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Segregation of functional networks is associated with cognitive resilience in Alzheimer's disease.


ABSTRACT: Cognitive resilience is an important modulating factor of cognitive decline in Alzheimer's disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal ageing, we tested the hypothesis that higher segregation of the brain's connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer's disease. Using resting-state functional MRI, we assessed both resting-state functional MRI global system segregation, i.e. the balance of between-network to within-network connectivity, and the alternate index of modularity Q as predictors of cognitive resilience. We performed all analyses in two independent samples for validation: (i) 108 individuals with autosomal dominantly inherited Alzheimer's disease and 71 non-carrier controls; and (ii) 156 amyloid-PET-positive subjects across the spectrum of sporadic Alzheimer's disease and 184 amyloid-negative controls. In the autosomal dominant Alzheimer's disease sample, disease severity was assessed by estimated years from symptom onset. In the sporadic Alzheimer's sample, disease stage was assessed by temporal lobe tau-PET (i.e. composite across Braak stage I and III regions). In both samples, we tested whether the effect of disease severity on cognition was attenuated at higher levels of functional network segregation. For autosomal dominant Alzheimer's disease, we found higher functional MRI-assessed system segregation to be associated with an attenuated effect of estimated years from symptom onset on global cognition (P = 0.007). Similarly, for patients with sporadic Alzheimer's disease, higher functional MRI-assessed system segregation was associated with less decrement in global cognition (P = 0.001) and episodic memory (P = 0.004) per unit increase of temporal lobe tau-PET. Confirmatory analyses using the alternate index of modularity Q revealed consistent results. In conclusion, higher segregation of functional connections into distinct large-scale networks supports cognitive resilience in Alzheimer's disease.

SUBMITTER: Ewers M 

PROVIDER: S-EPMC8370409 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Segregation of functional networks is associated with cognitive resilience in Alzheimer's disease.

Ewers Michael M   Luan Ying Y   Frontzkowski Lukas L   Neitzel Julia J   Rubinski Anna A   Dichgans Martin M   Hassenstab Jason J   Gordon Brian A BA   Chhatwal Jasmeer P JP   Levin Johannes J   Schofield Peter P   Benzinger Tammie L S TLS   Morris John C JC   Goate Alison A   Karch Celeste M CM   Fagan Anne M AM   McDade Eric E   Allegri Ricardo R   Berman Sarah S   Chui Helena H   Cruchaga Carlos C   Farlow Marty M   Graff-Radford Neill N   Jucker Mathias M   Lee Jae-Hong JH   Martins Ralph N RN   Mori Hiroshi H   Perrin Richard R   Xiong Chengjie C   Rossor Martin M   Fox Nick C NC   O'Connor Antoinette A   Salloway Stephen S   Danek Adrian A   Buerger Katharina K   Bateman Randall J RJ   Habeck Christian C   Stern Yaakov Y   Franzmeier Nicolai N  

Brain : a journal of neurology 20210801 7


Cognitive resilience is an important modulating factor of cognitive decline in Alzheimer's disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal ageing, we tested the hypothesis that higher segregation of the brain's connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer's disease. Using resting-state functional MRI, we assessed both resting-state functi  ...[more]

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