Cognitive Outcomes in Autosomal-Dominant Alzheimer's Disease: A Comprehensive Review from a Colombian Kindred with the Presenilin-1 E280A Mutation.

Background: The largest identified kindred worldwide with a single mutation causing autosomal-dominant Alzheimer's disease (ADAD) is a family from Antioquia, Colombia, carrying the Presenilin-1 (PSEN1) E280A (Paisa) mutation. The majority of mutation carriers develop dementia, typically commencing in their late 30 s, with a median onset age of 49 years. Cognitive decline is a hallmark feature. Objective: This review synthesizes the existing literature on neuropsychological assessments in PSEN1 E280A mutation carriers throughout their lifespan. We provide a comprehensive overview of cognitive outcomes in this unique population. Methods: We reviewed and integrated the published research, analyzing studies on neuropsychological assessments in PSEN1 E280A carriers. Our focus was on measures of verbal, semantic, episodic, and spatial memory, and encompassed other cognitive domains such as language, attention, visuospatial memory, and executive functioning. Results: Verbal, semantic, episodic, and spatial memory emerged as the most sensitive indicators of preclinical changes in PSEN1 E280A carriers. Inconsistencies were noted in findings from tests assessing language, attention, visuospatial memory, and executive functioning, suggesting potential limitations in detecting early cognitive changes in PSEN1 mutation carriers. Specific cognitive tasks developed for this population proved effective but underutilized. Conclusions: The review underscores the importance of continued test development tailored to detect early cognitive changes in PSEN1 E280A carriers, potentially enhancing ADAD screening. Furthermore, investigating ADAD mutations in children may identify early changes in AD and enhance our understanding of neuropsychological functioning across the lifespan. This synthesis provides valuable insights for researchers, clinicians, and policymakers engaged in the study and management of ADAD.

Depressive symptoms and hippocampal volume in autosomal dominant Alzheimer's disease.

INTRODUCTION: Depressive symptoms are among early behavioral changes in Alzheimer's disease (AD); however, the relationship between neurodegeneration and depressive symptoms remains inconclusive. To better understand this relationship in preclinical AD, we examined hippocampal volume and depressive symptoms in cognitively unimpaired carriers of the presenilin-1 (PSEN1) E280A mutation for autosomal dominant AD. METHODS: A total of 27 PSEN1 mutation carriers and 26 non-carrier family members were included. Linear regression was used to test the relationship between hippocampal volume and 15-item Geriatric Depression Scale. RESULTS: Carriers and non-carriers did not differ in depressive symptoms or hippocampal volume. Within carriers, lower hippocampal volume was associated with greater depressive symptoms, which remained significant after adjusting for age and cognition. This relationship was not significant in non-carriers. DISCUSSION: Hippocampal neurodegeneration may underlie depressive symptoms in preclinical autosomal dominant AD. These findings provide support for the utility of targeting depressive symptoms in AD prevention. HIGHLIGHTS: We compared unimpaired autosomal dominant Alzheimer's disease (AD) mutation carriers and non-carriers. Carriers and non-carriers did not differ in severity of depressive symptoms. In carriers, hippocampal volume was inversely associated with depressive symptoms. Depressive symptoms may be a useful target in AD prevention.

Theory of Mind and Its Elusive Structural Substrate.

Is brain structure related to function? Can one predict the other? These are questions that are still waiting to be answered definitively. In this paper we seek to investigate these questions, in particular, we are interested in the relation between brain structure and theory of mind (ToM). ToM is defined as the ability to attribute mental states to others. Previous studies have observed correlations between performance on ToM tasks, and gray-matter size/volume in dorsomedial prefrontal cortex (dmPFC), temporoparietal junction (TPJ) and precuneus (PCu). Despite these findings, there are concerns about false positive results and replicability issues. In this study we used two different tasks to evaluate ToM, Reading the Mind in the Eyes Test (RMET), and the Short Story Task (SST). Performance in these tasks was correlated to brain anatomy measures including voxel-based morphometry (VBM) and cortical thickness (CT) analysis, from ninety-one neurotypical participants. High-resolution structural brain images were acquired, and whole-brain and region of interest (ROI) analyses were implemented. The analyses did not show statistically significant associations between ToM performance and brain structural measures after correction. Significant associations between performance on ToM tests and a widespread array of regions loosely associated with ToM were observed only for whole brain uncorrected analysis (p < 0.001). These results do not replicate a previous study with neurotypical participants. We tested two different ToM tests, two different softwares for VBM and CT, and we used two samples, one with 91 and a sub-sample with 69 participants. Neither of these conditions made a difference in the results obtained. Consequently, these results suggest that if the population is neurotypical and homogenous, it is unlikely that a reliable association between brain anatomy measures and ToM performance, as measured with these tasks, may be found.