“…Any factor that affects normal brain function (such as AD risk factors including TBI, ischemia, hypercholesterolemia, atherosclerosis) could facilitate perturbations in energy metabolism. For example, TBI is known to cause oxidative stress (Uryu et al, 2002), and mitochondrial dysfunction is induced by the major precursors of atherosclerosis (hypercholesterolemia, hyperglycemia) and is clearly associated with atherosclerosis or cardiomyopathy in humans and animal models of oxidative stress (reviewed in Madamanchi and Runge, 2007). Indeed, young adults carrying the ApoE4 allele, and MCI patients, exhibit reduced brain glucose metabolism (Reiman et al, 1996;Small et al, 2000;Mosconi et al, 2004;Mosconi, 2005), indicating that impaired energy metabolism may be an early contributing event to AD pathology rather than a consequence of the disease process.…”