Bailey Madison, Ilchovska Zlatomira G, Hosseini Akram A, Jung JeYoung
School of Medicine, University of Nottingham, Nottingham, UK.
School of Psychology, University of Nottingham, Nottingham, UK.
J Clin Neurol. 2024 Sep;20(5):469-477. doi: 10.3988/jcn.2024.0176.
Alzheimer's disease (AD) is the most-prevalent form of dementia and imposes substantial burdens at the personal and societal levels. The apolipoprotein E (APOE) ε4 allele is a genetic factor known to increase AD risk and exacerbate brain atrophy and its symptoms. We aimed to provide a comprehensive review of the impacts of APOE ε4 on brain atrophy in AD as well as in mild cognitive impairment (MCI) as a transitional stage of AD.
We performed a coordinate-based meta-analysis of voxel-based morphometry studies to compare gray-matter atrophy patterns between carriers and noncarriers of APOE ε4. We obtained coordinate-based structural magnetic resonance imaging data from 1,135 individuals who met our inclusion criteria among 12 studies reported in PubMed and Google Scholar.
We found that atrophy of the hippocampus and parahippocampus was significantly greater in APOE ε4 carriers than in noncarriers, especially among those with AD and MCI, while there was no significant atrophy in these regions in healthy controls who were also carriers.
The present meta-analysis has highlighted the significant link between the APOE ε4 allele and hippocampal atrophy in both AD and MCI, which emphasizes the critical influence of the allele on neurodegeneration, especially in the hippocampus. These findings improve the understanding of AD pathology, potentially facilitating progress in early detection, targeted interventions, and personalized care strategies for individuals at risk of AD who carry the APOE ε4 allele.
阿尔茨海默病（AD）是最常见的痴呆形式，在个人和社会层面都带来了沉重负担。载脂蛋白E（APOE）ε4等位基因是一种已知会增加AD风险并加剧脑萎缩及其症状的遗传因素。我们旨在全面综述APOE ε4对AD以及作为AD过渡阶段的轻度认知障碍（MCI）中脑萎缩的影响。
我们对基于体素的形态学研究进行了基于坐标的荟萃分析，以比较APOE ε4携带者和非携带者之间的灰质萎缩模式。我们从PubMed和谷歌学术报告的12项研究中符合纳入标准的1135名个体中获取了基于坐标的结构磁共振成像数据。
我们发现，APOE ε4携带者的海马体和海马旁回萎缩明显大于非携带者，尤其是在患有AD和MCI的人群中，而同样是携带者的健康对照者在这些区域没有明显萎缩。
本荟萃分析突出了APOE ε4等位基因与AD和MCI中海马萎缩之间的显著联系，这强调了该等位基因对神经退行性变的关键影响，尤其是在海马体中。这些发现增进了对AD病理学的理解，可能有助于在对携带APOE ε4等位基因的AD风险个体进行早期检测、靶向干预和个性化护理策略方面取得进展。
