Apolipoprotein E polymorphism influences the cerebral metabolic pattern in Alzheimer's disease.

In 49 patients with the clinical diagnosis of probable Alzheimer's disease (AD) apoE genotyping as well as regional cerebral glucose metabolism (rCMRGI) using positron emission tomography (PET) of [18F]2-fluoro-2-deoxy-D-glucose (FDG) were studied. The metabolic pattern was condensed to a ratio by dividing the rCMRGI of typically affected regions (temporo-parietal and frontal association cortex) by the rCMRGI of the least affected regions (primary cortical areas, basal ganglia, cerebellum and brainstem). Epsilon4-heterozygotes and epsilon4-homozygotes were grouped together, and also those lacking the epsilon4-allele (non-epsilon4). For the metabolic pattern we found a significant correlation to severity of dementia in both groups (epsilon4: r = 0.49, P = 0.05; non-epsilon4: r = 0.59, P = 0.006). On ANCOVA severity of dementia and epsilon4 status were independent predictors of the cerebral metabolic pattern (P = 0.01). These differences may be attributed to epsilon4 dependent histopathologic changes.