Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia.
J Alzheimers Dis. 2022;85(1):309-321. doi: 10.3233/JAD-210401.
Alzheimer's disease (AD) is characterized by a progressive decline in cognitive functioning for which there is a stark lack of effective treatments. Investigating the neurophysiological markers of symptom severity in AD may aid in the identification of alternative treatment targets.
In the current study we used a multimodal approach to investigate the association between functional connectivity (specifically between scalp electrodes placed over frontal and parietal regions) and symptom severity in AD, and to explore the relationship between connectivity and cortical excitability.
40 people with AD (25 mild severity, 15 moderate severity) underwent neurobiological assessment (resting state electroencephalography (EEG) and prefrontal transcranial magnetic stimulation (TMS) with EEG) and cognitive assessment. Neurobiological outcomes were resting state functional connectivity and TMS-evoked potentials. Cognitive outcomes were scores on the Alzheimer's Disease Assessment Scale-Cognitive Subscale, Mini-Mental Status Examination, and a measure of episodic verbal learning.
Greater contralateral functional theta connectivity between frontal scalp electrodes and parietal scalp electrodes was associated with poorer cognitive performance. In addition, significant correlations were seen between the contralateral theta connectivity and the N100 and P60 TMS-evoked potentials measured from electrodes over the left dorsolateral prefrontal cortex.
Together these findings provide initial support for the use of multimodal neurophysiological approaches to investigate potential therapeutic targets in AD. Suggestions for future research are discussed.
阿尔茨海默病(AD)的特征是认知功能进行性下降,而目前对此病的治疗方法收效甚微。研究 AD 症状严重程度的神经生理标志物可能有助于确定替代治疗靶点。
在当前研究中,我们采用多模态方法研究 AD 患者中功能连接(特别是额区和顶区头皮电极之间的功能连接)与症状严重程度之间的关系,并探讨连接与皮质兴奋性之间的关系。
40 名 AD 患者(25 名轻度,15 名中度)接受神经生物学评估(静息态脑电图(EEG)和前额叶经颅磁刺激(TMS)结合 EEG)和认知评估。神经生物学结果为静息态功能连接和 TMS 诱发电位。认知结果为阿尔茨海默病评估量表认知分量表、简易精神状态检查和情景记忆口头学习测验的评分。
额区头皮电极和顶区头皮电极之间的对侧θ功能连接越强,认知表现越差。此外,还观察到左侧背外侧前额叶皮层 TMS 诱发的 N100 和 P60 电位与对侧θ连接之间存在显著相关性。
这些发现为采用多模态神经生理方法研究 AD 的潜在治疗靶点提供了初步支持。讨论了未来研究的建议。