Genetic Heterogeneity in Alzheimer Disease and Implications for Treatment Strategies

John M. Ringman, Alison Goate, Colin L. Masters, Nigel J. Cairns, Adrian Danek, Neill Graff-Radford, Bernardino Ghetti, John C. Morris

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Since the original publication describing the illness in 1907, the genetic understanding of Alzheimer’s disease (AD) has advanced such that it is now clear that it is a genetically heterogeneous condition, the subtypes of which may not uniformly respond to a given intervention. It is therefore critical to characterize the clinical and preclinical stages of AD subtypes, including the rare autosomal dominant forms caused by known mutations in the PSEN1, APP, and PSEN2 genes that are being studied in the Dominantly Inherited Alzheimer Network study and its associated secondary prevention trial. Similar efforts are occurring in an extended Colombian family with a PSEN1 mutation, in APOE ε4 homozygotes, and in Down syndrome. Despite commonalities in the mechanisms producing the AD phenotype, there are also differences that reflect specific genetic origins. Treatment modalities should be chosen and trials designed with these differences in mind. Ideally, the varying pathological cascades involved in the different subtypes of AD should be defined so that both areas of overlap and of distinct differences can be taken into account. At the very least, clinical trials should determine the influence of known genetic factors in post hoc analyses.

Original languageEnglish
JournalCurrent Neurology and Neuroscience Reports
Volume14
Issue number11
DOIs
StatePublished - 2014

Fingerprint

Genetic Heterogeneity
Alzheimer Disease
Mutation
Homozygote
Therapeutics
Secondary Prevention
Down Syndrome
Publications
Clinical Trials
Phenotype
Genes

Keywords

  • Alzheimer’s disease
  • Amyloid precursor protein
  • Apolipoprotein E
  • Genetic
  • Heterogeneity
  • Presenilin

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Ringman, J. M., Goate, A., Masters, C. L., Cairns, N. J., Danek, A., Graff-Radford, N., ... Morris, J. C. (2014). Genetic Heterogeneity in Alzheimer Disease and Implications for Treatment Strategies. Current Neurology and Neuroscience Reports, 14(11). https://doi.org/10.1007/s11910-014-0499-8

Genetic Heterogeneity in Alzheimer Disease and Implications for Treatment Strategies. / Ringman, John M.; Goate, Alison; Masters, Colin L.; Cairns, Nigel J.; Danek, Adrian; Graff-Radford, Neill; Ghetti, Bernardino; Morris, John C.

In: Current Neurology and Neuroscience Reports, Vol. 14, No. 11, 2014.

Research output: Contribution to journalArticle

Ringman, John M. ; Goate, Alison ; Masters, Colin L. ; Cairns, Nigel J. ; Danek, Adrian ; Graff-Radford, Neill ; Ghetti, Bernardino ; Morris, John C. / Genetic Heterogeneity in Alzheimer Disease and Implications for Treatment Strategies. In: Current Neurology and Neuroscience Reports. 2014 ; Vol. 14, No. 11.
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