNs) associated with dementia-related disorders. To achieve this, we employ the Phase Lag Index (PLI) as a connectivity measure, offering a comprehensive view of neural interactions. To enhance the analytical rigor, we introduce a data-driven threshold selection technique. This innovative approach allows us to compare the topological structures of the formulated BFNs using complex network measures quantitatively and statistically. Furthermore, we harness the power of these BFNs by utilizing them as pre-defined graph inputs for a Graph Convolution Network (GCN-net) based approach. The results demonstrate that graph theory metrics, such as the rich-club coefficient, transitivity, and assortativity coefficients, effectively distinguish between MCI, Alzheimer’s disease (AD) and vascular dementia (VD). Furthermore, GCN-net achieves high accuracy (95.07% delta, 80.62% theta) and F1-scores (0.92 delta, 0.67 theta), highlighting the effectiveness of EEG-based BFNs in the analysis of dementia-related disorders.

Han BI, et al. J Clin Neurol. 2021 Jan;17(1):1-10. https://doi.org/10.3988/jcn.2021.17.1.1