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Basic Science and Pathogenesis.

Aivi T Nguyen1, Vijay K Ramanan2, Scott A Przybelski3

  • 1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Microglial activation, specifically an MS4A6A SNP, plays a key role in cognitive resilience, even with high Alzheimer's disease neuropathologic change. Increased microglial activation markers were linked to better cognitive performance.

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Area of Science:

  • Neuroscience
  • Immunology
  • Genetics

Background:

  • Cognitive resilience is the ability to maintain normal cognition despite significant Alzheimer's disease neuropathologic change (ADNC).
  • The role of microglial activation in cognitive resilience remains understudied.

Purpose of the Study:

  • To investigate the association between microglial activation and cognitive resilience in individuals with intermediate to high ADNC.
  • To explore the impact of specific microglial-associated genes, such as MS4A gene cluster SNPs, on cognitive function.

Main Methods:

  • Identified cognitively resilient (CR) individuals from a high-cognitively unimpaired cohort based on ADNC levels.
  • Utilized regression models to assess the relationship between global cognition, ADNC, and microglial-specific genes (MS4A SNPs).
  • Performed postmortem analysis of microglial activation markers (ARM) and beta-amyloid in the dorsolateral prefrontal cortex, correlating with antemortem cognitive and imaging data.

Main Results:

  • A third of high-cognitively unimpaired individuals met criteria for cognitive resilience (intermediate/high ADNC).
  • An MS4A6A SNP was found in 28% of CR individuals, showing a protective cognitive effect.
  • Cognitively resilient individuals exhibited higher ARM:amyloid ratios and fewer neuritic plaques compared to controls.

Conclusions:

  • Microglial activation, modulated by MS4A6A SNPs, is present in a significant portion of cognitively resilient individuals.
  • Increased microglial activation (ARM:amyloid) is associated with better antemortem cognitive performance in resilient individuals.
  • These findings highlight microglial activation as a crucial component of cognitive resilience, warranting further investigation into protective mechanisms and vascular links.