Stability of graph theoretical measures in structural brain networks in Alzheimer's disease

Influence of individual's age on the characteristics of brain effective connectivity

Given the increasing number of older adults in society, there is a growing need for studies on changes in the aging brain. The aim of this research is to investigate the effective connectivity of different age groups using resting-state functional magnetic resonance imaging (fMRI) and graph theory. By examining connectivity in different age groups, a better understanding of age-related changes can be achieved. Lifespan pilot data from the Human Connectome Project (HCP) were used to examine dynamic effective connectivity (dEC) changes across different age groups. The Granger causality method with time windowing was employed to calculate dEC. After extracting graph measures, statistical analyses were performed to compare the age groups. Support vector machine and decision tree classifiers were used to classify the different age groups based on the extracted graph measures. Based on the obtained results, it can be concluded that there are significant differences in the effective connectivity among the three age groups. Statistical analyses revealed disassortativity. The global efficiency exhibited a decreasing trend, and the transitivity measure showed an increasing trend with the advancing age. The decision tree classifier showed an accuracy of 86.67 % with Kruskal-Wallis selected features. This study demonstrates that changes in effective connectivity across different age brackets can serve as a tool for better understanding brain function during the aging process.

Age-related changes in human brain functional connectivity using graph theory and machine learning techniques in resting-state fMRI data

Aging is the basis of neurodegeneration and dementia that affects each endemic in the body. Normal aging in the brain is associated with progressive slowdown and disruptions in various abilities such as motor ability, cognitive impairment, decreasing information processing speed, attention, and memory. With the aggravation of global aging, more research focuses on brain changes in the elderly adult. The graph theory, in combination with functional magnetic resonance imaging (fMRI), makes it possible to evaluate the brain network functional connectivity patterns in different conditions with brain modeling. We have evaluated the brain network communication model changes in three different age groups (including 8 to 15 years, 25 to 35 years, and 45 to 75 years) in lifespan pilot data from the human connectome project (HCP). Initially, Pearson correlation-based connectivity networks were calculated and thresholded. Then, network characteristics were compared between the three age groups by calculating the global and local graph measures. In the resting state brain network, we observed decreasing global efficiency and increasing transitivity with age. Also, brain regions, including the amygdala, putamen, hippocampus, precuneus, inferior temporal gyrus, anterior cingulate gyrus, and middle temporal gyrus, were selected as the most affected brain areas with age through statistical tests and machine learning methods. Using feature selection methods, including Fisher score and Kruskal-Wallis, we were able to classify three age groups using SVM, KNN, and decision-tree classifier. The best classification accuracy is in the combination of Fisher score and decision tree classifier obtained, which was 82.2%. Thus, by examining the measures of functional connectivity using graph theory, we will be able to explore normal age-related changes in the human brain, which can be used as a tool to monitor health with age.

The effect of cognitive reserve on the cognitive connectome in healthy ageing

During ageing, different cognitive functions decline at different rates. Additionally, cognitive reserve may influence inter-individual variability in age-related cognitive decline. These complex relationships can be studied by constructing a so-called cognitive connectome and characterising it with advanced graph-theoretical network analyses. This study examined the effect of cognitive reserve on the cognitive connectome across age. A total of 334 cognitively healthy participants were stratified into early middle age (37-50 years; n = 110), late middle age (51-64 years; n = 106), and elderly (65-78 years; n = 118) groups. Within each age group, individuals were subdivided into high and low cognitive reserve. For each subgroup, a cognitive connectome was constructed based on correlations between 47 cognitive variables. Applying graph theory, different global network measures were compared between the groups. Graph-theoretical network analyses revealed that individuals with high cognitive reserve were characterized by a stable cognitive connectome across age groups. High cognitive reserve groups only differed in modularity. In contrast, individuals with low cognitive reserve showed a marked reconfiguration of cognitive connectomes across age groups with differences extending over a variety of network measures including network strength, global efficiency, modularity, and small-worldness. Our results suggest a stabilizing effect of cognitive reserve on the cognitive connectome. Gaining further insights into these findings and underlying mechanisms will contribute to our understanding of age-related cognitive decline and guide the development of strategies to preserve cognitive function in ageing.

Association of neighborhood disadvantage with cognitive function and cortical disorganization in an unimpaired cohort

Objective

Neighborhood disadvantage is associated with worse health and cognitive outcomes. Morphological similarity network (MSN) is a promising approach to elucidate cortical network patterns underlying complex cognitive functions. We hypothesized that MSNs could capture intricate changes in cortical patterns related to neighborhood disadvantage and cognitive function, potentially explaining some of the risk for later life cognitive impairment among individuals who live in disadvantaged contexts.

Methods

This cross-sectional study included cognitively unimpaired participants (n=524, age=62.96±8.377, gender (M:F)=181:343, ADI(L:H) =450,74) from the Wisconsin Alzheimer's Disease Research Center or Wisconsin Registry for Alzheimer's Prevention. Neighborhood disadvantage status was obtained using the Area Deprivation Index (ADI). Cognitive performance was assessed through six tests evaluating memory, executive functioning, and the modified preclinical Alzheimer's cognitive composite (mPACC). Morphological Similarity Networks (MSN) were constructed for each participant based on the similarity in distribution of cortical thickness of brain regions, followed by computation of local and global network features. We used linear regression to examine ADI associations with cognitive scores and MSN features. The mediating effect of MSN features on the relationship between ADI and cognitive performance was statistically assessed.

Results

Neighborhood disadvantage showed negative association with category fluency, implicit learning speed, story recall and mPACC scores, indicating worse cognitive function among those living in more disadvantaged neighborhoods. Local network features of frontal and temporal brain regions differed based on ADI status. Centrality of left lateral orbitofrontal region showed a partial mediating effect between association of neighborhood disadvantage and story recall performance.

Conclusion

Our findings suggest differences in local cortical organization by neighborhood disadvantage, which also partially mediated the relationship between ADI and cognitive performance, providing a possible network-based mechanism to, in-part, explain the risk for poor cognitive functioning associated with disadvantaged neighborhoods. Future work will examine the exposure to neighborhood disadvantage on structural organization of the brain.

Review of the Brain's Behaviour after Injury and Disease for Its Application in an Agent-Based Model (ABM)

The brain is the most complex organ in the human body and, as such, its study entails great challenges (methodological, theoretical, etc.). Nonetheless, there is a remarkable amount of studies about the consequences of pathological conditions on its development and functioning. This bibliographic review aims to cover mostly findings related to changes in the physical distribution of neurons and their connections-the connectome-both structural and functional, as well as their modelling approaches. It does not intend to offer an extensive description of all conditions affecting the brain; rather, it presents the most common ones. Thus, here, we highlight the need for accurate brain modelling that can subsequently be used to understand brain function and be applied to diagnose, track, and simulate treatments for the most prevalent pathologies affecting the brain.

Grey matter networks in women and men with dementia with Lewy bodies

Sex differences permeate many aspects of dementia with Lewy bodies (DLB), yet sex differences in patterns of neurodegeneration in DLB remain largely unexplored. Here, we test whether grey matter networks differ between sexes in DLB and compare these findings to sex differences in healthy controls. In this cross-sectional study, we analysed clinical and neuroimaging data of patients with DLB and cognitively healthy controls matched for age and sex. Grey matter networks were constructed by pairwise correlations between 58 regional volumes after correction for age, intracranial volume, and centre. Network properties were compared between sexes and diagnostic groups. Additional analyses were conducted on w-scored data to identify DLB-specific sex differences. Data from 119 (68.7 ± 8.4 years) men and 45 women (69.9 ± 9.1 years) with DLB, and 164 healthy controls were included in this study. Networks of men had a lower nodal strength compared to women. In comparison to healthy women, the grey matter networks of healthy men showed a higher global efficiency, modularity, and fewer modules. None of the network measures showed significant sex differences in DLB. Comparing DLB patients with healthy controls revealed global differences in women and more local differences in men. Modular analyses showed a more distinct demarcation between cortical and subcortical regions in men compared with women. While topologies of grey matter networks differed between sexes in healthy controls, those sex differences were diluted in DLB patients. These findings suggest a disease-driven convergence of neurodegenerative patterns in women and men with DLB, which may inform precision medicine in DLB.

An Agent-Based Model to Reproduce the Boolean Logic Behaviour of Neuronal Self-Organised Communities through Pulse Delay Modulation and Generation of Logic Gates

The human brain is arguably the most complex "machine" to ever exist. Its detailed functioning is yet to be fully understood, let alone modelled. Neurological processes have logical signal-processing and biophysical aspects, and both affect the brain's structure, functioning and adaptation. Mathematical approaches based on both information and graph theory have been extensively used in an attempt to approximate its biological functioning, along with Artificial Intelligence frameworks inspired by its logical functioning. In this article, an approach to model some aspects of the brain learning and signal processing is presented, mimicking the metastability and backpropagation found in the real brain while also accounting for neuroplasticity. Several simulations are carried out with this model to demonstrate how dynamic neuroplasticity, neural inhibition and neuron migration can reshape the brain's logical connectivity to synchronise signal processing and obtain certain target latencies. This work showcases the importance of dynamic logical and biophysical remodelling in brain plasticity. Combining mathematical (agents, graph theory, topology and backpropagation) and biomedical ingredients (metastability, neuroplasticity and migration), these preliminary results prove complex brain phenomena can be reproduced-under pertinent simplifications-via affordable computations, which can be construed as a starting point for more ambitiously accurate simulations.

Exploring Alzheimer's disease: a comprehensive brain connectome-based survey

Dementia is an escalating global health challenge, with Alzheimer's disease (AD) at its forefront. Substantial evidence highlights the accumulation of AD-related pathological proteins in specific brain regions and their subsequent dissemination throughout the broader area along the brain network, leading to disruptions in both individual brain regions and their interconnections. Although a comprehensive understanding of the neurodegeneration-brain network link is lacking, it is undeniable that brain networks play a pivotal role in the development and progression of AD. To thoroughly elucidate the intricate network of elements and connections constituting the human brain, the concept of the brain connectome was introduced. Research based on the connectome holds immense potential for revealing the mechanisms underlying disease development, and it has become a prominent topic that has attracted the attention of numerous researchers. In this review, we aim to systematically summarize studies on brain networks within the context of AD, critically analyze the strengths and weaknesses of existing methodologies, and offer novel perspectives and insights, intending to serve as inspiration for future research.

Physical fitness, cognition, and structural network efficiency of brain connections across the lifespan

Inadequate levels of exercise is one of the most potent modifiable risk factors for preventing cognitive decline and dementia as we age. Meanwhile, network science-based measures of structural brain network global and local efficiency show promise as robust biomarkers of aging, cognitive decline, and pathological disease progression. Despite this, little to no work has established how maintaining physical activity (PA) and physical fitness might relate to cognition and network efficiency measures across the lifespan. Therefore the purpose of this study was to determine the relationship between (1) PA and fitness and cognition, (2) fitness and network efficiency, and (3) how network efficiency measures relate to cognition. To accomplish this, we analyzed a large cross-sectional data set (n = 720; 36-100 years) from the aging human connectome project, which included the Trail Making Task (TMT) A and B, a measure of fitness (2-min walk test), physical activity (International Physical Activity Questionnaire), and high-resolution diffusion imaging data. Our analysis consisted of employing multiple linear regression while controlling for age, sex, and education. Age was associated with lower global and local brain network efficiency and poorer Trail A & B performance. Meanwhile, fitness, but not physical activity, was related to better Trail A and B performance and fitness, and was positively associated with local and global brain efficiency. Finally, local efficiency was related to better TMT B performance and partially mediated the relationship between fitness and TMT B performance. These results indicate aging may be associated with a shift towards less efficient local and global neural networks and that maintaining physical fitness might protect against age-related cognitive performance deterioration by bolstering structural network efficiency.

Topologically convergent and divergent large scale complex networks among Alzheimer's disease spectrum patients: A systematic review

Alzheimer's disease (AD) is associated with disruption at the level of a large-scale complex network. To explore the underlying mechanisms in the progression of AD, graph theory was used to quantitatively analyze the topological properties of structural and functional connections. Although an increasing number of studies have shown altered global and nodal network properties, little is known about the topologically convergent and divergent patterns between structural and functional networks among AD-spectrum patients. In this review, we summarized the topological patterns of the large-scale complex networks using multimodal neuroimaging graph theory analysis in AD spectrum patients. Convergent deficits in the connectivity characteristics were primarily in the default mode network (DMN) itself both in the structural and functional networks, while a divergent changes in the neighboring regions of the DMN were also observed between the patient groups. Together, the application of graph theory to large-scale complex brain networks provides quantitative insights into topological principles of brain network organization, which may lead to increasing attention in identifying the underlying neuroimaging pathological changes and predicting the progression of AD.

BrainGB: A Benchmark for Brain Network Analysis With Graph Neural Networks

Mapping the connectome of the human brain using structural or functional connectivity has become one of the most pervasive paradigms for neuroimaging analysis. Recently, Graph Neural Networks (GNNs) motivated from geometric deep learning have attracted broad interest due to their established power for modeling complex networked data. Despite their superior performance in many fields, there has not yet been a systematic study of how to design effective GNNs for brain network analysis. To bridge this gap, we present BrainGB, a benchmark for brain network analysis with GNNs. BrainGB standardizes the process by (1) summarizing brain network construction pipelines for both functional and structural neuroimaging modalities and (2) modularizing the implementation of GNN designs. We conduct extensive experiments on datasets across cohorts and modalities and recommend a set of general recipes for effective GNN designs on brain networks. To support open and reproducible research on GNN-based brain network analysis, we host the BrainGB website at https://braingb.us with models, tutorials, examples, as well as an out-of-box Python package. We hope that this work will provide useful empirical evidence and offer insights for future research in this novel and promising direction.

Sex differences in grey matter networks in dementia with Lewy bodies

Objectives

Sex differences permeate many aspects of dementia with Lewy bodies (DLB), including epidemiology, pathogenesis, disease progression, and symptom manifestation. However, less is known about potential sex differences in patterns of neurodegeneration in DLB. Here, we test whether grey matter networks also differ between female and male DLB patients. To assess the specificity of these sex differences to DLB, we additionally investigate sex differences in healthy controls (HCs).

Methods

A total of 119 (68.7 ± 8.4 years) male and 45 female (69.9 ± 9.1 years) DLB patients from three European centres and the Mayo Clinic were included in this study. Additionally, we included 119 male and 45 female age-matched HCs from the Mayo Clinic. Grey matter volumes of 58 cortical, subcortical, cerebellar, and pontine brain regions derived from structural magnetic resonance images were corrected for age, intracranial volume, and centre. Sex-specific grey matter networks for DLB patients and HCs were constructed by correlating each pair of brain regions. Network properties of the correlation matrices were compared between sexes and groups. Additional analyses were conducted on W-scored data to identify DLB-specific findings.

Results

Networks of male HCs and male DLB patients were characterised by a lower nodal strength compared to their respective female counterparts. In comparison to female HCs, the grey matter networks of male HCs showed a higher global efficiency, modularity, and a lower number of modules. None of the global and nodal network measures showed significant sex differences in DLB.

Conclusions

The disappearance of sex differences in the structural grey matter networks of DLB patients compared to HCs may indicate a sex-dependent network vulnerability to the alpha-synuclein pathology in DLB. Future studies might investigate whether the differences in structural network measures are associated with differences in cognitive scores and clinical symptoms between the sexes.

(Dis-)Connected Dots in Dementia with Lewy Bodies-A Systematic Review of Connectivity Studies

Studies on dementia with Lewy bodies (DLB) have mainly focused on the degeneration of distinct cortical and subcortical regions related to the deposition of Lewy bodies. In view of the proposed trans-synaptic spread of the α-synuclein pathology, investigating the disease only in this segregated fashion would be detrimental to our understanding of its progression. In this systematic review, we summarize findings on structural and functional brain connectivity in DLB, as connectivity measures may offer better insights on how the brain is affected by the spread of the pathology. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched Web of Science, PubMed, and SCOPUS for relevant articles published up to November 1, 2021. Of 1215 identified records, we selected and systematically reviewed 53 articles that compared connectivity features between patients with DLB and healthy controls. Structural and functional magnetic resonance imaging, positron emission tomography, single-positron emission computer tomography, and electroencephalography assessments of patients revealed widespread abnormalities within and across brain networks in DLB. Frontoparietal, default mode, and visual networks and their connections to other brain regions featured the most consistent disruptions, which were also associated with core clinical features and cognitive impairments. Furthermore, graph theoretical measures revealed disease-related decreases in local and global network efficiency. This systematic review shows that structural and functional connectivity characteristics in DLB may be particularly valuable at early stages, before overt brain atrophy can be observed. This knowledge may help improve the diagnosis and prognosis in DLB as well as pinpoint targets for future disease-modifying treatments. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Consistency of Graph Theoretical Measurements of Alzheimer's Disease Fiber Density Connectomes Across Multiple Parcellation Scales

Graph theoretical measures have frequently been used to study disrupted connectivity in Alzheimer's disease human brain connectomes. However, prior studies have noted that differences in graph creation methods are confounding factors that may alter the topological observations found in these measures. In this study, we conduct a novel investigation regarding the effect of parcellation scale on graph theoretical measures computed for fiber density networks derived from diffusion tensor imaging. We computed 4 network-wide graph theoretical measures of average clustering coefficient, transitivity, characteristic path length, and global efficiency, and we tested whether these measures are able to consistently identify group differences among healthy control (HC), mild cognitive impairment (MCI), and AD groups in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort across 5 scales of the Lausanne parcellation. We found that the segregative measure of transtivity offered the greatest consistency across scales in distinguishing between healthy and diseased groups, while the other measures were impacted by the selection of scale to varying degrees. Global efficiency was the second most consistent measure that we tested, where the measure could distinguish between HC and MCI in all 5 scales and between HC and AD in 3 out of 5 scales. Characteristic path length was highly sensitive to the variation in scale, corroborating previous findings, and could not identify group differences in many of the scales. Average clustering coefficient was also greatly impacted by scale, as it consistently failed to identify group differences in the higher resolution parcellations. From these results, we conclude that many graph theoretical measures are sensitive to the selection of parcellation scale, and further development in methodology is needed to offer a more robust characterization of AD's relationship with disrupted connectivity.

The hippocampal sparing subtype of Alzheimer's disease assessed in neuropathology and in vivo tau positron emission tomography: a systematic review

Neuropathology and neuroimaging studies have identified several subtypes of Alzheimer's disease (AD): hippocampal sparing AD, typical AD, and limbic predominant AD. An unresolved question is whether hippocampal sparing AD cases can present with neurofibrillary tangles (NFT) in association cortices while completely sparing the hippocampus. To address that question, we conducted a systematic review and performed original analyses on tau positron emission tomography (PET) data. We searched EMBASE, PubMed, and Web of Science databases until October 2022. We also implemented several methods for AD subtyping on tau PET to identify hippocampal sparing AD cases. Our findings show that seven out of the eight reviewed neuropathologic studies included cases at Braak stages IV or higher and therefore, could not identify hippocampal sparing cases with NFT completely sparing the hippocampus. In contrast, tau PET did identify AD participants with tracer retention in the association cortex while completely sparing the hippocampus. We conclude that tau PET can identify hippocampal sparing AD cases with NFT completely sparing the hippocampus. Based on the accumulating data, we suggest two possible pathways of tau spread: (1) a canonical pathway with early involvement of transentorhinal cortex and subsequent involvement of limbic regions and association cortices, and (2) a less common pathway that affects association cortices with limbic involvement observed at end stages of the disease or not at all.

Functional Connectivity as an Index of Brain Changes Following a Unicycle Intervention: A Graph-Theoretical Network Analysis

Grey matter volume reductions in the right superior temporal gyrus (rSTG) were observed in young adults who learned to ride a unicycle. As these decreases were correlated with the acquired ability in unicycling, the authors interpreted the change as a brain tissue reorganization to increase postural control’s automated and efficient coordination. The current study aims to further corroborate this interpretation by looking at changes in the functional brain network in the very same sample of participants. For this reason, we applied graph theory, a mathematics field used to study network structure functionality. Four global and two local graph-theoretical parameters were calculated to measure whole brain and rSTG specific changes in functional network activity following the three-week-unicycle training. Findings revealed that the Local Efficiency of the rSTG was significantly elevated after the intervention indicating an increase in fault tolerance of the rSTG, possibly reflecting decentralisation of rSTG specific functions to neighbouring nodes. Thus, the increased Local Efficiency may indicate increased task efficiency by decentralising the processing of functions crucial for balance.

Multi-cohort and longitudinal Bayesian clustering study of stage and subtype in Alzheimer's disease

Understanding Alzheimer's disease (AD) heterogeneity is important for understanding the underlying pathophysiological mechanisms of AD. However, AD atrophy subtypes may reflect different disease stages or biologically distinct subtypes. Here we use longitudinal magnetic resonance imaging data (891 participants with AD dementia, 305 healthy control participants) from four international cohorts, and longitudinal clustering to estimate differential atrophy trajectories from the age of clinical disease onset. Our findings (in amyloid-β positive AD patients) show five distinct longitudinal patterns of atrophy with different demographical and cognitive characteristics. Some previously reported atrophy subtypes may reflect disease stages rather than distinct subtypes. The heterogeneity in atrophy rates and cognitive decline within the five longitudinal atrophy patterns, potentially expresses a complex combination of protective/risk factors and concomitant non-AD pathologies. By alternating between the cross-sectional and longitudinal understanding of AD subtypes these analyses may allow better understanding of disease heterogeneity.

Early diagnosis of Alzheimer's disease using machine learning: a multi-diagnostic, generalizable approach

BACKGROUND

Early and accurate diagnosis of Alzheimer's disease (AD) is essential for disease management and therapeutic choices that can delay disease progression. Machine learning (ML) approaches have been extensively used in attempts to develop algorithms for reliable early diagnosis of AD, although clinical usefulness, interpretability, and generalizability of the classifiers across datasets and MRI protocols remain limited.

METHODS

We report a multi-diagnostic and generalizable approach for mild cognitive impairment (MCI) and AD diagnosis using structural MRI and ML. Classifiers were trained and tested using subjects from the AD Neuroimaging Initiative (ADNI) database (n = 570) and the Open Access Series of Imaging Studies (OASIS) project database (n = 531). Several classifiers are compared and combined using voting for a decision. Additionally, we report tests of generalizability across datasets and protocols (IR-SPGR and MPRAGE), the impact of using graph theory measures on diagnostic classification performance, the relative importance of different brain regions on classification for better interpretability, and an evaluation of the potential for clinical applicability of the classifier.

RESULTS

Our "healthy controls (HC) vs. AD" classifier trained and tested on the combination of ADNI and OASIS datasets obtained a balanced accuracy (BAC) of 90.6% and a Matthew's correlation coefficient (MCC) of 0.811. Our "HC vs. MCI vs. AD" classifier trained and tested on the ADNI dataset obtained a 62.1% BAC (33.3% being the by-chance cut-off) and 0.438 MCC. Hippocampal features were the strongest contributors to the classification decisions (approx. 25-45%), followed by temporal (approx. 13%), cingulate, and frontal regions (approx. 8-13% each), which is consistent with our current understanding of AD and its progression. Classifiers generalized well across both datasets and protocols. Finally, using graph theory measures did not improve classification performance.

CONCLUSIONS

In sum, we present a diagnostic tool for MCI and AD trained using baseline scans and a follow-up diagnosis regardless of progression, which is multi-diagnostic, generalizable across independent data sources and acquisition protocols, and with transparently reported performance. Rated as potentially clinically applicable, our tool may be clinically useful to inform diagnostic decisions in dementia, if successful in real-world prospective clinical trials.

Bayesian Testing for Exogenous Partition Structures in Stochastic Block Models

Network data often exhibit block structures characterized by clusters of nodes with similar patterns of edge formation. When such relational data are complemented by additional information on exogenous node partitions, these sources of knowledge are typically included in the model to supervise the cluster assignment mechanism or to improve inference on edge probabilities. Although these solutions are routinely implemented, there is a lack of formal approaches to test if a given external node partition is in line with the endogenous clustering structure encoding stochastic equivalence patterns among the nodes in the network. To fill this gap, we develop a formal Bayesian testing procedure which relies on the calculation of the Bayes factor between a stochastic block model with known grouping structure defined by the exogenous node partition and an infinite relational model that allows the endogenous clustering configurations to be unknown, random and fully revealed by the block–connectivity patterns in the network. A simple Markov chain Monte Carlo method for computing the Bayes factor and quantifying uncertainty in the endogenous groups is proposed. This strategy is evaluated in simulations, and in applications studying brain networks of Alzheimer’s patients.

Structural brain splitting is a hallmark of Granulin-related frontotemporal dementia

Frontotemporal dementia associated with granulin (GRN) mutations presents asymmetric brain atrophy. We applied a Minimum Spanning Tree plus an Efficiency Cost Optimization approach to cortical thickness data in order to test whether graph theory measures could identify global or local impairment of connectivity in the presymptomatic phase of pathology, where other techniques failed in demonstrating changes. We included 52 symptomatic GRN mutation carriers (SC), 161 presymptomatic GRN mutation carriers (PSC) and 341 non-carriers relatives from the Genetic Frontotemporal dementia research Initiative cohort. Group differences of global, nodal and edge connectivity in (Minimum Spanning Tree plus an Efficiency Cost Optimization) graph were tested via Structural Equation Models. Global graph perturbation was selectively impaired in SC compared to non-carriers, with no changes in PSC. At the local level, only SC exhibited perturbation of frontotemporal nodes, but edge connectivity revealed a characteristic pattern of interhemispheric disconnection, involving homologous parietal regions, in PSC. Our results suggest that GRN-related frontotemporal dementia resembles a disconnection syndrome, with interhemispheric disconnection between parietal regions in presymptomatic phases that progresses to frontotemporal areas as symptoms emerge.

Cognitive Test Scores and Progressive Cognitive Decline in the Aberdeen 1921 and 1936 Birth Cohorts

The Aberdeen birth cohorts of 1921 and 1936 (ABC21 and ABC36) were subjected to IQ tests in 1932 or 1947 when they were aged about 11y. They were recruited between 1997–2001 among cognitively healthy community residents and comprehensively phenotyped in a long-term study of brain aging and health up to 2017. Here, we report associations between baseline cognitive test scores and long-term cognitive outcomes. On recruitment, significant sex differences within and between the ABC21 and ABC36 cohorts supported advantages in verbal ability and learning among the ABC36 women that were not significant in ABC21. Comorbid physical disorders were self-reported in both ABC21 and ABC36 but did not contribute to differences in terms of performance in cognitive tests. When used alone without other criteria, cognitive tests scores which fell below the −1.5 SD criterion for tests of progressive matrices, namely verbal learning, digit symbol and block design, did not support the concept that Mild Cognitive Impairment (MCI) is a stable class of acquired loss of function with significant links to the later emergence of a clinical dementia syndrome. This is consistent with many previous reports. Furthermore, because childhood IQ-type data were available, we showed that a lower cognitive performance at about 64 or 78 y than that predicted by IQ at 11 ± 0.5 y did not improve the prediction of progress to MCI or greater cognitive loss. We used binary logistic regression to explore how MCI might contribute to the prediction of later progress to a clinical dementia syndrome. In a fully adjusted model using ABC21 data, we found that non-amnestic MCI, along with factors such as female sex and depressive symptoms, contributed to the prediction of later dementia. A comparable model using ABC36 data did not do so. We propose that (1) MCI criteria restricted to cognitive test scores do not improve the temporal stability of MCI classifications; (2) pathways towards dementia may differ according to age at dementia onset and (3) the concept of MCI may require measures (not captured here) that underly self-reported subjective age-related cognitive decline.

OUP accepted manuscript

Analyses of alterations of brain networks have gained an increasing interest in stroke rehabilitation research. Compared with functional networks derived from resting-state analyses, there is limited knowledge of how structural network topology might undergo changes after stroke and, more importantly, if structural network information obtained early after stroke could enhance recovery models to infer later outcomes. The present work re-analysed cross-sectional structural imaging data, obtained within the first 2 weeks, of 45 acute stroke patients (22 females, 24 right-sided strokes, age 68 ± 13 years). Whole-brain tractography was performed to reconstruct structural connectomes and graph-theoretical analyses were employed to quantify global network organization with a focus on parameters of network integration and modular processing. Graph measures were compared between stroke patients and 34 healthy controls (15 females, aged 69 ± 10 years) and they were integrated with four clinical scores of the late subacute stage, covering neurological symptom burden (National Institutes of Health Stroke Scale), global disability (modified Rankin Scale), activity-related disability (Barthel Index) and motor functions (Upper-Extremity Score of the Fugl-Meyer Assessment). The analyses were employed across the complete cohort and, based on clustering analysis, separately within subgroups stratified in mild to moderate (n = 21) and severe (n = 24) initial deficits. The main findings were (i) a significant reduction of network’s global efficiency, specifically in patients with severe deficits compared with controls (P = 0.010) and (ii) a significant negative correlation of network efficiency with the extent of persistent functional deficits at follow-up after 3–6 months (P ≤ 0.032). Specifically, regression models revealed that this measure was capable to increase the explained variance in future deficits by 18% for the modified Rankin Scale, up to 24% for National Institutes of Health Stroke Scale, and 16% for Barthel Index when compared with models including the initial deficits and the lesion volume. Patients with mild to moderate deficits did not exhibit a similar impact of network efficiency on outcome inference. Clustering coefficient and modularity, measures of segregation and modular processing, did not exhibit comparable structure–outcome relationships, neither in severely nor in mildly affected patients. This study provides empirical evidence that structural network efficiency as a graph-theoretical marker of large-scale network topology, quantified early after stroke, relates to recovery. Notably, this contribution was only evident in severely but not mildly affected stroke patients. This suggests that the initial clinical deficit might shape the dependency of recovery on global network topology after stroke.

Different brain functional networks between subjective cognitive decline and health control based on graph theory

Subjective cognitive decline (SCD) is a preclinical stage before cognitive impairment, which has a high conversion risk into Alzheimer's disease. However, it is still unknown on the brain functional differences between SCD and healthy controls (HC) subjects. This study therefore proposed a complex brain network analysis based on graph theory. In this study, we selected functional magnetic resonance imaging (fMRI) scans from Xuanwu Hospital of Capital Medical University, including 27 SCD and 42 HC subjects. First, we constructed brain functional connectivity network to obtain brain network topology parameters, including clustering parameters, shortest path length, global efficiency, local efficiency, small world attributes, and modularity. Then, we compared differences on the parameters between two groups. As a result, both SCD and HC groups showed the characteristics of small world. Both global efficiency and local efficiency of HC groups were higher than those of the SCD group. In addition, we found that the global modularity of the SCD group (6 modules) was higher than the HC group (7 modules). Our findings indicated that there were differences in brain functional networks between SCD and HC groups. Graph theory analysis may be useful and helpful to discriminate SCD and HC subjects.

The Cognitive Connectome in Healthy Aging

Objectives: Cognitive aging has been extensively investigated using both univariate and multivariate analyses. Sophisticated multivariate approaches such as graph theory could potentially capture unknown complex associations between multiple cognitive variables. The aim of this study was to assess whether cognition is organized into a structure that could be called the “cognitive connectome,” and whether such connectome differs between age groups.

Methods: A total of 334 cognitively unimpaired individuals were stratified into early-middle-age (37–50 years, n = 110), late-middle-age (51–64 years, n = 106), and elderly (65–78 years, n = 118) groups. We built cognitive networks from 47 cognitive variables for each age group using graph theory and compared the groups using different global and nodal graph measures.

Results: We identified a cognitive connectome characterized by five modules: verbal memory, visual memory—visuospatial abilities, procedural memory, executive—premotor functions, and processing speed. The elderly group showed reduced transitivity and average strength as well as increased global efficiency compared with the early-middle-age group. The late-middle-age group showed reduced global and local efficiency and modularity compared with the early-middle-age group. Nodal analyses showed the important role of executive functions and processing speed in explaining the differences between age groups.

Conclusions: We identified a cognitive connectome that is rather stable during aging in cognitively healthy individuals, with the observed differences highlighting the important role of executive functions and processing speed. We translated the connectome concept from the neuroimaging field to cognitive data, demonstrating its potential to advance our understanding of the complexity of cognitive aging.

Decoupling of structural and functional connectivity in hubs and cognitive impairment after mild traumatic brain injury

INTRODUCTION

Mild traumatic brain injury (mild TBI) exhibited abnormal brain network topologies associated with cognitive dysfunction. However, it was still unclear which aspects of network organization were critical underlying the key pathology of mild TBI. Here, a multi-imaging strategy was applied to capture dynamic topological features of both structural and functional connectivity networks (SCN and FCN), to provide more sensitive detection of altered FCN from its anatomical backbone and identify novel biomarkers of mild TBI outcomes.

METHODS

62 mild TBI patients (30 subjects as an original sample with 3-12 months follow-up, 32 subjects as independent replicated sample), and 37 healthy controls were recruited. Both diffusion tensor imaging (DTI) and resting-state fMRI were used to create global connectivity matrices in the same individuals. Global and regional network analyses were applied to identify group differences and correlations with clinical assessments.

RESULTS

Most global network properties were conserved in both SCNs and FCNs in subacute mild TBI, whereas SCNs presented decreased global efficiency and characteristic path length at follow-up. Specifically, some hubs in healthy brain networks typically became non-hubs in patients and vice versa, such as the medial prefrontal cortex, superior temporal gyrus, middle frontal gyrus. The relationship between structural and functional connectivity (SC and FC) in patients also showed salient decoupling as a function of time, primarily located in the hubs.

CONCLUSIONS

These results suggested mild TBI influences the relationship between SCN and FCN, and the SC-FC coupling strength may be used as a potential biomarker to predict long-term outcomes after injury.

White Matter Brain Network Research in Alzheimer's Disease Using Persistent Features

Despite the severe social burden caused by Alzheimer’s disease (AD), no drug than can change the disease progression has been identified yet. The structural brain network research provides an opportunity to understand physiological deterioration caused by AD and its precursor, mild cognitive impairment (MCI). Recently, persistent homology has been used to study brain network dynamics and characterize the global network organization. However, it is unclear how these parameters reflect changes in structural brain networks of patients with AD or MCI. In this study, our previously proposed persistent features and various traditional graph-theoretical measures are used to quantify the topological property of white matter (WM) network in 150 subjects with diffusion tensor imaging (DTI). We found significant differences in these measures among AD, MCI, and normal controls (NC) under different brain parcellation schemes. The decreased network integration and increased network segregation are presented in AD and MCI. Moreover, the persistent homology-based measures demonstrated stronger statistical capability and robustness than traditional graph-theoretic measures, suggesting that they represent a more sensitive approach to detect altered brain structures and to better understand AD symptomology at the network level. These findings contribute to an increased understanding of structural connectome in AD and provide a novel approach to potentially track the progression of AD.

The reliability of a deep learning model in clinical out-of-distribution MRI data: A multicohort study

Deep learning (DL) methods have in recent years yielded impressive results in medical imaging, with the potential to function as clinical aid to radiologists. However, DL models in medical imaging are often trained on public research cohorts with images acquired with a single scanner or with strict protocol harmonization, which is not representative of a clinical setting. The aim of this study was to investigate how well a DL model performs in unseen clinical datasets-collected with different scanners, protocols and disease populations-and whether more heterogeneous training data improves generalization. In total, 3117 MRI scans of brains from multiple dementia research cohorts and memory clinics, that had been visually rated by a neuroradiologist according to Scheltens' scale of medial temporal atrophy (MTA), were included in this study. By training multiple versions of a convolutional neural network on different subsets of this data to predict MTA ratings, we assessed the impact of including images from a wider distribution during training had on performance in external memory clinic data. Our results showed that our model generalized well to datasets acquired with similar protocols as the training data, but substantially worse in clinical cohorts with visibly different tissue contrasts in the images. This implies that future DL studies investigating performance in out-of-distribution (OOD) MRI data need to assess multiple external cohorts for reliable results. Further, by including data from a wider range of scanners and protocols the performance improved in OOD data, which suggests that more heterogeneous training data makes the model generalize better. To conclude, this is the most comprehensive study to date investigating the domain shift in deep learning on MRI data, and we advocate rigorous evaluation of DL models on clinical data prior to being certified for deployment.

Imaging biomarkers in neurodegeneration: current and future practices

There is an increasing role for biological markers (biomarkers) in the understanding and diagnosis of neurodegenerative disorders. The application of imaging biomarkers specifically for the in vivo investigation of neurodegenerative disorders has increased substantially over the past decades and continues to provide further benefits both to the diagnosis and understanding of these diseases. This review forms part of a series of articles which stem from the University College London/University of Gothenburg course "Biomarkers in neurodegenerative diseases". In this review, we focus on neuroimaging, specifically positron emission tomography (PET) and magnetic resonance imaging (MRI), giving an overview of the current established practices clinically and in research as well as new techniques being developed. We will also discuss the use of machine learning (ML) techniques within these fields to provide additional insights to early diagnosis and multimodal analysis.

Gaussian Graphical Models Reveal Inter-Modal and Inter-Regional Conditional Dependencies of Brain Alterations in Alzheimer's Disease

Alzheimer's disease (AD) is characterized by a sequence of pathological changes, which are commonly assessed in vivo using various brain imaging modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET). Currently, the most approaches to analyze statistical associations between regions and imaging modalities rely on Pearson correlation or linear regression models. However, these models are prone to spurious correlations arising from uninformative shared variance and multicollinearity. Notably, there are no appropriate multivariate statistical models available that can easily integrate dozens of multicollinear variables derived from such data, being able to utilize the additional information provided from the combination of data sources. Gaussian graphical models (GGMs) can estimate the conditional dependency from given data, which is conceptually expected to closely reflect the underlying causal relationships between various variables. Hence, we applied GGMs to assess multimodal regional brain alterations in AD. We obtained data from N = 972 subjects from the Alzheimer's Disease Neuroimaging Initiative. The mean amyloid load (AV45-PET), glucose metabolism (FDG-PET), and gray matter volume (MRI) were calculated for each of the 108 cortical and subcortical brain regions. GGMs were estimated using a Bayesian framework for the combined multimodal data and the resulted conditional dependency networks were compared to classical covariance networks based on Pearson correlation. Additionally, graph-theoretical network statistics were calculated to determine network alterations associated with disease status. The resulting conditional dependency matrices were much sparser (≈10% density) than Pearson correlation matrices (≈50% density). Within imaging modalities, conditional dependency networks yielded clusters connecting anatomically adjacent regions. For the associations between different modalities, only few region-specific connections were detected. Network measures such as small-world coefficient were significantly altered across diagnostic groups, with a biphasic u-shape trajectory, i.e., increased small-world coefficient in early mild cognitive impairment (MCI), similar values in late MCI, and decreased values in AD dementia patients compared to cognitively normal controls. In conclusion, GGMs removed commonly shared variance among multimodal measures of regional brain alterations in MCI and AD, and yielded sparser matrices compared to correlation networks based on the Pearson coefficient. Therefore, GGMs may be used as alternative to thresholding-approaches typically applied to correlation networks to obtain the most informative relations between variables.

Effect of Fixed-Density Thresholding on Structural Brain Networks: A Demonstration in Cerebral Small Vessel Disease

A popular solution to control for edge density variability in structural brain network analysis is to threshold the networks to a fixed density across all subjects. However, it remains unclear how this type of thresholding affects the basic network architecture in terms of edge weights, hub location, and hub connectivity and, especially, how it affects the sensitivity to detect disease-related abnormalities. We investigated these two questions in a cohort of patients with cerebral small vessel disease and age-matched controls. Brain networks were reconstructed from diffusion magnetic resonance imaging data using deterministic fiber tractography. Networks were thresholded to a fixed density by removing edges with the lowest number of streamlines. We compared edge length (mm), fractional anisotropy (FA), proportion of hub connections, and hub location between the unthresholded and the thresholded networks of each subject. Moreover, we compared weighted graph measures of global and local connectivity obtained from the (un)thresholded networks between patients and controls. We performed these analyses over a range of densities (2-20%). Results indicate that fixed-density thresholding disproportionally removes edges composed of long streamlines, but is independent of FA. The edges removed were not preferentially connected to hub or nonhub nodes. Over half of the original hubs were reproducible when networks were thresholded to a density ≥10%. Furthermore, the between-group differences in graph measures observed in the unthresholded network remained present after thresholding, irrespective of the chosen density. We therefore conclude that moderate fixed-density thresholds can successfully be applied to control for the effects of density in structural brain network analysis.

Hub disruption in patients with chronic neck pain: a graph analytical approach

Chronic pain is known to alter the brain's network dynamics. These dynamics are often demonstrated by identifying alterations in the brain network topology. A common approach used for this purpose is graph theory. To date, little is known on how these potentially altered networks in chronic pain relate to the symptoms reported by these patients. Here, we applied a graph theoretical approach to identify network changes in patients suffering from chronic neck pain, a group that is often neglected in chronic pain research. Participants with chronic traumatic and nontraumatic neck pain were compared to healthy pain-free controls. They showed higher levels of self-reported symptoms of sensitization, higher levels of disability, and impaired sensorimotor control. Furthermore, the brain suffering from chronic neck pain showed altered network properties in the posterior cingulate cortex, amygdala, and pallidum compared with the healthy pain-free brain. These regions have been identified as brain hubs (ie, regions that are responsible for orchestrating communication between other brain regions) and are therefore known to be more vulnerable in brain disorders including chronic pain. We were furthermore able to uncover associations between these altered brain network properties and the symptoms reported by patients. Our findings indicate that chronic neck pain patients reflect brain network alterations and that targeting the brain in patients might be of utmost importance.

White Matter Network Alterations in Alzheimer’s Disease Patients

Previous studies have revealed the occurrence of alterations of white matter (WM) and grey matter (GM) microstructures in Alzheimer’s disease (AD) and their prodromal state amnestic mild cognitive impairment (MCI). In general, these alterations can be studied comprehensively by modeling the brain as a complex network, which describes many important topological properties, such as the small-world property, modularity, and efficiency. In this study, we systematically investigated white matter abnormalities using unbiased whole brain network analysis. We compared regional and network related WM features between groups of 19 AD and 25 MCI patients and 22 healthy controls (HC) using tract-based spatial statistics (TBSS), network based statistics (NBS) and graph theoretical analysis. We did not find significant differences in fractional anisotropy (FA) between two groups on TBSS analysis. However, observable alterations were noticed at a network level. Brain network measures such as global efficiency and small world properties were low in AD patients compared to HCs.

Is brain connectome research the future frontier for subjective cognitive decline? A systematic review

OBJECTIVE

We performed a systematic literature review on Subjective Cognitive Decline (SCD) in order to examine whether the resemblance of brain connectome and functional connectivity (FC) alterations in SCD with respect to MCI, AD and HC can help us draw conclusions on the progression of SCD to more advanced stages of dementia.

METHODS

We searched for studies that used any neuroimaging tool to investigate potential differences/similarities of brain connectome in SCD with respect to HC, MCI, and AD.

RESULTS

Sixteen studies were finally included in the review. Apparent FC connections and disruptions were observed in the white matter, default mode and gray matter networks in SCD with regards to HC, MCI, and AD. Interestingly, more apparent connections in SCD were located over the posterior regions, while an increase of FC over anterior regions was observed as the disease progressed.

CONCLUSIONS

Elders with SCD display a significant disruption of the brain network, which in most of the cases is worse than HC across multiple network parameters.

SIGNIFICANCE

The present review provides comprehensive and balanced coverage of a timely target research activity around SCD with the intention to identify similarities/differences across patient groups on the basis of brain connectome properties.

Subtypes of Alzheimer's Disease Display Distinct Network Abnormalities Extending Beyond Their Pattern of Brain Atrophy

Different subtypes of Alzheimer's disease (AD) with characteristic distributions of neurofibrillary tangles and corresponding brain atrophy patterns have been identified using structural magnetic resonance imaging (MRI). However, the underlying biological mechanisms that determine this differential expression of neurofibrillary tangles are still unknown. Here, we applied graph theoretical analysis to structural MRI data to test the hypothesis that differential network disruption is at the basis of the emergence of these AD subtypes. We studied a total of 175 AD patients and 81 controls. Subtyping was done using the Scheltens' scale for medial temporal lobe atrophy, the Koedam's scale for posterior atrophy, and the Pasquier's global cortical atrophy scale for frontal atrophy. A total of 89 AD patients showed a brain atrophy pattern consistent with typical AD; 30 patients showed a limbic-predominant pattern; 29 patients showed a hippocampal-sparing pattern; and 27 showed minimal atrophy. We built brain structural networks from 68 cortical regions and 14 subcortical gray matter structures for each AD subtype and for the controls, and we compared between-group measures of integration, segregation, and modular organization. At the global level, modularity was increased and differential modular reorganization was detected in the four subtypes. We also found a decrease of transitivity in the typical and hippocampal-sparing subtypes, as well as an increase of average local efficiency in the minimal atrophy and hippocampal-sparing subtypes. We conclude that the AD subtypes have a distinct signature of network disruption associated with their atrophy patterns and further extending to other brain regions, presumably reflecting the differential spread of neurofibrillary tangles. We discuss the hypothetical emergence of these subtypes and possible clinical implications.