Chronic psychological stress has been implicated as a risk factor for Alzheimer’s disease (AD), potentially through cortisol-mediated acceleration of disease progression. However, the molecular pathways underlying this relationship remain poorly understood. Epigenetic regulation of the glucocorticoid and mineralocorticoid receptor genes ( NR3C1 and NR3C2 ), which encode receptors for cortisol, may play an important role, but has not been examined in relation to AD progression. Therefore, this study investigated associations between DNA methylation of NR3C1/NR3C2 and AD-related phenotypes, including cognition, brain amyloid-β (Aβ) burden, and regional brain volumes. These associations were examined in two independent cohorts of cognitively unimpaired individuals with accumulating brain Aβ ( n = 89–298 across outcomes) using linear regression and meta-analyses. The study also explored whether DNA methylation within NR3C1 and NR3C2 interacted with depression symptoms to influence relationships with AD-related phenotypes. While only nominal associations were observed in direct analyses, stronger associations emerged in interaction with depressive symptoms. Interaction analyses showed that relationships between DNA methylation and AD-related phenotypes (cognition, hippocampal volume and ventricular expansion) differed depending on the presence of depression symptoms. Consistent patterns across cohorts were observed, with associations primarily evident among individuals with clinically relevant depressive symptoms. One site ( NR3C1 cg24052866 ) was associated with cognitive decline, one ( NR3C1 cg08845721 ) with cross-sectional hippocampal volume, and eight ( NR3C1 cg21979215, cg16594263; NR3C2 cg27460943, cg17253842, cg04867484, cg10993059, cg25672354, cg27234800 ) with ventricular expansion. These exploratory findings suggest epigenetic variation within cortisol receptor genes may influence AD-related neurodegeneration in a depression-dependent manner.
Exploring the relationship between methylation of the cortisol receptor genes and brain and cognitive outcomes in individuals with elevated amyloid-β
Ayeisha Milligan Armstrong·Lidija Milicic·Michael Vacher·Shane Fernandez·Eleanor K. O’Brien·Vincent Doré·Pierrick Bourgeat·Rosita Shishegar·Ying Xia·Christopher C. Rowe·Victor L. Villemagne·Paul Maruff·Colin L. Masters·Giuseppe Verdile·Simon M. Laws·David Groth·Tenielle Porter·on behalf of the Alzheimer’s Disease Neuroimaging Initiative·Michael Weiner·Paul Aisen·Ronald Petersen·Clifford R. Jack·William Jagust·John Q. Trojanowki·Arthur W. Toga·Laurel Beckett·Robert C. Green·Andrew J. Saykin·Leslie M. Shaw·Enchi Liu·Tom Montine·Ronald G. Thomas·Michael Donohue·Sarah Walter·Devon Gessert·Tamie Sather·Gus Jiminez·Danielle Harvey·Matthew Bernstein·Nick Fox·Paul Thompson·Norbert Schuff·Charles DeCarli·Bret Borowski·Jeff Gunter·Matt Senjem·Prashanthi Vemuri·David Jones·Kejal Kantarci·Chad Ward·Robert A. Koeppe·Norm Foster·Eric M. Reiman·Kewei Chen·Chet Mathis·Susan Landau·John C. Morris·Nigel J. Cairns·Erin Householder·Lisa Taylor Reinwald·Virginia Lee·Magdalena Korecka·Michal Figurski·Karen Crawford·Scott Neu·Tatiana M. Foroud·Steven Potkin·Li Shen·Faber Kelley·Sungeun Kim·Kwangsik Nho·Zaven Kachaturian·Richard Frank·Peter J. Snyder·Susan Molchan·Jeffrey Kaye·Joseph Quinn·Betty Lind·Raina Carter·Sara Dolen·Lon S. Schneider·Sonia Pawluczyk·Mauricio Beccera·Liberty Teodoro·Bryan M. Spann·James Brewer·Helen Vanderswag·Adam Fleisher·Judith L. Heidebrink·Joanne Lord·Sara S. Mason·Colleen S. Albers·David Knopman·Kris Johnson·Rachelle S. Doody·Javier Villanueva Meyer·Munir Chowdhury·Susan Rountree·Mimi Dang·Yaakov Stern

