Use of cDNA microarray in the search for molecular markers involved in the onset of Alzheimer's disease dementia.

Alzheimer's disease (AD) is the most common form of dementia, affecting as many as 4 million older persons and results from abnormal changes in the brain that most likely begin long before cognitive impairment and other clinical symptoms become apparent. Thus, efforts aimed at identifying methods of early detection and diagnosis for improving AD care might be the most appropriate strategy to initiate promising new treatments and/or prevention. We used cDNA microarray technology to investigate the sequence of changes in gene expression in brain that may take place during the transition from normal cognitive functioning through the early stages of impairment to frank AD. We examined the expression of approximately 7,000 genes in the brains of cases at the early stage of AD dementia using reference sample cases characterized by normal cognitive status. Genes that are differentially regulated in early AD cases were identified and were categorized into gene clusters based on similarities in biological functions. This analysis revealed that selected biological processes, including protein and amino acid metabolism, cytoskeleton integrity, and fatty acid metabolism, are involved in early phases of AD dementia. Most notable is the observation that selected genes involved in neurotransmitter release are differentially regulated in the brains of cases at high risk for dementia. This evidence supports the feasibility and usefulness of cDNA microarray techniques to study sequential changes of distinctive gene-expression patterns in the brain as a function of the progression of AD dementia. The study suggests new means to dissect and classify stages of AD dementia, or neuropathology, at the molecular level. Copyright 2001 Wiley-Liss, Inc.