title: Increased brain activation during working memory in cognitively intact adults with the APOE epsilon4 allele.
abstract: OBJECTIVE
  Altered patterns of brain activity during cognitive tasks have been demonstrated using functional magnetic resonance imaging (fMRI) in mild cognitive impairment and Alzheimer's disease. However, there have been few studies of adults at genetic risk for Alzheimer's disease prior to the onset of symptoms. The purpose of this study was to determine whether brain activation patterns associated with working memory differ as a function of apolipoprotein E (APOE) genotype in cognitively intact adults.
  
  
  METHODS
  Participants were cognitively intact, healthy adults who completed genotyping, comprehensive neuropsychological testing, and structural and functional neuroimaging. Twenty-two participants had the APOE epsilon3/epsilon3 genotype, and 13 participants had the APOE epsilon3/epsilon4 genotype. The study employed an auditory verbal N-back task to probe working memory-related brain activity.
  
  
  RESULTS
  The epsilon3/epsilon3 and epsilon3/epsilon4 groups did not differ in demographic characteristics, cognitive ability, mood, or in-scanner task performance. The epsilon3/epsilon4 group showed greater activity during working memory in the medial frontal and parietal regions bilaterally and in the right dorsolateral prefrontal cortex. There were no regions in which the epsilon3/epsilon3 group showed greater activation than the epsilon3/epsilon4 group.
  
  
  CONCLUSIONS
  These results indicate that differences in brain activity are evident in cognitively intact individuals who are at risk for late-onset Alzheimer's disease by virtue of their APOE allele status. As neuroprotective interventions become available, early detection will increase in importance. The combination of genetic and functional neuroimaging strategies may prove useful for monitoring individuals at risk for Alzheimer's disease before the onset of cognitive symptoms.
authors.affiliation: Neuropsychology Program and Brain Imaging Laboratory, Department of Psychiatry, Dartmouth Medical School/DHMC, One Medical Center Dr., Lebanon, NH 03756-0001, USA. wishart@dartmouth.edu
authors.forename: Heather A
authors.initials: HA
authors.lastname: Wishart
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Saykin
authors.forename: Laura A
authors.initials: LA
authors.lastname: Rabin
authors.forename: Robert B
authors.initials: RB
authors.lastname: Santulli
authors.forename: Laura A
authors.initials: LA
authors.lastname: Flashman
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Guerin
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Mamourian
authors.forename: Dorothy R
authors.initials: DR
authors.lastname: Belloni
authors.forename: C Harker
authors.initials: CH
authors.lastname: Rhodes
authors.forename: Thomas W
authors.initials: TW
authors.lastname: McAllister
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D001921:Brain / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005838:Genotype; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000502:physiology; D017397:Prefrontal Cortex / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology; D012307:Risk Factors; D013647:Task Performance and Analysis; D014705:Verbal Behavior / Q000502:physiology
chemical_list: D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E