MARC

LEADER 00000nab a2200000uu 4500
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022 |a 1552-5260 
022 |a 1552-5279 
024 7 |a 10.1002/alz70856_099115  |2 doi 
035 |a 3286270129 
045 0 |b d20251201 
100 1 |a Wugalter, Katrina A  |u Department of Psychology, University of Illinois Chicago, Chicago, IL, USA, 
245 1 |a Evidence of Early APOE4‐Related Vulnerabilities in Memory Systems in Midlife Women 
260 |b John Wiley & Sons, Inc.  |c Dec 1, 2025 
513 |a Journal Article 
520 3 |a Background Among older adults, APOE4‐related associations with neuroimaging outcomes are more pronounced in women than men. At midlife, a critical period for prevention and treatment of risk factors for cognitive decline, the influence of APOE4 genotype on women's cognitive and brain health is subtle. Therefore, there is a need for early biomarkers of brain vulnerabilities in female APOE4 carriers. Here, we examined APOE4‐related differences in patterns of activation and hippocampal functional connectivity during word encoding in cognitively normal midlife women and the associations of these patterns with verbal memory performance and plasma Alzheimer's disease (AD) biomarkers. Method Women participating in MsBrain, a cohort study of brain health in midlife women, completed functional magnetic resonance imaging assessments during verbal encoding and recognition tasks. We measured both activation patterns and hippocampal functional connectivity, the latter using generalized psychophysiological interaction analyses (SPM12, Conn) with AlphaSim (AFNI) to correct for multiple comparisons. APOE4 group differences (carriers [E3E4 and E4E4] vs. non‐carriers [E3E3]) were tested using linear regression. Associations of neuroimaging indices with verbal memory (California Verbal Learning Test measures [CVLT learning, semantic clustering]) and plasma AD biomarkers (Aβ42/40, p‐tau 181, p‐tau 231) were tested via linear regression. All analyses adjusted for age, race, and education. Result In 145 women (mean age=59.1 years, 86.2% white, 24.1% APOE4+), APOE4 carriers and non‐carriers did not significantly differ on in‐scanner verbal recognition performance, CVLT measures, or plasma AD biomarkers. During verbal encoding, APOE4 non‐carriers had significantly greater activation and hippocampal functional connectivity in several regions compared to APOE4 carriers (Figure 1). Of the regions showing greater activation among non‐carriers, left inferior frontal gyrus activation was positively associated with CVLT measures, and greater connectivity from the left hippocampus to the left declive/fusiform was associated with lower p‐tau 181 levels (Figure 2). Conclusion Female midlife APOE4 carriers have decreased activity and connectivity in key memory regions during word encoding compared to non‐carriers, despite showing similar cognitive performance and plasma amyloid and tau levels. Associations of certain connectivity outcomes with AD biomarkers suggest relevance to AD pathogenesis. These functional brain patterns may emerge earlier than the adverse effects of APOE4 genotype on cognition and brain. 
653 |a Neuroimaging 
653 |a Alzheimer's disease 
653 |a Genotypes 
653 |a Memory 
653 |a Brain 
653 |a Regression analysis 
653 |a Regions 
653 |a Women 
653 |a Race 
653 |a Middle age 
653 |a Older people 
653 |a Cohort analysis 
653 |a Cognition 
653 |a Midlife 
653 |a Physiological psychology 
653 |a Cognitive impairment 
653 |a Learning 
653 |a Encoding 
653 |a Associations 
653 |a Biological markers 
653 |a Clustering 
653 |a Tests 
653 |a Functional magnetic resonance imaging 
653 |a Plasma 
653 |a Risk factors 
653 |a Encoding (Cognitive process) 
653 |a Recognition 
653 |a Side effects 
653 |a Acknowledgment 
653 |a Medical imaging 
653 |a Carriers 
653 |a Verbal learning 
653 |a Semantics 
653 |a Adults 
653 |a Cognitive ability 
653 |a Functional connectivity 
653 |a Older women 
653 |a Biomarkers 
653 |a Gender differences 
653 |a Hippocampus 
700 1 |a Thurston, Rebecca C.  |u Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA, 
700 1 |a Wu, Minjie  |u Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA, 
700 1 |a Kamboh, M. Ilyas  |u University of Pittsburgh Alzheimer's Disease Research Center, Pittsburgh, PA, USA, 
700 1 |a Aizenstein, Howard J  |u Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA, 
700 1 |a Derby, Carol A.  |u Department of Neurology, and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA, 
700 1 |a Maki, Pauline M  |u Departments of Psychiatry, Psychology, and Obstetrics & Gynecology, University of Illinois Chicago, Chicago, IL, USA, 
773 0 |t Alzheimer's & Dementia  |g vol. 21 (Dec 1, 2025) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3286270129/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3286270129/fulltext/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3286270129/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch