Journal
BRAIN RESEARCH
Volume 1385, Issue -, Pages 151-162Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.brainres.2010.12.038
Keywords
Alzheimer's disease; Intracranial volume; Cognitive or brain reserve; APOE; Dementia
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Funding
- National Institutes of Health [AG-1380]
- Ira Fulton Foundation
- Radiology Department at Logan Regional Medical Center Logan, Utah
- John C.S. Breitner, M.D.
- Boston University Alzheimer's Disease Core Center [RO1-AG11380, RO1-AG21136, K23MH073416, P30-AG013486]
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The brain reserve hypothesis has been posited as being one important mediating factor for developing dementia, especially Alzheimer's disease (AD). Evidence for this hypothesis is mixed though different methodologies have made these findings difficult to interpret. We examined imaging data from a large cohort (N=194) of mixed dementia patients and controls, 65 years old and older from the Cache County, Utah Study of Memory and Aging for evidence of the brain reserve hypothesis using total intracranial volume (TICV) as a quantitative measure of pre-morbid brain size and a vicarious indicator of reserve. A broader spectrum of non-demented elderly control subjects from previous studies was also included for comparison (N=423). In addition, non-parametric Classification and Regression Tree (CART) analyses were performed to model group heterogeneity and identify any subgroups of patients where TICV might be an important predictor of dementia. Parametrically, no main effect was found for TICV when predicting a dementia diagnosis; however, the CART analysis did reveal important TICV subgroups, including a sex differential wherein epsilon 4 APOE allele presence in males and low TICV predicted AD classification. TICV, APOE, and other potential mediator/moderator variables are discussed in the context of the brain reserve hypothesis. (C) 2010 Published by Elsevier B.V.
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