Regional brain atrophy and functional disconnection across Alzheimer's disease evolution

ObjectiveTo assess the contribution of regional grey matter (GM) atrophy and functional disconnection in determining the level of cognitive decline in patients with Alzheimer's disease (AD) at different clinical stages.MethodsTen patients with amnesic mild cognitive impairment (a-MCI), 11 patie...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry Vol. 82; no. 1; pp. 58 - 66
Main Authors: Gili, T, Cercignani, M, Serra, L, Perri, R, Giove, F, Maraviglia, B, Caltagirone, C, Bozzali, M
Format: Journal Article
Language:English
Published: London BMJ Publishing Group Ltd 01.01.2011
BMJ Publishing Group
BMJ Publishing Group LTD
Subjects:
Aged
Alzheimer Disease - pathology
Alzheimer Disease - psychology
Alzheimer's disease
Amnesia - pathology
Amnesia - psychology
Atrophy
Biological and medical sciences
Brain
Brain - pathology
Cognition Disorders - pathology
Cognition Disorders - psychology
Cognitive ability
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia
Disease Progression
Female
Fourier transforms
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Medical sciences
Memory
Middle Aged
Nerve Net - pathology
Neural Pathways - pathology
Neurology
Neuropsychological Tests
Neuropsychology
Atrophy
Nervous system diseases
Alzheimer disease
Central nervous system disease
Central nervous system
Evolution
Degenerative disease
Cerebral disorder
Encephalon
ALZHEIMER'S DISEASE
DEMENTIA
COGNITION
DISCONNECTION
IMAGE ANALYSIS
ISSN:0022-3050, 1468-330X, 1468-330X
Online Access:Get full text
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Summary:ObjectiveTo assess the contribution of regional grey matter (GM) atrophy and functional disconnection in determining the level of cognitive decline in patients with Alzheimer's disease (AD) at different clinical stages.MethodsTen patients with amnesic mild cognitive impairment (a-MCI), 11 patients with probable AD and 10 healthy controls were recruited. T1 volumes were obtained from each subject and postprocessed according to an optimised voxel based morphometry protocol. Resting state functional MRI data were also collected from the same individuals and analysed to produce connectivity maps after identification of the default mode network (DMN) by independent component analysis.ResultsCompared with healthy controls, both AD and a-MCI patients showed a similar regional pattern of brain disconnection between the posterior cingulate cortex (PCC) and the medial prefrontal cortex and the rest of the brain. Conversely, the distribution of GM atrophy was significantly more restricted in a-MCI than in AD patients. Interestingly, the PCC showed reduced connectivity in a-MCI patients in the absence of GM atrophy, which was, in contrast, detectable at the stage of fully developed AD.ConclusionsThis study indicates that disconnection precedes GM atrophy in the PCC, which is a critical area of the DMN, and supports the hypothesis that GM atrophy in specific regions of AD brains likely reflects a long term effect of brain disconnection. In this context, our study indicates that GM atrophy in PCC accompanies the conversion from MCI to AD.
Bibliography:local:jnnp;82/1/58
PMID:20639384
ArticleID:jnnp199935
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ISSN:0022-3050
1468-330X
1468-330X
DOI:10.1136/jnnp.2009.199935