The neurochemistry of Alzheimer's disease

The last 15–20 years have seen a wealth of studies to characterize the neurochemical abnormalities of Alzheimer's disease, in particular those involving the β‐amyloid and tau proteins, as well as more recently, apolipoprotein E4. This article provides a summary of the evidence for the involvement of these proteins in Alzheimer's disease pathogenesis based on postmortem brain and CSF studies. Summary: directions for future studies Our knowledge of the neurochemical pathology of AD has increased immensely the last years. Although it is now clear that mutations in the APP gene can cause some rare hereditary forms of AD, and that ApoE4 is a prominent risk factor for AD, we at present know little about the underlying cause of AD in the general population and the biochemical mechanisms by which the apolipoprotein E4 isoform affects AD pathogenesis. It is hoped that the near future will see a resolution of the current controversies in AD research, including: 1) whether APP mutations cause Alzheimer's disease by affecting Aβ deposition or the function of APP itself; 2) whether abnormal phosphorylation of tau is a central pathogenetic event, or whether it occurs as epiphenomena that reflect general neurodegeneration in a variety of disease processes; 3) Whether Aβ deposition in the brain is the central event in AD or whether it occurs as epiphenomena in a variety of brain disorders such as head trauma; and 4) whether altered tau phosphorylation occurs secondary to Aβ deposition or vice versa, and what the link is (if any) between the two processes.