Resting-state FMRI analysis in apathetic alzheimer's disease

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Büyükgök D., BAYRAKTAROĞLU Z., Seda Buker H., Işın Baral Kulaksızoğlu M., Hakan Gurvit İ.

Diagnostic and Interventional Radiology, vol.26, no.4, pp.363-369, 2020 (SCI-Expanded) identifier identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 4
  • Publication Date: 2020
  • Doi Number: 10.5152/dir.2019.19445
  • Journal Name: Diagnostic and Interventional Radiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.363-369
  • Istanbul Medipol University Affiliated: Yes


PURPOSE Diagnosis of comorbid psychiatric conditions are a significant determinant for the prognosis of neurodegenerative diseases. Apathy, which is a behavioral executive dysfunction, frequently accompanies Alzheimer's disease (AD) and leads to higher daily functional loss. We assume that frontal lobe hypofunction in apathetic AD patients are more apparent than the AD patients without apathy. This study aims to address the neuroanatomical correlates of apathy in the early stage of AD using task-free functional magnetic resonance imaging (MRI). METHODS Patients (n=20) were recruited from the Neurology and Psychiatry Departments of İstanbul University, İstanbul School of Medicine whose first referrals were 6-to 12-month history of progressive cognitive decline. Patients with clinical dementia rating 0.5 and 1 were included in the study. The patient group was divided into two subgroups as apathetic and non-apathetic AD according to their psychiatric examination and assessment scores. A healthy control group was also included (n=10). All subjects underwent structural and functional MRI. The resting-state condition was recorded eyes open for 5 minutes. RESULTS The difference between the three groups came up in the pregenual anterior cingulate cortex (pgACC) at the trend level (P = 0.056). Apathetic AD group showed the most constricted activation area at pgACC. CONCLUSION The region in and around anterior default mode network (pgACC) seems to mediate motivation to initiate behavior, and this function appears to weaken as the apathy becomes more severe in AD.