Abstract

Alzheimer’s disease (AD) is the most prevalent cause of dementia, being considered a major health problem, especially in developed countries. Late-onset AD is the most common form of the disease, with symptoms appearing after 65 years old. Genetic determinants of AD risk are vastly unknown, though, 4 allele of the ApoE gene has been reported as the strongest genetic risk factor for AD. The objective of this study was to analyze the relationship between brain complexity and the presence of ApoE4 alleles along the AD continuum. For this purpose, resting-state electroencephalography (EEG) activity was analyzed by computing Lempel-Ziv complexity (LZC) from 46 healthy control subjects, 49 mild cognitive impairment subjects, 45 mild AD patients, 44 moderate AD patients and 33 severe AD patients, subdivided by ApoE status. Subjects with one or more ApoE4 alleles were included in the carriers subgroups, whereas the ApoE4 non-carriers subgroups were formed by subjects without any 4 allele. Our results showed that AD continuum is characterized by a progressive complexity loss. No differences were observed between AD ApoE4 carriers and non-carriers. However, brain activity from healthy subjects with ApoE4 allele (carriers subgroup) is more complex than from non-carriers, mainly in left temporal, frontal and posterior regions (p-values < 0.05, FDR-corrected Mann–Whitney U-test). These results suggest that the presence of ApoE4 allele could modify the EEG complexity patterns in different brain regions, as the temporal lobes. These alterations might be related to anatomical changes associated to neurodegeneration, increasing the risk of suffering dementia due to AD before its clinical onset. This interesting finding might help to advance in the development of new tools for early AD diagnosis.

Highlights

  • Dementia due to Alzheimer’s disease (AD) is characterized by progressive decline in several areas of cognition, including memory, language and executive functions

  • In the current study we address the following research questions: (i) does ApoE ε4 status alter complexity patterns of neural activity? (ii) what are the spatial patterns associated to the alterations in the complexity of EEG that can be linked to this genotype? and (iii) is it possible to establish a relationship between the alterations in complexity EEG patterns and ApoE risk allele in the left temporal lobe along the AD continuum?

  • mild cognitive impairment (MCI) and dementia due to AD patients were diagnosed in accordance with National Institute of Aging and Alzheimer’s Association (NIA-AA) criteria [52,53], being AD stages established through the Mini-Mental State Examination (MMSE) test [54]

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Summary

Introduction

Dementia due to Alzheimer’s disease (AD) is characterized by progressive decline in several areas of cognition, including memory, language and executive functions. An intermediate state between normal aging and AD has been described as mild cognitive impairment (MCI) [4,5]. This term is used to refer to individuals who show slight memory impairments and declined thinking skills, but do not meet dementia due to AD diagnostic criteria [4]. MCI has been accepted as a prodromal stage of the disease, since 15–18% of people over 60 years tend to develop MCI, with 8–15% of them evolving to dementia every year [4]

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