Neural mechanisms of cognitive reserve in Alzheimer's disease

Alzheimer’s disease (AD) is the most common cause of age-related dementia, where neuropathological changes develop gradually over years before the onset of dementia symptoms. Yet, despite the progression of AD pathology, the decline in cognitive abilities such as episodic memory can be relatively slow. A slower decline of cognition and delayed onset of dementia relative to the progression of neuropathology has been associated with particular intellectual and lifestyle factors such as more years of education and IQ. Thus education and IQ are seen as protective factors that are associated with an increased ability to cope with brain pathology, i.e. cognitive reserve. While numerous studies showed that education, IQ and other lifestyle factors are associated with relatively high cognitive abilities in AD, little is known about the underlying brain mechanisms of reserve. Most previous studies tested the association between protective factors such as education or IQ and differences in brain structure and function in order to identify brain mechanisms underlying reserve. Since such protective factors are global in nature and unspecific with regard to reserve, the results were highly variable. So far, there is a lack of knowledge of brain features that are associated with a higher ability to maintain cognition in the face of AD pathology. The overall aim of this dissertation was to test a priori selected functional network features that may underlie cognitive reserve. We focused on resting-state functional networks, and in particular the fronto-parietal control network as correlate of cognitive reserve. Such functional networks are thought to be composed of brain regions that are co-activated during a particular task, where the interaction between brain regions may be critical to support cognitive function. During task-free resting-state periods, the different and often distant brain regions of such network show correlated activity, i.e. functional connectivity. For the fronto-parietal control network, and in particular its globally connected hub in the left frontal cortex (LFC), higher resting-state connectivity has been previously shown to be associated with higher cognitive abilities as well as higher education and IQ, i.e. protective factors associated with reserve. Since that network and its LFC hub are relatively spared in AD, in contrast to more posterior parietal networks, we investigated whether higher connectivity of the fronto-parietal control network is associated with higher reserve in AD. We argued that the fronto-parietal control network is relatively stable during the initial stages of AD and may thus be well posited to subserve reserve in AD. In contrast, networks like the default mode network (DMN) that cover midline brain structures including the medial frontal lobe and the posterior cingulate may be highly vulnerable to AD pathology, given the previous observations of altered DMN connectivity and posterior parietal FDG-PET hypometabolism in AD. In particular, the resting-state connectivity between the DMN and the dorsal attention network (DAN) may be predictive of lower episodic memory in AD. Both networks interact in a competitive (i.e. anti-correlated) way during task and resting-state, which is critical for cognitive processes such as episodic memory. In a first step, we tested whether the resting-state connectivity between the DMN and theDAN (i.e. anti-correlated activity) is associated with lower episodic memory in subjects with amnestic mild cognitive impairment (MCI), i.e. subjects at increased risk to convertto AD dementia. Furthermore, we tested whether protective factors such as higher education moderate the association between the DMN-DAN anti-correlation andcognition. Here, the DMN-DAN anti-correlation was a measure of AD relatedpathological change rather than a substrate of reserve.We could show in two independent samples of patients at risk of AD dementia that a weaker DMN-DAN anti-correlation was associated with lower episodic memory, where the decrements in episodic memory were however weaker in subjects with higher education or IQ (interaction DMN-DAN x education/IQ). These results suggest that MCI subjects with higher protective factors (education, IQ) maintain episodic memory relatively well at a given level of AD-related brain changes. In the second step, we sought to identify those network differences that support cognitive reserve, i.e. that may explain the association between higher education and milder cognitive impairment in AD. Here, we could show that greater resting-state fMRI assessed global connectivity of the LFC, i.e. a key hub of the fronto-parietal control network, was associated with greater education and attenuated effects of neurodegeneration (measured by parietal FDG-PET hypometabolism) on memory in prodromal AD. Together, these results support the idea that global connectivity of a fronto-parietal control network hub supports cognitive reserve in AD. Based on this finding, we developed a novel restingstate fMRI index of fronto-parietal control network connectivity as a functional imaging marker of cognitive reserve. This marker is highly correlated with education and may thus be used as an imaging-based index of cognitive reserve. Together, our results provide for the first time evidence that cognitive reserve in AD is supported by higher functional connectivity of the fronto-parietal control network, in particular its LFC hub

Neural mechanisms of cognitive reserve in Alzheimer's disease

Alzheimer’s disease (AD) is the most common cause of age-related dementia, where neuropathological changes develop gradually over years before the onset of dementia symptoms. Yet, despite the progression of AD pathology, the decline in cognitive abilities such as episodic memory can be relatively slow. A slower decline of cognition and delayed onset of dementia relative to the progression of neuropathology has been associated with particular intellectual and lifestyle factors such as more years of education and IQ. Thus education and IQ are seen as protective factors that are associated with an increased ability to cope with brain pathology, i.e. cognitive reserve. While numerous studies showed that education, IQ and other lifestyle factors are associated with relatively high cognitive abilities in AD, little is known about the underlying brain mechanisms of reserve. Most previous studies tested the association between protective factors such as education or IQ and differences in brain structure and function in order to identify brain mechanisms underlying reserve. Since such protective factors are global in nature and unspecific with regard to reserve, the results were highly variable. So far, there is a lack of knowledge of brain features that are associated with a higher ability to maintain cognition in the face of AD pathology. The overall aim of this dissertation was to test a priori selected functional network features that may underlie cognitive reserve. We focused on resting-state functional networks, and in particular the fronto-parietal control network as correlate of cognitive reserve. Such functional networks are thought to be composed of brain regions that are co-activated during a particular task, where the interaction between brain regions may be critical to support cognitive function. During task-free resting-state periods, the different and often distant brain regions of such network show correlated activity, i.e. functional connectivity. For the fronto-parietal control network, and in particular its globally connected hub in the left frontal cortex (LFC), higher resting-state connectivity has been previously shown to be associated with higher cognitive abilities as well as higher education and IQ, i.e. protective factors associated with reserve. Since that network and its LFC hub are relatively spared in AD, in contrast to more posterior parietal networks, we investigated whether higher connectivity of the fronto-parietal control network is associated with higher reserve in AD. We argued that the fronto-parietal control network is relatively stable during the initial stages of AD and may thus be well posited to subserve reserve in AD. In contrast, networks like the default mode network (DMN) that cover midline brain structures including the medial frontal lobe and the posterior cingulate may be highly vulnerable to AD pathology, given the previous observations of altered DMN connectivity and posterior parietal FDG-PET hypometabolism in AD. In particular, the resting-state connectivity between the DMN and the dorsal attention network (DAN) may be predictive of lower episodic memory in AD. Both networks interact in a competitive (i.e. anti-correlated) way during task and resting-state, which is critical for cognitive processes such as episodic memory. In a first step, we tested whether the resting-state connectivity between the DMN and theDAN (i.e. anti-correlated activity) is associated with lower episodic memory in subjects with amnestic mild cognitive impairment (MCI), i.e. subjects at increased risk to convertto AD dementia. Furthermore, we tested whether protective factors such as higher education moderate the association between the DMN-DAN anti-correlation andcognition. Here, the DMN-DAN anti-correlation was a measure of AD relatedpathological change rather than a substrate of reserve.We could show in two independent samples of patients at risk of AD dementia that a weaker DMN-DAN anti-correlation was associated with lower episodic memory, where the decrements in episodic memory were however weaker in subjects with higher education or IQ (interaction DMN-DAN x education/IQ). These results suggest that MCI subjects with higher protective factors (education, IQ) maintain episodic memory relatively well at a given level of AD-related brain changes. In the second step, we sought to identify those network differences that support cognitive reserve, i.e. that may explain the association between higher education and milder cognitive impairment in AD. Here, we could show that greater resting-state fMRI assessed global connectivity of the LFC, i.e. a key hub of the fronto-parietal control network, was associated with greater education and attenuated effects of neurodegeneration (measured by parietal FDG-PET hypometabolism) on memory in prodromal AD. Together, these results support the idea that global connectivity of a fronto-parietal control network hub supports cognitive reserve in AD. Based on this finding, we developed a novel restingstate fMRI index of fronto-parietal control network connectivity as a functional imaging marker of cognitive reserve. This marker is highly correlated with education and may thus be used as an imaging-based index of cognitive reserve. Together, our results provide for the first time evidence that cognitive reserve in AD is supported by higher functional connectivity of the fronto-parietal control network, in particular its LFC hub

Use of high-dimensional spectral data to evaluate organic matter, reflectance relationships in soils

Recent breakthroughs in remote sensing technology have led to the development of a spaceborne high spectral resolution imaging sensor, HIRIS, to be launched in the mid-1990s for observation of earth surface features. The effects of organic carbon content on soil reflectance over the spectral range of HIRIS, and to examine the contributions of humic and fulvic acid fractions to soil reflectance was evaluated. Organic matter from four Indiana agricultural soils was extracted, fractionated, and purified, and six individual components of each soil were isolated and prepared for spectral analysis. The four soils, ranging in organic carbon content from 0.99 percent, represented various combinations of genetic parameters such as parent material, age, drainage, and native vegetation. An experimental procedure was developed to measure reflectance of very small soil and organic component samples in the laboratory, simulating the spectral coverage and resolution of the HIRIS sensor. Reflectance in 210 narrow (10 nm) bands was measured using the CARY 17D spectrophotometer over the 400 to 2500 nm wavelength range. Reflectance data were analyzed statistically to determine the regions of the reflective spectrum which provided useful information about soil organic matter content and composition. Wavebands providing significant information about soil organic carbon content were located in all three major regions of the reflective spectrum: visible, near infrared, and middle infrared. The purified humic acid fractions of the four soils were separable in six bands in the 1600 to 2400 nm range, suggesting that longwave middle infrared reflectance may be useful as a non-destructive laboratory technique for humic acid characterization

The BIN1 rs744373 SNP is associated with increased tau-PET levels and impaired memory

The single nucleotide polymorphism (SNP) rs744373 in the bridging integrator-1 gene (BIN1) is a risk factor for Alzheimer's disease (AD). In the brain, BIN1 is involved in endocytosis and sustaining cytoskeleton integrity. Post-mortem and in vitro studies suggest that BIN1-associated AD risk is mediated by increased tau pathology but whether rs744373 is associated with increased tau pathology in vivo is unknown. Here we find in 89 older individuals without dementia, that BIN1 rs744373 risk-allele carriers show higher AV1451 tau-PET across brain regions corresponding to Braak stages II-VI. In contrast, the BIN1 rs744373 SNP was not associated with AV45 amyloid-PET uptake. Furthermore, the rs744373 risk-allele was associated with worse memory performance, mediated by increased global tau levels. Together, our findings suggest that the BIN1 rs744373 SNP is associated with increased tau but not beta-amyloid pathology, suggesting that alterations in BIN1 may contribute to memory deficits via increased tau pathology

Enhanced sensitivity to ALDH1A3-dependent ferroptosis in TMZ-resistant glioblastoma cells

Temozolomide (TMZ) is standard treatment for glioblastoma (GBM); nonetheless, resistance and tumor recurrence are still major problems. In addition to its association with recurrent GBM and TMZ resistance, ALDH1A3 has a role in autophagy-dependent ferroptosis activation. In this study, we treated TMZ-resistant LN229 human GBM cells with the ferroptosis inducer RSL3. Remarkably, TMZ-resistant LN229 clones were also resistant to ferroptosis induction, although lipid peroxidation was induced by RSL3. By using Western blotting, we were able to determine that ALDH1A3 was down-regulated in TMZ-resistant LN229 cells. Most intriguingly, the cell viability results showed that only those clones that up-regulated ALDH1A3 after TMZ withdrawal became re-sensitized to ferroptosis induction. The recovery of ALDH1A3 expression appeared to be regulated by EGFR-dependent PI3K pathway activation since Akt was activated only in ALDH1A3 high clones. Blocking the EGFR signaling pathway with the EGFR inhibitor AG1498 decreased the expression of ALDH1A3. These findings shed light on the potential application of RSL3 in the treatment of glioblastoma relapse

Resting-State Connectivity of the Left Frontal Cortex to the Default Mode and Dorsal Attention Network Supports Reserve in Mild Cognitive Impairment

Reserve refers to the phenomenon of relatively preserved cognition in disproportion to the extent of neuropathology, e.g., in Alzheimer’s disease. A putative functional neural substrate underlying reserve is global functional connectivity of the left lateral frontal cortex (LFC, Brodmann Area 6/44). Resting-state fMRI-assessed global LFC-connectivity is associated with protective factors (education) and better maintenance of memory in mild cognitive impairment (MCI). Since the LFC is a hub of the fronto-parietal control network that regulates the activity of other networks, the question arises whether LFC-connectivity to specific networks rather than the whole-brain may underlie reserve. We assessed resting-state fMRI in 24 MCI and 16 healthy controls (HC) and in an independent validation sample (23 MCI/32 HC). Seed-based LFC-connectivity to seven major resting-state networks (i.e., fronto-parietal, limbic, dorsal-attention, somatomotor, default-mode, ventral-attention, visual) was computed, reserve was quantified as residualized memory performance after accounting for age and hippocampal atrophy. In both samples of MCI, LFC-activity was anti-correlated with the default-mode network (DMN), but positively correlated with the dorsal-attention network (DAN). Greater education predicted stronger LFC-DMN-connectivity (anti-correlation) and LFC-DAN-connectivity. Stronger LFC-DMN and LFC-DAN-connectivity each predicted higher reserve, consistently in both MCI samples. No associations were detected for LFC-connectivity to other networks. These novel results extend our previous findings on global functional connectivity of the LFC, showing that LFC-connectivity specifically to the DAN and DMN, two core memory networks, enhances reserve in the memory domain in MCI

Left frontal cortex connectivity underlies cognitive reserve in prodromal Alzheimer disease

Objective: To test whether higher global functional connectivity of the left frontal cortex (LFC) in Alzheimer disease (AD) is associated with more years of education (a proxy of cognitive reserve [CR]) and mitigates the association between AD-related fluorodeoxyglucose (FDG)-PET hypometabolism and episodic memory. Methods: Forty-four amyloid-PET-positive patients with amnestic mild cognitive impairment (MCI-A beta 1) and 24 amyloid-PET-negative healthy controls (HC) were included. Voxel-based linear regression analyses were used to test the association between years of education and FDG-PET in MCI-Ab1, controlled for episodic memory performance. Global LFC (gLFC) connectivity was computed through seed-based resting-state fMRI correlations between the LFC (seed) and each voxel in the gray matter. In linear regression analyses, education as a predictor of gLFC connectivity and the interaction of gLFC connectivity 3 FDG-PET hypometabolism on episodic memory were tested. Results: FDG-PET metabolism in the precuneus was reduced in MCI-A beta 1 compared to HC (p = 0.028), with stronger reductions observed in MCI-A beta 1 with more years of education (p = 0.006). In MCI-A beta 1, higher gLFC connectivity was associated with more years of education (p = 0.021). At higher levels of gLFC connectivity, the association between precuneus FDG-PET hypometabolism and lower memory performance was attenuated (p = 0.027). Conclusions: Higher gLFC connectivity is a functional substrate of CR that helps to maintain episodic memory relatively well in the face of emerging FDG-PET hypometabolism in earlystage AD

Cognitive Reserve Moderates the Association between Functional Network Anti-Correlations and Memory in MCI

Cognitive reserve (CR) shows protective effects on cognitive function in older adults. Here, we focused on the effects of CR at the functional network level. We assessed in patients with amnestic mild cognitive impairment (aMCI) whether higher CR moderates the association between low internetwork cross-talk on memory performance. In 2 independent aMCI samples (n = 76 and 93) and healthy controls (HC, n = 36), CR was assessed via years of education and intelligence (IQ). We focused on the anti-correlation between the dorsal attention network (DAN) and an anterior and posterior default mode network (DMN), assessed via sliding time window analysis of resting-state functional magnetic resonance imaging (fMRI). The DMN-DAN anti-correlation was numerically but not significantly lower in aMCI compared to HC. However, in aMCI, lower anterior DMN-DAN anti-correlation was associated with lower memory performance. This association was moderated by CR proxies, where the association between the internetwork anti-correlation and memory performance was alleviated at higher levels of education or IQ. In conclusion, lower DAN-DMN cross-talk is associated with lower memory in aMCI, where such effects are buffered by higher CR