Volume 17, Number 1, May 2009

Pages 1-3
Claudia H. Kawas
Robert Katzman, MD: In Memoriam

Pages 7-31
Review Article
Francesco Panza, Cristiano Capurso, Alessia D’Introno, Anna M Colacicco, Vincenza Frisardi, Maria Lorusso, Andrea Santamato, Davide Seripa, Alberto Pilotto, Emanuele Scafato, Gianluigi Vendemiale, Antonio Capurso, Vincenzo Solfrizzi
Alcohol Drinking, Cognitive Functions in Older Age, Predementia, and Dementia Syndromes
Abstract: Among lifestyle-related factors, low to moderate alcohol drinking has been proposed as a protective factor against the development of age-related changes in cognitive function, predementia syndromes, and cognitive decline of degenerative (Alzheimer’s disease, AD) or vascular origin (vascular dementia, VaD) in several longitudinal studies, but contrasting findings also exist. Furthermore, many of these studies were limited by cross-sectional design, restriction by age or sex, or incomplete ascertainment. Different outcomes, beverages, drinking patterns, or follow-up periods, or possible interactions with other lifestyle-related (i.e., smoking) or genetic factors [i.e., apolipoprotein E (APOE) genotyping] may be sources of great variability. Light to moderate alcohol use may be associated with a reduced risk of unspecified incident dementia and AD, while for VaD, cognitive decline, and predementia syndromes, the current evidence is only suggestive of a protective effect. In conclusion, as intervention studies are not feasible in this area, the best evidence comes from an overview of epidemiological studies, suggesting that the protective effects are more likely with wine consumption and the absence of an APOE e4 allele. At present, there is no indication that light to moderate alcohol drinking would be harmful to cognition and dementia, but it is not possible to define a specific beneficial level of alcohol intake.

Pages 33-47
Review Article
Hozefa Amijee and David I. C. Scopes
The Quest for Small Molecules as Amyloid Inhibiting Therapies for Alzheimer’s Disease
Abstract: Amyloid-β (Aβ) peptide is one of the most promising targets for the development of new therapies for Alzheimer’s disease (AD). A growing body of evidence suggests a key pathogenic role for soluble oligomers of Aβ, and therapeutics which block the generation of toxic Aβ assemblies may provide successful new treatments for AD. This is therapeutically attractive because the aggregation process is believed to be an exclusively pathological event and therefore compounds targeting this mechanism are more likely to have an acceptable safety profile. A number of studies have shown that AD severity correlates more closely with soluble oligomeric forms of Aβ than with fibrillar forms of the peptide. Thus, blocking the initial stages of Aβ aggregation with small molecules could hold considerable promise as an entry to new therapies for AD. The rapid development in our understanding of toxic amyloid assemblies now provides fresh impetus for this interesting approach, and this review assesses the status of drug development in this area. Recent progress with clinical studies and highlights of new structural series that are showing promise in the discovery/pre-clinical phase are discussed.

Commentary on Lopes et al., J Alzheimers Dis 16(3), 541-549, 2009
   Pages 49-51
   Zixu Mao
   The Question of Cell Cycle Reentry by Mature Neurons in Response to Amyloid-ß and Tau Pathology

Pages 53-57
Short Communication
Susanne T. de Bot, H.P.H. Kremer, Dennis Dooijes, Marcel M. Verbeek (Communicated by Sanna-Kaisa Herukka)
CSF Studies Facilitate DNA Diagnosis in Familial Alzheimer’s Disease Due to a Presenilin-1 Mutation
Abstract: In sporadic Alzheimer’s disease (AD), cerebrospinal fluid (CSF) analysis is becoming increasingly relevant to establish an early diagnosis. We present a case of familial AD due to a presenilin-1 mutation in which CSF studies suggested appropriate DNA diagnostics. A 38 year old Dutch man presented with dementia, spastic paraparesis, and frontal executive function impairments, mimicking familial Creutzfeldt Jakob disease and frontotemporal dementia. CSF studies, revealing increased total tau and phosphorylated-tau levels with decreased amyloid β42, distinguished familial AD from Creutzfeldt Jakob disease and frontotemporal dementia. A causative p.L424R PSEN1 mutation was subsequently identified.

Pages 59-68
Nicola Origlia, Simona Capsoni, Antonino Cattaneo, Fang Fang, Ottavio Arancio, Shi Du Yan, Luciano Domenici
Aβ-Dependent Inhibition of LTP in Different Intra-Cortical Circuits of the Visual Cortex: The Role of RAGE
Abstract: Oligomeric amyloid-β (Aβ) interferes with long term potentiation (LTP) and cognitive processes, suggesting that Aβ peptides may play a role in the neuronal dysfunction which characterizes the early stages of Alzheimer’s disease (AD). Multiple lines of evidence have highlighted RAGE (receptor for advanced glycation end-products) as a receptor involved in Aβ-induced neuronal and synaptic dysfunction. In the present study, we investigated the effect of oligomeric soluble Aβ1-42 on LTP elicited by the stimulation of different intracortical pathways in the mouse visual cortex. A variety of nanomolar concentrations (20-200 nM) of Aβ1-42 were able to inhibit LTP in cortical layer II-III induced by either white matter (WM-Layer II/III) or the layer II/III (horizontal pathway) stimulation, whereas the inhibition of LTP was more susceptible to Ab1-42, which occurred at 20 nM of Aβ, when stimulating layer II-III horizontal pathway. Remarkably, cortical slices were resistant to nanomolar Aβ1-42 in the absence of RAGE (genetic deletion of RAGE) or blocking RAGE by RAGE antibody. These results indicate that nanomolar Aβ inhibits LTP expression in different neocortical circuits. Crucially, it is demonstrated that Aβ-induced reduction of LTP in different cortical pathways is mediated by RAGE.

Pages 69-79
Hamid R. Sohrabi, Kristyn A. Bates, Mark Rodrigues, Kevin Taddei, Georgia Martins, Simon M. Laws, Nicola T. Lautenschlager, Satvinder S. Dhaliwal, Jonathan K. Foster, Ralph N. Martins
The Relationship Between Memory Complaints, Perceived Quality of Life and Mental Health in Apolipoprotein Eε4 Carriers and Non-Carriers?
Abstract: Apolipoprotein E ε4 (APOE-ε4) is a major genetic risk factor for Alzheimer’s disease. In this study, we addressed the question of whether possession of the APOE-ε4 allele results in adverse effects on perceived health-related quality of life (HRQL) and on symptoms of depression and anxiety in people with subjective memory complaints (SMC). 138 healthy, community-dwelling elderly volunteers, aged 52 to 85, were assessed for HRQL, depression, and anxiety. The participants were classified as i) APOE-ε4 carriers or ii) non-carriers with a) SMC or b) without memory complaints. The possible interactions of APOE genotype, gender, and SMC on HRQL, depression, and anxiety were investigated statistically. SMC was significantly associated with poorer outcomes on measures of depression, trait anxiety, and mental health. APOE-ε4 carriers did not significantly differ from non-carriers on HRQL, depression, and anxiety. However, significant interaction was found between APOE-ε4 genotype and SMC on depression. These findings are important from a health perspective and suggest that memory complaints are associated with markers of mental health and quality of life that are independent of possession of the APOE-ε4 allele, despite the importance of this polymorphism in the risk of AD and other health problems.

Pages 81-90
Mario Suwalsky, Silvia Bolognin, Paolo Zatta
Interaction between Alzheimer’s Amyloid-β and Amyloid-β-Metal Complexes with Cell Membranes
Abstract: A number of observations indicate that the primary target of amyloid-β (Aβ) peptide is the cellular membrane of neurons. In the context of these observations we investigated, using X-ray diffraction techniques, whether Aβ-metal complexes were able to affect lipid bilayers as a model of cell membranes. The binding of Al to Aβ gave particular conformational properties to the peptide that led to a marked alteration of the lipid bilayer representing phospholipids located in the outer monolayer of cell membranes. This effect was peculiar, since in our experimental conditions Aβ alone did not affect the lipid architecture, whereas the Al salt did, but only at concentrations several orders of magnitude higher than those of the Aβ-Al complex, which produced similar alterations to the lipid. In accordance with the effects observed with lipid bilayers, studies with human neuroblastoma cells demonstrated an impairment of cell functioning only in the presence of Aβ-Al complex. Our findings imply that Al, compared to the other Aβ-metal complexes tested, could have a specifically relevant effect in enhancing Aβ toxicity.

Pages 91-103
Anis Larbi, Graham Pawelec, Jacek M. Witkowski, Hyman M. Schipper, Evelyna Derhovanessian, David Goldeck, Tamas Fulop (Communicated by Marcella Reale)
Dramatic Shifts in Circulating CD4 but not CD8 T Cell Subsets in Mild Alzheimer’s Disease
Abstract: The distribution of peripheral T cell subsets in young and healthy old people is markedly different, characterized by decreased numbers of naïve cells and increased numbers and clonal expansions of memory cells, predominantly in the CD8+ MHC class I-restricted subset. Here, however, we document dramatic alterations in naïve and memory subsets of CD4+ cells in patients with mild Alzheimer’s disease (AD), with greatly decreased percentages of naïve cells, elevated memory cells, and increased proportions of CD4+ but not CD8+ cells lacking the important costimulatory receptor CD28. CD4+CD25 high potentially T regulatory cells with a naïve phenotype are also reduced in AD patients. Together these data provide stronger evidence than hitherto presented for more highly differentiated CD4+ as well as CD8+ T cells in AD patients, consistent with an adaptive immune system undergoing persistent antigenic challenge and possibly manifesting dysregulation as a result.

Pages 105-144
Sophie Germain, Stéphane Adam, Catherine Olivier, Helen Cash, Pierre Jean Ousset, Sandrine Andrieu, Bruno Vellas, Thierry Meulemans, Emma Reynish, Eric Salmon, the ICTUS-EADC Network
Does cognitive impairment influence burden in caregivers of patients with Alzheimer’s disease?
Abstract: Alzheimer’s disease (AD) is characterized by a progressive deterioration of various cognitive and behavioral abilities, and it also has a health impact on the patients’ caregiver. Our aim was to determine the patient (and to a lesser extent the caregiver) characteristics that contribute most to the caregiver burden. We used the baseline data from the ICTUS study, a European longitudinal cohort of patients with mild to moderate AD. Data from 1091 patients and their caregivers was used for analysis. Three principal components analyses were performed on variables from the domains of cognition, neuropsychiatric symptoms, and daily function using the MMSE plus the ADAS-Cog, NPI, and IADL subscores, respectively. These were followed by a stepwise logistic regression to identify patient characteristics which best predict caregiver burden. The regression model (R2 = 0.35, p < 0.001) shows that the best explanatory variables are: 1) neuropsychiatric symptoms (NPI); 2) difficulties in the IADL; 3) time taken by caregiving; 4) demographic variables such as caregiver’s age and patient sex; and 5) severity of cognitive impairment. In conclusion, our results demonstrate that although the strongest determinant of the caregiver burden is behavioral disturbance, the impact of the degree of cognitive impairment on burden is also significant.

Pages 115-123
Christoph Laske, Konstantinos Stellos, Elke Stransky, Thomas Leyhe, Meinrad Gawaz (Communicated by Milan Fiala)
Decreased Plasma Levels of Granulocyte-Colony Stimulating Factor (G-CSF) in Patients with Early Alzheimer's Disease
Abstract: Alzheimer’s disease (AD) is characterized by massive neuronal cell loss in the brain. Granulocyte-colony stimulating factor (G-CSF) is a hematopoietic growth factor that promotes neuroprotective effects and supports neurogenesis in the brain. In the present study, we found significantly lower G-CSF plasma levels in 50 early AD patients in comparison with 50 age-matched healthy controls. In AD patients, G-CSF levels showed a significant inverse correlation with amyloid-β (Aβ1-42) levels in cerebrospinal fluid, but not with levels of tau protein in cerebrospinal fluid or Mini-Mental Status Examination scores. In addition, G-CSF plasma levels were significantly inversely correlated with age in AD patients and healthy controls. In conclusion, decreased G-CSF plasma levels in early AD patients may contribute to a deficient hematopoietic brain support with putative pathogenic relevance. Further studies are needed to examine whether a modulation of hematopoietic growth factors such as G-CSF could be a promising new therapeutic strategy for AD.

Pages 125-133
Daniela Galimberti, Eliana Venturelli, Chiara Villa, Chiara Fenoglio, Francesca Clerici, Alessandra Marcone, Luisa Benussi, Francesca Cortini, Diego Scalabrini, Luca Perini, Ilaria Restelli, Giuliano Binetti, Stefano Cappa, Claudio Mariani, Nereo Bresolin, Elio Scarpini
MCP-1 A-2518G Polymorphism: Effect on Susceptibility for Frontotemporal Lobar Degeneration and on Cerebrospinal Fluid MCP-1 Levels
Abstract: The distribution of the MCP-1 A-2518G single nucleotide polymorphisms (SNP) was analyzed in a population of 212 patients with frontotemporal lobar degeneration (FTLD) compared with 203 age-matched controls. A significantly decreased allelic frequency of the G allele in patients compared with controls was observed (21.1 versus 29.3%, P=0.011, OR: 0.59, CI: 0.40-0.87). Stratifying according to gender, the association was maintained in male patients versus male controls (17.8 versus 29.4%, P=0.016, OR=0.46, 95% CI: 0.25-0.84), but not in female patients compared with female controls (23.5 versus 29.2%, P>0.05). The frequency of apolipoprotein E ε4 carriers was increased in patients (26.4 versus 13.8%, P=0.0015, OR: 2.24, 95% CI: 1.37-3.67). Apolipoprotein E status did not influence the distribution of the A-2518G SNP. Monocyte chemotactic protein (MCP)-1 levels were determined in cerebrospinal fluid (CSF) collected from 23 patients and 17 controls. MCP-1 CSF levels were increased in patients compared with controls (449.01±27.57 versus 364.19±23.75 pg/ml, P=0.011). Stratifying patients according to the presence of the polymorphic allele, significantly increased CSF MCP-1 levels were observed in carriers of the G allele compared with non-carriers (502.21±44.57 versus 395.87±21.92 pg/ml, P=0.045). The MCP-1 A-2518G SNP acts as protective factor for sporadic FTLD, possibly by influencing MCP-1production.

Pages 135-142
Hamid R. Sohrabi, Kristyn A. Bates, Mark Rodrigues, Kevin Taddei, Simon M. Laws, Nicola T. Lautenschlager, Satvinder S. Dhaliwal, Amy N.B. Johnston, Alan Mackay-Sim, Samuel Gandy, Jonathan K. Foster, Ralph N. Martins
Olfactory Dysfunction is Associated with Subjective Memory Complaints in Community-Dwelling Elderly Individuals
Abstract: Olfactory dysfunction has been reported in clinical and preclinical phases of Alzheimer’s disease. Subjective memory complaints have been proposed as a potential early indicator for increased risk of Alzheimer’s disease, but have also been associated with depression, personality characteristics, and health problems. In this study, we aimed to determine which of these putative markers can predict memory complaints in community-dwelling elderly individuals, focusing on olfactory symptoms. A cohort of 144 elderly volunteers (42 males and 102 females), aged 50 to 86, was recruited from an ongoing longitudinal study. Participants were assessed for olfactory capacities (threshold, discrimination, and identification), subjective memory complaints, depression, and cognitive functions. Subjective memory complaints were significantly associated with olfactory discrimination and identification but not with threshold. Olfactory functions and depressive symptoms were both significantly associated with subjective memory complaints. In addition, memory complainers were significantly worse than non-complainers with respect to olfactory discrimination, identification, and overall olfactory functioning. The findings suggest that olfactory capacity may be a potentially significant biomarker for identifying community-dwelling elderly with memory complaints who are at increased risk for age-related cognitive decline and Alzheimer’s disease.

Pages 143-149
Ana Lloret, Mari-Carmen Badía, Nancy J. Mora, Federico V. Pallardó, Maria-Dolores Alonso, Jose Viña
Vitamin E Paradox in Alzheimer’s Disease: It Does Not Prevent Loss of Cognition and May Even Be Detrimental
Abstract: There is controversy as to whether vitamin E is beneficial in Alzheimer’s disease (AD). In this study, we tested if vitamin E prevents oxidative stress and loss of cognition in AD. Fifty-seven AD patients were recruited and divided in two groups: placebo or treated with 800 IU of vitamin E per day for six months. Of these 57 patients, only 33 finished the study. We measured blood oxidized glutathione (GSSG) and used the following cognitive tests: Mini-Mental State Examination, Blessed-Dementia Scale, and Clock Drawing Test. Of those patients treated with vitaimin E, we found two groups. In the first group, “respondents” to vitamin E, GSSG levels were lower after the treatment and scores on the cognitive tests were maintained. The second group, “non-respondents”, consisted of patients in which vitamin E was not effective in preventing oxidative stress. In these patients, cognition decreased sharply, to levels even lower than those of patients taking placebo. Based on our findings, it appears that vitamin E lowers oxidative stress in some AD patients and maintains cognitive status, however, in those in which vitamin E does not prevent oxidative stress, it is detrimental in terms of cognition. Therefore, supplementation of AD patients with vitamin E cannot be recommended without determination of its antioxidant effect in each patient.

Pages 151-159
William B. Grant
Does Vitamin D Reduce the Risk of Dementia?
Abstract: The understanding of the role of vitamin D in maintaining optimal health has advanced sharply in the past two decades. There is mounting evidence for beneficial roles for vitamin D in reducing the risk of bone diseases and fractures, many types of cancer, bacterial and viral infections, autoimmune diseases, and cardiovascular diseases. Recently, several reports have also been published regarding the role of vitamin D in neuroprotection. This article develops the hypothesis that vitamin D can reduce the risk of developing dementia, presenting the evidence from observational and laboratory studies. The observational evidence includes that low serum 25-hydroxyvitamin D [25(OH)D] has been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are either considered risk factors for dementia or have preceded incidence of dementia. The laboratory evidence includes several findings on the role of vitamin D in neuroprotection and reducing inflammation. Although this evidence is supportive, there do not appear to be observational studies of incidence of dementia with respect to prediagnostic serum 25(OH)D or vitamin D supplementation. Such studies now appear to be warranted.

Pages 161-176
Debora Cutuli, Francesca Foti, Laura Mandolesi, Paola De Bartolo, Francesca Gelfo, Francesca Federico, Laura Petrosini (Communicated by Sigfrido Scarpa)
Cognitive Performances of Cholinergically Depleted Rats Following Chronic Donepezil Administration
Abstract: Since acute and chronic administration of the acetylcholinesterase inhibitors, namely donepezil, improves cognitive functions in patients afflicted by mild to moderate dementia and reverses memory deficits in experimental models of learning and memory, it seemed interesting to assess the effects of chronic donepezil treatment on cognitive functions in adult rats with forebrain cholinergic depletion. Lesions were performed by means of intracerebroventricular injections of the immunotoxin 192 IgG-saporin. The cognitive functions of lesioned animals treated or not treated with donepezil were compared with those of intact animals. Cholinergic depletion affected working memory functions, weakened procedural competencies, affected the acquisition of localizing knowledge, and evoked remarkable compulsive and perseverative behaviors. In lesioned animals, chronic donepezil treatment ameliorated localizatory capabilities, performances linked to cognitive flexibility and procedural abilities. Furthermore, it attenuated compulsive deficits. The present data indicate positive effects of chronic donepezil treatment on specific cognitive performances, suggesting that an aimed use of acetylcholinesterase inhibitors, targeting some symptoms more than others, may be beneficial in the case of cholinergic hypofunction. The animal model used in the present research may provide an efficient method for analyzing cognition-enhancing drugs before clinical trials.

Pages 177-191
Paola De Bartolo, Francesca Gelfo, Laura Mandolesi, Francesca Foti, Debora Cutuli, Laura Petrosini (Communicated by Sigfrido Scarpa)
Effects of Chronic Donepezil Treatment and Cholinergic Deafferentation on Parietal Pyramidal Neuron Morphology
Abstract: Although clinical and experimental research has demonstrated that acetylcholinesterase inhibitors, such as donepezil, are able to enhance cognitive functioning in intact subjects as well as in patients affected by different degrees of dementia, no morphological study has ever analyzed whether donepezil treatment is able to modify neocortical neuronal morphology in the intact brain and in response to cholinergic depletion. Spines (number, density, distribution) and branching (length, intersections, nodes) of apical and basal dendrites of III-layer parietal pyramidal neurons were evaluated following chronic donepezil treatment in intact animals and in animals in which the cholinergic lesion was produced by intracerebroventricular injections of immunotoxin 192 IgG-saporin. In intact animals, the drug treatment provoked a proximal shift of spines towards the cell soma in basal dendrites. In lesioned animals, donepezil treatment reduced the upregulation of the spines induced by the cholinergic lesion in both apical and basal dendrites. Thus, while in the intact brain chronic donepezil treatment induced plastic changes in the dendritic morphology of pyramidal neurons of parietal cortex, in the presence of cholinergic depletion, it prevented the compensatory response of parietal pyramidal neurons to the loss of cholinergic inputs from basal forebrain.

Pages 193-203
Letícia Rodrigues, Regina Biasibetti, Alessandra Swarowsky, Marina C Leite, André Quincozes-Santos, Jorge A Quilfeldt, Matilde Achaval, Carlos-Alberto Gonçalves
Hippocampal Alterations in Rats Submitted to Streptozotocin-Induced Dementia Model are Prevented by Aminoguanidine
Abstract: Although the exact cause of Alzheimer’s disease remains elusive, many possible risk factors and pathological alterations have been used in the elaboration of in vitro and in vivo models of this disease in rodents, including intracerebral infusion of streptozotocin (STZ). Using this model, we evaluated spatial cognitive deficit and neurochemical hippocampal alterations, particularly astroglial protein markers such as glial fibrillary acidic protein (GFAP) and S100B, glutathione content, nitric oxide production, and cerebrospinal fluid (CSF) S100B. In addition, prevention of these alterations by aminoguanidine administration was evaluated. Results confirm a spatial cognitive deficit and nitrative stress in this dementia model as well as specific astroglial alterations, particularly S100B accumulation in the hippocampus and decreased CSF S100B. The hippocampal astroglial activation occurred independently of the significant alteration in GFAP content. Moreover, all these alterations were completely prevented by aminoguanidine administration, confirming the neuroprotective potential of this compound, but suggesting that nitrative stress and/or glycation may be underlying these alterations. These findings contribute to the understanding of diseases accompanied by cognitive deficits and the STZ-model of dementia.

Pages 203-211
Francesco Angelucci, Sergio Bernardini, Paolo Gravina, Lorenza Bellincampi, Alberto Trequattrini, Fulvia Di Iulio, Diego Vanni, Giorgio Federici, Carlo Caltagirone, Paola Bossù, Gianfranco Spalletta (Communicated by Christian Jacob)
Delusion Symptoms and Response to Antipsychotic Treatment are Associated with the 5-HT2A (102T/C) Receptor Polymorphism in Alzheimer’s Disease: A 3-Year Follow-up Longitudinal Study
Abstract: Although the etiology of psychotic symptoms (hallucinations and delusions) in Alzheimer's disease is still not known, alterations in serotonergic neurotransmission have been proposed. In a 3-year follow-up study, we evaluated the association of serotonin (5-HT) receptor 5-HT2a 102T/C polymorphism (allelic variants CC, CT and TT) with psychotic symptom severity and response to treatment with atypical antipsychotics (risperidone, olanzapine and quietapine) in 80 patients with a diagnosis of probable Alzheimer’s disease. The Neuropsychiatric Inventory (NPI) was administered to determine the frequency and severity (FxS) of psychotic and other behavioral symptoms. There was a significant difference in the NPI FxS delusion score among the three variants of the 5-HT2a 102T/C polymorphism, with patients carrying the TT genotype the most delusional during the follow-up period. In particular, NPI FxS delusion score was higher in TT than in CC genotype at year 2. Moreover, patients with delusion symptoms carrying the CT and TT genotypes were resistant to the treatment with antipsychotic drugs. Thus our study, although at preliminary level, suggests that the presence of T allele of the 102T/C polymorphism in patients with Alzheimer’s disease is associated with both increased presence of delusion symptoms and treatment-resistance to second generation antipsychotic drugs.

Pages 213-221
Philipp A. Thomann, Vasco Dos Santos, Ulrich Seidl, Pablo Toro, Marco Essig, Johannes Schröder (Communicated by Cynthia Carlsson)
MRI-Derived Atrophy of the Olfactory Bulb and Tract in Mild Cognitive Impairment and Alzheimer’s Disease
Abstract: There is increasing histopathological evidence that the olfactory bulb and tract (OBT) is a primary focus of neurodegenerative changes in Alzheimer’s disease (AD). Correspondingly, high-resolution magnetic resonance imaging revealed significant atrophy of the OBT in manifest AD. Whether these alterations are already present in mild cognitive impairment, the assumed preclinical stage of AD, has not been investigated yet. OBT volumes were assessed by manual tracing in 29 patients with mild cognitive impairment, 27 patients with probable AD, and 30 healthy controls. In a second step, voxel based morphometry was used to investigate the potential association between OBT atrophy and morphological changes in other brain regions. Patients had significantly lower OBT volumes when compared to controls, with atrophy being most prominent in the AD group. In addition, OBT atrophy was associated with a decreased medial temporal lobe (MTL) gray matter density bilaterally. Our findings indicate that neurodegeneration in OBT and MTL regions is linked and suggest that OBT volume might be a surrogate marker in AD.

Pages 223-232
Leung-Wing Chu, Sidney Tam, Peter WH Lee, Ping-Yiu Yik, Youqiang Song, Bernard MY Cheung, Karen SL Lam
Late-Life Body Mass Index and Waist Circumference in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease
Abstract: We investigated the progressive associations of late-life body mass index (BMI) and waist circumference (WC) with amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) in Chinese older adults in a case-control study. Late-life BMI and WC were measured. AD was diagnosed by the NINCDS-ADRDA criteria for probable AD and aMCI by the Petersen’s criteria. 426 Chinese older adults [125 AD, 125 aMCI and 176 controls with normal cognition (NC)], aged 55 to 93 years old, were recruited. Both BMI and WC decreased significantly across the normal, aMCI, and AD groups (dementia diagnostic group: p for trend <0.001 and 0.016 respectively, 1-way ANOVA). After adjustment for significant confounders, multivariate general linear model analyses showed that the dementia diagnostic group (AD/aMCI/NC) was asignificant independent predictor of both the late-life BMI and late-life WC (p=0.002 and 0.018 respectively). In conclusion, late-life BMI and WC progressively decrease in older adults with normal cognition, aMCI, and AD. Low late-life BMI and WC represent potentially useful pre-clinical markers of aMCI and AD.

Pages 233-238
Transcript of Live Discussion held at the Alzheimer Research Forum
Alzheimer Research Forum Live Discussion: Meet New Players, Histone Deacetylase and Sirtuin—Will They Help the Cell Cycle, DNA Repair, and Gene Expression Break Into Alzheimerology’s Major League?