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Hirjak D, Wolf RC, Pfeifer B, Kubera KM, Thomann AK, Seidl U, Maier-Hein KH, Schröder J, Thomann PA. Cortical signature of clock drawing performance in Alzheimer's disease and mild cognitive impairment. J Psychiatr Res 2017; 90:133-142. [PMID: 28284155 DOI: 10.1016/j.jpsychires.2017.02.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/19/2017] [Accepted: 02/21/2017] [Indexed: 12/24/2022]
Abstract
It is unclear whether clock drawing test (CDT) performance relies on a widely distributed cortical network, or whether this test predominantly taps into parietal cortex function. So far, associations between cortical integrity and CDT impairment in Alzheimer's disease (AD) and mild cognitive impairment (MCI) largely stem from cortical volume analyses. Given that volume is a product of thickness and surface area, investigation of the relationship between CDT and these two cortical measures might contribute to better understanding of this cognitive screening tool for AD. 38 patients with AD, 38 individuals with MCI and 31 healthy controls (HC) underwent CDT assessment and MRI at 3 Tesla. The surface-based analysis via Freesurfer enabled calculation of cortical thickness and surface area. CDT was scored according to the method proposed by Shulman and related to the two distinct cortical measurements. Higher CDT scores across the entire sample were associated with cortical thickness in bilateral temporal gyrus, the right supramarginal gyrus, and the bilateral parietal gyrus, respectively (p < 0.001 CWP corr.). Significant associations between CDT and cortical thickness reduction in the parietal lobe remained significant when analyses were restricted to AD individuals. There was no statistically significant association between CDT scores and surface area (p < 0.001 CWP corr.). In conclusion, CDT performance may be driven by cortical thickness alterations in regions previously identified as "AD vulnerable", i.e. regions predominantly including temporal and parietal lobes. Our results suggest that cortical features of distinct evolutionary and genetic origin differently contribute to CDT performance.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany; Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Barbara Pfeifer
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Anne K Thomann
- Department of Internal Medicine II, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Ulrich Seidl
- Center for Mental Health, Department of Psychiatry, Prießnitzweg 24, Stuttgart 70374, Germany
| | - Klaus H Maier-Hein
- Medical Image Computing Group, German Cancer Research Center (DKFZ), Germany
| | | | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany; Center for Mental Health, Odenwald District Healthcare Center, Albert-Schweitzer-Straße 10-20, 64711 Erbach, Germany
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5
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Filley CM, Fields RD. White matter and cognition: making the connection. J Neurophysiol 2016; 116:2093-2104. [PMID: 27512019 DOI: 10.1152/jn.00221.2016] [Citation(s) in RCA: 242] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/04/2016] [Indexed: 12/14/2022] Open
Abstract
Whereas the cerebral cortex has long been regarded by neuroscientists as the major locus of cognitive function, the white matter of the brain is increasingly recognized as equally critical for cognition. White matter comprises half of the brain, has expanded more than gray matter in evolution, and forms an indispensable component of distributed neural networks that subserve neurobehavioral operations. White matter tracts mediate the essential connectivity by which human behavior is organized, working in concert with gray matter to enable the extraordinary repertoire of human cognitive capacities. In this review, we present evidence from behavioral neurology that white matter lesions regularly disturb cognition, consider the role of white matter in the physiology of distributed neural networks, develop the hypothesis that white matter dysfunction is relevant to neurodegenerative disorders, including Alzheimer's disease and the newly described entity chronic traumatic encephalopathy, and discuss emerging concepts regarding the prevention and treatment of cognitive dysfunction associated with white matter disorders. Investigation of the role of white matter in cognition has yielded many valuable insights and promises to expand understanding of normal brain structure and function, improve the treatment of many neurobehavioral disorders, and disclose new opportunities for research on many challenging problems facing medicine and society.
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Affiliation(s)
- Christopher M Filley
- Behavioral Neurology Section, Departments of Neurology and Psychiatry, University of Colorado School of Medicine, Aurora, Colorado; .,Denver Department of Veterans Affairs Medical Center, Denver, Colorado; and
| | - R Douglas Fields
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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6
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Ferreri F, Vecchio F, Vollero L, Guerra A, Petrichella S, Ponzo D, Määtta S, Mervaala E, Könönen M, Ursini F, Pasqualetti P, Iannello G, Rossini PM, Di Lazzaro V. Sensorimotor cortex excitability and connectivity in Alzheimer's disease: A TMS-EEG Co-registration study. Hum Brain Mapp 2016; 37:2083-96. [PMID: 26945686 DOI: 10.1002/hbm.23158] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 02/13/2016] [Accepted: 02/17/2016] [Indexed: 12/27/2022] Open
Abstract
Several studies have shown that, in spite of the fact that motor symptoms manifest late in the course of Alzheimer's disease (AD), neuropathological progression in the motor cortex parallels that in other brain areas generally considered more specific targets of the neurodegenerative process. It has been suggested that motor cortex excitability is enhanced in AD from the early stages, and that this is related to disease's severity and progression. To investigate the neurophysiological hallmarks of motor cortex functionality in early AD we combined transcranial magnetic stimulation (TMS) with electroencephalography (EEG). We demonstrated that in mild AD the sensorimotor system is hyperexcitable, despite the lack of clinically evident motor manifestations. This phenomenon causes a stronger response to stimulation in a specific time window, possibly due to locally acting reinforcing circuits, while network activity and connectivity is reduced. These changes could be interpreted as a compensatory mechanism allowing for the preservation of sensorimotor programming and execution over a long period of time, regardless of the disease's progression. Hum Brain Mapp 37:2083-2096, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Florinda Ferreri
- Department of Neurology, University Campus Biomedico, Rome, Italy.,Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Fabrizio Vecchio
- Brain Connectivity Laboratory, IRCCS S. Raffaele-Pisana, Rome, Italy
| | - Luca Vollero
- Department of Computer Science and Computer Engineering, University Campus Bio-Medico, Rome, Italy
| | - Andrea Guerra
- Department of Neurology, University Campus Biomedico, Rome, Italy
| | - Sara Petrichella
- Department of Computer Science and Computer Engineering, University Campus Bio-Medico, Rome, Italy
| | - David Ponzo
- Department of Neurology, University Campus Biomedico, Rome, Italy.,Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Sara Määtta
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Esa Mervaala
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Mervi Könönen
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Francesca Ursini
- Department of Neurology, University Campus Biomedico, Rome, Italy
| | - Patrizio Pasqualetti
- Brain Connectivity Laboratory, IRCCS S. Raffaele-Pisana, Rome, Italy.,AFaR Division, Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy
| | - Giulio Iannello
- Department of Computer Science and Computer Engineering, University Campus Bio-Medico, Rome, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, IRCCS S. Raffaele-Pisana, Rome, Italy.,Institute of Neurology, Department of Geriatrics, Neurosciences, Orthopaedics, Policlinic a. Gemelli, Catholic University, Rome, Italy
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7
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Calamante F. Super-Resolution Track Density Imaging: Anatomic Detail versus Quantification. AJNR Am J Neuroradiol 2016; 37:1066-7. [PMID: 26915572 DOI: 10.3174/ajnr.a4721] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- F Calamante
- Florey Institute of Neuroscience and Mental Health Heidelberg, Victoria, Australia Florey Department of Neuroscience and Mental Health University of Melbourne Melbourne, Victoria, Australia Department of Medicine Austin Health and Northern Health, University of Melbourne Melbourne, Victoria, Australia
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8
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Calamante F, Smith RE, Tournier JD, Raffelt D, Connelly A. Quantification of voxel-wise total fibre density: Investigating the problems associated with track-count mapping. Neuroimage 2015; 117:284-93. [DOI: 10.1016/j.neuroimage.2015.05.070] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/30/2015] [Accepted: 05/24/2015] [Indexed: 12/13/2022] Open
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9
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Cholinergic basal forebrain structure influences the reconfiguration of white matter connections to support residual memory in mild cognitive impairment. J Neurosci 2015; 35:739-47. [PMID: 25589767 DOI: 10.1523/jneurosci.3617-14.2015] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The fornix and hippocampus are critical to recollection in the healthy human brain. Fornix degeneration is a feature of aging and Alzheimer's disease. In the presence of fornix damage in mild cognitive impairment (MCI), a recognized prodrome of Alzheimer's disease, recall shows greater dependence on other tracts, notably the parahippocampal cingulum (PHC). The current aims were to determine whether this shift is adaptive and to probe its relationship to cholinergic signaling, which is also compromised in Alzheimer's disease. Twenty-five human participants with MCI and 20 matched healthy volunteers underwent diffusion MRI, behavioral assessment, and volumetric measurement of the basal forebrain. In a regression model for recall, there was a significant group × fornix interaction, indicating that the association between recall and fornix structure was weaker in patients. The opposite trend was present for the left PHC. To further investigate this pattern, two regression models were generated to account for recall performance: one based on fornix microstructure and the other on both fornix and left PHC. The realignment to PHC was positively correlated with free recall but not non-memory measures, implying a reconfiguration that is beneficial to residual memory. There was a positive relationship between realignment to PHC and basal forebrain gray matter volume despite this region demonstrating atrophy at a group level, i.e., the cognitive realignment to left PHC was most apparent when cholinergic areas were relatively spared. Therefore, cholinergic systems appear to enable adaptation to injury even as they degenerate, which has implications for functional restoration.
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