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. 2025 Jan 2;15(1):363.
doi: 10.1038/s41598-024-82769-x.

Resting-state functional magnetic resonance imaging study on cerebrovascular reactivity changes in the precuneus of Alzheimer's disease and mild cognitive impairment patients

Xue Tang #  1 , Luoyu Wang #  2   3 , Qi Feng  3 , Hanjun Hu  3   4 , Yidi Zhu  1 , Zhengluan Liao  5 , Zhongxiang Ding  6 , Xiufang Xu  7
Affiliations

Resting-state functional magnetic resonance imaging study on cerebrovascular reactivity changes in the precuneus of Alzheimer's disease and mild cognitive impairment patients

Xue Tang et al. Sci Rep. .

Abstract

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by memory impairment and cognitive decline, ultimately culminating in dementia. This study aims to evaluate cerebrovascular reactivity (CVR) and functional connectivity (FC) in patients with AD and mild cognitive impairment (MCI) using resting-state functional magnetic resonance imaging (rs-fMRI), bypassing the requirement for hypercapnia. The study cohort comprised 53 AD patients, 38 MCI patients, and 39 normal control (NC) subjects. CVR is derived by extracting signals within specific frequency bands of rs-fMRI. This study compares the differences in CVR and FC among the three groups, using the brain regions with CVR differences as region of interest (ROI) for FC analysis. The correlation between CVR and FC and cognitive scale score was discussed. Compared with NC subjects, AD patients exhibited a decrease in CVR in the PCUN.L, whereas MCI patients showed an increase in CVR in the PCUN.R. With PCUN.L as ROI, FC in PCUN.R decreased in AD patients, and FC in SFGmed.R and other brain regions increased in MCI patients compared with NC subjects. The results of the correlation analysis indicate that CVR in all patients, as well as FC with the PCUN.L as the ROI to the PCUN.R and SFGmed.R, show positive correlations with MMSE and MoCA scores. These results suggest that there are significant differences between CVR and FC with CVR differential brain regions as ROI among the AD, MCI, and NC groups, which may help to explain the hemodynamic mechanism. CVR obtained with rs-fMRI may be a potential biomarker for assessing cognitive impairment.

Keywords: Alzheimer’s disease; cerebrovascular reactivity; mild cognitive impairment; resting-state functional magnetic resonance imaging.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: All procedures performed in studies involving human participants were 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. Informed consent was obtained from all individual participants included in the study, and all experimental protocols were approved by the Ethics Committee of Zhejiang Provincial People’s Hospital (The People’s Hospital of Hangzhou Medical College) (No. 2012KY002).

Figures

Fig. 1
Fig. 1
CVR results among AD, MCI, and NC. Post hoc comparisons of analysis of covariance. The connection between two bars represents significant between-group differences (**denotes a significant level of P < 0.01, and ***indicates a significant level of P < 0.001, Bonferroni correction). (A) Right Precuneus. (B) Left Precuneus. CVR cerebrovascular reactivity, PCUN.R right precuneus, PCUN.L left precuneus, NC normal controls, MCI mild cognitive impairment, AD Alzheimer’s disease.
Fig. 2
Fig. 2
PCUN.R-ROI FC results among AD, MCI, and NC. Post hoc comparisons of analysis of covariance. The connection between two bars represents significant between-group differences (** denotes a significant level of P < 0.01, and *** indicates a significant level of P < 0.001, Bonferroni correction). (A) Differences among the AD, MCI, and NC; (B) Post hoc comparisons between AD, MCI, and NC. PCUN.R right precuneus, ROI region of interest, FC functional connectivity, CC2.L left crus II of cerebellar hemisphere, DCG.R right middle cingulate and paracingulate gyri, ANG.L left angular gyrus, MFG.L left middle frontal gyrus, MFG.R right middle frontal gyrus, NC normal controls, MCI mild cognitive impairment, AD Alzheimer’s disease.
Fig. 3
Fig. 3
PCUN.L-ROI FC results among AD, MCI, and NC. Post hoc comparisons of analysis of covariance. The connection between two bars represents significant between-group differences (*denotes a significant level of P < 0.05, **denotes a significant level of P < 0.01, and ***indicates a significant level of P < 0.001, Bonferroni correction). (A) Differences among the AD, MCI, and NC; (B) Post hoc comparisons between AD, MCI, and NC. PCUN.L left precuneus, ROI region of interest, FC functional connectivity, Cere8.L left lobule VIII of cerebellar hemisphere, Cere6.R right lobule VI of cerebellar hemisphere, PCUN.R right precuneus, SFGmed.R right superior frontal gyrus, medial, NC normal controls, MCI mild cognitive impairment, AD Alzheimer’s disease.
Fig. 4
Fig. 4
Correlation between CVR values and MMSE/MoCA scales in patients with cognitive impairment (MCI + AD). (A) Positive correlation between CVR values of PCUN.R and MMSE scores; (B) Positive correlation between CVR values of PCUN.R and MoCA scores; (C) Positive correlation between CVR values of PCUN.L and MMSE scores; (D) Positive correlation between CVR values of PCUN.L and MoCA scores. MMSE mini-mental state examination, MoCA Montreal cognitive assessment, PCUN.R right precuneus, PCUN.L left precuneus, CVR cerebrovascular reactivity, MCI mild cognitive impairment, AD Alzheimer’s disease.
Fig. 5
Fig. 5
Correlation between PCUN.L-ROI FC values and MMSE/MoCA scales in patients with cognitive impairment (MCI + AD). (A) Positive correlation between PCUN.L-ROI FC values of PCUN.R and MMSE scores; (B) Positive correlation between PCUN.L-ROI FC values of PCUN.R and MoCA scores; (C) Positive correlation between PCUN.L-ROI FC values of SFGmed.R and MMSE scores; (D) Positive correlation between PCUN.L-ROI FC values of SFGmed.R and MoCA scores. MMSE mini-mental state examination, MoCA Montreal cognitive assessment, PCUN.R right precuneus, SFGmed.R right superior frontal gyrus, medial, PCUN.L left precuneus, ROI region of interest, FC functional connectivity, MCI mild cognitive impairment, AD Alzheimer’s disease.
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