Elisa Canu1, Federica Agosta1, Silvia Basaia1, Alessandro Meani1, Sebastiano Galantucci1, Francesca Caso1, Giuseppe Magnani2, Roberto Santangelo2, Monica Falautano2, Giancarlo Comi2, Andrea Falini3, and Massimo Filippi1,2
1Neuroimaging Research Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, 2Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, 3Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
Synopsis
This
is a graph analysis study applying a new parcellation approach, which combines
the need for equal sized nodes with respecting brain anatomy, on resting state
fMRI data from a population of 247 patients with neurodegenerative cognitive
impairment (early [EO] and late onset [LO] Alzheimer’s disease (AD),
behavioural frontotemporal dementia [bvFTD], mild cognitive impairment [MCI])
and 86 controls. Compared to other groups, AD patients showed disrupted global
network connectivity, while MCI had specific regional changes,
suggesting that graph-analysis is promising to detect early features of
neurodegeneration. Global and regional graph network properties were able to
distinguish EOAD and bvFTD. Purpose
Graph theory provides a powerful tool to
describe quantitatively the topological organization of brain connectivity. A better understanding of network disruption in Alzheimer’s disease (AD) and
other neurodegenerative diseases may provide non-invasive biomarkers for dementia differential diagnosis and
disease monitoring. This study aimed at investigating functional brain network
architecture in late-onset (LO) and early-onset (EO) AD, mild cognitive
impairment (MCI), and behavioral variant of frontotemporal dementia (bvFTD).
Methods
The study involved 122 AD patients, 61 MCI patients, and 51 age-matched controls. 35 EOAD
patients were also compared with 29 bvFTD patients and 35 age-matched controls.
All subjects underwent 3D
T1-weighted and resting state (RS) functional MRI. Network
nodes were defined parcellating the
AAL atlas (Fig.1A)
into 262 regions, using a new parcellation approach which combines the need for
high number of equal sized nodes with respecting brain anatomy (Fig.1B). The parcellated atlas was coregistred
to the RS subject space (Fig.1C) and
the BOLD signal was extracted from each node and correlated among node pairs to
obtain functional matrices (Fig.1D). Graph
theory analysis was used to measure the global topological properties of
functional brain networks and to define brain modules. Differences in regional functional
networks among groups were investigated using Network-based statistic.
Results
While controls showed high-densely connected modules,
AD groups and bvFTD patients showed a loss of long-distance intra-module
connections, involving all modules in AD and the fronto-parietal-parahippocampal
module in bvFTD (Fig.2). Regardless the age of onset, AD patients showed
altered global network measures (lower network degree and clustering
coefficient, and longer path length) compared to controls and to the other
patient groups. Although MCI patients did not show global network alterations,
they were characterized by a decreased regional functional connectivity in the fronto-parietal
connections compared with controls. A decreased regional functional
connectivity was prominent in the parieto-occipital connections in EOAD and in
the fronto-temporal-parietal connections in bvFTD patients (Fig.3).
Discussion and Conclusions
Global graph properties of brain networks are severely altered in AD,
while they are relatively maintained in the other patient groups, thus
suggesting that they are promising in distinguishing EOAD from bvFTD patients. Furthermore,
the fronto-parietal connectivity disruptions in MCI patients could reflect an
early marker of the disease. Graph analysis is promising
to detect functional changes in the early phase of neurodegenerative diseases
and to serve for a prompt differential diagnosis among dementia syndromes.
Acknowledgements
Partially supported by the Italian Ministry of Health (#GR-2010-2303035) and the Alzheimer’s Drug Discovery
Foundation (#20131211).References
No reference found.