Impaired default network functional connectivity in autosomal dominant Alzheimer disease
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Abstract
Objective: To investigate default mode network (DMN) functional connectivity MRI (fcMRI) in a large cross-sectional cohort of subjects from families harboring pathogenic presenilin-1 (PSEN1), presenilin-2 (PSEN2), and amyloid precursor protein (APP) mutations participating in the Dominantly Inherited Alzheimer Network.
Methods: Eighty-three mutation carriers and 37 asymptomatic noncarriers from the same families underwent fMRI during resting state at 8 centers in the United States, United Kingdom, and Australia. Using group-independent component analysis, fcMRI was compared using mutation status and Clinical Dementia Rating to stratify groups, and related to each participant's estimated years from expected symptom onset (eYO).
Results: We observed significantly decreased DMN fcMRI in mutation carriers with increasing Clinical Dementia Rating, most evident in the precuneus/posterior cingulate and parietal cortices (p < 0.001). Comparison of asymptomatic mutation carriers with noncarriers demonstrated decreased fcMRI in the precuneus/posterior cingulate (p = 0.014) and right parietal cortex (p = 0.0016). We observed a significant interaction between mutation carrier status and eYO, with decreases in DMN fcMRI observed as mutation carriers approached and surpassed their eYO.
Conclusion: Functional disruption of the DMN occurs early in the course of autosomal dominant Alzheimer disease, beginning before clinically evident symptoms, and worsening with increased impairment. These findings suggest that DMN fcMRI may prove useful as a biomarker across a wide spectrum of disease, and support the feasibility of DMN fcMRI as a secondary endpoint in upcoming multicenter clinical trials in Alzheimer disease.
GLOSSARY
- Aβ=
- amyloid-β;
- AD=
- Alzheimer disease;
- ADAD=
- autosomal dominant Alzheimer disease;
- ANOVA=
- analysis of variance;
- APP=
- amyloid precursor protein;
- CDR=
- Clinical Dementia Rating;
- DGC=
- DIAN Genetics Core;
- DIAN=
- Dominantly Inherited Alzheimer Network;
- DMN=
- default mode network;
- eYO=
- estimated years from expected symptom onset;
- fcMRI=
- functional connectivity MRI;
- GLM=
- general linear model;
- ICA=
- independent component analysis;
- LOAD=
- late-onset Alzheimer disease;
- LPC=
- left lateral parietal cortex;
- MCI=
- mild cognitive impairment;
- MNI=
- Montreal Neurological Institute;
- mPFC=
- medial prefrontal cortex;
- NCRAD=
- National Cell Repository for Alzheimer's Disease;
- PPC=
- precuneus/posterior cingulate;
- PSEN1=
- presenilin-1;
- PSEN2=
- presenilin-2;
- RPC=
- right lateral parietal cortex
Footnotes
↵* These authors contributed equally to this manuscript.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received March 12, 2013.
- Accepted in final form May 13, 2013.
- © 2013 American Academy of Neurology
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