The study of persons with or at-risk for genetically-determined autosomal dominant Alzheimer?s disease (ADAD) due to mutations in the PSEN and APP genes has made tremendous contributions to our understanding of AD in general. As the future development of AD in persons inheriting ADAD mutations can be reliably predicted, one can define the disease phenotype and changes occurring during the presymptomatic phase of the disease with great sensitivity, enabling the evaluation of other factors influencing disease course (e.g. modifying genes, effects of putative disease-modifying interventions). Such research is facilitated by the identification of large families sharing the same genetic predisposition, an approach that has been best implemented in an extended family in Colombia with a common mutation in PSEN1 (E280A). A similar founder effect for a distinct mutation in PSEN1 (A431E) and another large family with a different ADAD-causing mutation in APP (V717I) has been identified in the State of Jalisco in Mexico but to date these families have been understudied. The goal of the current application is to facilitate the performance of clinical studies of this population by investigators in Jalisco. This will be achieved through the following specific aims:
Specific Aim #1) To characterize and follow persons with and at-risk for ADAD in Jalisco by harmonizing measures between the Centro de Investigacin Biomdica de Occidente Genetics clinic in Guadalajara, the University of Guadalajara Polyclinic in Tepatitlan, and the USC Alzheimer?s Disease Research Center. By providing gene-sequencing technology and training, we will also enable the genetic characterization of this population.
Specific Aim #2) To perform studies to identify genes that affect the age of disease onset and the presence of leg stiffness in ADAD.
Specific Aim #3) To improve the ability of clinicians and researchers in Jalisco to deliver presymptomatic genetic counseling for persons at-risk for ADAD, thus optimizing autonomy with regards to research participation. This project will improve our understanding of the pathophysiology of ADAD and lay the groundwork for future studies of this informative population in Mexico.
The study of persons with or at-risk for autosomal dominant Alzheimer?s disease (ADAD) had made significant contributions to our understanding of AD in general. In collaboration with investigators in Mexico, we have identified a large number of families there with this otherwise rare form of AD. Therefore, there is a substantial population of persons with or at-risk for ADAD available for and motivated to participate in research. To date, little systematic research has been performed in this population in Mexico, in part due to a lack of resources and infrastructure. In this project we propose to facilitate research in ADAD in Jalisco state by providing the technology for research and clinical genetics as well as funding and training to develop a cohort that will prospectively be followed using standardized clinical and cognitive measures, enabling additional research studies.
