Studies indicate TOMM40 variants are associated with estimating onset of Alzheimer disease and interaction with ApoE status can increase disease onset, which may be geographically dependent.120 We found that TOMM40 expression was significantly increased in Braak stage III compared to I/II with no difference in transcript variants based on reference-guided assembly. The gene discussed is TOMM40; the disease is early-onset autosomal dominant Alzheimer disease.