Higher global efficiency in functional brain network could delay cognitive decline in amyloid‐positive individuals: The cognitive reserve theory

Abstract

AbstractBackgroundIt is known that cognitive reserve (CR) support resilience against the effects of brain pathology. However, it still remains to be elucidated what can be served as a proxy for the CR. In the current study we investigated whether particular functional brain features have protective effect for future cognitive decline. We also examined if the relationship is different according to amyloid‐beta (aß) positivity.MethodFunctional MRI data, clinical and neuropsychological data, and follow‐up information were downloaded from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. In the final analysis, 48 cognitively normal (CN) elderly and 46 elderly with mild cognitive impairment (MCI) were included. Cognitive decline was measured by mini mental status examination (MMSE) change score from baseline and the last follow‐up. Resting state function image data processing was carried out using FMRIB’s Software Library and Brain Connectivity Toolbox. Cox proportional hazards models were conducted to investigate the associations between several cognitive reserve proxies and future cognitive decline. In addition, the relationship was explored separately for aß positivityResultMean follow‐up month were 45.84 (50.33 for CN, 41.15 for MCI). Based on MMSE change score, 41 were identified as cognitively decliners. Among baseline functional brain network parameters (density, clustering coefficients, path length, and global efficiency) education, and American National Adult Reading Test (AMNART) error score, and 4 ADNI neuropsychological summary scores, global efficiency (HR=2.04, 95% CI 1.07‐3.91) and ADNI‐EF score (HR=0.41, 95% CI 0.26‐0.64) were significant in the Cox proportional hazard model (Figure1A). This association was observed only in aß positive group, whereas no significant association was found in aß negative group (Figure 1BC).ConclusionOur findings indicate that higher global efficiency in functional brain network and better executive function could delay cognitive decline, especially in aß positive group. Cognitive reserve is to preserve cognitive function better in the presence of brain pathology. Our study preliminary suggest that higher brain efficiency could play a key role in cognitive reserve in elders.