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阿尔茨海默病的功能连接组与神经精神症状群。

Functional connectome and neuropsychiatric symptom clusters of Alzheimer's disease.

机构信息

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.

Department of Neurology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan; Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Neuroscience Research Center, Chang-Gung University, Linkou, Taoyuan, Taiwan; Taipei Medical University, Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Shuang Ho Hospital, Taipei, Taiwan.

出版信息

J Affect Disord. 2020 Aug 1;273:48-54. doi: 10.1016/j.jad.2020.04.054. Epub 2020 May 14.

Abstract

BACKGROUND

Neuropsychiatric symptoms (NPSs) are important aspects of Alzheimer's disease (AD). Investigation of the effect of functional network abnormalities on clustered NPSs may uncover loci of altered connectivity for more targeted pharmacological and behavioral interventions in AD. The study aimed to investigate functional connectivity in AD and the clustered NPSs, as assessed by the Neuropsychiatric Inventory (NPI).

METHODS

In one hundred and fifty-nine patients with mild dementia stage of AD, graph metrics measuring functional connectivity at global network- and local network-level were assessed by closeness-centrality, betweenness-centrality, average-path-length, local-efficiency, and clustering-coefficient, respectively. The relationship between the NPI composite score and functional connectivity was assessed.

RESULTS

In AD, an increase in behavioral composite score was associated with changes in functional connectivity at local network-level, and regions displayed the changes was left lingual gyrus, left sub-genual ACC nodes, and left supra-genual ACC nodes (P < 0.05). An increase in affective composite score was associated with changes in functional connectivity at global network-level, and regions displayed the change was right caudate (P = 0.014). An increase in psychotic composite score was associated with changes in functional connectivity at global network-level, and regions displayed the change was left precuneus and right dorsolateral superior frontal gyrus (P < 0.05).

LIMITATIONS

Cognitively normal elderly subjects and longitudinal follow-up will be needed to see the evolution of NPS clusters and pathological changes in the functional connectivity at global or local network-level.

CONCLUSIONS

Different NPS clusters corresponded to distinct changes in functional connectivity at global and local network-level.

摘要

背景

神经精神症状(NPSs)是阿尔茨海默病(AD)的重要方面。研究功能网络异常对聚类 NPSs 的影响可能会发现 AD 中改变连接的位置,以便更有针对性地进行药物和行为干预。本研究旨在通过神经精神病学问卷(NPI)评估 AD 及聚类 NPSs 的功能连接。

方法

在 159 名轻度痴呆阶段的 AD 患者中,通过接近中心度、介数中心度、平均路径长度、局部效率和聚类系数分别评估了全局网络和局部网络水平的功能连接的图度量。评估了 NPI 综合评分与功能连接之间的关系。

结果

在 AD 中,行为综合评分的增加与局部网络水平的功能连接变化有关,显示变化的区域为左侧舌回、左侧前扣带回节点和左侧上扣带回节点(P<0.05)。情感综合评分的增加与全局网络水平的功能连接变化有关,显示变化的区域为右侧尾状核(P=0.014)。精神病综合评分的增加与全局网络水平的功能连接变化有关,显示变化的区域为左侧楔前叶和右侧背外侧额上回(P<0.05)。

局限性

需要认知正常的老年受试者和纵向随访,以观察 NPS 聚类的演变和全局或局部网络水平的功能连接的病理变化。

结论

不同的 NPS 聚类对应于全局和局部网络水平功能连接的不同变化。

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