Large-scale functional brain network abnormalities in Alzheimer's disease: insights from functional neuroimaging.
Large-scale functional brain network abnormalities in Alzheimer's disease: insights from functional neuroimaging.
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DOI：
10.3233/ben-2009-0227
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发表时间：
2009
影响因子：
2.8
通讯作者：
Sperling RA
中科院分区：
文献类型：
--
作者：
Dickerson BC;Sperling RA
功能性磁共振成像（fMRI）研究轻度认知障碍（MCI）和阿尔茨海默病（AD）已经开始揭示大规模记忆和认知脑网络的异常。由于内侧颞叶（MTL）记忆系统是AD的早期病理学部位，因此许多研究都集中在大脑的这一区域。然而，很明显，大规模情景记忆网络的其他区域也在疾病早期受到影响，并且功能磁共振成像已经开始阐明MCI和AD患者额叶、颞叶和顶叶皮质的功能异常。除了可预测的大脑区域的低激活，因为它们积累病理和经历萎缩，也有大脑记忆和认知回路的过度激活区域，可能代表试图补偿活动。最近的功能磁共振成像数据在MCI和AD开始揭示MTL记忆系统和功能连接的大脑区域，如楔前叶的功能活动异常之间的关系。“静息状态”功能磁共振成像数据的额外工作是阐明功能解剖大脑回路和疾病对其的破坏。随着这项工作的不断成熟，它可能会有助于我们理解人类大脑中的基本记忆过程以及这些过程在记忆障碍中是如何被扰乱的。我们希望这些见解将转化为将任务相关脑功能的测量纳入诊断评估或治疗监测，希望有一天这将有助于证明临床试验中测试的治疗的有益效果。
Functional MRI (fMRI) studies of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) have begun to reveal abnormalities in large-scale memory and cognitive brain networks. Since the medial temporal lobe (MTL) memory system is a site of very early pathology in AD, a number of studies have focused on this region of the brain. Yet it is clear that other regions of the large-scale episodic memory network are affected early in the disease as well, and fMRI has begun to illuminate functional abnormalities in frontal, temporal, and parietal cortices as well in MCI and AD. Besides predictable hypoactivation of brain regions as they accrue pathology and undergo atrophy, there are also areas of hyperactivation in brain memory and cognitive circuits, possibly representing attempted compensatory activity. Recent fMRI data in MCI and AD are beginning to reveal relationships between abnormalities of functional activity in the MTL memory system and in functionally connected brain regions, such as the precuneus. Additional work with “resting state” fMRI data is illuminating functional-anatomic brain circuits and their disruption by disease. As this work continues to mature, it will likely contribute to our understanding of fundamental memory processes in the human brain and how these are perturbed in memory disorders. We hope these insights will translate into the incorporation of measures of task-related brain function into diagnostic assessment or therapeutic monitoring, which will hopefully one day be useful for demonstrating beneficial effects of treatments being tested in clinical trials.