Sintini Irene, Corriveau-Lecavalier Nick, Jones David T, Machulda Mary M, Gunter Jeffrey L, Schwarz Christopher G, Botha Hugo, Carlos Arenn F, Kamykowski Michael G, Singh Neha Atulkumar, Petersen Ronald C, Jack Clifford R, Lowe Val J, Graff-Radford Jonathan, Josephs Keith A, Whitwell Jennifer L
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Brain Commun. 2024 Jan 8;6(2):fcae005. doi: 10.1093/braincomms/fcae005. eCollection 2024.
Disruption of the default mode network is a hallmark of Alzheimer's disease, which has not been extensively examined in atypical phenotypes. We investigated cross-sectional and 1-year longitudinal changes in default mode network sub-systems in the visual and language variants of Alzheimer's disease, in relation to age and tau. Sixty-one amyloid-positive Alzheimer's disease participants diagnosed with posterior cortical atrophy ( = 33) or logopenic progressive aphasia ( = 28) underwent structural MRI, resting-state functional MRI and [F]flortaucipir PET. One-hundred and twenty-two amyloid-negative cognitively unimpaired individuals and 60 amyloid-positive individuals diagnosed with amnestic Alzheimer's disease were included as controls and as a comparison group, respectively, and had structural and resting-state functional MRI. Forty-one atypical Alzheimer's disease participants, 26 amnestic Alzheimer's disease participants and 40 cognitively unimpaired individuals had one follow-up functional MRI ∼1-2 years after the baseline scan. Default mode network connectivity was calculated using the dual regression method for posterior, ventral, anterior ventral and anterior dorsal sub-systems derived from independent component analysis. A global measure of default mode network connectivity, the network failure quotient, was also calculated. Linear mixed-effects models and voxel-based analyses were computed for each connectivity measure. Both atypical and amnestic Alzheimer's disease participants had lower cross-sectional posterior and ventral and higher anterior dorsal connectivity and network failure quotient relative to cognitively unimpaired individuals. Age had opposite effects on connectivity in Alzheimer's disease participants and cognitively unimpaired individuals. While connectivity declined with age in cognitively unimpaired individuals, younger Alzheimer's disease participants had lower connectivity than the older ones, particularly in the ventral default mode network. Greater baseline tau-PET uptake was associated with lower ventral and anterior ventral default mode network connectivity in atypical Alzheimer's disease. Connectivity in the ventral default mode network declined over time in atypical Alzheimer's disease, particularly in older participants, with lower tau burden. Voxel-based analyses validated the findings of higher anterior dorsal default mode network connectivity, lower posterior and ventral default mode network connectivity and decline in ventral default mode network connectivity over time in atypical Alzheimer's disease. Visuospatial symptoms were associated with default mode network connectivity disruption. In summary, default mode connectivity disruption was similar between atypical and amnestic Alzheimer's disease variants, and discriminated Alzheimer's disease from cognitively unimpaired individuals, with decreased posterior and increased anterior connectivity and with disruption more pronounced in younger participants. The ventral default mode network declined over time in atypical Alzheimer's disease, suggesting a shift in default mode network connectivity likely related to tau pathology.
默认模式网络的破坏是阿尔茨海默病的一个标志,在非典型表型中尚未得到广泛研究。我们调查了阿尔茨海默病视觉和语言变体中默认模式网络子系统的横断面和1年纵向变化,以及与年龄和tau的关系。61名被诊断为后部皮质萎缩(n = 33)或语义性进行性失语(n = 28)的淀粉样蛋白阳性阿尔茨海默病参与者接受了结构MRI、静息态功能MRI和[18F]氟代脱氧葡萄糖正电子发射断层显像(PET)检查。分别纳入122名淀粉样蛋白阴性认知未受损个体和60名被诊断为遗忘型阿尔茨海默病的淀粉样蛋白阳性个体作为对照和比较组,并进行了结构和静息态功能MRI检查。41名非典型阿尔茨海默病参与者、26名遗忘型阿尔茨海默病参与者和40名认知未受损个体在基线扫描后约1 - 2年进行了一次随访功能MRI检查。使用双回归方法计算源自独立成分分析的后部、腹侧、前腹侧和背侧前子系统的默认模式网络连接性。还计算了默认模式网络连接性的全局测量值,即网络故障商数。针对每个连接性测量值计算线性混合效应模型和基于体素的分析。相对于认知未受损个体,非典型和遗忘型阿尔茨海默病参与者的横断面后部和腹侧连接性较低,背侧前连接性和网络故障商数较高。年龄对阿尔茨海默病参与者和认知未受损个体的连接性有相反的影响。在认知未受损个体中,连接性随年龄下降,而较年轻的阿尔茨海默病参与者的连接性低于较年长的参与者,特别是在腹侧默认模式网络中。在非典型阿尔茨海默病中,更高的基线tau - PET摄取与较低的腹侧和前腹侧默认模式网络连接性相关。在非典型阿尔茨海默病中,腹侧默认模式网络的连接性随时间下降,特别是在tau负担较低的老年参与者中。基于体素的分析验证了非典型阿尔茨海默病中背侧前默认模式网络连接性较高、后部和腹侧默认模式网络连接性较低以及腹侧默认模式网络连接性随时间下降的结果。视觉空间症状与默认模式网络连接性破坏有关。总之,非典型和遗忘型阿尔茨海默病变体之间的默认模式连接性破坏相似,并且将阿尔茨海默病与认知未受损个体区分开来,后部连接性降低,前部连接性增加,并且在较年轻参与者中破坏更明显。在非典型阿尔茨海默病中,腹侧默认模式网络随时间下降,表明默认模式网络连接性的转变可能与tau病理相关。