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. 2018;65(4):1301-1312.
doi: 10.3233/JAD-180570.

Atrophy in Distributed Networks Predicts Cognition in Alzheimer's Disease and Type 2 Diabetes

Stephanie S Buss  1 , Jaya Padmanabhan  1 , Sadhvi Saxena  1   2 , Alvaro Pascual-Leone  1   3 , Peter J Fried  1
Affiliations

Atrophy in Distributed Networks Predicts Cognition in Alzheimer's Disease and Type 2 Diabetes

Stephanie S Buss et al. J Alzheimers Dis. 2018.

Abstract

Background: Alzheimer's disease (AD) and type 2 diabetes (T2DM) are common causes of cognitive decline among older adults and share strong epidemiological links. Distinct patterns of cortical atrophy are observed in AD and T2DM, but robust comparisons between structure-function relationships across these two disease states are lacking.

Objective: To compare how atrophy within distributed brain networks is related to cognition across the spectrum of cognitive aging.

Methods: The relationship between structural MRI changes and cognition was studied in 22 mild-to-moderate AD, 28 T2DM, and 27 healthy participants. Cortical thickness measurements were obtained from networks of interest (NOIs) matching the limbic, default, and frontoparietal resting-state networks. Composite cognitive scores capturing domains of global cognition, memory, and executive function were created. Associations between cognitive scores and the NOIs were assessed using linear regression, with age as a covariate. Within-network General Linear Model (GLM) analysis was run in Freesurfer 6.0 to visualize differences in patterns of cortical atrophy related to cognitive function in each group. A secondary analysis examined hemispheric differences in each group.

Results: Across all groups, cortical atrophy within the limbic NOI was significantly correlated with Global Cognition (p = 0.009) and Memory Composite (p = 0.002). Within-network GLM analysis and hemispheric analysis revealed qualitatively different patterns of atrophy contributing to cognitive dysfunction between AD and T2DM.

Conclusion: Brain network atrophy is related to cognitive function across AD, T2DM, and healthy participants. Differences in cortical atrophy patterns were seen between AD and T2DM, highlighting neuropathological differences.

Keywords: Alzheimer’s disease; cognitive aging; dementia; diabetes mellitus; executive function; memory disorders.

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Figures

Fig. 1.
Fig. 1.
NOI thickness and cognitive composite scores. Within each NOI, linear regression between cortical thickness and cognitive composite scores are shown. Models which were significant based on uncorrected p-values are marked with a black box. (a) There is a significant relationship between cortical thickness in the limbic NOI and Global Cognition, (d) between cortical thickness in the limbic NOI and Memory Composite, and (i) between cortical thickness in the frontoparietal NOI and Executive Composite.
See this image and copyright information in PMC

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