Loss of ‘Small-World’ Networks in Alzheimer's Disease: Graph Analysis of fMRI Resting-State Functional Connectivity

BACKGROUND: Local network connectivity disruptions in Alzheimer's disease patients have been found using graph analysis in BOLD fMRI. Other studies using MEG and cortical thickness measures, however, show more global long distance connectivity changes, both in functional and structural imaging data. The form and role of functional connectivity changes thus remains ambiguous. The current study shows more conclusive data on connectivity changes in early AD using graph analysis on resting-state condition fMRI data. METHODOLOGY/PRINCIPAL FINDINGS: 18 mild AD patients and 21 healthy age-matched control subjects without memory complaints were investigated in resting-state condition with MRI at 1.5 Tesla. Functional coupling between brain regions was calculated on the basis of pair-wise synchronizations between regional time-series. Local (cluster coefficient) and global (path length) network measures were quantitatively defined. Compared to controls, the characteristic path length of AD functional networks is closer to the theoretical values of random networks, while no significant differences were found in cluster coefficient. The whole-brain average synchronization does not differ between Alzheimer and healthy control groups. Post-hoc analysis of the regional synchronization reveals increased AD synchronization involving the frontal cortices and generalized decreases located at the parietal and occipital regions. This effectively translates in a global reduction of functional long-distance links between frontal and caudal brain regions. CONCLUSIONS/SIGNIFICANCE: We present evidence of AD-induced changes in global brain functional connectivity specifically affecting long-distance connectivity. This finding is highly relevant for it supports the anterior-posterior disconnection theory and its role in AD. Our results can be interpreted as reflecting the randomization of the brain functional networks in AD, further suggesting a loss of global information integration in disease

Changes in brain electrical activity during extended continuous word recognition

Twenty healthy subjects (10 men, 10 women) participated in an EEG study with an extended continuous recognition memory task, in which each of 30 words was randomly shown 10 times and subjects were required to make old vs. new decisions. Both event-related brain potentials (ERPs) and induced band power (IBP) were investigated. We hypothesized that repeated presentations affect recollection rather than familiarity. For the 300- to 500-ms time window, an 'old/new' ERP effect was found for the first vs. second word presentations. The correct recognition of an 'old' word was associated with a more positive waveform than the correct identification of a new word. The old/new effect was most pronounced at and around the midline parietal electrode position. For the 500- to 800-ms time window, a linear repetition effect was found for multiple word repetitions. Correct recognition after an increasing number of repetitions was associated with increasing positivity. The multiple repetitions effect was most pronounced at the midline central (Cz) and fronto-central (FCz) electrode positions and reflects a graded recollection process: the stronger the memory trace grows, the more positive the ERP in the 500- to 800-ms time window. The ERP results support a dual-processing model, with familiarity being discernable from a more graded recollection state that depends on memory strengths. For IBP, we found 'old/new' effects for the lower-2 alpha, theta, and delta bands, with higher bandpower during 'old' words. The lower-2 alpha 'old/new' effect most probably reflects attentional processes, whereas the theta and delta effects reflect encoding and retrieval processes. Upon repeated word presentations, the magnitude of induced delta power in the 375- to 750-ms time window diminished linearly. Correlation analysis suggests that decreased delta power is moderately associated with faster decision speed and higher accurac

Resting state functional connectivity differences between behavioral variant frontotemporal dementia and Alzheimer's disease

Introduction: Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are the most common types of early-onset dementia. Early differentiation between both types of dementia may be challenging due to heterogeneity and overlap of symptoms. Here, we apply resting state functional magnetic resonance imaging (fMRI) to study functional brain connectivity differences between AD and bvFTD. Methods: We used resting state fMRI data of 31 AD patients, 25 bvFTD patients, and 29 controls from two centers specialized in dementia. We studied functional connectivity throughout the entire brain, applying two different analysis techniques, studying network-to-region and region-to-region connectivity. A general linear model approach was used to study group differences, while controlling for physiological noise, age, gender, study center, and regional gray matter volume. Results: Given gray matter differences, we observed decreased network-to-region connectivity in bvFTD between (a) lateral visual cortical network and lateral occipital and cuneal cortex, and (b) auditory system network and angular gyrus. In AD, we found decreased network-to-region connectivity between the dorsal visual stream network and lateral occipital and parietal opercular cortex. Region-to-region connectivity was decreased in bvFTD between superior temporal gyrus and cuneal, supracalcarine, intracalcarine cortex, and lingual gyrus. Conclusion: We showed that the pathophysiology

Joint assessment of white matter integrity, cortical and subcortical atrophy to distinguish AD from behavioral variant FTD: A two-center study

We investigated the ability of cortical and subcortical gray matter (GM) atrophy in combination with white matter (WM) integrity to distinguish behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) and from controls using voxel-based morphometry, subcortical structure segmentation, and tract-based spatial statistics. To determine which combination of MR markers differentiated the three groups with the highest accuracy, we conducted discriminant function analyses. Adjusted for age, sex and center, both types of dementia had more GM atrophy, lower fractional anisotropy (FA) and higher mean (MD), axial (L1) and radial diffusivity (L23) values than controls. BvFTD patients had more GM atrophy in orbitofrontal and inferior frontal areas than AD patients. In addition, caudate nucleus and nucleus accumbens were smaller in bvFTD than in AD. FA values were lower; MD, L1 and L23 values were higher, especially in frontal areas of the brain for bvFTD compared to AD patients. The combination of cortical GM, hippocampal volume and WM integrity measurements, classified 97-100% of controls, 81-100% of AD and 67-75% of bvFTD patients correctly. Our results suggest that WM integrity measures add complementary information to measures of GM atrophy, thereby improving the classification between AD and bvFTD

Linkage disequilibrium analysis to enable more efficient gene and QTL mapping in apple

BACKGROUND/OBJECTIVE: Overlapping clinical symptoms often complicate differential diagnosis between patients with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Magnetic resonance imaging (MRI) reveals disease specific structural and functional differences that aid in differentiating AD from bvFTD patients. However, the benefit of combining structural and functional connectivity measures to-on a subject-basis-differentiate these dementia-types is not yet known. METHODS: Anatomical, diffusion tensor (DTI), and resting-state functional MRI (rs-fMRI) of 30 patients with early stage AD, 23 with bvFTD, and 35 control subjects were collected and used to calculate measures of structural and functional tissue status. All measures were used separately or selectively combined as predictors for training an elastic net regression classifier. Each classifier's ability to accurately distinguish dementia-types was quantified by calculating the area under the receiver operating characteristic curves (AUC). RESULTS: Highest AUC values for AD and bvFTD discrimination were obtained when mean diffusivity, full correlations between rs-fMRI-derived independent components, and fractional anisotropy (FA) were combined (0.811). Similarly, combining gray matter density (GMD), FA, and rs-fMRI correlations resulted in highest AUC of 0.922 for control and bvFTD classifications. This, however, was not observed for control and AD differentiations. Classifications with GMD (0.940) and a GMD and DTI combination (0.941) resulted in similar AUC values (p = 0.41). CONCLUSION: Combining functional and structural connectivity measures improve dementia-type differentiations and may contribute to more accurate and substantiated differential diagnosis of AD and bvFTD patients. Imaging protocols for differential diagnosis may benefit from also including DTI and rs-fMRI

Cholinergic challenge in Alzheimer patients and mild cognitive impairment differentially affects hippocampal activation - A pharmacological fMRI study

Pharmacological functional MRI (phMRI) examines the impact of pharmacologically induced neurochemical changes on brain function at a system level. The current phMRI study directly compared effects of cholinergic stimulation on brain function between patients with Alzheimer's disease and mild cognitive impairment, a disease stage preceding the development of Alzheimer's disease. Brain function during recognition of (un)familiar information was examined for changes after exposure to galantamine, a cholinesterase inhibitor used for treating memory deficits in Alzheimer's disease. Alzheimer patients [n = 18; age 74.5 years ± 8.2; Mini-Mental State Examination (MMSE) 22.5 ± 2.4] and patients with mild cognitive impairment (n = 28; mean age 73.6 ± 7.5; MMSE 27.0 ± 1.2) were scanned during face recognition under three different conditions: at baseline, and after acute (single dose) and prolonged exposure (5 days) to galantamine. Functional data were analysed in an event-related fashion. In both groups, acute exposure produced strong increases in brain activation (Z > 3.1). Prolonged exposure produced less strong effects that mainly involved decreases in activation (Z > 3.1). In mild cognitive impairment, acute exposure increased activation in posterior cingulate, left inferior parietal, and anterior temporal lobe. Prolonged exposure decreased activation in similar posterior cingulate areas, and in bilateral prefrontal areas. Effects were stronger for positive ('familiar') than for negative ('unfamiliar') decisions, indicating that the effect was specific to memory retrieval. In Alzheimer patients, acute exposure increased activation bilaterally in hippocampal areas, whereas prolonged exposure decreased activation in these areas. Effects were more pronounced for negative than for positive decisions, suggesting a preferential effect on memory encoding. Unique profiles of signal reactivity were found in a number of areas, including left inferior parietal lobe and left hippocampus proper. The reactivity of posterior cingulate and hippocampal structures to cholinergic challenge suggests a key role of the cholinergic system in the functional processes that lead to Alzheimer's disease. The differential response to cholinergic challenge in mild cognitive impairment and Alzheimer patients may reflect a difference in the functional status of the cholinergic system between both groups, which is in line with recent results showing a differential clinical response to cholinergic treatment

Unbiased whole-brain analysis of gray matter loss in Alzheimer's disease

In patients with Alzheimer's disease, substantial tissue loss occurs in the medial temporal lobe. In this study, we applied a voxel-based, unbiased whole-brain analysis method to compare magnetic resonance imaging scans of seven patients with Alzheimer's disease and seven healthy elderly controls. Images were transformed to standard coordinate space and tested for gray matter loss in patients. We found symmetrical decreases of gray matter in patients in the hippocampus, and, unexpectedly, also in the head of the caudate nucleus and the insula. The exact role of these two structures in the symptomatology of Alzheimer's disease deserves further attention. Copyright (C) 2000 Elsevier Science Ireland Ltd

Whole brain analysis of T2* weighted baseline FMRI signal in dementia

Brain activation in studies using blood oxygenation level dependent (BOLD) FMRI is associated with an increase in T2* weighted signal between baseline and an active condition. This BOLD technique is often applied to study differences in brain activation between patients and healthy controls. However, the baseline T2* signal itself may also be different between groups, as shown in the hippocampus in Alzheimer's disease using the resting oxygen or ROXY approach (Small et al. [2002]: Ann Neurol 51:290-295). In the current study, we analyzed whole brain, voxel-wise T2* weighted signal of averaged baseline scans of a BOLD FMRI experiment in 41 healthy elderly controls and 46 patients with mild cognitive impairment or Alzheimer's disease. In each subject, T2* weighted images were normalized to the CSF signal of the same image. Additionally, gray matter probability maps of high-resolution structural scans were also compared between groups to assess atrophy. T2* signal was decreased in dementia in the hippocampus, insula/putamen, posterior and middle cingulate cortex, and parietal cortex. Most of these regions also showed decreased gray matter, except insula/putamen. Hippocampal and posterior cingulate gray matter differences were significantly larger than T2* differences. Therefore, decreased T2* signal in most regions are likely to be caused by gray matter atrophy, although decreased metabolism or perhaps iron deposition are also factors that may contribute. We conclude that in FMRI studies of dementia, not only the dynamic BOLD signal (activation and deactivation) but also the average baseline signal is diminished in certain regions. The method we applied may also be used in task-related BOLD FMRI and add to the understanding of the mechanism of task-related group differences

Lewis acid catalyzed hetero Diels-Alder reactions of olefinic and acetylenic compounds with 6-methyl-3,5-dichloro-2H-1,4-oxazin-2-one

For the first time Lewis acid catalysis is described for the hetero Diels-Alder reaction of a conformationally fixed 2-azadiene system in a 2H-1,4-oxazin-2-one with a variety of alkenes and alkynes. The reaction is shown to occur under much milder conditions as hitherto reported. With dienophiles containing no heteroatoms an important increase in regio- and/or stereoselectivity is observed.status: publishe