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Hu H, Wang L, Abdul S, Tang X, Feng Q, Mu Y, Ge X, Liao Z, Ding Z. Frequency-dependent alterations in functional connectivity in patients with Alzheimer's Disease spectrum disorders. Front Aging Neurosci 2024; 16:1375836. [PMID: 38605859 PMCID: PMC11007178 DOI: 10.3389/fnagi.2024.1375836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Background In the spectrum of Alzheimer's Disease (AD) and related disorders, the resting-state functional magnetic resonance imaging (rs-fMRI) signals within the cerebral cortex may exhibit distinct characteristics across various frequency ranges. Nevertheless, this hypothesis has not yet been substantiated within the broader context of whole-brain functional connectivity. This study aims to explore potential modifications in degree centrality (DC) and voxel-mirrored homotopic connectivity (VMHC) among individuals with amnestic mild cognitive impairment (aMCI) and AD, while assessing whether these alterations differ across distinct frequency bands. Methods This investigation encompassed a total of 53 AD patients, 40 aMCI patients, and 40 healthy controls (HCs). DC and VMHC values were computed within three distinct frequency bands: classical (0.01-0.08 Hz), slow-4 (0.027-0.073 Hz), and slow-5 (0.01-0.027 Hz) for the three respective groups. To discern differences among these groups, ANOVA and subsequent post hoc two-sample t-tests were employed. Cognitive function assessment utilized the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Pearson correlation analysis was applied to investigate the associations between MMSE and MoCA scores with DC and VMHC. Results Significant variations in degree centrality (DC) were observed among different groups across diverse frequency bands. The most notable differences were identified in the bilateral caudate nucleus (CN), bilateral medial superior frontal gyrus (mSFG), bilateral Lobule VIII of the cerebellar hemisphere (Lobule VIII), left precuneus (PCu), right Lobule VI of the cerebellar hemisphere (Lobule VI), and right Lobule IV and V of the cerebellar hemisphere (Lobule IV, V). Likewise, disparities in voxel-mirrored homotopic connectivity (VMHC) among groups were predominantly localized to the posterior cingulate gyrus (PCG) and Crus II of the cerebellar hemisphere (Crus II). Across the three frequency bands, the brain regions exhibiting significant differences in various parameters were most abundant in the slow-5 frequency band. Conclusion This study enhances our understanding of the pathological and physiological mechanisms associated with AD continuum. Moreover, it underscores the importance of researchers considering various frequency bands in their investigations of brain function.
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Affiliation(s)
- Hanjun Hu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, China
| | - Sammad Abdul
- International Education College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Yuzhu Mu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
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Li Y, Zhu W, Zhou S, Li H, Gao Z, Huang Z, Li X, Yu Y, Li X. Sex differences in functional connectivity and the predictive role of the connectome-based predictive model in Alzheimer's disease. J Neurosci Res 2024; 102:e25307. [PMID: 38444265 DOI: 10.1002/jnr.25307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 03/07/2024]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease characterized by cognitive decline. Sex differences in the progression of AD exist, but the neural mechanisms are not well understood. The purpose of the current study was to explore sex differences in brain functional connectivity (FC) at different stages of AD and their predictive ability on Montreal Cognitive Assessment (MoCA) scores using connectome-based predictive modeling (CPM). Resting-state functional magnetic resonance imaging was collected from 81 AD patients (44 females), 78 amnestic mild cognitive impairment patients (44 females), and 92 healthy controls (50 females). The FC analysis was conducted and the interaction effect between sex and group was investigated using two-factor variance analysis. The CPM was used to predict MoCA scores. There were sex-by-group interaction effects on FC between the left dorsolateral superior frontal gyrus and left middle temporal gyrus, left precuneus and right calcarine fissure surrounding cortex, left precuneus and left middle occipital gyrus, left middle temporal gyrus and left precentral gyrus, and between the left middle temporal gyrus and right cuneus. In the CPM, the positive network predictive model significantly predicted MoCA scores in both males and females. There were significant sex-by-group interaction effects on FC between the left precuneus and left middle occipital gyrus, and between the left middle temporal gyrus and right cuneus could predict MoCA scores in female patients. Our results suggest that there are sex differences in FC at different stages of AD. The sex-specific FC can further predict MoCA scores at individual level.
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Affiliation(s)
- Yuqing Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wanqiu Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shanshan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziwen Gao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziang Huang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoshu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Liang X, Xue C, Zheng D, Yuan Q, Qi W, Ruan Y, Chen S, Song Y, Wu H, Lu X, Xiao C, Chen J. Repetitive transcranial magnetic stimulation regulates effective connectivity patterns of brain networks in the spectrum of preclinical Alzheimer's disease. Front Aging Neurosci 2024; 16:1343926. [PMID: 38410745 PMCID: PMC10894951 DOI: 10.3389/fnagi.2024.1343926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are considered as the spectrum of preclinical Alzheimer's disease (AD), with abnormal brain network connectivity as the main neuroimaging feature. Repetitive transcranial magnetic stimulation (rTMS) has been proven to be an effective non-invasive technique for addressing neuropsychiatric disorders. This study aims to explore the potential of targeted rTMS to regulate effective connectivity within the default mode network (DMN) and the executive control network (CEN), thereby improving cognitive function. Methods This study included 86 healthy controls (HCs), 72 SCDs, and 86 aMCIs. Among them, 10 SCDs and 11 aMCIs received a 2-week rTMS course of 5-day, once-daily. Cross-sectional analysis with the spectral dynamic causal model (spDCM) was used to analyze the DMN and CEN effective connectivity patterns of the three groups. Afterwards, longitudinal analysis was conducted on the changes in effective connectivity patterns and cognitive function before and after rTMS for SCD and aMCI, and the correlation between them was analyzed. Results Cross-sectional analysis showed different effective connectivity patterns in the DMN and CEN among the three groups. Longitudinal analysis showed that the effective connectivity pattern of the SCD had changed, accompanied by improvements in episodic memory. Correlation analysis indicated a negative relationship between effective connectivity from the left angular gyrus (ANG) to the anterior cingulate gyrus and the ANG.R to the right middle frontal gyrus, with visuospatial and executive function, respectively. In patients with aMCI, episodic memory and executive function improved, while the effective connectivity pattern remained unchanged. Conclusion This study demonstrates that PCUN-targeted rTMS in SCD regulates the abnormal effective connectivity patterns in DMN and CEN, thereby improving cognition function. Conversely, in aMCI, the mechanism of improvement may differ. Our findings further suggest that rTMS is more effective in preventing or delaying disease progression in the earlier stages of the AD spectrum. Clinical Trial Registration http://www.chictr.org.cn, ChiCTR2000034533.
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Affiliation(s)
- Xuhong Liang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Darui Zheng
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yiming Ruan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Huimin Wu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Neurology, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Altered structural and functional homotopic connectivity associated with the progression from mild cognitive impairment to Alzheimer's disease. Psychiatry Res 2023; 319:115000. [PMID: 36502711 DOI: 10.1016/j.psychres.2022.115000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
The progressive mild cognitive impairment (pMCI) is associated with an increased risk of Alzheimer's disease (AD). Many studies have reported the disrupted brain alteration during the imminent conversion from pMCI to AD. However, the subtle difference of structural and functional of inter-hemispheric between pMCI and stable mild cognitive impairment (sMCI) remains unknown. In the present study, we scanned the multimodal magnetic resonance imaging of 38 sMCI, 26 pMCI, and 50 healthy controls (HC) and assessed the cognitive function. The voxel-mirrored homotopic connectivity (VMHC) and volume of corpus callosum were calculated. A structural equation modeling (SEM) was established to determine the relationships between the corpus callosum, the inter-hemispheric connectivity, and cognitive assessment. Compared to sMCI, pMCI exhibited decreased VMHC in insular and thalamus, and reduced volume of corpus callosum. SEM results showed that decreased inter-hemispheric connectivity was directly associated with cognitive impairment and corpus callosum atrophy, and corpus callosum atrophy indirectly caused cognitive impairment by mediating inter-hemispheric connectivity in pMCI. In conclusion, the destruction of homotopic connectivity is related to cognitive impairment, and the corpus callosum atrophy partially mediates the association between the homotopic connectivity and cognitive impairment in pMCI.
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Liebe T, Dordevic M, Kaufmann J, Avetisyan A, Skalej M, Müller N. Investigation of the functional pathogenesis of mild cognitive impairment by localisation-based locus coeruleus resting-state fMRI. Hum Brain Mapp 2022; 43:5630-5642. [PMID: 36441846 PMCID: PMC9704796 DOI: 10.1002/hbm.26039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/27/2022] [Accepted: 07/25/2022] [Indexed: 01/15/2023] Open
Abstract
Dementia as one of the most prevalent diseases urges for a better understanding of the central mechanisms responsible for clinical symptoms, and necessitates improvement of actual diagnostic capabilities. The brainstem nucleus locus coeruleus (LC) is a promising target for early diagnosis because of its early structural alterations and its relationship to the functional disturbances in the patients. In this study, we applied our improved method of localisation-based LC resting-state fMRI to investigate the differences in central sensory signal processing when comparing functional connectivity (fc) of a patient group with mild cognitive impairment (MCI, n = 28) and an age-matched healthy control group (n = 29). MCI and control participants could be differentiated in their Mini-Mental-State-Examination (MMSE) scores (p < .001) and LC intensity ratio (p = .010). In the fMRI, LC fc to anterior cingulate cortex (FDR p < .001) and left anterior insula (FDR p = .012) was elevated, and LC fc to right temporoparietal junction (rTPJ, FDR p = .012) and posterior cingulate cortex (PCC, FDR p = .021) was decreased in the patient group. Importantly, LC to rTPJ connectivity was also positively correlated to MMSE scores in MCI patients (p = .017). Furthermore, we found a hyperactivation of the left-insula salience network in the MCI patients. Our results and our proposed disease model shed new light on the functional pathogenesis of MCI by directing to attentional network disturbances, which could aid new therapeutic strategies and provide a marker for diagnosis and prediction of disease progression.
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Affiliation(s)
- Thomas Liebe
- Department of PsychiatryMedical University of ViennaViennaAustria
- Department of RadiologyUniversity Hospital JenaJenaGermany
- Department of PsychiatryUniversity Hospital JenaJenaGermany
- Clinical Affective Neuroimaging LaboratoryLeibniz Institute for NeurobiologyMagdeburgGermany
| | - Milos Dordevic
- Department of Degenerative and Chronic DiseasesUniversity PotsdamPotsdamGermany
| | - Jörn Kaufmann
- Department of NeurologyUniversity Hospital MagdeburgMagdeburgGermany
| | - Araks Avetisyan
- Neuroprotection LabGerman Center for Neurodegenerative Diseases (DZNE)MagdeburgGermany
| | - Martin Skalej
- Department of Neuroradiology, Clinic and Policlinic of RadiologyUniversity Hospital HalleHalleGermany
| | - Notger Müller
- Department of Degenerative and Chronic DiseasesUniversity PotsdamPotsdamGermany
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Warren A. Heightened emotion processing as a compensatory mechanism in persons with Alzheimer's disease: Psychological insights from the tri-network model. FRONTIERS IN DEMENTIA 2022; 1:983331. [PMID: 39081476 PMCID: PMC11285592 DOI: 10.3389/frdem.2022.983331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/31/2022] [Indexed: 08/02/2024]
Abstract
Social and emotional communication is an integral tenant of life quality and well-being. Aberrations in functional connectivity can alter social emotional behavior in numerous disease states, including dementia. This paper aims to review the major network changes observed in Alzheimer's disease, with a focus on the tri-network model. The central executive network, default mode network, and principally the salience network will be discussed as they relate to both pathology and compensatory behavioral manifestations in persons with dementia. The psychological and behavioral correlates of these network changes will be reviewed with the intent of increasing understanding about the conscious experience and communication modalities utilized by persons with dementia, the understanding of which may promote meaningful communication with care providers and loved ones. This paper further seeks to reframe social emotional communication methods used by persons with dementia by marrying current knowledge of neuroscience, psychology, and person-centered care. In this way, a perspective is offered that considers the heightened emotional states experienced by persons with dementia as a potential compensatory mechanism that may hold practical value under some circumstances. The many ways in which the brain adapts to physical and psychological changes, aging, and injury are still under exploration. Emotion processing may provide clinical insight into the subjective experience of dementia in this regard. Emotions, therefore, may serve to promote social bonds, provide an avenue for non-verbal communication, and act as a construct to maintain agency in persons who ultimately lose autonomy.
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Affiliation(s)
- Alison Warren
- The Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Cheung EYW, Chau ACM, Shea YF, Chiu PKC, Kwan JSK, Mak HKF. Level of Amyloid-β (Aβ) Binding Leading to Differential Effects on Resting State Functional Connectivity in Major Brain Networks. Biomedicines 2022; 10:biomedicines10092321. [PMID: 36140422 PMCID: PMC9496530 DOI: 10.3390/biomedicines10092321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction: Amyloid-β protein (Aβ) is one of the biomarkers for Alzheimer’s disease (AD). The recent application of interhemispheric functional connectivity (IFC) in resting-state fMRI has been used as a non-invasive diagnostic tool for early dementia. In this study, we focused on the level of Aβ accumulated and its effects on the major functional networks, including default mode network (DMN), central executive network (CEN), salience network (SN), self-referential network (SRN) and sensory motor network (SMN). Methods: 58 participants (27 Hi Aβ (HiAmy) and 31 low Aβ (LowAmy)) and 25 healthy controls (HC) were recruited. [18F]flutemetamol PET/CT was performed for diseased groups, and MRI scanning was done for all participants. Voxel-by-voxel correlation analysis was done for both groups in all networks. Results: In HiAmy, IFC was reduced in all networks except SN. A negative correlation in DMN, CEN, SRN and SMN suggests high Aβ related to IFC reduction; However, a positive correlation in SN suggests high Aβ related to an increase in IFC. In LowAmy, IFC increased in CEN, SMN, SN and SRN. Positive correlation in all major brain networks. Conclusion: The level of Aβ accumulated demonstrated differential effects on IFC in various brain networks. As the treatment to reduce Aβ plaque deposition is available in the market, it may be an option for the HiAmy group to improve their IFC in major brain networks.
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Affiliation(s)
- Eva Y. W. Cheung
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- School of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong
- Correspondence: (E.Y.W.C.); (H.K.F.M.)
| | - Anson C. M. Chau
- Medical Radiation Science, Allied Health and Human Performance Unit, University of South Australia, City East Campus, Bonython Jubilee Building, 1-26, Adelaide, SA 5001, Australia
| | - Yat-Fung Shea
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Patrick K. C. Chiu
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Joseph S. K. Kwan
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Henry K. F. Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
- Alzheimer’s Disease Research Network, The University of Hong Kong, Hong Kong
- Correspondence: (E.Y.W.C.); (H.K.F.M.)
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Luo B, Dong W, Chang L, Qiu C, Lu Y, Liu D, Xue C, Zhang L, Liu W, Zhang W, Yan J. Altered Interhemispheric Functional Connectivity Associated With Early Verbal Fluency Decline After Deep Brain Stimulation in Parkinson’s Disease. Front Aging Neurosci 2022; 14:799545. [PMID: 35431904 PMCID: PMC9011328 DOI: 10.3389/fnagi.2022.799545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) experience a decline in verbal fluency (VF) immediately after undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN). This phenomenon is thought to be related to surgical microlesions. Purpose We investigated the alterations in interhemispheric functional connectivity after STN-DBS in PD patients. We also evaluated the correlation between these changes and decreased VF scores. Method Overall, 30 patients with PD were enrolled in the study. Resting-state functional magnetic resonance imaging scans were performed twice, once before and once after DBS, in PD patients. Voxel-mirrored homotopic connectivity (VMHC) was applied in order to evaluate the synchronicity of functional connectivity between the hemispheres. Result After undergoing STN-DBS, PD patients demonstrated reduced VMHC value in the posterior cerebellum lobe, angular gyrus, precuneus/posterior cingulate gyrus (PCC), supramarginal gyrus, superior frontal gyrus (SFG) (medial and dorsolateral) and middle frontal gyrus (MFG). In addition, we observed a significant positive correlation between the altered VMHC value in the SFG and MFG and the change of phonemic VF scores. Conclusion PD patients demonstrated an interhemispheric coordination disorder in the prefrontal cortex, cerebellum, supramarginal gyrus and DMN after undergoing STN-DBS. The positive correlation between reduced VMHC value in the SFG and MFG and the changes of VF scores provides a novel understanding with regard to the decline of VF after DBS.
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Affiliation(s)
- Bei Luo
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Dong
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Chang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chang Qiu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Lu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Wenbin Zhang,
| | - Jun Yan
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Jun Yan,
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Kuang Y, Wu X, Lai H, Wang Z, Lei Q, Zhong W, Yang Y, Deng C, Zhou Z. Abnormal corpus callosum induced by overt hepatic encephalopathy impairs interhemispheric functional coordination in cirrhosis patients. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1579. [PMID: 34790785 PMCID: PMC8576733 DOI: 10.21037/atm-21-5109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/21/2021] [Indexed: 11/06/2022]
Abstract
Background Although overt hepatic encephalopathy (OHE) patients were shown to have bilaterally symmetrical structural and functional abnormalities in the whole brain, few studies have focused on the bilateral cerebral hemisphere commissural fibers and measured functional coordination between bilateral hemispheres. This study aimed to investigate the structural changes of the corpus callosum (CC) and interhemispheric functional coordination in patients with OHE and to test the hypothesis that abnormal CC induced by OHE impairs interhemispheric functional coordination in cirrhosis patients. Methods The microstructural integrity and the volumes of each subregion of the CC were analyzed by diffusion tensor imaging (DTI) and three-dimensional T1-weighted imaging. Voxel-mirrored homotopic connectivity (VMHC) was derived from resting-state functional magnetic resonance imaging (MRI). Results Compared with the healthy controls (HCs) and patients without hepatic encephalopathy (noHE), the OHE group showed decreased volumes in all subregions of the CC. In OHE patients, the decreased fractional anisotropy (FA) of CC-5 correlated with decreased VMHC in the middle occipital gyrus (MOG) and precuneus. The value of FA in CC-5 and the volumes of CC-3, CC-4, and CC-5 showed correlations with neuropsychological performance in patients with OHE. Conclusions These findings suggest that impairment of interhemispheric white matter pathways may disturb the functional connectivity associated with coordination and neurocognitive performance.
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Affiliation(s)
- Yangying Kuang
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaojia Wu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Lai
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhigang Wang
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiang Lei
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Weijia Zhong
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ya Yang
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chen Deng
- Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiming Zhou
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Diagnostic Efficacy of Voxel-Mirrored Homotopic Connectivity in Vascular Dementia as Compared to Alzheimer's Related Neurodegenerative Diseases-A Resting State fMRI Study. Life (Basel) 2021; 11:life11101108. [PMID: 34685479 PMCID: PMC8538280 DOI: 10.3390/life11101108] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022] Open
Abstract
Previous studies have demonstrated that functional connectivity (FC) of different brain regions in resting state function MRI were abnormal in patients suffering from mild cognitive impairment (MCI) and Alzheimer’s disease (AD) when comparing to healthy controls (HC) using seed based, independent component analysis (ICA) or small world network techniques. A new technique called voxel-mirrored homotopic connectivity (VMHC) was used in the current study to evaluate the value of interhemispheric functional connectivity (IFC) as a diagnostic tool to differentiate vascular dementia (VD) from other Alzheimer’s related neurodegenerative diseases. Eighty-three participants were recruited from the university hospital memory clinic. A multidisciplinary panel formed by a neuroradiologist and two geriatricians classified the participants into VD (13), AD (16), MCI (29), and HC (25) based on clinical history, Montreal Cognitive Assessment Hong Kong version (HK-MoCA) neuropsychological score, structural MRI, MR perfusion, and 18-F Flutametamol (amyloid) PET-CT findings of individual subjects. We adopted the calculation method used by Kelly et al. (2011) and Zuo et al. (2010) in obtaining VMHC maps. Specific patterns of VMHC maps were obtained for VD, AD, and MCI to HC comparison. VD showed significant reduction in VMHC in frontal orbital gyrus and gyrus rectus. Increased VMHC was observed in default mode network (DMN), executive control network (ECN), and the remaining salient network (SN) regions. AD showed a reduction of IFC in all DMN, ECN, and SN regions; whereas MCI showed VMHC reduction in vSN, and increased VMHC in DMN and ECN. When combining VMHC values of relevant brain regions, the accuracy was improved to 87%, 92%, and 83% for VD, AD, and MCI from HC, respectively, in receiver operating characteristic (ROC) analysis. Through studying the VMHC maps and using VMHC values in relevant brain regions, VMHC can be considered as a reliable diagnostic tool for VD, AD, and MCI from HC.
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Song Y, Xu W, Chen S, Hu G, Ge H, Xue C, Qi W, Lin X, Chen J. Functional MRI-Specific Alterations in Salience Network in Mild Cognitive Impairment: An ALE Meta-Analysis. Front Aging Neurosci 2021; 13:695210. [PMID: 34381352 PMCID: PMC8350339 DOI: 10.3389/fnagi.2021.695210] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/01/2021] [Indexed: 01/03/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia. Amnestic MCI (aMCI) and non-amnestic MCI are the two subtypes of MCI with the former having a higher risk for progressing to Alzheimer's disease (AD). Compared with healthy elderly adults, individuals with MCI have specific functional alterations in the salience network (SN). However, no consistent results are documenting these changes. This meta-analysis aimed to investigate the specific functional alterations in the SN in MCI and aMCI. Methods: We systematically searched PubMed, Embase, and Web of Science for scientific neuroimaging literature based on three research methods, namely, functional connectivity (FC), regional homogeneity (ReHo), and the amplitude of low-frequency fluctuation or fractional amplitude of low-frequency fluctuation (ALFF/fALFF). Then, we conducted the coordinate-based meta-analysis by using the activation likelihood estimation algorithm. Results: In total, 30 functional neuroimaging studies were included. After extracting the data and analyzing it, we obtained specific changes in some brain regions in the SN including decreased ALFF/fALFF in the left superior temporal gyrus, the insula, the precentral gyrus, and the precuneus in MCI and aMCI; increased FC in the thalamus, the caudate, the superior temporal gyrus, the insula, and the cingulate gyrus in MCI; and decreased ReHo in the anterior cingulate gyrus in aMCI. In addition, as to FC, interactions of the SN with other networks including the default mode network and the executive control network were also observed mainly in the middle frontal gyrus and superior frontal gyrus in MCI and inferior frontal gyrus in aMCI. Conclusions: Specific functional alternations in the SN and interactions of the SN with other networks in MCI could be useful as potential imaging biomarkers for MCI or aMCI. Meanwhile, it provided a new insight in predicting the progression of health to MCI or aMCI and novel targets for proper intervention to delay the progression. Systematic Review Registration: [PROSPERO], identifier [No. CRD42020216259].
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Affiliation(s)
- Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Xu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
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12
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Ibrahim B, Suppiah S, Ibrahim N, Mohamad M, Hassan HA, Nasser NS, Saripan MI. Diagnostic power of resting-state fMRI for detection of network connectivity in Alzheimer's disease and mild cognitive impairment: A systematic review. Hum Brain Mapp 2021; 42:2941-2968. [PMID: 33942449 PMCID: PMC8127155 DOI: 10.1002/hbm.25369] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/20/2022] Open
Abstract
Resting‐state fMRI (rs‐fMRI) detects functional connectivity (FC) abnormalities that occur in the brains of patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). FC of the default mode network (DMN) is commonly impaired in AD and MCI. We conducted a systematic review aimed at determining the diagnostic power of rs‐fMRI to identify FC abnormalities in the DMN of patients with AD or MCI compared with healthy controls (HCs) using machine learning (ML) methods. Multimodal support vector machine (SVM) algorithm was the commonest form of ML method utilized. Multiple kernel approach can be utilized to aid in the classification by incorporating various discriminating features, such as FC graphs based on “nodes” and “edges” together with structural MRI‐based regional cortical thickness and gray matter volume. Other multimodal features include neuropsychiatric testing scores, DTI features, and regional cerebral blood flow. Among AD patients, the posterior cingulate cortex (PCC)/Precuneus was noted to be a highly affected hub of the DMN that demonstrated overall reduced FC. Whereas reduced DMN FC between the PCC and anterior cingulate cortex (ACC) was observed in MCI patients. Evidence indicates that the nodes of the DMN can offer moderate to high diagnostic power to distinguish AD and MCI patients. Nevertheless, various concerns over the homogeneity of data based on patient selection, scanner effects, and the variable usage of classifiers and algorithms pose a challenge for ML‐based image interpretation of rs‐fMRI datasets to become a mainstream option for diagnosing AD and predicting the conversion of HC/MCI to AD.
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Affiliation(s)
- Buhari Ibrahim
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Department of Physiology, Faculty of Basic Medical Sciences, Bauchi State University Gadau, Gadau, Nigeria
| | - Subapriya Suppiah
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mazlyfarina Mohamad
- Centre for Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasyma Abu Hassan
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nisha Syed Nasser
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - M Iqbal Saripan
- Department of Computer and Communication System Engineering, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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13
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Cheng R, Chen L, Liu X, Luo T, Gong J, Jiang P. Changes in Gray Matter Asymmetries of the Fusiform and Parahippocampal Gyruses in Patients With Subcortical Ischemic Vascular Disease. Front Neurol 2021; 11:603977. [PMID: 33551966 PMCID: PMC7859431 DOI: 10.3389/fneur.2020.603977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Changes in the normal asymmetry of the human brain often mean pathology. Current studies on the correlation between asymmetry and cognitive impairment have focused on Alzheimer's disease (AD) and AD-related mild cognitive impairment (MCI). The purpose of this study was to investigate changes in gray matter asymmetry and their relationship with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) by using voxel-based morphological measurements. Methods: Fifty-nine SIVD patients with (subcortical vascular cognitive impairment, SVCI, N = 30) and without (pre-SVCI, N = 29) cognitive impairment and 30 normal controls (NC, N = 30) underwent high-resolution structural MRI and neuropsychological examinations. The differences in gray matter asymmetry among the three groups were estimated by using one-way ANOVA. Moreover, partial correlation analysis was performed to explore the relationships between the asymmetry index (AI) values and cognitive assessments controlled for age, sex, and education. Results: The gray matter asymmetries in the fusiform and parahippocampal gyruses of the SVCI group were significantly different from those of the NC group and the pre-SVCI group, while no differences were found between the NC group and the pre-SVCI group in the same areas. More specifically, in the fusiform and parahippocampal gyruses, the SVCI group displayed a dramatic rightward asymmetry, whereas the NC group and pre-SVCI group exhibited a marked leftward asymmetry. The results of the correlation analysis showed that the "mean AI" in significant cluster was strongly correlated with the changes in cognitive outcomes. Conclusion: This study demonstrated different lateralization in the fusiform and parahippocampal gyruses of SIVD patients with cognitive impairment compared to healthy subjects and SIVD patients without cognitive decline. Our findings may contribute to better understanding the possible mechanism of cognitive impairment in patients with SIVD, and they suggest the possibility of using gray matter asymmetry as a biomarker for disease progression.
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Affiliation(s)
- Runtian Cheng
- The Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Chen
- The Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiaoshuang Liu
- The Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tianyou Luo
- The Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junwei Gong
- The Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peiling Jiang
- The Department of Radiology, The Second Affiliated Hospital of Military Medical University, Chongqing, China
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14
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Li X, Wang F, Liu X, Cao D, Cai L, Jiang X, Yang X, Yang T, Asakawa T. Changes in Brain Function Networks in Patients With Amnestic Mild Cognitive Impairment: A Resting-State fMRI Study. Front Neurol 2020; 11:554032. [PMID: 33101173 PMCID: PMC7554345 DOI: 10.3389/fneur.2020.554032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/02/2020] [Indexed: 12/12/2022] Open
Abstract
Patients with amnestic mild cognitive impairment (aMCI) are at high risk of developing dementia. This study used resting-state functional magnetic resonance imaging (rs-fMRI) and an independent component analysis (ICA) approach to explore changes in functional connectivity (FC) in the default mode network (DMN), executive control network (ECN), and salience network (SN). Thirty patients with aMCI and 30 healthy controls (HCs) were enrolled. All the participants underwent an rs-fMRI scan. The brain FC in DMN, ECN, and SN was calculated using the ICA approach. We found that the FC of brain regions in DMN decreased significantly and that of brain regions in ECN increased, which was in accordance with the findings of previous studies on Alzheimer's disease (AD) and aMCI. We also found that the FC of brain regions in SN increased, which was different from the findings of previous studies on AD. The increase in FC in brain regions in SN might result from different pathophysiological states in AD and aMCI, indicating that a decrease in FC in SN does not occur in a person with aMCI. These results are consistent with those of previous studies using the voxel-mirrored homotopic connectivity approach and seed-based correlation analysis. We therefore considered that the decrease in FC in DMN and the increase in FC in ECN and SN might be peculiar patterns observed on the rs-fMRI of a person with aMCI. These findings may contribute to the development of imaging biomarkers for the diagnosis of aMCI.
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Affiliation(s)
- Xiaoling Li
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Feng Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaohui Liu
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Danna Cao
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lina Cai
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoxu Jiang
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xu Yang
- Division of CT and MRI, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tiansong Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Research Base of Traditional Chinese Medicine Syndrome, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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15
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Axelrud LK, Sato JR, Santoro ML, Talarico F, Pine DS, Rohde LA, Zugman A, Junior EA, Bressan RA, Grassi-Oliveira R, Pan PM, Hoffmann MS, Simioni AR, Guinjoan SM, Hakonarson H, Brietzke E, Gadelha A, Pellegrino da Silva R, Hoexter MQ, Miguel EC, Belangero SI, Salum GA. Genetic risk for Alzheimer's disease and functional brain connectivity in children and adolescents. Neurobiol Aging 2019; 82:10-17. [PMID: 31376729 DOI: 10.1016/j.neurobiolaging.2019.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/22/2019] [Accepted: 06/30/2019] [Indexed: 12/13/2022]
Abstract
Research suggested accumulation of tau proteins might lead to the degeneration of functional networks. Studies investigating the impact of genetic risk for Alzheimer's disease (AD) on early brain connections might shed light on mechanisms leading to AD development later in life. Here, we aim to investigate whether the polygenic risk score for Alzheimer's disease (AD-PRS) influences the connectivity among regions susceptible to tau pathology during childhood and adolescence. Participants were youth, aged 6-14 years, and recruited in Porto Alegre (discovery sample, n = 332) and São Paulo (replication sample, n = 304), Brazil. Subjects underwent genotyping and 6-min resting state funcional magnetic resonance imaging. Connections between the local maxima of tau pathology networks were used as dependent variables. The AD-PRS was associated with the connectivity between the right precuneus and the right superior temporal gyrus (discovery sample: β = 0.180, padjusted = 0.036; replication sample: β = 0.202, p = 0.031). This connectivity was also associated with inhibitory control (β = 0.157, padjusted = 0.035) and moderated the association between the AD-PRS and both immediate and delayed recall. These findings suggest the AD-PRS may affect brain connectivity in youth, which might impact memory performance and inhibitory control in early life.
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Affiliation(s)
- Luiza Kvitko Axelrud
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Section on Negative Affect and Social Processes, Porto Alegre, Brazil; National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
| | - João Ricardo Sato
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, Santo André, Brazil
| | - Marcos Leite Santoro
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Morfologia e Genética, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Fernanda Talarico
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Morfologia e Genética, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel Samuel Pine
- Emotion and Development Branch, National Institute of Mental Health Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Luis Augusto Rohde
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Section on Negative Affect and Social Processes, Porto Alegre, Brazil; National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
| | - Andre Zugman
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Edson Amaro Junior
- Department of Radiology, University of São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maurício Scopel Hoffmann
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Section on Negative Affect and Social Processes, Porto Alegre, Brazil; National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
| | - Andre Rafael Simioni
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Section on Negative Affect and Social Processes, Porto Alegre, Brazil; National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil
| | | | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Elisa Brietzke
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Sintia Iole Belangero
- National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil; Departamento de Morfologia e Genética, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Giovanni Abrahão Salum
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Section on Negative Affect and Social Processes, Porto Alegre, Brazil; National Institute of Developmental Psychiatry (INPD, CNPq), São Paulo, Brazil.
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