Disruption of cerebral networks and cognitive impairment in Alzheimer disease
Disruption of cerebral networks and cognitive impairment in Alzheimer disease
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DOI：
10.1212/wnl.0b013e31828c2ee5
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发表时间：
2013-04-01
期刊：
影响因子：
9.9
通讯作者：
Biessels, Geert Jan
中科院分区：
文献类型：
--
作者：
Reijmer, Yael D.;Leemans, Alexander;Biessels, Geert Jan
目的：研究全脑白色物质连接和认知能力的早期阿尔茨海默病（AD）患者使用基于网络的方法，并评估网络参数是否提供信息，是补充传统的MRI标记AD。方法：50例患者（平均年龄78.8 +/- 7.1岁）与早期AD招募通过记忆诊所之间的关系。此外，15名年龄，性别和教育相匹配的对照组参与者被用作参考组。所有参与者都接受了3-T MRI扫描和认知评估。基于扩散张量成像的纤维束成像被用来重建每个人的大脑网络，然后进行图形理论分析。整体网络效率进行了评估的措施，本地（聚类系数，本地效率）和全球（路径长度，全球效率）的连接。年龄、性别和教育调整的认知评分与网络测量和常规MRI参数（即，结果：与对照组相比，患者的结构性脑网络显示出降低的局部效率。在患者组中，记忆和执行功能的较差表现与局部效率降低（r = 0.434; p = 0.002）、路径长度增加（r = -0.538; p < 0.001）和整体效率降低（r = 0.431; p = 0.005）相关。网络效率的措施解释了高达27%的差异，在传统的MRI markers上的认知功能（p < 0.01）。结论：这项研究表明，基于网络的分析大脑白色物质连接提供了一种新的方式来揭示AD认知功能障碍的结构基础。
Objective: To examine the relation between measures of whole-brain white matter connectivity and cognitive performance in patients with early Alzheimer disease (AD) using a network-based approach and to assess whether network parameters provide information that is complementary to conventional MRI markers of AD.Methods: Fifty patients (mean age 78.8 +/- 7.1 years) with early AD were recruited via a memory clinic. In addition, 15 age-, sex-, and education-matched control participants were used as a reference group. All participants underwent a 3-T MRI scan and cognitive assessment. Diffusion tensor imaging-based tractography was used to reconstruct the brain network of each individual, followed by graph theoretical analyses. Overall network efficiency was assessed by measures of local (clustering coefficient, local efficiency) and global (path length, global efficiency) connectivity. Age-, sex-, and education-adjusted cognitive scores were related to network measures and to conventional MRI parameters (i.e., degree of cerebral atrophy and small-vessel disease).Results: The structural brain network of patients showed reduced local efficiency compared to controls. Within the patient group, worse performance in memory and executive functioning was related to decreased local efficiency (r = 0.434; p = 0.002), increased path length (r = -0.538; p < 0.001), and decreased global efficiency (r = 0.431; p = 0.005). Measures of network efficiency explained up to 27% of the variance in cognitive functioning on top of conventional MRI markers (p < 0.01).Conclusion: This study shows that network-based analysis of brain white matter connections provides a novel way to reveal the structural basis of cognitive dysfunction in AD.