Swaminathan, Shanker

We used whole‐exome sequencing to identify variants other than APOE associated with the rate of hippocampal atrophy in amnestic mild cognitive impairment. An in‐silico predicted missense variant in REST (rs3796529) was found exclusively in subjects with slow hippocampal volume loss and validated using unbiased whole‐brain analysis and meta‐analysis across 5 independent cohorts. REST is a master regulator of neurogenesis and neuronal differentiation that has not been previously implicated in Alzheimer's disease. These findings nominate REST and its functional pathways as protective and illustrate the potential of combining next‐generation sequencing with neuroimaging to discover novel disease mechanisms and potential therapeutic targets. Ann Neurol 2015;77:547–552

AbstractBackgroundApolipoprotein E (APOE) ε4 allele's role as a modulator of the relationship between soluble plasma amyloid beta (Aβ) and fibrillar brain Aβ measured by Pittsburgh compound B positron emission tomography ([11C]PiB PET) has not been assessed.MethodsNinety‐six Alzheimer's Disease Neuroimaging Initiative participants with [11C]PiB scans and plasma Aβ1–40 and Aβ1–42 measurements at the time of PET scanning were included. Regional and voxelwise analyses of [11C]PiB data were used to determine the influence of APOE ε4 allele on association of plasma Aβ1–40, Aβ1–42, and Aβ1–40/Aβ1–42 with [11C]PiB uptake.ResultsIn APOE ε4− but not ε4+ participants, positive relationships between plasma Aβ1–40/Aβ1–42 and [11C]PiB uptake were observed. Modeling the interaction of APOE and plasma Aβ1–40/Aβ1–42 improved the explained variance in [11C]PiB binding compared with using APOE and plasma Aβ1–40/Aβ1–42 as separate terms.ConclusionsThe results suggest that plasma Aβ is a potential Alzheimer's disease biomarker and highlight the importance of genetic variation in interpretation of plasma Aβ levels.

The role of the Alzheimer's Disease Neuroimaging Initiative Genetics Core is to facilitate the investigation of genetic influences on disease onset and trajectory as reflected in structural, functional, and molecular imaging changes; fluid biomarkers; and cognitive status. Major goals include (1) blood sample processing, genotyping, and dissemination, (2) genome‐wide association studies (GWAS) of longitudinal phenotypic data, and (3) providing a central resource, point of contact and planning group for genetics within the Alzheimer's Disease Neuroimaging Initiative. Genome‐wide array data have been publicly released and updated, and several neuroimaging GWAS have recently been reported examining baseline magnetic resonance imaging measures as quantitative phenotypes. Other preliminary investigations include copy number variation in mild cognitive impairment and Alzheimer's disease and GWAS of baseline cerebrospinal fluid biomarkers and longitudinal changes on magnetic resonance imaging. Blood collection for RNA studies is a new direction. Genetic studies of longitudinal phenotypes hold promise for elucidating disease mechanisms and risk, development of therapeutic strategies, and refining selection criteria for clinical trials.