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  Vol. 64 No. 10, October 2007 TABLE OF CONTENTS
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Effect of Alzheimer Disease Risk on Brain Function During Self-appraisal in Healthy Middle-aged Adults

Sterling C. Johnson, PhD; Michele L. Ries, PhD; Timothy M. Hess, PhD; Cynthia M. Carlsson, MD; Carey E. Gleason, PhD; Andrew L. Alexander, PhD; Howard A. Rowley, MD; Sanjay Asthana, MD; Mark A. Sager, MD

Arch Gen Psychiatry. 2007;64(10):1163-1171.

Context  Asymptomatic middle-aged adult children of patients with Alzheimer disease (AD) recently were found to exhibit functional magnetic resonance imaging (fMRI) deficits in the mesial temporal lobe during an encoding task. Whether this effect will be observed on other fMRI tasks is yet unknown. This study examines the neural substrates of self-appraisal (SA) in persons at risk for AD. Accurate appraisal of deficits is a problem for many patients with AD, and prior fMRI studies of healthy young adults indicate that brain areas vulnerable to AD such as the anterior mesial temporal lobe and posterior cingulate are involved during SA tasks.

Objective  To determine whether parental family history of AD (hereafter referred to as FH) or presence of the {varepsilon}4 allele of the apolipoprotein E gene (APOE4) exerts independent effects on brain function during SA.

Design  Cross-sectional factorial design in which APOE4 status (present vs absent) was one factor and FH was the other. All participants received cognitive testing, genotyping, and an fMRI task that required subjective SA decisions regarding trait adjective words in comparison with semantic decisions about the same words.

Setting  An academic medical center with a research-dedicated 3.0-T MR imaging facility.

Participants  Cognitively normal middle-aged adults (n = 110), 51 with an FH and 59 without an FH.

Main Outcome Measure  Blood oxygen–dependent contrast measured using T2*-weighted echo-planar imaging.

Results  Parental family history of AD and APOE4 status interacted in the posterior cingulate and left superior and medial frontal regions. There were main effects of FH (FH negative > FH positive) in the left hippocampus and ventral posterior cingulate. There were no main effects of APOE genotype.

Conclusions  Our results suggest that FH may affect brain function during subjective SA in regions commonly affected by AD. Although the participants in this study were asymptomatic and middle-aged, the findings suggest that there may be subtle alterations in brain function attributable to AD risk factors.


Author Affiliations: Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital (Drs Johnson, Ries, Hess, Carlsson, Gleason, and Asthana) and University of Wisconsin School of Medicine and Public Health, Departments of Medicine (Drs Johnson, Ries, Hess, Carlsson, Gleason, Asthana, and Sager), Medical Physics (Dr Alexander), and Radiology (Dr Rowley) Madison.







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