Changes in brain function occur years before the onset of cognitive impairment
Lori L Beason-Held1, Joshua O Goh, Yang An
1Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224, Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei 100, Taiwan, Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, and Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224.
Early Alzheimer's disease detection may be possible by monitoring brain blood flow changes. Resting-state brain function, specifically regional cerebral blood flow (rCBF), showed distinct patterns years before cognitive impairment onset in a longitudinal study.
Area of Science:
- Neuroscience
- Medical Imaging
- Gerontology
Background:
- Identifying early markers for Alzheimer's disease (AD) is crucial for developing targeted interventions.
- Pre-symptomatic changes in brain function may precede cognitive decline in AD.
Purpose of the Study:
- To examine longitudinal changes in resting-state brain function in cognitively normal individuals who later developed cognitive impairment.
- To identify early markers of brain changes associated with future cognitive impairment.
Main Methods:
- Longitudinal study of regional cerebral blood flow (rCBF) using (15)O-water PET scans over a mean of 7 years.
- Comparison of rCBF changes between participants who developed cognitive impairment (n=22) and those who remained cognitively normal (n=99).
- Voxel-based mixed model analysis to assess group differences in longitudinal rCBF changes, with all participants being cognitively normal during the scanning interval.
Main Results:
- Participants who later developed cognitive impairment showed significantly greater longitudinal increases in rCBF in frontal regions (orbitofrontal, medial frontal, anterior cingulate).
- These participants also exhibited greater longitudinal decreases in rCBF in parietal, temporal, and thalamic regions compared to cognitively healthy controls.
- Accelerated rCBF changes were linear, not influenced by tissue volume changes, and occurred in regions critical for cognitive function and known for early AD pathology.
Conclusions:
- Longitudinal changes in regional cerebral blood flow (rCBF) can serve as early markers for cognitive impairment, potentially preceding clinical diagnosis.
- Observed rCBF alterations in specific brain regions suggest a link between early pathological changes in Alzheimer's disease and functional brain alterations.
- These findings support the potential for using advanced neuroimaging techniques to detect pre-symptomatic changes in brain function relevant to Alzheimer's disease.
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