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Seoane S, van den Heuvel M, Acebes Á, Janssen N. The subcortical default mode network and Alzheimer's disease: a systematic review and meta-analysis. Brain Commun 2024; 6:fcae128. [PMID: 38665961 PMCID: PMC11043657 DOI: 10.1093/braincomms/fcae128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/28/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The default mode network is a central cortical brain network suggested to play a major role in several disorders and to be particularly vulnerable to the neuropathological hallmarks of Alzheimer's disease. Subcortical involvement in the default mode network and its alteration in Alzheimer's disease remains largely unknown. We performed a systematic review, meta-analysis and empirical validation of the subcortical default mode network in healthy adults, combined with a systematic review, meta-analysis and network analysis of the involvement of subcortical default mode areas in Alzheimer's disease. Our results show that, besides the well-known cortical default mode network brain regions, the default mode network consistently includes subcortical regions, namely the thalamus, lobule and vermis IX and right Crus I/II of the cerebellum and the amygdala. Network analysis also suggests the involvement of the caudate nucleus. In Alzheimer's disease, we observed a left-lateralized cluster of decrease in functional connectivity which covered the medial temporal lobe and amygdala and showed overlap with the default mode network in a portion covering parts of the left anterior hippocampus and left amygdala. We also found an increase in functional connectivity in the right anterior insula. These results confirm the consistency of subcortical contributions to the default mode network in healthy adults and highlight the relevance of the subcortical default mode network alteration in Alzheimer's disease.
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Affiliation(s)
- Sara Seoane
- Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
- Institute of Biomedical Technologies (ITB), University of La Laguna, Tenerife 38200, Spain
- Instituto Universitario de Neurociencia (IUNE), University of La Laguna, Tenerife 38200, Spain
| | - Martijn van den Heuvel
- Department of Complex Traits Genetics, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Section Complex Trait Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam UMC, Amsterdam 1081 HV, The Netherlands
| | - Ángel Acebes
- Institute of Biomedical Technologies (ITB), University of La Laguna, Tenerife 38200, Spain
- Department of Basic Medical Sciences, University of La Laguna, Tenerife 38200, Spain
| | - Niels Janssen
- Institute of Biomedical Technologies (ITB), University of La Laguna, Tenerife 38200, Spain
- Instituto Universitario de Neurociencia (IUNE), University of La Laguna, Tenerife 38200, Spain
- Department of Cognitive, Social and Organizational Psychology, University of La Laguna, Tenerife 38200, Spain
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Parrotta I, Cacciatore S, D'Andrea F, D'Anna M, Giancaterino G, Lazzaro G, Arcara G, Manzo N. Prevalence, treatment, and neural correlates of apathy in different forms of dementia: a narrative review. Neurol Sci 2024; 45:1343-1376. [PMID: 38015288 PMCID: PMC10942903 DOI: 10.1007/s10072-023-07197-7] [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: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES The aim of this review is to provide an overview on prevalence and clinical tools for the diagnosis of apathy, as well as on neurophysiological and neuroimaging findings obtained from studies in patients with apathy in different forms of dementia, including Alzheimer's disease (AD), vascular (VaD) and mixed dementia, frontotemporal dementia (FTD), and Parkinson's disease dementia (PDD). METHODS Randomized controlled trials, non-randomized controlled trials, controlled before-after studies, and interrupted time series from four databases (WebOfScience, Scopus, Pubmed, and PsycINFO) addressing apathy in adults or older people aged over 65 years of age affected by dementia were included. RESULTS The prevalence of apathy was 26-82% for AD, 28.6-91.7 for VaD, 29-97.5% in PDD, and 54.8-88.0 in FTD. The assessment of apathy was not consistent in the reviewed studies. Methylphenidate was the most successful pharmacological treatment for apathy. Neurobiological studies highlighted the relationship between both structural and functional brain areas and the presence or severity of apathy. CONCLUSION Apathy is a very common disorder in all types of dementia, although it is often underdiagnosed and undertreated. Further studies are needed to investigate its diagnosis and management. A consensus on the different evaluation scales should be achieved.
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Affiliation(s)
- Ilaria Parrotta
- Movement Control and Neuroplasticity Research Group, Tervuursevest 101, 3001, Louvain, Belgium
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
- Young Epidemiologists of the Italian Society of Gerontology and Geriatrics (SIGG) (YES) Working Group, Italian Society of Gerontology and Geriatrics, Via Giulio Cesare Vanini 5, 50129, Florence, Italy
| | - Stefano Cacciatore
- Young Epidemiologists of the Italian Society of Gerontology and Geriatrics (SIGG) (YES) Working Group, Italian Society of Gerontology and Geriatrics, Via Giulio Cesare Vanini 5, 50129, Florence, Italy.
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168, Rome, Italy.
| | - Flavio D'Andrea
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Marianna D'Anna
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giulia Giancaterino
- Department of Human Neuroscience, Sapienza University, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giovanni Lazzaro
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy
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Chaudhary S, Zhornitsky S, Chao HH, van Dyck CH, Li CSR. Hypothalamic Functional Connectivity and Apathy in People with Alzheimer's Disease and Cognitively Normal Healthy Controls. J Alzheimers Dis 2022; 90:1615-1628. [PMID: 36314209 PMCID: PMC10064487 DOI: 10.3233/jad-220708] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Earlier studies have described the neural markers of apathy in Alzheimer's disease (AD) and mild cognitive impairment (MCI), but few focused on the motivation circuits. Here, we targeted hypothalamus, a hub of the motivation circuit. OBJECTIVE To examine hypothalamic resting state functional connectivity (rsFC) in relation to apathy. METHODS We performed whole-brain regression of hypothalamic rsFC against Apathy Evaluation Scale (AES) total score and behavioral, cognitive, and emotional subscores in 29 patients with AD/MCI and 28 healthy controls (HC), controlling for age, sex, education, cognitive status, and depression. We evaluated the results at a corrected threshold and employed path analyses to assess possible interaction between hypothalamic rsFCs, apathy and depression/memory. Finally, we re-examined the findings in a subsample of amyloid-β-verified AD. RESULTS AES total score correlated negatively with hypothalamic precuneus (PCu)/posterior cingulate cortex (PCC) and positively with left middle temporal gyrus (MTG) and supramarginal gyrus rsFCs. Behavioral subscore correlated negatively with hypothalamic PCu/PCC and positively with middle frontal gyrus rsFC. Cognitive subscore correlated positively with hypothalamic MTG rsFC. Emotional subscore correlated negatively with hypothalamic calcarine cortex rsFC. In path analyses, hypothalamic-PCu/PCC rsFC negatively modulated apathy and, in turn, depression. The model where hypothalamic MTG rsFC and memory independently modulated apathy also showed a good fit. The findings of diminished hypothalamic-PCu/PCC rsFC in relation to apathy and, in turn, depression were confirmed in amyloid-verified AD. CONCLUSION The findings together support a role of altered hypothalamic connectivity in relation to apathy and depression, and modulation of apathy by memory dysfunction.
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Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Herta H Chao
- VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Medicine & Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher H van Dyck
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, CT, USA.,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA.,Wu Tsai Institute, Yale University, New Haven, CT, USA
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