0
Editorial |

Apolipoprotein E, Neurodegeneration, and Alzheimer Disease

William Jagust, MD
JAMA Neurol. 2013;70(3):299-300. doi:10.1001/jamaneurol.2013.726.
Text Size: A A A
Published online

Extract

Because of a widespread belief that effective therapies for Alzheimer disease (AD) will require intervention prior to the onset of dementia, intense effort has been devoted to identifying asymptomatic individuals who are likely to develop the disease. Major strategies include biomarker measurement to detect subtle signs of AD in asymptomatic individuals and investigation of people with genetic mutations or polymorphisms indicative of high risk. The biomarkers of greatest interest have been separated into 2 categories, one of which is the measurement of the AD hallmark protein β-amyloid (Aβ), apparent as reduced concentration in cerebrospinal fluid or increased retention of positron emission tomography (PET) tracers that bind to fibrillar Aβ. The second category includes biomarkers that are presumptive measures of neurodegeneration, such as atrophy of the hippocampus and cerebral glucose hypometabolism in the temporoparietal cortex. Genetic and biomarker approaches may be combined, as in the Dominantly Inherited Alzheimer Network, a study of people with mendelian mutations that cause AD. In the Dominantly Inherited Alzheimer Network study, evidence of brain Aβ deposition, glucose hypometabolism, and hippocampal atrophy were seen in asymptomatic mutation carriers 10 to 15 years prior to the expected age at disease onset.1 Charting the temporal course of these biomarker changes provides a basis for defining at-risk populations for treatment selection and informs us about basic mechanisms of disease.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

brightcove.createExperiences();