Neuropsychiatric Symptoms in Alzheimer's Disease Are Related to Functional Connectivity Alterations in the Salience Network
Neuropsychiatric Symptoms in Alzheimer's Disease Are Related to Functional Connectivity Alterations in the Salience Network
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DOI：
10.1002/hbm.22248
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发表时间：
2014-04-01
影响因子：
4.8
通讯作者：
Cendes, Fernando
中科院分区：
文献类型：
--
作者：
Balthazar, Marcio L. F.;Pereira, Fabricio R. S.;Cendes, Fernando
神经精神综合征在阿尔茨海默病（AD）中非常普遍，但其神经生物学机制尚未完全明确。功能性磁共振成像的新方法，如固有功能连接或静息态分析，可能有助于阐明这一问题。利用这些方法，已经描述了阿尔茨海默病中默认模式网络和突显网络（SN）的改变，尽管它们与特定症状的关系仍不清楚。因此，我们对20例轻至中度AD患者进行了静息态功能连接分析，并将他们在神经精神量表综合征（冷漠、多动、情感综合征和精神病）上的得分与默认模式网络和突显网络中的连接图相关联。此外，我们将这些患者的网络连接与17名健康老年对照受试者进行了比较。所有分析都对灰质密度和其他潜在的混杂因素进行了控制。与对照组相比，阿尔茨海默病患者在突显网络内（右侧前扣带回皮质和左侧内侧额回）显示出功能连接增加，同时在默认模式网络（双侧楔前叶）中功能连接降低。发现突显网络的前扣带回皮质和右侧脑岛区域的连接增加与多动综合征（激越、易怒、异常运动行为、欣快和去抑制）之间存在相关性。这些发现表明AD中特定网络变化与特定神经精神症状类型之间存在关联。这强调了静息态改变在未来诊断和治疗中的潜在临床意义。《人类大脑图谱》35:1237 - 1246, 2014。（c）2013威利期刊公司
Neuropsychiatric syndromes are highly prevalent in Alzheimer's disease (AD), but their neurobiology is not completely understood. New methods in functional magnetic resonance imaging, such as intrinsic functional connectivity or resting-state analysis, may help to clarify this issue. Using such approaches, alterations in the default-mode and salience networks (SNs) have been described in Alzheimer's, although their relationship with specific symptoms remains unclear. We therefore carried out resting-state functional connectivity analysis with 20 patients with mild to moderate AD, and correlated their scores on neuropsychiatric inventory syndromes (apathy, hyperactivity, affective syndrome, and psychosis) with maps of connectivity in the default mode network and SN. In addition, we compared network connectivity in these patients with that in 17 healthy elderly control subjects. All analyses were controlled for gray matter density and other potential confounds. Alzheimer's patients showed increased functional connectivity within the SN compared with controls (right anterior cingulate cortex and left medial frontal gyrus), along with reduced functional connectivity in the default-mode network (bilateral precuneus). A correlation between increased connectivity in anterior cingulate cortex and right insula areas of the SN and hyperactivity syndrome (agitation, irritability, aberrant motor behavior, euphoria, and disinhibition) was found. These findings demonstrate an association between specific network changes in AD and particular neuropsychiatric symptom types. This underlines the potential clinical significance of resting state alterations in future diagnosis and therapy. Hum Brain Mapp 35:1237-1246, 2014. (c) 2013 Wiley Periodicals, Inc.