Abstract 19: Default Mode Network Alterations in Cerebral Amyloid Angiopathy: A Resting State FMRI Study

Abstract

Introduction: Cerebral amyloid angiopathy (CAA) is an established cause of intracerebral hemorrhage and vascular dysfunction leading to ischemia. Functional connectivity analysis using MRI is becoming an important tool to analyze the brain activity during resting state, the default mode network (DMN) representing the prototypical set of connections. As CAA pathology has a posterior predominance, we sought to characterize the functional connectivity of the posterior DMN at resting state in patients with CAA. Methods: Patients with probable CAA diagnosed using Boston Criteria and healthy controls (HC) were prospectively enrolled and received high resolution 3T MRI scans including dedicated resting-state fMRI sequences. Functional seed-to-seed analyses were done using the default processing pipeline in the CONN Toolbox. Correlation maps between the established DMN and specific regions of the posterior DMN, the precuneus and posterior cingulate, were averaged within groups and compared in an ANCOVA model. Results: Study participants consisted of 60 patients with probable CAA and 20 healthy controls [aged 69 ± 7.5 vs 72.3 ± 8 years, P = 0.108]. Seed-to-seed analysis revealed a significantly lower strength of DMN connectivity in CAA when compared to controls in the precuneus [ P = 0.009] and posterior cingulate [ P = 0.003] adjusted for age and sex (Fig 1). Conclusion: Patients with CAA exhibited significant loss of connectivity in the posterior regions of the DMN when compared to controls. The precuneus and posterior cingulate are core regions of the DMN with reportedly high metabolic rates at rest. Disruption of these posterior DMN regions might occur due to vascular amyloid pathology that shows a predominantly posterior distribution.