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. 2021 Aug 27;11(9):1137.
doi: 10.3390/brainsci11091137.

Changes in Default Mode Network Connectivity in Resting-State fMRI in People with Mild Dementia Receiving Cognitive Stimulation Therapy

Tianyin Liu  1 , Aimee Spector  2 , Daniel C Mograbi  3   4 , Gary Cheung  5 , Gloria H Y Wong  1   6
Affiliations

Changes in Default Mode Network Connectivity in Resting-State fMRI in People with Mild Dementia Receiving Cognitive Stimulation Therapy

Tianyin Liu et al. Brain Sci. .

Abstract

Group cognitive stimulation therapy (CST) is a 7-week activity-based non-pharmacological intervention for people with mild to moderate dementia. Despite consistent evidence of clinical efficacy, the cognitive and brain mechanisms of CST remain unclear. Theoretically, group CST as a person-centred approach may work through promoting social interaction and personhood, executive function, and language use, especially in people with higher brain/cognitive reserve. To explore these putative mechanisms, structural MRI and resting-state functional MRI data were collected from 16 people with mild dementia before and after receiving CST, and in 13 dementia controls who received treatment as usual (TAU). Voxel-based morphometry (VBM) and resting-state functional connectivity (rs-FC) analyses were performed. Compared with TAU, the CST group maintained the total brain volume/total intracranial volume (TBV/TICV) ratio. Increased rs-FC in the default mode network (DMN) in the posterior cingulate cortex and bilateral parietal cortices nodes was observed in the CST over TAU groups between pre- and post-intervention timepoints. We provided preliminary evidence that CST maintains/enhances brain reserve both structurally and functionally. Considering the role of DMN in episodic memory retrieval and mental self-representation, preservation of personhood may be an important mechanism of CST for further investigation.

Keywords: Cognitive Stimulation Therapy (CST); DMN; cognitive reserve; dementia; resting-state fMRI.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Between conditions (follow-up vs. baseline) and between subjects (cognitive stimulation therapy (CST) vs. treatment as usual (TAU)) second-level contrast maps with significant results. Positive contrasts (follow-up > baseline and CST > TAU) are shown in red colors. (Note: only default mode network (DMN) showed significant positive contrasts).
Figure 2
Figure 2
Relationship between (a) standardised years of work and (b) standardised baseline TBV/TICV with standardised ADAS-Cog changes controlled for age and gender. Positive values signify improvement on ADAS-Cog.
See this image and copyright information in PMC

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