Amyloid futures in the expanding pathology of brain aging and dementia.

Positron emission tomography (PET) imaging studies of Alzheimer's disease (AD) patients show progressive increases of fibrillar Aß-amyloid. Because current PET ligands underestimate nonfibrillar forms, we assayed soluble Aß in AD and controls. To identify the mechanisms responsible for soluble Aß in AD brains, we examined lipid rafts (LRs), where amyloid precursor protein (APP) is enzymatically processed. Frontal cortex was compared with cerebellum, which has minimal AD pathology. Compared with cognitively normal controls (CTL; Braak 0-1), elevations of soluble Aß40 and Aß42 were similar for intermediate- and later-stage AD (Braak 2-3 and 4-6). Clinical-grade AD showed a greater increase in soluble Aß40 than Aß42 relative to CTL. LR raft yield per gram AD frontal cortex was 20% below that of controls, whereas cerebellar LR did not differ by Braak score. The extensive overlap of soluble Aß levels in controls with AD contrasts with the PET findings on fibrillar Aß. These findings further support fibrillar Aß as a biomarker for AD treatments and show the need for more detailed postmortem analysis of diverse soluble and insoluble Aß aggregates in relation to PET.