Department of Psychiatry, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Psychiatry and Mental Health, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China.
J Zhejiang Univ Sci B. 2018;19(12):924-934. doi: 10.1631/jzus.B1800381.
The purpose of this study was to explore the differences in interhemispheric functional connectivity in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) based on a triple network model consisting of the default mode network (DMN), salience network (SN), and executive control network (ECN). The technique of voxel-mirrored homotopic connectivity (VMHC) analysis was applied to explore the aberrant connectivity of all patients. The results showed that: (1) the statistically significant connections of interhemispheric brain regions included DMN-related brain regions (i.e. precuneus, calcarine, fusiform, cuneus, lingual gyrus, temporal inferior gyrus, and hippocampus), SN-related brain regions (i.e. frontoinsular cortex), and ECN-related brain regions (i.e. frontal middle gyrus and frontal inferior); (2) the precuneus and frontal middle gyrus in the AD group exhibited lower VMHC values than those in the aMCI and healthy control (HC) groups, but no significant difference was observed between the aMCI and HC groups; and (3) significant correlations were found between peak VMHC results from the precuneus and Mini Mental State Examination (MMSE) and Montreal Cognitive Scale (MOCA) scores and their factor scores in the AD, aMCI, and AD plus aMCI groups, and between the results from the frontal middle gyrus and MOCA factor scores in the aMCI group. These findings indicated that impaired interhemispheric functional connectivity was observed in AD and could be a sensitive neuroimaging biomarker for AD. More specifically, the DMN was inhibited, while the SN and ECN were excited. VMHC results were correlated with MMSE and MOCA scores, highlighting that VMHC could be a sensitive neuroimaging biomarker for AD and the progression from aMCI to AD.
本研究旨在基于由默认模式网络(DMN)、突显网络(SN)和执行控制网络(ECN)组成的三重网络模型,探讨阿尔茨海默病(AD)和遗忘型轻度认知障碍(aMCI)患者半球间功能连接的差异。采用体素镜像同伦连接(VMHC)分析技术来探索所有患者异常连接的情况。结果表明:(1)半球间脑区的统计显著连接包括 DMN 相关脑区(即楔前叶、距状回、梭状回、楔叶、舌回、颞下回和海马)、SN 相关脑区(即额岛盖皮质)和 ECN 相关脑区(即额中回和额下回);(2)AD 组的楔前叶和额中回 VMHC 值低于 aMCI 组和健康对照组(HC),但 aMCI 组和 HC 组之间无显著差异;(3)AD、aMCI 和 AD 合并 aMCI 组中,楔前叶的 VMHC 峰值与简易精神状态检查(MMSE)和蒙特利尔认知量表(MOCA)评分及其因子评分呈显著正相关,aMCI 组中额中回与 MOCA 因子评分呈显著正相关。这些发现表明 AD 存在半球间功能连接受损,可能是 AD 的敏感神经影像学生物标志物。更具体地说,DMN 受到抑制,而 SN 和 ECN 被激活。VMHC 结果与 MMSE 和 MOCA 评分相关,提示 VMHC 可能是 AD 的敏感神经影像学生物标志物,以及从 aMCI 进展为 AD 的标志物。