Investigating the spontaneous brain activities of patients with subjective cognitive decline and mild cognitive impairment: an amplitude of low-frequency fluctuation functional magnetic resonance imaging study

Yaxin Gao; Shui Tian; Yao Tang; Xi Yang; Weiqiang Dou; Tong Wang; Ying Shen; Yin Tang; Ling Zhang; Hongyuan Ding; Qinqin Zhu; Jiahuan Li; Ming Qi; Yi Zhu

doi:10.21037/qims-23-808

Investigating the spontaneous brain activities of patients with subjective cognitive decline and mild cognitive impairment: an amplitude of low-frequency fluctuation functional magnetic resonance imaging study

Quant Imaging Med Surg. 2023 Dec 1;13(12):8557-8570. doi: 10.21037/qims-23-808. Epub 2023 Nov 7.

Authors

Yaxin Gao^#^{1

2}, Shui Tian^#³, Yao Tang⁴, Xi Yang⁵, Weiqiang Dou⁶, Tong Wang¹, Ying Shen¹, Yin Tang⁷, Ling Zhang³, Hongyuan Ding³, Qinqin Zhu³, Jiahuan Li⁵, Ming Qi³, Yi Zhu¹

Affiliations

¹ Rehabilitation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
² Rehabilitation Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.
³ Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁴ Rehabilitation Medicine Department, Jiangsu Province Geriatric Hospital, Nanjing, China.
⁵ School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China.
⁶ GE Healthcare, MR Research China, Beijing, China.
⁷ Department of Medical imaging, Jingjiang People's Hospital, Jingjiang, China.

^# Contributed equally.

Abstract

Background: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are neurodegenerative processing stages of Alzheimer's disease (AD). Cognitive decline is thought to manifest in intrinsic brain activity changes, but research results yielded conflicting and few studies have explored the roles of brain regions in cognitive decline, and sensitivity of the cognitive field to changes in the altered intrinsic brain activity.

Methods: In this cross-sectional study, 158 elderly participants were recruited from the memory clinic of the First Affiliated Hospital of Nanjing Medical University from July 2019 to May 2021, and grouped into SCD (n=73), MCI (n=46), and normal controls (NC) (n=39). The amplitude of low-frequency fluctuation (ALFF) was calculated and evaluated among the groups. Then canonical correlation analysis (CCA) was conducted to investigate the associations between imaging outcomes and cognitive behaviors.

Results: Neuropsychological tests in different cognitive dimensions and ALFF values of the prefrontal, parietal, and temporal gyrus, were significantly different (P<0.05) among the three groups, with no appreciable decline in daily activity. The changes in intrinsic activities were closely related to the decline in cognitive function (R=0.73, P=0.002). ALFF values in the left middle occipital gyrus, right middle frontal gyrus, left superior frontal gyrus, left angular gyrus, and superior temporal gyrus played significant roles in the analysis, while the Montreal Cognitive Assessment (MoCA) and Auditory-Verbal Learning Test scores were found to be more sensitive to changes in ALFF values.

Conclusions: Spontaneous brain activity is a stable imaging biomarker of cognitive impairment. ALFF changes of the prefrontal, occipital, left angular, and temporal gyrus were sensitive to identifying cognitive decline, and the scores of the Auditory-Verbal Learning Test and MoCA could predict the abnormal intrinsic activities.

Keywords: Alzheimer’s disease (AD); amplitude of low-frequency fluctuation (ALFF); functional magnetic resonance imaging (functional MRI); mild cognitive impairment (MCI); subjective cognitive decline (SCD).