Anosognosia and default mode subnetwork dysfunction in Alzheimer's disease
Anosognosia and default mode subnetwork dysfunction in Alzheimer's disease
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DOI：
10.1002/hbm.24775
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发表时间：
2019-08-24
影响因子：
4.8
通讯作者：
Salmon, Eric
中科院分区：
文献类型：
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作者：
Antoine, Nicolas;Bahri, Mohamed A.;Salmon, Eric
对阿尔茨海默病感缺失的神经相关性的研究因方法和目的而异：他们比较不同的测量方法，使用不同的神经成像方式，探索大脑网络之间的连接，解决特定大脑区域的作用或试图支持无意识的理论模型。我们使用静息态fMRI连接与两个不同的种子区域和两个措施的病感失认症在不同的患者样本，以调查一致的修改默认模式子网络，我们对齐的结果与认知意识模型。在第一项研究中，患者和他们的亲属被出示了记忆意识评定量表。病感缺失作为患者相对差异评分进行测量，并使用海马旁种子研究连接性。在第二项研究中，通过比较自我报告的评级与记忆表现，测量了患有脑淀粉样蛋白（作为疾病生物标志物）的患者的病感失认症，并用海马种子检查了连接性。在这两项研究中，病感失认症一致地与默认模式网络的内侧颞叶子系统内的断开连接有关，从而影响情景记忆过程。重要的是，分数也与内侧颞叶与默认模式网络的核心子系统（参与自我反思）和背内侧子系统（颞中回，可能有助于第二项研究中的个人数据库）之间的断开有关。我们认为，在默认模式网络的子系统内和子系统之间的连通性的差距可能反映了受损的认知模型的意识的途径的功能。
Research on the neural correlates of anosognosia in Alzheimer's disease varied according to methods and objectives: they compared different measures, used diverse neuroimaging modalities, explored connectivity between brain networks, addressed the role of specific brain regions or tried to give support to theoretical models of unawareness. We used resting-state fMRI connectivity with two different seed regions and two measures of anosognosia in different patient samples to investigate consistent modifications of default mode subnetworks and we aligned the results with the Cognitive Awareness Model. In a first study, patients and their relatives were presented with the Memory Awareness Rating Scale. Anosognosia was measured as a patient-relative discrepancy score and connectivity was investigated with a parahippocampal seed. In a second study, anosognosia was measured in patients with brain amyloid (taken as a disease biomarker) by comparing self-reported rating with memory performance, and connectivity was examined with a hippocampal seed. In both studies, anosognosia was consistently related to disconnection within the medial temporal subsystem of the default mode network, subserving episodic memory processes. Importantly, scores were also related to disconnection between the medial temporal and both the core subsystem (participating to self-reflection) and the dorsomedial subsystem of the default mode network (the middle temporal gyrus that might subserve a personal database in the second study). We suggest that disparity in connectivity within and between subsystems of the default mode network may reflect impaired functioning of pathways in cognitive models of awareness.