Abstract

The impairment of large-scale brain networks has been observed in dementia with Lewy bodies (DLB) using functional connectivity, but the potential for an analogous effect on structural covariance patterns has not been determined. Twenty-four probable DLB subjects (mean age 74.3 ± 6.7 years, 16.7% female) and 23 similarly aged Controls were included. All participants underwent 3T MRI imaging with high-resolution T1-weighted magnetization-prepared rapid gradient echo (MPRAGE) sequence. Graph theoretical analyses were performed using variation in regional cortical thickness to construct a structural association matrix with pairwise Pearson correlations. Global and nodal graph parameters were computed to assess between-group differences and community structure was studied in order to quantify large-scale brain networks in both groups. In comparison to Controls, DLB subjects had decreased global efficiency, clustering, modularity and small-worldness of structural networks (all p < 0.05). Nodal measures showed that DLB subjects also had decreased clustering in bilateral temporal regions and decreased closeness centrality in extensive areas including right middle frontal, left cingulate and bilateral occipital lobe (all false-discovery rate (FDR)-corrected q < 0.05). Whereas four distinct modules could be clearly identified in Controls, DLB showed extensively disorganized modules, including default-mode network and dorsal attentional network. Our results suggest a marked impairment in large-scale brain structural networks in DLB, mirroring functional connectivity networks disruption.

Highlights

  • Dementia with Lewy bodies (DLB) is the second-leading degenerative dementia in older people after Alzheimer’s disease (AD), accounting for 10–15% of cases (Jellinger and Attems 2011; Arnaoutoglou et al 2019)

  • DLB clinical core features were collected: parkinsonism was assessed with Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III (Goetz et al 2008), cognitive fluctuations with the Clinician Assessment of Fluctuation (CAF) scale (Walker et al 2000), while the presence of visual hallucinations and RBD was assessed with history taking

  • mini-mental state evaluation (MMSE) and ACER scores were significantly lower in the DLB group (p < 0.001, Mann-Whitney U test) (Table 1)

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Summary

Introduction

Dementia with Lewy bodies (DLB) is the second-leading degenerative dementia in older people after Alzheimer’s disease (AD), accounting for 10–15% of cases (Jellinger and Attems 2011; Arnaoutoglou et al 2019). Increased, reduced or even preserved default-mode network (DMN) connectivity has been described in DLB (Galvin et al 2011; Lowther et al 2014; Schumacher et al 2018). Reports on other large-scale networks are heterogeneous, with impaired connectivity being described for salience, executive (Lowther et al 2014), attentional

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