Background: Alzheimer's disease (AD) with early onset often presents with a distinct cognitive profile, potentially reflecting a different distribution of underlying neuropathology. The purpose of this study was to examine the relationships between age and both in vivo fibrillary amyloid deposition and glucose metabolism in AD. Methods: Dynamic [11 C]Pittsburgh compound-B (PIB) (90 minutes) and static [18 F]fluorodeoxyglucose (FDG) (15 minutes) scans were obtained in 100 AD patients and 20 healthy controls. Parametric nondisplaceable binding potential images of [ 11 C]PIB and standardized uptake value ratio images of [ 18 F]FDG were generated using cerebellar grey matter as reference tissue. Nine [ 11 C]PIB negative patients were excluded. The remaining patients were categorized into younger (n = 45, age: 56±4) and older (n = 46, age: 69 ± 5) groups, based on the median age (62) at time-of-diagnosis. Results: Younger patients showed more severe impairment on visuo-spatial function, attention and executive function composite scores (p < 0.05), while we found a trend towards poorer memory performance for older patients (p = 0.11 18 F]FDG uptake in the parietal cortex of younger patients (both p < 0.05). Linear regression analyses showed negative associations between visuo-spatial functioning and parietal www.jcbfm.com entiation in downstream processes, but may originate from distinctive distributions of early upstream events. As such, increased amyloid burden, together with metabolic dysfunction, in the parietal lobe of younger AD patients may contribute to the distinct cognitive profile in these patients.P002. Differential impact of apolipoprotein E genotype on distributions of amyloid load and glucose metabolism in Alzheimer's disease Rik Ossenkoppele, Wiesje van der Flier, Sofie Adriaanse, Marissa Zwan, Ronald Boellaard, Albert Windhorst, Frederik Barkhof, Philip Scheltens, Adriaan Lammertsma and Bart van Berckel VU University Medical Center, Amsterdam, The Netherlands Background: Apolipoprotein E (APOE) e4 is the major genetic risk factor for sporadic Alzheimer's disease (AD), but its impact on pathophysiological processes and neuronal function is not completely understood. The purpose of this study was to examine the relationships between APOE e4-dose and in vivo distributions of both fibrillary amyloid burden and glucose metabolism in the same AD patients. 18 F]FDG were generated using cerebellar grey matter as reference tissue. Regions-of-interest are the frontal, parietal, temporal, posterior cingulate, and occipital cortices. AD patients were categorized into APOE e4 negative (n = 22), heterozygous (n = 40), and homozygous (n = 22) groups. Results: Multivariate ANOVAs with adjustment for age, gender, and MMSE, showed main effects for APOE e4-dose for distributions of both [11 C]PIB (p < 0.05) and [18 F]FDG (p < 0.01). More specifically, ANOVAs of individual regions showed increased [ 11 C]PIB BP ND in the frontal cortex of APOE e4 noncarriers compared with APOE e4 carriers (p < 0.05). By contrast, APOE e4...