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Brain Scans May Show Alzheimer’s Beginnings

December 17, 2010
Written by: , Filed in: Neuroradiology
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Functional MRI shows abnormal brain function among those with a genetic risk factor for Alzheimer’s disease, according to a new study, and might eventually be able to flag the onset of the disease in time for preventive treatment to be effective.

Yvette I. Sheline, MD, and colleagues at Washington University School of Medicine in St. Louis have been using imaging to study brain function in people at risk for Alzheimer’s. The most recent study focused on patients with a form of the apolipoprotein E (APOE) gene called APOE4, a risk factor for late-onset Alzheimer’s.

The researchers conducted fMRI scans of 100 people, average age 62, with slightly fewer than half carrying the APOE4 gene. Earlier PET scans had shown that their brains did not have amyloid deposits. Amyloid is a protein that forms plaques in the brains of Alzheimer’s sufferers that interfere with cognitive functions. Other tests revealed that the test subjects had normal amyloid levels in their cerebrospinal fluid.

“As far as their brain amyloid burden and their cerebrospinal fluid levels, these individuals were completely normal,” said Dr. Sheline, as quoted in a Washington University news release. “But the people who had the APOE4 variant had significant differences in the way various brain regions connected with one another.”

Dr. Sheline is a professor of psychiatry, of radiology, and of neurology at Washington University and director of the school’s Center for Depression, Stress and Neuroimaging.

Though none of the subjects showed evidence of any dementia or amyloid deposits, those with the APOE4 variant still manifested irregular functioning in the brain’s default mode network. That network is active when the subject isn’t thinking about anything in particular.

The study subjects will be followed to see whether they develop amyloid deposits and Alzheimer’s. “We hope that if some people begin to accumulate amyloid,” Dr. Sheline said, “we’ll be able to look back at our data and identify particular patterns of brain function that might eventually be used to predict who is developing Alzheimer’s disease.”

The goal is to create treatments that could be deployed at the first sign that amyloid is beginning to build up. “The current belief is that from the time excess amyloid begins to collect in the brain, it takes about 10 years for a person to develop dementia,” Dr. Sheline said. “But this new study would suggest we might be able to intervene even before amyloid plaques begin to form. That could give us an even longer time window to intervene once an effective treatment can be developed.”

A study detailing the research appears in the December 15 issue of The Journal of Neuroscience.

Related seminar: Neuroradiology Review

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