Functional Connectivity Of Posterior Cingulate Cortex Research Articles

Aberrant Functional Connectivity of the Posterior Cingulate Cortex in Type 2 Diabetes Without Cognitive Impairment and Microvascular Complications.

ObjectiveWe aimed to investigate the alterations of brain functional connectivity (FC) in type 2 diabetes mellitus (T2DM) patients without clinical evidence of cognitive impairment and microvascular complications (woCIMC-T2DM) using resting-state functional MRI (rs-fMRI) and to determine whether its value was correlated with clinical indicators.MethodsA total of 27 T2DM and 26 healthy controls (HCs) were prospectively examined. Cognitive impairment was excluded using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scales, and microvascular complications were excluded by fundus photography, microalbuminuria, and other indicators. The correlation maps, derived from rs-fMRI with posterior cingulate cortex (PCC) as the seed, were compared between T2DM patients and HCs. Pearson’s correlation analysis was performed to determine the relationship between the FC of PCC and the clinical indicators.ResultsCompared with HC, woCIMC-T2DM patients showed significantly decreased FCs with PCC (PCC-FCs) in the anterior cingulate cortex (ACC), right superior frontal gyrus, right medial frontal gyrus, and right angular gyrus. Meanwhile, increased PCC-FCs was observed in the right superior temporal gyrus and calcarine fissure (CAL). The FC of PCC-ACC was negatively correlated with glycosylated hemoglobin (HbA1c) and diabetes duration, and the FC of PCC-CAL was significantly positively correlated with HbA1c and diabetes duration.ConclusionThe FC, especially of the PCC with cognitive and visual brain regions, was altered before clinically measurable cognitive impairment and microvascular complications occurred in T2DM patients. In addition, the FC of the PCC with cognitive and visual brain regions was correlated with HbA1c and diabetes duration. This indicates that clinicians should pay attention not only to blood glucose control but also to brain function changes before the occurrence of adverse complications, which is of great significance for the prevention of cognitive dysfunction and visual impairment.

Altered functional connectivity of the posterior cingulate cortex in type 2 diabetes with cognitive impairment

The posterior cingulate cortex (PCC) has been suggested to be a cortical hub of the default mode network (DMN). Our goal in the current study was to determine whether there were alterations in the PCC's functional connectivity (FC) with whole brain regions in type 2 diabetes mellitus (T2DM) and to determine their relationships with cognitive dysfunction. In this study, the FC of the PCC was characterized by using resting-state functional MRI and a seed-based whole-brain correlation method in 24 T2DM patients and compared with 24 well-matched healthy controls. Spearman correlation analysis was performed to determine the relationships between the FC of the PCC and cognitive dysfunction. T2DM was associated with a significantly decreased FC of the PCC to widespread brain regions (p< 0.05, corrected for AlphaSim). We also found that the FC of the PCC in these brain regions was positively correlated with several neuropsychological test scores, such as the FC to the right angular gyrus (AnG) and the bilateral middle temporal gyrus (MTG) with the Auditory Verbal Learning Test (AVLT) and the FC to the bilateral inferior frontal gyrus (IFG) with the digit span test (DST). Moreover, the FCs of the PCC to the right superior parietal lobule (SPL), bilateral temporal lobes and left cerebrum were detected as negatively correlated with the Trail Making Test (TMT). No such correlations were detected in healthy controls. The present study provides useful information about the effect of the FC of the PCC on the underlying neuropathological process of T2DM-related cognitive dysfunction and may provide supporting evidence for further molecular biology studies.

Abnormal resting-state functional connectivity in posterior cingulate cortex of Parkinson's disease with mild cognitive impairment and dementia.

To investigate changes in the functional connectivity (FC) pattern in the posterior cingulate cortex (PCC) of Parkinson's disease (PD) patients with mild cognitive impairment and dementia by employing resting-state functional magnetic resonance imaging (RS-fMRI). Twenty-seven PD patients with different cognitive status and 9 healthy control subjects (control group) were enrolled for RS-fMRI. The RS-fMRI data were analyzed with DPARSF and REST software. Regions with changed functional connectivity were determined by the seed-based voxelwise method and compared between groups. Correlation between the intensity of FC and the MoCA scores of PD group was analyzed. Parametric maps showed statistical increases in PCC functional connectivity in PD-MCI patients and decreases in PCC connectivity in PDD patients. The latter group of patients also showed evidence for increased connectivity between prefrontal cortices and posterior cerebellum. A significant positive correlation was found between the MoCA scores and the strength of PCC connectivity in the angular gyrus and posterior cerebellum and a negative correlation between MoCA scores and PCC connectivity in all other brain regions. When patients transition from PD-NCI to PD-MCI, there appears to be an increase in functional connectivity in the PCC, suggesting an expansion of the cortical network. Another new network (a compensatory prefrontal cortical-cerebellar loop) later develops during the transition from PD-MCI to PDD.

Abnormal functional connectivity of the posterior cingulate cortex is associated with depressive symptoms in patients with Alzheimer's disease.

BackgroundDepressive symptoms are significant and very common psychiatric complications in patients with Alzheimer’s disease (AD), which can aggravate the decline in social function. However, changes in the functional connectivity (FC) of the brain in AD patients with depressive symptoms (D-AD) remain unclear.ObjectiveTo investigate whether any differences exist in the FC of the posterior cingulate cortex (PCC) between D-AD patients and non-depressed AD patients (nD-AD).Materials and methodsWe recruited 15 D-AD patients and 17 age-, sex-, educational level-, and Mini-Mental State Examination (MMSE)-matched nD-AD patients to undergo tests using the Neuropsychiatric Inventory, Hamilton Depression Rating Scale, and 3.0T resting-state functional magnetic resonance imaging. Bilateral PCC were selected as the regions of interest and between-group differences in the PCC FC network were assessed using Student’s t-test.ResultsCompared with the nD-AD group, D-AD patients showed increased PCC FC in the right amygdala, right parahippocampus, right superior temporal pole, right middle temporal lobe, right middle temporal pole, and right hippocampus (AlphaSim correction; P<0.05). In the nD-AD group, MMSE scores were positively correlated with PCC FC in the right superior temporal pole and right hippocampus (false discovery rate corrected; P<0.05).ConclusionDifferences were detected in PCC FC between nD-AD and D-AD patients, which may be related to depressive symptoms. Our study provides a significant enhancement to our understanding of the functional mechanisms underlying D-AD.

DIFFERENTIAL FUNCTIONAL CONNECTIVITY OF POSTERIOR CINGULATE CORTEX IN THE DECLINE OF COGNITIVE RESERVE BETWEEN AMNESTIC MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER’S DISEASE

Previous studies have shown that compensatory mechanisms work in the trajectory of Alzheimer's disease (AD). However, brain regions recruited for compensation have been reported to vary according to the trajectory of AD. A cognitive reserve is known as the main source of compensatory mechanisms. Therefore, in this study, we investigated the correlation between the decline of cognitive reserve and the functional connectivity of posterior cingulate cortex (PCC) in the trajectory of AD. A total of 28 subjects, including 11 amnestic mild cognitive impairment (aMCI) subjects and 17 mild AD subjects completed the fMRI. The decline of cognitive reserve is measured by subtracting the premorbid IQ from the current IQ and dividing the result by the premorbid IQ. PCC connectivity was investigated by examination of the correlation between low frequency fMRI signal fluctuation in the PCC and those in all other brain regions. In addition, partial correlation analysis was done between the decline of cognitive reserve and PCC connectivity adjusting for age, gender, category of APOE gene, premorbid IQ. We explored the association between the fALFF (fractional amplitude of low frequency fluctuation) in significantly connected regions and cognitive impairments. Amnestic MCI subjects showed significant positive and negative correlation between PCC functional connectivity and the decline of IQ. However, mild AD subjects showed only significant positive correlation between PCC functional connectivity and the decline of IQ. In addition, significant correlations were not observed between fALFF values of significantly connected regions and cognitive impairment in AD subjects but in aMCI subjects. These findings suggest a differential functional connectivity of posterior cingulate cortex between aMCI and mild AD subjects may contribute differential compensatory mechanisms in the decline of cognitive reserve. Brain regions showing significant correlation between PCC functional connectivity and the decline of IQ, (A) aMCI group; (B) mild AD group. Visual inspection reveals the differential correlation pattern between aMCI group and mild AD group. The maps are the results of correlation analysis with corrected p<0.001 and cluster size>(A) 31 voxels; (B) 75 voxels, respectively. Red and blue denotes positive and negative functional connectivity. The color bar indicated the z-values. For the details of the involved regions, see Table 1. PCC, Posterior cingulate cortex. Correlation between the fractional amplitude of low frequency fluctuation(fALFF) in significantly connected regions and cognitive impairments. (A) Regions of positive correlation in aMCI. fALFF values in regions of mild AD group showed no significant correlation with cognitive impairments. Significantly connected regions are listed in Table 1. Cognitive impairments were assessed by the Korean version of Consortium to Establish a Registry for Alzheimer's disease. VF, verbal fluency; MMSE, Mini Mental Status Examination CP, constructional praxis. Correlation between the fractional amplitude of low frequency fluctuation(fALFF) in significantly connected regions and cognitive impairments. (B) Regions of negative correlation in aMCI. fALFF values in regions of mild AD group showed no significant correlation with cognitive impairments. Significantly connected regions are listed in Table 1. Cognitive impairments were assessed by the Korean version of Consortium to Establish a Registry for Alzheimer's disease. MMSE, Mini Mental Status Examination; BNT, 15-item Boston Naming Test; WLM, Word List Memory.

Disentangling resting-state BOLD variability and PCC functional connectivity in 22q11.2 deletion syndrome

Although often ignored in fMRI studies, moment-to-moment variability of blood oxygenation level dependent (BOLD) signals reveals important information about brain function. Indeed, higher brain signal variability has been associated with better cognitive performance in young adults compared to children and elderly adults. Functional connectivity, a very common approach in resting-state fMRI analysis, is scaled for variance. Thus, alterations might be confounded or driven by BOLD signal variance alterations. Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a neurodevelopmental disorder that is associated with a vast cognitive and clinical phenotype. To date, several resting-state fMRI studies reported altered functional connectivity in 22q11.2DS, however BOLD signal variance has not yet been analyzed. Here, we employed PLS correlation analysis to reveal multivariate patterns of diagnosis-related alterations and age-relationship throughout the cortex of 50 patients between 9 and 25 years old and 50 healthy controls in the same age range. To address how functional connectivity in the default mode network is influenced by BOLD signal fluctuations, we conducted the same analysis on seed-to-voxel connectivity of the posterior cingulate cortex (PCC) and compared resulting brain patterns. BOLD signal variance was lower mainly in regions of the default mode network and in the dorsolateral prefrontal cortex, but higher in large parts of the temporal lobes. In those regions, BOLD signal variance was correlated with age in healthy controls, but not in patients, suggesting deviant developmental trajectories from child- to adulthood. Positive connectivity of the PCC within the default mode network as well as negative connectivity towards the frontoparietal network were weaker in patients with 22q11.2DS. We furthermore showed that lower functional connectivity of the PCC was not driven by higher BOLD signal variability. Our results confirm the strong implication of BOLD variance in aging and give an initial insight in its relationship with functional connectivity in the DMN.

Abnormal resting-state functional connectivity study in unilateral pulsatile tinnitus patients with single etiology: A seed-based functional connectivity study

ObjectivePrevious studies demonstrated altered regional neural activations in several brain areas in patients with pulsatile tinnitus (PT), especially indicating an important role of posterior cingulate cortex (PCC). However, few studies focused on the degree of functional connectivity (FC) of this area in PT patients. In this study, we will compare the FC of PCC in patients affected with this condition and normal controls by using resting-state functional magnetic resonance imaging (fMRI). MethodsStructural and functional MRI data were obtained from 36 unilateral PT patients with single etiology and 36 matched healthy controls. FC feature of the region of interest (PCC) were characterized using a seed-based correlation method with the voxels in the whole-brain. ResultsCompared with healthy controls, patients showed significant decreased FC to the right middle temporal gyrus (MTG), right thalamus and bilateral insula. By contrast, PCC demonstrated increased functional connectivity between the precuneus, bilateral inferior parietal lobule and middle occipital gyrus. We also found correlations between the disease duration of PT and FC of PCC-right MTG (r=−0.616, p<0.001). ConclusionsUnilateral PT patients could have abnormal FC to the PCC bilaterally in the brain. PCC, as a highly integrated brain area, is an example of nucleus that was involved in mediation between different neural networks. It might be a modulation core between visual network and auditory network. The decreased FC of MTG to PCC may indicate a down regulation of activity between PCC and auditory associated brain cortex. Decreased FC between limbic system (bilateral AI) and PCC may reflect the emotional message control in patient group. This study facilitated understanding of the underlying neuropathological process in patients with pulsatile tinnitus.

Alteration of functional connectivity in autism spectrum disorder: effect of age and anatomical distance

Autism spectrum disorder (ASD) is associated with disruption of local- and long-range functional connectivity (FC). The direction of those changes in FC (increase or decrease), however, is inconsistent across studies. Further, age-dependent changes of distance-specific FC in ASD remain unclear. In this study, we used resting-state functional magnetic resonance imaging data from sixty-four typical controls (TC) and sixty-four patients with ASD, whom we further classified into child (<11 years), adolescent (11–18 years) and adult cohorts (>18 years). Functional connectivity (FC) analysis was conducted at voxel level. We employed a three-way analysis of covariance on FC to conduct statistical analyses. Results revealed that patients with ASD had lower FC than TC in cerebellum, fusiform gyrus, inferior occipital gyrus and posterior inferior temporal gyrus. Significant diagnosis-by-distance interaction was observed in ASD patients with reduced short-range and long-range FC in posterior cingulate cortex and medial prefrontal cortex. Importantly, we found significant diagnosis-by-age-by-distance interaction in orbitofrontal cortex with short-range FC being lower in autistic children, but –to a less extent– higher in autistic adults. Our findings suggest a major role of connection length in development changes of FC in ASD. We hope our study will facilitate deeper understanding of the neural mechanisms underlying ASD.

Effect of rs1344706 in the ZNF804A gene on the connectivity between the hippocampal formation and posterior cingulate cortex

ZNF804A is one of the most promising candidate genes for schizophrenia. Previous fMRI studies have repeatedly shown an association between SNP rs1344706 in this gene and the functional connectivity from the right dorsolateral prefrontal cortex (rDLPFC) to the left hippocampal formation (lHF) during the N-back task. However, the rDLPFC–lHF functional connectivity included several subconnections and it is not known whether rs1344706 plays the same role in these subconnections. This study addressed that question using both fMRI and DTI data of 87 subjects. First, we replicated the association between rs1344706 and the rDLPFC–lHF functional connectivity using our fMRI data from the N-back task. Second, we reconstructed fiber connections between rDLPFC and lHF using our DTI data, which included three subconnections: from lHF to posterior cingulate cortex (PCC), from PCC to anterior cingulated cortex (ACC), and from ACC to rDLPFC. We found that only the lHF–PCC tract showed significantly lower fractional anisotropy (FA) in risk allele homozygotes. Finally, we analyzed the fMRI data (from the N-back task and the resting state). Both consistently showed relatively lower lHF–PCC functional connectivity in risk allele homozygotes. Taken together, the disconnectivity of the lHF–PCC tract seems to be a plausible intermediate phenotype that links rs1344706 and schizophrenia.

Alterations in dorsal and ventral posterior cingulate connectivity in APOE ε4 carriers at risk of Alzheimer's disease.

BackgroundRecent evidence suggests that exercise plays a role in cognition and that the posterior cingulate cortex (PCC) can be divided into dorsal and ventral subregions based on distinct connectivity patterns.AimsTo examine the effect of physical activity and division of the PCC on brain functional connectivity measures in subjective memory complainers (SMC) carrying the epsilon 4 allele of apolipoprotein E (APOE ε4) allele.MethodParticipants were 22 SMC carrying the APOE ε4 allele (ε4+; mean age 72.18 years) and 58 SMC non-carriers (ε4–; mean age 72.79 years). Connectivity of four dorsal and ventral seeds was examined. Relationships between PCC connectivity and physical activity measures were explored.Resultsε4+ individuals showed increased connectivity between the dorsal PCC and dorsolateral prefrontal cortex, and the ventral PCC and supplementary motor area (SMA). Greater levels of physical activity correlated with the magnitude of ventral PCC–SMA connectivity.ConclusionsThe results provide the first evidence that ε4+ individuals at increased risk of cognitive decline show distinct alterations in dorsal and ventral PCC functional connectivity.Declaration of interestD.A. has served on scientific advisory boards for Novartis, Eli Lilly, Janssen, Prana and Pfizer, and as Editor-in-Chief for International Psychogeriatrics; received speaker honoraria from Pfizer and Lundbeck, and research support from Eli Lilly, GlaxoSmithKline, Forest Laboratories, Novartis, and CSIRO. C.L.M. has received consulting fees from Eli Lilly and Prana Biotechnology, and has stock ownership in Prana Biotechnology. C.C.R. has received consultancy payments from Roche and Piramal, and research support from Avid Radiopharmaceuticals, Eli Lilly, GE Healthcare, Piramal and Navidea for amyloid imaging. C.S. has provided clinical consultancy and been on scientific advisory committees for the Australian CSIRO, Alzheimer's Australia, University of Melbourne and other relationships, which are subject to confidentiality clauses; she has been a named Chief Investigator on investigator-driven collaborative research projects in partnership with Pfizer, Merck, Piramal, Bayer and GE Healthcare. Her research programme has received support from the National Health and Medical Research Council Alzheimer's Association, Collier Trust, Scobie and Claire McKinnon Foundation, JO and JR Wicking Trust, Shepherd Foundation, Brain Foundation, Mason Foundation, Ramaciotti Foundation, Alzheimer's Australia and the Royal Australian College of Physicians.Copyright and usage© The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Decoupling of structural and functional brain connectivity in older adults with white matter hyperintensities

Age-related impairments in the default network (DN) have been related to disruptions in connecting white matter tracts. We hypothesized that the local correlation between DN structural and functional connectivity is negatively affected in the presence of global white matter injury. In 125 clinically normal older adults, we tested whether the relationship between structural connectivity (via diffusion imaging tractography) and functional connectivity (via resting-state functional MRI) of the posterior cingulate cortex (PCC) and medial prefrontal frontal cortex (MPFC) of the DN was altered in the presence of white matter hyperintensities (WMH). A significant correlation was observed between microstructural properties of the cingulum bundle and MPFC–PCC functional connectivity in individuals with low WMH load, but not with high WMH load. No correlation was observed between PCC–MPFC functional connectivity and microstructure of the inferior longitudinal fasciculus, a tract not passing through the PCC or MPFC. Decoupling of connectivity, measured as the absolute difference between structural and functional connectivity, in the high WMH group was related to poorer executive functioning and memory performance. These results suggest that such decoupling may reflect reorganization of functional networks in response to global white matter pathology and may provide an early marker of clinically relevant network alterations.

EPA-0082 - Age-related changes in the posterior cingulate cortex functional connectivity: a resting-state fmri study in adults free of neuropsychiatric disorders

Introduction Studies of normal aging have shown age-related decreases in functional connectivity (FC) within the default mode network (DMN), particularly involving the posterior cingulate cortex (PCC). Although psychiatric conditions are common and underdiagnosed, none of these studies have combined psychiatric structured interview and neuropsychological evaluation to select the sample. Objectives to characterize age-related changes in PCC-FC connectivity in adults carefully screened to rule out neuropsychiatric disorders. Methods neuropsychiatric disorders were excluded by the Structured Clinical Interview for DSM-IV and neuropsychological evaluation. Restingstate functional MRI was acquired from 40, young, middle-age and elderly participants. After preprocessing, whole-brain, seed-based FC was estimated using a PCC seed. The relationship between age and PCC-FC was assessed using partial least squares. Results age was positively associated with PCC-FC in the left dorsolateral prefrontal cortex, bilateral supplementary motor area, right insula and left cerebellum; PCC-FC in these regions was negative or close to zero in young adults. PCC-FC of the medial part of the ventral prefrontal cortex was negatively associated with age; this region presented high positive PCC-FC in young adults (see figure). Conclusions age-related increases in PCC-FC were found in regions which are anti-correlated with the DMN, suggesting a decrease in the magnitude of anti-correlation. This may reflect a dedifferentiation process or weaker inter-network interactions. The careful sample selection prevents confounds related to neuropsychiatric disorders. Download : Download full-size image

Altered patterns of functional connectivity of posterior cingulate cortex on resting-state magnetic resonance imaging in children with attention-deficit or hyperactivity disorder

To explore the pathophysiological changes in the functional connectivity of posterior cingulate cortex (PCC) with other brain regions in children with attention-deficit or hyperactivity disorder (ADHD) on resting-state functional magnetic resonance imaging(fMRI) and explore the neural mechanisms of ADHD at the point of relationships between brain regions. Thirty children with ADHD from the Third Affiliated Hospital of Soochow University from June 2008 to April 2010 and another 30 age-and-gender-matched controls from a normal primary school over the same period underwent resting-state fMRI scans. And blood oxygenation level dependent (BOLD) signal was acquired to calculate the functional connectivity of PCC with other brain regions controls. Significant differences of connectivity between groups were analyzed with REST software. The pattern of functional connectivity of PCC for the ADHD group was similar to that of the control group. Significant positive functional connectivity with PCC was observed in the default mode of network (DMN) while negative functional connectivity was present in dorsolateral prefrontal cortex, anterior cingulate, parietal cortex and basal ganglia(all P < 0.05, corrected). Compared to the controls, the ADHD group exhibited decreased positive connectivity with PCC in bilateral medial prefrontal cortex (0.07 ± 0.20 vs 0.33 ± 0.23, t = -5.47), right posterior cingulate gyrus(0.25 ± 0.28 vs 0.48 ± 0.30, t = -3.44), right inferior temporal gyrus (-0.05 ± 0.19 vs 0.22 ± 0.22, t = -4.61) and cerebellar posterior lobe (-0.04 ± 0.21 vs 0.17 ± 0.16, t = -3.99), while decreased negative functional connectivity with PCC was observed in left insula (-0.10 ± 0.26 vs -0.30 ± 0.19, t = 3.71), right inferior parietal lobule (0.02 ± 0.18 vs -0.23 ± 0.17, t = 5.20), left postcentral gyrus (0.08 ± 0.26 vs -0.17 ± 0.25, t = 4.06), left superior temporal gyrus (-0.04 ± 0.25 vs -0.27 ± 0.17, t = 4.27), right superior temporal gyrus (-0.08 ± 0.25 vs -0.31 ± 0.21, t = 3.80) and left fusiform gyrus (-0.01 ± 0.25 vs -0.18 ± 0.17, t = 3.57)(all P < 0.05, corrected). The connectivity of DMN between brain regions is abnormal in ADHD group. And the strengthen of negative relationship between DMN and task activated network becomes reduced. It is surmised that the decreased internal synchronization of default network and disrupted balance between DMN and prefrontal-parietal attentional networks may be important neural mechanisms of ADHD.

Functional alteration patterns of default mode networks: comparisons of normal aging, amnestic mild cognitive impairment and Alzheimer's disease

Most default mode network (DMN) studies in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) are based on the comparison of only two groups, namely patients and controls. Information derived from comparing three groups, normal, aMCI and AD, simultaneously may lead us to better understand the progression of dementia. The purpose of this study was to evaluate functional connectivity of DMN in the continuum from normal through aMCI to AD. Differences in functional connectivity were compared between the three groups using independent component analysis. The relationship between functional connectivity and disease progression was investigated using multiple regression analysis with Mini-Mental State Examination (MMSE) scores. The results revealed differences throughout the left posterior cingulate cortex (PCC), left middle temporal gyrus (MTG), right middle frontal gyrus (MFG) and bilateral parahippocampal gyrus (PHG). Both patients with aMCI and those with AD showed decreased connectivity in the left PCC and left PHG compared with healthy subjects. Furthermore, patients with AD also showed decreased connectivity in the left MTG and right PHG. Increased functional connectivity was observed in the right MFG of patients with AD compared with other groups. MMSE scores exhibited significant positive and negative correlations with functional connectivity in PCC, MTG and MFG regions. Taken together, increased functional connectivity in the MFG for AD patients might compensate for the loss of function in the PCC and MTG via compensatory mechanisms in corticocortical connections.

The baseline and longitudinal changes of PCC connectivity in mild cognitive impairment: a combined structure and resting-state fMRI study.

The baseline and longitudinal changes of the posterior cingulate cortex (PCC) connectivity were assessed in order to clarify the neural mechanism of mild cognitive impairment (MCI). Twenty-eight right-handed subjects (14 MCI patients and 14 healthy elders) participated in this study. Clinical and neuropsychological examinations were performed on all the subjects. PCC functional connectivity was studied by examining the correlation between low frequency fMRI signal fluctuations in the PCC and those in all the other brain regions. Additionally, we traced all the MCI patients and compared their PCC connectivity in the initial stage and that in 3 years later. We also explored the relationship between the PCC functional connectivity strength and cognitive performances. Our results are as follows: Functional connectivity between the PCC and a set of regions is decreased in MCI patients. Most of these regions are within the default mode network (DMN). Three years later, the regions of superior frontal gyrus (SFG) and middle frontal gyrus (MFG) presented further decreased connectivity to the PCC in MCI. In addition, we also find enhanced functional connectivity between PCC and medial prefrontal cortex (MPFC), PCC and anterior cingulate cortex (ACC) in MCI patients. At last, our research also shows that the PCC connectivity with some regions significantly correlates with the cognitive performances of patients as measured by mini-mental state examination (MMSE), and California verbal learning test (CVLT) scores. The baseline and longitudinal changes of the PCC connectivity in our study suggest that impairment and compensation coexist in the disease progress of MCI patients.

Resting Brain Connectivity: Changes during the Progress of Alzheimer Disease

To investigate alterations in functional connectivity in the resting brain networks in healthy elderly volunteers and patients with mild, moderate, or severe Alzheimer Disease (AD). This study was approved by the institutional ethics committee, and informed consent was obtained. Forty-six patients with AD and 16 healthy elderly volunteers were prospectively examined. Resting-state functional magnetic resonance imaging was used to detect alterations in posterior cingulate cortex (PCC) functional connectivity through a comparison of the healthy control group with three separate AD groups-mild, moderate, and severe AD. A temporal correlation method was used to obtain PCC connectivity maps. Dissociated functional connectivity between the PCC and a set of regions, including the visual cortices bilaterally, the inferior temporal cortex, the hippocampus, and especially the medial prefrontal cortex and the precuneus and/or cuneus, was observed in all AD groups. The disruption of connectivity intensified as the stage of AD progression increased. There were also regions that exhibited increased connectivity; these regions extended from left lateralized frontoparietal regions and spread to bilateral frontoparietal regions along with AD progression. Changes in PCC functional connectivity comprised bidirectional alterations in the resting networks in AD-affected brains, and the impaired resting functional connectivity seemed to change with AD progression. Therefore, alterations in functional connectivity in the default mode network might play a role in the progression of AD.

Detection of PCC functional connectivity characteristics in resting-state fMRI in mild Alzheimer’s disease

Resting-state networks dissociate in the early stage of Alzheimer’s disease (AD). The posterior cingulate cortex (PCC) in AD brain is vulnerable to isolation from the rest of brain. However, it remains unclear how this functional connectivity is related to PCC changes. We employed resting-state functional MRI (fMRI) to examine brain regions with a functional connection to PCC in a mild AD group compared with matched control subjects. PCC connectivity was gathered by investigating synchronic low frequency fMRI signal fluctuations with a temporal correlation method. We found asymmetric PCC-left hippocampus, right dorsal–lateral prefrontal cortex and right thalamus connectivity disruption. In addition, some other regions such as the bilateral visual cortex, the infero-temporal cortex, the posterior orbital frontal cortex, the ventral medial prefrontal cortex and the precuneus showed decreased functional connectivity to the PCC. There were also some regions, primarily in the left frontal–parietal cortices, that showed increased connectivity. These regions included the medial prefrontal cortex, bilateral dorsal–lateral prefrontal cortex, the left basal ganglia and the left primary motor cortex. Impairments to memory, high vision-related functions and olfaction in AD can be explained by a disruption to the functional connection of resting-state networks. The results of increased connectivity may support the compensatory-recruitment hypothesis. Our findings suggest that the characteristics of resting-state functional connectivity could plausibly provide an early imaging biomarker for AD.

OPERATIVE TREATMENT FOR HAEMORRHOIDS

Functional imaging studies have shown that certain brain regions, including posterior cingulate cortex (PCC) and ventral anterior cingulate cortex (vACC), consistently show greater activity during resting states than during cognitive tasks. This finding led to the hypothesis that these regions constitute a network supporting a default mode of brain function. In this study, we investigate three questions pertaining to this hypothesis: Does such a resting-state network exist in the human brain? Is it modulated during simple sensory processing? How is it modulated during cognitive processing? To address these questions, we defined PCC and vACC regions that showed decreased activity during a cognitive (working memory) task, then examined their functional connectivity during rest. PCC was strongly coupled with vACC and several other brain regions implicated in the default mode network. Next, we examined the functional connectivity of PCC and vACC during a visual processing task and show that the resultant connectivity maps are virtually identical to those obtained during rest. Last, we defined three lateral prefrontal regions showing increased activity during the cognitive task and examined their resting-state connectivity. We report significant inverse correlations among all three lateral prefrontal regions and PCC, suggesting a mechanism for attenuation of default mode network activity during cognitive processing. This study constitutes, to our knowledge, the first resting-state connectivity analysis of the default mode and provides the most compelling evidence to date for the existence of a cohesive default mode network. Our findings also provide insight into how this network is modulated by task demands and what functions it might subserve.