Abstract

AbstractBackgroundSeveral neural mechanisms underlying brain resilience to Alzheimer’s disease (AD) have been proposed, including redundant neural connections between the posterior hippocampi and all other brain regions (pHipp‐redundancy), and global functional connectivity of the left frontal cortex (gLFC). It remains unclear whether these two mechanisms confer resilience to AD pathologies through similar or distinctive mechanisms. We examined if redundancy, measured through graph theory, underlies the neuroprotective effects of both pHipp‐redundancy and gLFC connectivity in the early stage of AD pathologies.MethodFrom the ADNI database, 370 CN and MCI participants were utilized. Aβ‐positivity (Aβ+) was defined as PET AV45 SUVR normalized to cerebellum greater than 1.11. Resting state data were preprocessed using fMRIprep (v20.2.6). Network graphs were constructed with 263 functional ROIs as nodes and z‐transformed correlations between each node as edges. Redundancy was calculated by summing the direct and indirect paths (path lengths=1‐4) between each hippocampal region (i.e., anterior and posterior hippocampal regions, bilaterally and LFC) and its 262 connections. Group differences (Aβ‐status, diagnosis) were computed in R using non‐parametric ANCOVA models with 10,000 permutations. Regression analyses were conducted to examine if Aβ‐status and diagnosis moderated the relationship between SUVR and redundancy. Models covaried for age, sex, education, and APOE4.ResultAcross CN and MCI, Aβ‐ had higher bilateral pHipp‐redundancy than Aβ+ (p’s<.034). Diagnosis significantly moderated the relationship between SUVR and left pHipp‐redundancy (β=0.112, p=.042). CN exhibited a stronger negative relationship between SUVR and left pHipp‐redundancy than MCI (p<.001). Finally, in CN, Aβ‐status significantly moderated the relationship between SUVR and right aHipp‐redundancy (β=0.358, p=.012), showing that in Aβ‐ CN, redundancy decreased with higher SUVR (p=.01), while in Aβ+ CN, redundancy remained the same as SUVRs increased. No relationships between Aβ‐status and redundancy, and interactions between SUVR and Aβ‐status or diagnosis, were significant in LFC.ConclusionTogether, these findings suggest that bilateral pHipp‐redundancy may reflect normal brain aging without Aβ, rather than resilience in pathological aging, and a distinctive mechanism of brain aging from that of gLFC connectivity in the progression of AD.

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