Abstract

Introduction: Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are the most common types of early-onset dementia. Early differentiation between both types of dementia may be challenging due to heterogeneity and overlap of symptoms. Here, we apply resting state functional magnetic resonance imaging (fMRI) to study functional brain connectivity differences between AD and bvFTD.Methods: We used resting state fMRI data of 31 AD patients, 25 bvFTD patients, and 29 controls from two centers specialized in dementia. We studied functional connectivity throughout the entire brain, applying two different analysis techniques, studying network-to-region and region-to-region connectivity. A general linear model approach was used to study group differences, while controlling for physiological noise, age, gender, study center, and regional gray matter volume.Results: Given gray matter differences, we observed decreased network-to-region connectivity in bvFTD between (a) lateral visual cortical network and lateral occipital and cuneal cortex, and (b) auditory system network and angular gyrus. In AD, we found decreased network-to-region connectivity between the dorsal visual stream network and lateral occipital and parietal opercular cortex. Region-to-region connectivity was decreased in bvFTD between superior temporal gyrus and cuneal, supracalcarine, intracalcarine cortex, and lingual gyrus.Conclusion: We showed that the pathophysiology of functional brain connectivity is different between AD and bvFTD. Our findings support the hypothesis that resting state fMRI shows disease-specific functional connectivity differences and is useful to elucidate the pathophysiology of AD and bvFTD. However, the group differences in functional connectivity are less abundant than has been shown in previous studies.

Highlights

  • Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia are the most common types of early-onset dementia

  • We studied functional connections throughout the brain in AD and behavioral variant frontotemporal dementia (bvFTD) and showed that functional connectivity is different between both types of dementia

  • The decreased cuneal connectivity found in bvFTD patients was found with the region-to-region connectivity analysis showing decreased connectivity between superior temporal gyrus and cuneal cortex, supracalcarine, intracalcarine cortex, and lingual gyrus. These findings support the hypothesis that resting state functional magnetic resonance imaging (fMRI) shows disease-specific functional connectivity differences and is useful to elucidate the pathophysiology of AD and bvFTD

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Summary

Introduction

Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are the most common types of early-onset dementia. Differentiation between both types of dementia may be challenging due to heterogeneity and overlap of symptoms. The most common types of early-onset dementia are Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) (Ratnavalli et al, 2002). Symptoms may vary considerably, with overlap of symptoms between AD and bvFTD, including memory disturbances (Irish et al, 2014), and behavioral abnormalities (Woodward et al, 2010) Due to this heterogeneity and overlap of symptoms, clinical differentiation between both types of dementia may be challenging, early in the disease. BvFTD pathology is most often found in the anterior cingulate cortex, frontoinsula, and frontal brain regions (Seeley et al, 2009; Krueger et al, 2010)

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