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. 2024 Oct;18(5):1001-1009.
doi: 10.1007/s11682-024-00899-2. Epub 2024 May 24.

Increased anterior insula connectivity associated with cognitive maintenance in amnestic mild cognitive impairment: a longitudinal study

Hui Li  1 , Xiang Fan  2 , Kuncheng Li  3 , Chen Zhang  4 , Xiuqin Jia  5
Affiliations

Increased anterior insula connectivity associated with cognitive maintenance in amnestic mild cognitive impairment: a longitudinal study

Hui Li et al. Brain Imaging Behav. 2024 Oct.

Abstract

The insula, a crucial hub of the human brain network, can be divided into anterior and posterior regions. Previous studies have reported that different insula subregions play various roles in amnestic mild cognitive impairment (aMCI). However, the longitudinal changes in the functional connectivity (FC) of each insula subregion in aMCI patients over time remain unclear. Twenty aMCI patients and 20 healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging (fMRI) scans and neuropsychological assessments at baseline and at the 15-month follow-up. FMRI data were preprocessed using SPM 12 and the CONN toolbox. Two-way analysis of covariance was used to compare longitudinal changes in the FC of each insula subregion with covariates including sex, age, education, follow-up interval, volume of gray matter, and global correlation (GCOR). Pearson's correlation was used to evaluate the relationship between insula subregional FC and neuropsychological performance in aMCI patients. In aMCI patients, the right anterior insula exhibited significantly increased FC with the left anterior cingulate cortex, whereas the left posterior insula exhibited decreased FC with the right precuneus compared with HCs. Furthermore, FC between the right anterior insula and left anterior cingulate cortex was significantly correlated with global cognition at follow-up. The current findings revealed different functional alterations in the insula subregions and provided new insights into the neurodegenerative process in aMCI patients.

Keywords: Amnestic mild cognitive impairment; Insula subregions; Longitudinal study; Resting-state functional connectivity.

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Conflict of interest statement

Declarations. Ethical approval: All procedures in the studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The left and right insula subregions including the anterior insula (red) and posterior insula (green)
Fig. 2
Fig. 2
Longitudinal alterations in insula subregional FC in aMCI patients and HCs. (a) Increased FC between the right AIC and left ACC in aMCI patients compared to HCs at follow-up vs. baseline (interaction effect). (b) Decreased FC between the left PIC and right precuneus in aMCI patients compared to HCs at follow-up vs. baseline (interaction effect). FC, functional connectivity; ACC, anterior cingulate cortex; AIC, anterior insula cortex; PIC, posterior insula cortex
Fig. 3
Fig. 3
Linear correlation of FC between the right AIC and left ACC and MMSE scores in aMCI patients at follow-up. FC, functional connectivity; ACC, anterior cingulate cortex; AIC, anterior insula connectivity; MMSE, Mini-Mental State Examination
See this image and copyright information in PMC

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