Network-based substrate of cognitive reserve in Alzheimer's disease

Serra, Laura, Mancini, Matteo, Cercignani, Mara, Di Domenico, Carlotta, Spanò, Barbara, Giulietti, Giovanni, Koch, Giacomo, Marra, Camillo and Bozzali, Marco (2016) Network-based substrate of cognitive reserve in Alzheimer's disease. Journal of Alzheimer's Disease, 55 (1). pp. 421-430. ISSN 1387-2877

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Cognitive reserve (CR) is known to modulate the clinical features of Alzheimer’s disease (AD). This concept may be critical for the development of non-pharmacological interventions able to slow down patients’ cognitive decline in the absence of disease-modifying treatments. We aimed at identifying the neurobiological substrates of CR (i.e., neural reserve) over the transition between normal aging and AD, by assessing the underlying brain networks and their topological properties. A cohort of 154 participants (n = 68 with AD, n = 61 with amnestic mild cognitive impairment (aMCI), and 25 healthy subjects) underwent resting-state functional MRI and neuropsychological testing. Within each group, participants were classified as having high or low CR, and functional connectivity measures were compared, within group, between high and low CR individuals. Network-based statistics and topological network properties derived from graph theory were explored. Connectivity differences between high and low CR were evident only for aMCI patients, with participants with high CR showing a significant increase of connectivity in a network involving mainly fronto-parietal nodes. Conversely, they showed significantly decreased connectivity in a network involving fronto-temporo-cerebellar nodes. Consistently, changes to topological measures were observed in either direction, and were associated with measures of global cognitive function. These findings support the hypothesis that CR impacts on neurodegenerative process in the early phase of AD only. In addition, they fit with the existence of a “neural reserve”, characterized by specific neural networks and their efficiency. It remains to be demonstrated whether interventions later in life can modulate this “neural reserve”.

Item Type: Article
Keywords: Alzheimer’s disease; amnestic mild cognitive impairment; brain connectivity; cognitive reserve; compensatory network; neural reserve
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry > RC0346 Neurology. Diseases of the nervous system Including speech disorders
Depositing User: Patricia Butler
Date Deposited: 30 Jan 2017 16:37
Last Modified: 25 Jul 2017 11:09
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