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全面评估静息态网络:痴呆症中脑-小脑网络功能完整性的双向改变。

A comprehensive assessment of resting state networks: bidirectional modification of functional integrity in cerebro-cerebellar networks in dementia.

机构信息

Department of Industrial and Information Engineering, University of Pavia Pavia, Italy ; Brain Connectivity Center, C. Mondino National Neurological Institute Pavia, Italy.

Brain Connectivity Center, C. Mondino National Neurological Institute Pavia, Italy ; Department of Physics, University of Pavia Pavia, Italy.

出版信息

Front Neurosci. 2014 Jul 30;8:223. doi: 10.3389/fnins.2014.00223. eCollection 2014.

Abstract

In resting state fMRI (rs-fMRI), only functional connectivity (FC) reductions in the default mode network (DMN) are normally reported as a biomarker for Alzheimer's disease (AD). In this investigation we have developed a comprehensive strategy to characterize the FC changes occurring in multiple networks and applied it in a pilot study of subjects with AD and Mild Cognitive Impairment (MCI), compared to healthy controls (HC). Resting state networks (RSNs) were studied in 14 AD (70 ± 6 years), 12 MCI (74 ± 6 years), and 16 HC (69 ± 5 years). RSN alterations were present in almost all the 15 recognized RSNs; overall, 474 voxels presented a reduced FC in MCI and 1244 in AD while 1627 voxels showed an increased FC in MCI and 1711 in AD. The RSNs were then ranked according to the magnitude and extension of FC changes (gFC), putting in evidence 6 RSNs with prominent changes: DMN, frontal cortical network (FCN), lateral visual network (LVN), basal ganglia network (BGN), cerebellar network (CBLN), and the anterior insula network (AIN). Nodes, or hubs, showing alterations common to more than one RSN were mostly localized within the prefrontal cortex and the mesial-temporal cortex. The cerebellum showed a unique behavior where voxels of decreased gFC were only found in AD while a significant gFC increase was only found in MCI. The gFC alterations showed strong correlations (p < 0.001) with psychological scores, in particular Mini-Mental State Examination (MMSE) and attention/memory tasks. In conclusion, this analysis revealed that the DMN was affected by remarkable FC increases, that FC alterations extended over several RSNs, that derangement of functional relationships between multiple areas occurred already in the early stages of dementia. These results warrant future work to verify whether these represent compensatory mechanisms that exploit a pre-existing neural reserve through plasticity, which evolve in a state of lack of connectivity between different networks with the worsening of the pathology.

摘要

在静息态功能磁共振成像(rs-fMRI)中,通常仅将默认模式网络(DMN)的功能连接(FC)减少报告为阿尔茨海默病(AD)的生物标志物。在这项研究中,我们开发了一种全面的策略来描述发生在多个网络中的 FC 变化,并将其应用于 AD 和轻度认知障碍(MCI)患者的试点研究中,与健康对照组(HC)进行比较。在 14 名 AD(70±6 岁)、12 名 MCI(74±6 岁)和 16 名 HC(69±5 岁)中研究了静息态网络(RSN)。几乎所有 15 个公认的 RSN 都存在 RSN 改变;总体而言,MCI 中有 474 个体素的 FC 降低,AD 中有 1244 个体素的 FC 降低,而 MCI 中有 1627 个体素的 FC 增加,AD 中有 1711 个体素的 FC 增加。然后根据 FC 变化的幅度和范围(gFC)对 RSN 进行排名,突显了 6 个具有明显变化的 RSN:DMN、额皮质网络(FCN)、外侧视觉网络(LVN)、基底节网络(BGN)、小脑网络(CBLN)和前岛叶网络(AIN)。改变共同涉及多个 RSN 的节点或枢纽主要位于前额叶皮质和内侧颞叶皮质内。小脑表现出独特的行为,AD 中仅发现降低的 gFC 体素,而 MCI 中仅发现明显的 gFC 增加。gFC 改变与心理评分(特别是简易精神状态检查(MMSE)和注意力/记忆任务)强烈相关(p<0.001)。总之,这项分析表明,DMN 受到显著 FC 增加的影响,FC 改变扩展到多个 RSN,多个区域之间的功能关系紊乱在痴呆的早期阶段就已经发生。这些结果证明需要进一步的工作来验证这些是否代表通过可塑性利用预先存在的神经储备的补偿机制,随着病理的恶化,不同网络之间的连接状态缺乏,这些机制逐渐演变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab11/4115623/16b556fa5a74/fnins-08-00223-g0001.jpg

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