title: Influence of cognitive status, age, and APOE-4 genetic risk on brain FDDNP positron-emission tomography imaging in persons without dementia.
abstract: BACKGROUND
  Amyloid senile plaques and tau neurofibrillary tangles are neuropathological hallmarks of Alzheimer disease that accumulate in the brains of people without dementia years before they develop dementia. Positron emission tomography (PET) scans after intravenous injections of 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile (FDDNP), which binds to plaques and tangles in vitro, demonstrate increased cerebral binding in patients with Alzheimer disease compared with cognitively intact controls. Here we investigated whether known risk factors for Alzheimer disease and dementia are associated with FDDNP-PET binding.
  
  
  OBJECTIVE
  To determine if impaired cognitive status, older age, apolipoprotein E-4 (APOE-4) genetic risk for Alzheimer disease, family history of dementia, and less education are associated with increased regional cerebral FDDNP-PET binding.
  
  
  METHODS
  Cross-sectional clinical study.
  
  
  METHODS
  A university research institute.
  
  
  METHODS
  Volunteer sample of 76 middle-aged and older persons without dementia (mean age, 67 years) including 36 with mild cognitive impairment. Of the 72 subjects with genetic data, 34 were APOE-4 carriers.
  
  
  METHODS
  The FDDNP-PET signal in brain regions of interest, including medial and lateral temporal, posterior cingulate, parietal, and frontal.
  
  
  RESULTS
  For all regions studied, cognitive status was associated with increased FDDNP binding (P < .02 to .005). Older age was associated with increased lateral temporal FDDNP binding. Carriers of APOE-4 demonstrated higher frontal FDDNP binding than noncarriers. In the mild cognitive impairment group, age was associated with increased medial and lateral temporal FDDNP binding, and APOE-4 carriers had higher medial temporal binding than noncarriers.
  
  
  CONCLUSIONS
  Impaired cognitive status, older age, and APOE-4 carrier status are associated with increased brain FDDNP-PET binding in persons without dementia, consistent with previous clinical and postmortem studies associating these risk factors with amyloid plaque and tau tangle accumulation. Stratifying subject groups according to APOE-4 carrier status, age, and cognitive status may therefore be an informative strategy in future clinical trials using FDDNP-PET.
authors.affiliation: Semel Institute, 760 Westwood Plaza, Ste 88-201, Los Angeles, CA 90024, USA. gsmall@mednet.ucla.edu
authors.forename: Gary W
authors.initials: GW
authors.lastname: Small
authors.forename: Prabha
authors.initials: P
authors.lastname: Siddarth
authors.forename: Alison C
authors.initials: AC
authors.lastname: Burggren
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kepe
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ercoli
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Miller
authors.forename: Helen
authors.initials: H
authors.lastname: Lavretsky
authors.forename: Paul M
authors.initials: PM
authors.lastname: Thompson
authors.forename: Greg M
authors.initials: GM
authors.lastname: Cole
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
authors.forename: Michael E
authors.initials: ME
authors.lastname: Phelps
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Bookheimer
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Barrio
mesh_terms: D000368:Aged; D000483:Alleles; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000235:genetics*; D004522:Educational Status; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D016874:Neurofibrillary Tangles / Q000000981:diagnostic imaging; D009483:Neuropsychological Tests; D009570:Nitriles; D058225:Plaque, Amyloid / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D012307:Risk Factors; D016875:tau Proteins / Q000378:metabolism
chemical_list: C444520:2-(1-(6-((2-fluoroethyl)(methyl)amino)-2-naphthyl)ethylidene)malononitrile; D053327:Apolipoprotein E4; C054369:MAPT protein, human; D009570:Nitriles; D016875:tau Proteins