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Published on: June 26, 2013
Alterations of voxel-wise spontaneous activity and corresponding brain functional networks in multiple system atrophy
Yingmei Li1, Hu Liu1, Hongmei Yu2
1Department of Radiology, The First Hospital, China Medical University, Shenyang, Liaoning, China.
Abstract:
Emerging evidence has indicated that cognitive impairment is an underrecognized feature of multiple system atrophy (MSA). Mild cognitive impairment (MCI) is related to a high risk of dementia. However, the mechanism underlying MCI in MSA remains controversial. In this study, we conducted the amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analyses to detect the characteristics of local neural activity and corresponding network alterations in MSA patients with MCI (MSA-MCI). We enrolled 80 probable MSA patients classified as cognitively normal (MSA-NC, n = 36) and MSA-MCI (n = 44) and 40 healthy controls. Compared with MSA-NC, MSA-MCI exhibited decreased ALFF in the right dorsal lateral prefrontal cortex (RDLPFC) and increased ALFF in the right cerebellar lobule IX and lobule IV-V. In the secondary FC analyses, decreased FC in the left inferior parietal lobe (IPL) was observed when we set the RDLPFC as the seed region. Decreased FC in the bilateral cuneus, left precuneus, and left IPL and increased FC in the right middle temporal gyrus were shown when we set the right cerebellar lobule IX as the seed region. Furthermore, FC of DLPFC-IPL and cerebello-cerebral circuit, as well as ALFF alterations, were significantly correlated with Montreal Cognitive Assessment scores in MSA patients. We also employed whole-brain voxel-based morphometry analysis, but no gray matter atrophy was detected between the patient subgroups. Our findings indicate that altered spontaneous activity in the DLPFC and the cerebellum and disrupted DLPFC-IPL, cerebello-cerebral networks are possible biomarkers of early cognitive decline in MSA patients.
Insights
Cognitive impairment in Multiple System Atrophy (MSA) is linked to altered brain activity in the prefrontal cortex and cerebellum, not gray matter loss. These changes may signal early cognitive decline in MSA patients.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Cognitive impairment is an underrecognized symptom of Multiple System Atrophy (MSA).
- Mild cognitive impairment (MCI) in MSA patients carries a high risk for dementia.
- The underlying mechanisms of MCI in MSA are not fully understood.
Purpose of the Study:
- To investigate the neural activity and network alterations in MSA patients with MCI (MSA-MCI).
- To identify potential biomarkers for early cognitive decline in MSA.
Main Methods:
- Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analyses were performed.
- 80 probable MSA patients (MSA-NC: 36, MSA-MCI: 44) and 40 healthy controls were enrolled.
- Whole-brain voxel-based morphometry was used to assess gray matter atrophy.
Main Results:
- MSA-MCI patients showed decreased ALFF in the right dorsal lateral prefrontal cortex (RDLPFC) and increased ALFF in the right cerebellar lobule IX and lobule IV-V compared to MSA-NC.
- Decreased FC was observed between RDLPFC and the left inferior parietal lobe (IPL).
- Altered FC in cerebello-cerebral networks and ALFF changes correlated with cognitive scores (Montreal Cognitive Assessment).
Conclusions:
- Altered spontaneous brain activity in the DLPFC and cerebellum are associated with cognitive impairment in MSA.
- Disrupted DLPFC-IPL and cerebello-cerebral networks may serve as biomarkers for early cognitive decline in MSA.
- No significant gray matter atrophy was detected between MSA subgroups, suggesting functional changes precede structural ones.
