Functional Connectivity, Physical Activity, and Behavioral Abnormality in Patients with Vascular Cognitive Impairment

Abstract

Purpose of the research: Neuropsychiatric Symptoms (NPSs) can negatively impact the survival and quality of life in Vascular Cognitive Impairment (VCI) patients. Physical Activity (PA) has been shown to reduce NPSs in dementia patients, possibly by influencing synaptic plasticity. This study investigates the relationship between NPSs, Default Mode Network (DMN), and PA in patients with VCI. Methods: The study included 42 VCI patients. Functional Connectivity (FC) within the DMN and neurobehavioral performance was assessed. NPSs were categorized. The severity of Hyperactivity and Behavioral Symptoms (HBS) was quantified using a Hyperactivity and Behavioral Composite Score (HBCS). Patients’ PA levels were measured using Fitbit Charge 2. Principal results: After accounting for disease severity, increased FC between the left Posterior Cingulate Cortex (PCC) seed and the right inferior parietal gyrus was linked to more severe HBS. There was an inverse correlation between HBCS and average step counts per day (steps/d) as well as average distance per day (km/d). This suggests that higher levels of PA were associated with less severe HBS. HBCS was also inversely correlated with steps/d and km/d, reinforcing the idea that increased PA was linked to reduced symptom severity. Major conclusions: The study concludes that increased FC within the DMN is associated with more severe HBS in VCI patients. Greater levels of PA (measured by step counts and distance) were associated with a reduction in the severity of HBS. This suggests that FC within the DMN may play a role in the modulation of HBS by PA in VCI patients.