Effects of Anosognosia on Static and Dynamic Amplitudes of Low-Frequency Fluctuation in Mild Cognitive Impairment.

Yanv Fu,Kaicheng Li,Minming Zhang,Xiaopei Xu,Yanxing Chen,Luwei Hong,Xiao Luo,Qingze Zeng,Zhirong Liu,Tianyi Zhang,Zheyu Li

doi:10.3389/fnagi.2021.705097

Abstract

Background: Anosognosia is a significant symptom in patients with mild cognitive impairment (MCI) while the underlying neurological mechanism behind it is still unclear.Methods: A total of 121 subjects were included and classified into three groups, including 39 normal controls (NCs), 42 individuals with MCI without anosognosia (MCI-NA), and 40 individuals with MCI with anosognosia (MCI-A), based on their everyday cognition (ECog) questionnaire (discrepancy score). Resting-state functional MRIs were acquired from all the subjects, and the static amplitudes of low-frequency fluctuation (sALFF) and dynamic ALFF (dALFF) variance were investigated to evaluate the intrinsic functional network strength and stability, respectively, and both were corrected by age, sex, education, and gray matter volume. Eventually, correlation analyses were conducted to explore the relationship between brain activity changes and cognitive status in all the subjects.Results: No significant difference was found between MCI-A and MCI-NA (P > 0.05) in cognitive ability. Regarding intrinsic brain activity, MCI-A had increased sALFF and dALFF variance in the anterior cingulate cortex (ACC) relative to MCI-NA, as well as decreased sALFF and dALFF variance in the precuneus relative to MCI-NA and controls. Moreover, MCI-A had decreased sALFF in the inferior temporal gyrus (ITG) and paracentral lobule (PCL) compared to MCI-NA. Among all the subjects, correlation analyses showed that the sALFF and dALFF variance in the precuneus was related to the Ecog discrepancy score (r = 0.232 and 0.235, respectively), immediate story recall (r = 0.200 and 0.277, respectively), and delayed story recall (r = 0.255 and 0.298, respectively).Conclusion: Alterations of intrinsic brain activation in the ACC and precuneus seem to be associated with the anosognosia symptom in patients with MCI.

Highlights

A high prevalence of anosognosia symptoms (24.2–71.0%) is reported in patients with Alzheimer’s disease (AD) (Mondragon et al, 2019), and the frequency of which is usually associated with the severity of dementia
Correlation analyses showed that the static amplitudes of low-frequency fluctuation (sALFF) and dynamic amplitudes of low-frequency fluctuation (ALFF) (dALFF) variance in the precuneus was related to the Ecog discrepancy score (r = 0.232 and 0.235, respectively), immediate story recall (r = 0.200 and 0.277, respectively), and delayed story recall (r = 0.255 and 0.298, respectively)
Correlation results showed that sALFF and dALFF variance of anterior cingulate cortex (ACC) are significantly related to immediate story recall (IST) (r = 0.355, p < 0.001; r = 0.408, p < 0.001) and delayed story recall (DST) scales (r = 0.322, p < 0.001; r = 0.352, p < 0.001)

Summary

Introduction

A high prevalence of anosognosia symptoms (24.2–71.0%) is reported in patients with Alzheimer’s disease (AD) (Mondragon et al, 2019), and the frequency of which is usually associated with the severity of dementia. At the prodromal AD stage, the patients with mild cognitive impairment (MCI) who have anosognosia symptoms are more likely to progress and eventually end up with dementia (Edmonds et al, 2014; Munro et al, 2018; Therriault et al, 2018). This suggests that anosognosia is an independent risk factor of the transition from MCI to AD (Gerretsen et al, 2017). Anosognosia is a significant symptom in patients with mild cognitive impairment (MCI) while the underlying neurological mechanism behind it is still unclear

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