Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden.
Cereb Cortex. 2019 May 1;29(5):2173-2182. doi: 10.1093/cercor/bhz020.
Alterations in cognitive performance have been noted in nondemented subjects with elevated accumulation of amyloid-β (Aβ) fibrils. However, it is not yet understood whether brain function is already influenced by Aβ deposition during the very earliest stages of the disease. We therefore investigated associations between [18F]Flutemetamol PET, resting-state functional connectivity, gray and white matter structure and cognitive performance in 133 cognitively normal elderly that exhibited normal global Aβ PET levels. [18F]Flutemetamol uptake in regions known to accumulate Aβ fibrils early in preclinical AD (i.e., mainly certain parts of the default-mode network) was positively associated with dynamic but not static functional connectivity (r = 0.77). Dynamic functional connectivity was further related to better cognitive performance (r = 0.21-0.72). No significant associations were found for Aβ uptake with gray matter volume or white matter diffusivity. The findings demonstrate that the earliest accumulation of Aβ fibrils is associated with increased functional connectivity, which occurs before any structural alterations. The enhanced functional connectivity may reflect a compensatory mechanism to maintain high cognitive performance in the presence of increasing amyloid accumulation during the earliest phases of AD.
在认知正常的老年人中,有研究发现,即使在疾病的早期阶段,β淀粉样蛋白(Aβ)纤维的蓄积也会影响脑功能。在本研究中,我们调查了 133 名认知正常的老年人的[18F]氟比莫特正电子发射断层扫描(PET)、静息态功能连接、灰质和白质结构与认知表现之间的关系,这些老年人的全局 Aβ PET 水平正常。在疾病的早期阶段,淀粉样蛋白纤维就会在某些区域蓄积,而这些区域也已知会积聚 Aβ纤维(即默认模式网络的某些部分),这些区域的[18F]氟比莫特摄取与动态而非静态功能连接呈正相关(r = 0.77)。动态功能连接与更好的认知表现进一步相关(r = 0.21-0.72)。Aβ摄取与灰质体积或白质各向异性弥散率无显著相关性。这些发现表明,Aβ纤维的最早蓄积与功能连接的增加有关,而这种增加发生在任何结构改变之前。增强的功能连接可能反映了一种补偿机制,以在 AD 早期阶段淀粉样蛋白蓄积增加的情况下维持较高的认知表现。