pISSN 1226-6329 / eISSN 2733-4600
대한노인정신의학회 (28권1호 16-23)
The Effect of Apolipoprotein E ε4 Genotype on the Medial Temporal Lobe Atrophy in Cognitively Impaired Patients With Amyloid Deposition: 2 Years Longitudinal Magnetic Resonance Imaging Study
아밀로이드 양성인 인지기능저하군에서 APOE ε4 유전형이 내측두엽 위축에 미치는 영향: 자기공명영상 장기연구
Jihye Kim, MD, Young-Min Lee, MD, PhD, Byung-Dae Lee, MD, PhD, Eunsoo Moon, MD, PhD, Hwagyu Suh, MD, Kyungwon Kim, MD, PhD, Hyunji Lee, MD, Hak-Jin Kim, MD, PhD, Kyongjune Park, MD, PhD, and Kyung-Un Choi, MD, PhD
Departments of Psychiatry, Radiology, Nuclear Medicine, and Pathology, Biomedical Research Institute, Pusan National University Hospital, Busan, Departments of Psychiatry, Radiology, Nuclear Medicine, and Pathology, Pusan National University School of Medicine, Pusan National University, Busan, Korea
Objective: Apolipoprotein E (APOE) genotype is associated with risk of Alzheimer’s disease (AD), but the association of
APOE ε4 allele with longitudinal medial temporal lobe atrophy (MTA) has been controversial. This study aims to evaluate the
effect of APOE genotype on longitudinal MTA over a 2-year period in cognitively impaired patients with amyloid deposition.
Methods: This retrospective longitudinal study included 65 cognitively impaired subjects with amyloid deposition (subjective
memory impairment, mild cognitive impairment, and mild AD). Participants were divided into carriers (n=27) and non-carriers
(n=38) of the ε4 allele. The main outcome is longitudinal reduction of medial temporal lobe (hippocampus, entorhinal cortex, and
parahippocampal gyrus) over 2 years. Analysis of covariance was conducted to compare the differences in longitudinal MTA
between groups, controlling for covariates.
Results: At baseline, hippocampal volume was 4.6% smaller (6.38±1.13 vs. 6.69±0.83, p=0.026) and entorhinal thickness was
6.4% thinner (3.51±0.57 vs. 3.75±0.52, p=0.033) in APOE ε4 carriers than non-carriers. Furthermore, APOE ε4 carriers had
significantly 72% greater longitudinal hippocampal atrophy compared to non-carriers (-0.43±0.30 vs. -0.25±0.31, p=0.041).
Conclusion: Our findings of baseline or longitudinal MTA in APOE ε4 carriers suggest that APOE ε4 genotype may contribute to underlying pathophysiology of medial temporal lobe in AD.
Apolipoproteins E; Medial temporal lobe; Hippocampus; Alzheimer’s disease; Mild cognitive impairment; Subjective memory impairment.
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