Xie Ye, Zhao Tinghao, Zhang Wei, Chen Qi, Qiu Anqi, Li Yunxia, Ku Yixuan
Guangdong Provincial Key Laboratory of Brain Function and Disease, Center for Brain and Mental Well-Being, Department of Psychology, Sun Yat-sen University, Guangzhou, China.
School of Psychology, Shenzhen University, Shenzhen, China.
Alzheimers Dement. 2025 Feb;21(2):e14475. doi: 10.1002/alz.14475. Epub 2025 Jan 17.
Visual short-term memory (VSTM) is a critical indicator of Alzheimer's disease (AD), but whether its neural substrates could adapt to early disease progression and contribute to cognitive resilience in amnestic mild cognitive impairment (aMCI) has been unclear.
Fifty-five aMCI patients and 68 normal controls (NC) performed a change-detection task and underwent multimodal neuroimaging scanning.
Among the atrophic brain regions in aMCI, VSTM performance correlated with the volume of the right prefrontal cortex (PFC) but not the medial temporal lobe (MTL), and this correlation was mainly present in patients with greater MTL atrophy. Furthermore, VSTM was primarily correlated with frontal structural connectivity in aMCI but was correlated with more distributed frontal and MTL connectivity in NC.
This study provided evidence on neural adaptation in the precursor stages of AD, highlighting the compensatory role of PFC as MTL deteriorated and suggesting potential targets in early intervention for cognitive preservation.
Atrophic left medial temporal lobe (MTL) no longer correlated with visual short-term memory (VSTM) in amnestic mild cognitive impairment (aMCI). Atrophic right middle frontal area continued to correlate with VSTM in aMCI. Frontal brain-behavior correlation was mainly present in the aMCI subgroup with greater medial temporal lobe (MTL) atrophy. Reliance of VSTM on frontal connectivity increased in compensation for MTL dysfunction.
视觉短期记忆（VSTM）是阿尔茨海默病（AD）的一项关键指标，但在遗忘型轻度认知障碍（aMCI）中，其神经基质是否能适应疾病早期进展并有助于认知恢复尚不清楚。
55名aMCI患者和68名正常对照（NC）完成了一项变化检测任务，并接受了多模态神经影像扫描。
在aMCI患者脑萎缩区域中，VSTM表现与右侧前额叶皮质（PFC）体积相关，而与内侧颞叶（MTL）体积无关，且这种相关性主要存在于MTL萎缩更严重的患者中。此外，在aMCI中，VSTM主要与额叶结构连接相关，而在NC中，VSTM与更广泛分布的额叶和MTL连接相关。
本研究为AD前驱期的神经适应性提供了证据，突出了MTL退化时PFC的代偿作用，并提示了早期干预中认知保护的潜在靶点。
在遗忘型轻度认知障碍（aMCI）中，萎缩的左侧内侧颞叶（MTL）不再与视觉短期记忆（VSTM）相关。萎缩的右侧额中回区域在aMCI中继续与VSTM相关。额叶脑-行为相关性主要存在于内侧颞叶（MTL）萎缩更严重的aMCI亚组中。VSTM对额叶连接的依赖增加以代偿MTL功能障碍。
