Objective-To determine whether APOE genotype influences brain response and whether nonverbal stimuli generate findings comparable with those of previous studies that used verbal stimuli. The relationship between APOE genotype and blood oxygenation level dependent (BOLD) brain response was examined during a picture-encoding task in nondemented older adults.Methods-Twenty nondemented participants with normal episodic memory function were divided into two groups based on the presence (n = 10) or absence (n = 10) of the APOE ε4 allele. Picture learning was completed during functional MRI in a blocked design alternating between experimental (novel pictures) and control (repeated picture) conditions.Results-Nondemented older adults with an APOE ε4 allele showed greater magnitude and extent of BOLD brain response during learning of new pictures relative to their matched ε3 counterparts. Different patterns and directions of association between hippocampal activity and learning and memory performance were also demonstrated.
Conclusions-The results suggest that brain response differences are not due to poorer general memory abilities, differential atrophy, or brain response during control conditions, but instead appear to be directly influenced by APOE genotype. Results are consistent with a compensatory hypothesis wherein older adults at genetic risk for Alzheimer disease by virtue of the APOE ε4 allele appear to require additional cognitive effort to achieve comparable performance levels on tests of episodic memory encoding.Studies of nondemented older adults who later develop Alzheimer disease (AD) show a subtle decline in episodic memory prior to emergence of the obvious cognitive and behavioral changes required for a clinical diagnosis of the disease. 1-7 Often this decline in episodic memory is evident some years prior to the development of dementia and has been shown to predict the subsequent development of AD. [1][2][3][4]8,9 In addition, the ε4 allele of the gene coding for APOE is linked to an increased risk of developing late-onset AD. 10,11 There have been a variety of brain changes associated with the APOE ε4 allele in AD, including structural 12,13 and functional brain changes, 14 as well as subtle neuropsychologic deficits. 8,9,15 Further, studies suggest that the pathologic burden of AD may begin decades-not years-prior to the diagnosis of AD and may be influenced by one's APOE genotype. 16Given the increasing emergence of treatments for dementia, sensitive and reliable markers of incipient dementia are needed to enhance our ability to detect AD in its earliest stages when potential neuroprotective agents might be most effective. 17 fMRI offers considerable promise as a noninvasive technique for detection of early brain changes associated with an incipient Initial work 19 demonstrated an increase in the intensity and extent of brain activation in nondemented middle-aged and older adults with the APOE ε4 allele during verbal learning, suggesting a compensatory mechanism wherein APOE ε4 carriers util...