Reduced Thickness of the Anterior Cingulate Cortex as a Predictor of Amnestic-Mild Cognitive Impairment Conversion to Alzheimer’s Disease with Psychosis

2021 ◽  
pp. 1-9
Author(s):  
Hee-Jeong Jeong ◽  
Young-Min Lee ◽  
Je-Min Park ◽  
Byung-Dae Lee ◽  
Eunsoo Moon ◽  
...  

Background: A long-term follow-up study in patients with amnestic mild cognitive impairment (aMCI) is needed to elucidate the association between regional brain volume and psychopathological mechanisms of Alzheimer’s disease with psychosis (AD + P). Objective: The purpose of this study was to investigate the effect of the thickness of the angular cingulate cortex (ACC) on the risk of AD + P conversion in patients with aMCI. Methods: This was a hospital-based prospective longitudinal study including 174 patients with aMCI. The main outcome measure was time-to-progression from aMCI to AD + P. Subregions of the ACC (rostral ACC, rACC; caudal ACC, cACC) and hippocampus (HC) were measured as regions of interest with magnetic resonance imaging and the Freesurfer analysis at baseline. Survival analysis with time to incident AD + P as an event variable was calculated with Cox proportional hazards models using the subregions of the ACC and HC as a continuous variable. Results: Cox proportional hazard analyses showed that the risk of AD + P was associated with sub-regional ACC thickness but not HC volume: reduced cortical thickness of the left cACC (HR [95%CI], 0.224 [0.087–0.575], p = 0.002), right cACC (HR [95%CI], 0.318 [0.132–0.768], p = 0.011). This association of the cACC with the risk of AD also remained significant when adjusted for HC volume. Conclusion: We found that reduced cortical thickness of the cACC is a predictor of aMCI conversion to AD + P, independent of HC, suggesting that the ACC plays a vital role in the underlying pathogenesis of AD + P.

2020 ◽  
Author(s):  
BUHARI IBRAHIM ◽  
Nisha Syed Nasser ◽  
NORMALA IBRAHIM ◽  
Mazlyfarina Mohamed ◽  
Hasyma Abu Hassan ◽  
...  

Resting state fMRI (rs-fMRI) detects functional connectivity (FC) abnormalities that occur in the brains of patients with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). FC of the default mode network (DMN), which is involved in memory consolidation, is commonly impaired in AD and MCI. We aimed to determine the diagnostic power of rs-fMRI to identify FC abnormalities in the DMN, which help to distinguish patients with AD or MCI from healthy controls (HCs). We searched articles in PubMed and Scopus databases using the search terms such as AD, MCI, resting-state fMRI, sensitivity and specificity through to 27th March 2020 and removed duplicate papers. We screened 390 published articles, and shortlisted 12 articles for the final analysis. The range of sensitivity of DMN FC at the posterior cingulate cortex (PCC) for diagnosing AD was between 65.7% - 100% and specificity ranged from 66 - 95%. Reduced DMN FC between the PCC and anterior cingulate cortex (ACC) in the frontal lobes was observed in MCI patients. AD patients had impaired FC in most regions of the DMN; particularly the PCC in early AD. This indicates that DMN's rs-fMRI FC can offer moderate to high diagnostic power to distinguish AD and MCI patients. fMRI detected abnormal DMN FC, particularly in the PCC that helps to differentiate AD and MCI patients from healthy controls (HCs). Combining multivariate method of analysis with other MRI parameters such as structural changes improve the diagnostic power of rs-fMRI in distinguishing patients with AD or MCI from HCs.


2020 ◽  
Vol 17 ◽  
Author(s):  
Hyung-Ji Kim ◽  
Jae-Hong Lee ◽  
E-nae Cheong ◽  
Sung-Eun Chung ◽  
Sungyang Jo ◽  
...  

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.


2014 ◽  
Vol 11 (2) ◽  
pp. 200-205
Author(s):  
Aleksandra Klimkowicz-Mrowiec ◽  
Lukasz Krzywoszanski ◽  
Karolina Spisak ◽  
Bryan Donohue ◽  
Andrzej Szczudlik ◽  
...  

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