title: Genetic influences on atrophy patterns in familial Alzheimer's disease: a comparison of APP and PSEN1 mutations.
abstract: Mutations in the presenilin1 (PSEN1) and amyloid β-protein precursor (APP) genes account for the majority of cases of autosomal dominantly inherited Alzheimer's disease (AD). We wished to assess and compare the patterns of cerebral loss produced by these two groups of mutations. Volumetric magnetic resonance imaging and neuropsychological assessments were performed in individuals with clinical AD carrying mutations in the APP (n = 10) and PSEN1 (n = 18) genes and in healthy controls (n = 18). Voxel-based morphometry (VBM), cortical thickness, and region of interest analyses were performed. Mini-Mental State Examination scores were similar in the two disease groups suggesting similar levels of disease severity. There was evidence that APP subjects have smaller hippocampal volume compared with PSEN1 subjects (p = 0.007), and weak evidence that they have larger whole-brain and grey matter volumes (both p = 0.07). Although there was no evidence of statistically significant differences between APP and PSEN1 in VBM or cortical thickness analyses, effect-maps were suggestive of APP subjects having more medial temporal lobe atrophy and conversely PSEN1 subjects showing more neocortical loss. Neuropsychological data were consistent with these regional differences and suggested greater memory deficits in the APP patients and greater impairment in non-memory domains in the PSEN1 group, although these differences were not statistically significant. We conclude that the mechanisms by which APP and PSEN1 mutations cause neuronal loss may differ which furthers our understanding of the neuropathology underlying AD and may inform future therapeutic strategies and trial designs.
authors: Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK. r.scahill@ucl.ac.uk
authors: Rachael I
authors: RI
authors: Scahill
authors: Gerard R
authors: GR
authors: Ridgway
authors: Jonathan W
authors: JW
authors: Bartlett
authors: Josephine
authors: J
authors: Barnes
authors: Natalie S
authors: NS
authors: Ryan
authors: Simon
authors: S
authors: Mead
authors: Jonathan
authors: J
authors: Beck
authors: Matthew J
authors: MJ
authors: Clarkson
authors: Sebastian J
authors: SJ
authors: Crutch
authors: Jonathan M
authors: JM
authors: Schott
authors: Sebastien
authors: S
authors: Ourselin
authors: Jason D
authors: JD
authors: Warren
authors: John
authors: J
authors: Hardy
authors: Martin N
authors: MN
authors: Rossor
authors: Nick C
authors: NC
authors: Fox
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000235:genetics* / Q000473:pathology*; D016564:Amyloid beta-Protein Precursor / Q000235:genetics*; D001284:Atrophy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D019579:Neocortex / Q000473:pathology; D053764:Presenilin-1 / Q000235:genetics*; D013702:Temporal Lobe / Q000473:pathology
chemical_list: D016564:Amyloid beta-Protein Precursor; C508853:PSEN1 protein, human; D053764:Presenilin-1
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