Synapse loss correlates with a cognitive decline in Alzheimer's disease (AD), but whether this is caused by fibrillar deposits known as senile plaques or soluble oligomeric forms of amyloid ␤ (A␤) is controversial. By using array tomography, a technique that combines ultrathin sectioning of tissue with immunofluorescence, allowing precise quantification of small structures, such as synapses, we have tested the hypothesis that oligomeric A␤ surrounding plaques contributes to synapse loss in a mouse model of AD. We find that senile plaques are surrounded by a halo of oligomeric A␤. Analysis of >14,000 synapses (represented by PSD95-stained excitatory synapses) shows that there is a 60% loss of excitatory synapses in the halo of oligomeric A␤ surrounding plaques and that the density increases to reach almost control levels in volumes further than 50 m from a plaque in an approximately linear fashion (linear regression, r 2 ‫؍‬ 0.9; P < 0.0001). Further, in transgenic cortex, microdeposits of oligomeric A␤ associate with a subset of excitatory synapses, which are significantly smaller than those not in contact with oligomeric A␤. The proportion of excitatory synapses associated with A␤ correlates with decreasing density (correlation, ؊0.588; P < 0.0001). These data show that senile plaques are a potential reservoir of oligomeric A␤, which colocalizes with the postsynaptic density and is associated with spine collapse, reconciling the apparently competing schools of thought of ''plaque'' vs. ''oligomeric A␤'' as the synaptotoxic species in the brain of AD patients.Alzheimer ͉ array tomography ͉ neurodegeneration ͉ synaptotoxicity L oss of connectivity caused by neuronal death and synapse loss is thought to underlie cognitive decline in neurodegenerative conditions, such as Alzheimer's disease (AD). Synapse loss appears to be particularly important in the pathogenesis of AD. Indeed, it is known that synapses are lost during AD and that in AD tissue, synapse loss correlates strongly with cognitive decline (1-3). There is a growing consensus, based primarily on cell-based assays, that amyloid ␤ (A␤), the main component of senile plaques, is toxic to synapses (4-6). In both AD patients and animal models of the disease, synapse loss is greatest near senile plaques, indicating a link between amyloid pathology and synaptotoxicity in vivo. Work by several groups has shown a decrease in dendritic spine density and synaptophysin-positive synapses radiating out from the surface of plaques in mouse models of AD (7-10). Whether this is caused by fibrillar plaques or soluble oligomeric A␤ is controversial. We used multiphoton imaging of the living brain to show that this spine loss is caused by impaired spine stability over time near plaques and postulated that a plaque-related diffusible bioactive molecule was responsible (11). Here, we test the hypothesis that oligomeric A␤ is directly synaptotoxic.We hypothesize that soluble oligomeric A␤ associates with the postsynaptic density and causes the loss of synapses and spines observ...

The apolipoprotein E ε4 gene is the most important genetic risk factor for sporadic Alzheimer's disease, but the link between this gene and neurodegeneration remains unclear. Using array tomography, we analysed >50000 synapses in brains of 11 patients with Alzheimer's disease and five non-demented control subjects and found that synapse loss around senile plaques in Alzheimer's disease correlates with the burden of oligomeric amyloid-β in the neuropil and that this synaptotoxic oligomerized peptide is present at a subset of synapses. Further analysis reveals apolipoprotein E ε4 patients with Alzheimer's disease have significantly higher oligomeric amyloid-β burden and exacerbated synapse loss around plaques compared with apolipoprotein E ε3 patients. Apolipoprotein E4 protein colocalizes with oligomeric amyloid-β and enhances synaptic localization of oligomeric amyloid-β by >5-fold. Biochemical characterization shows that the amyloid-β enriched at synapses by apolipoprotein E4 includes sodium dodecyl sulphate-stable dimers and trimers. In mouse primary neuronal culture, lipidated apolipoprotein E4 enhances oligomeric amyloid-β association with synapses via a mechanism involving apolipoprotein E receptors. Together, these data suggest that apolipoprotein E4 is a co-factor that enhances the toxicity of oligomeric amyloid-β both by increasing its levels and directing it to synapses, providing a link between apolipoprotein E ε4 genotype and synapse loss, a major correlate of cognitive decline in Alzheimer's disease.

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by insidious cognitive decline and memory dysfunction. Synapse loss is the best pathological correlate of cognitive decline in AD and mounting evidence suggests that AD is primarily a disease of synaptic dysfunction. Soluble oligomeric forms of amyloid beta (Aβ), the peptide that aggregates to form senile plaques in the brain of AD patients, have been shown to be toxic to neuronal synapses both in vitro and in vivo. Aβ oligomers inhibit long-term potentiation (LTP) and facilitate long-term depression (LTD), electrophysiological correlates of memory formation. Furthermore, oligomeric Aβ has also been shown to induce synapse loss and cognitive impairment in animals. The molecular underpinnings of these observations are now being elucidated, and may provide clear therapeutic targets for effectively treating the disease. Here, we review recent findings concerning AD pathogenesis with a particular focus on how Aβ impacts synapses.