Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?

Background: Posterior cortical atrophy (PCA) is a clinical variant of Alzheimer's disease (AD) that presents with progressive visuospatial symptoms. While amnestic AD is characterized by disrupted default mode network (DMN) connectivity with corresponding increases in salience network (SN) conn...

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Main Authors: Carolyn A. Fredericks, Jesse A. Brown, Jersey Deng, Abigail Kramer, Rik Ossenkoppele, Katherine Rankin, Joel H. Kramer, Bruce L. Miller, Gil D. Rabinovici, William W. Seeley
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:NeuroImage: Clinical
Online Access:http://www.sciencedirect.com/science/article/pii/S2213158218303760
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author Carolyn A. Fredericks
Jesse A. Brown
Jersey Deng
Abigail Kramer
Rik Ossenkoppele
Katherine Rankin
Joel H. Kramer
Bruce L. Miller
Gil D. Rabinovici
William W. Seeley
author_facet Carolyn A. Fredericks
Jesse A. Brown
Jersey Deng
Abigail Kramer
Rik Ossenkoppele
Katherine Rankin
Joel H. Kramer
Bruce L. Miller
Gil D. Rabinovici
William W. Seeley
author_sort Carolyn A. Fredericks
collection DOAJ
description Background: Posterior cortical atrophy (PCA) is a clinical variant of Alzheimer's disease (AD) that presents with progressive visuospatial symptoms. While amnestic AD is characterized by disrupted default mode network (DMN) connectivity with corresponding increases in salience network (SN) connectivity, a visuospatial network appears to be disrupted early in PCA. Based on PCA patients' clinical features, we hypothesized that, in addition to early decreased integrity within the visuospatial network, patients with PCA would show increases in SN connectivity despite relative preservation of DMN. As the lateral pulvinar nucleus of the thalamus has direct anatomical connections with striate and extrastriate cortex and DMN, and the medial pulvinar is anatomically interconnected with SN, we further hypothesized that lateral and medial pulvinar nuclei might be implicated in intrinsic connectivity changes in PCA. Methods: 26 patients with PCA and 64 matched controls were recruited through UCSF Memory and Aging Center research programs. Each completed a standardized neuropsychological battery, structural MRI, and task-free fMRI. Seed-based functional correlations were used to probe networks of interest, including those seeded by the medial and lateral pulvinar thalamic nuclei, across the whole brain, and functional data analyses were adjusted for brain atrophy. Results: Patients with PCA showed disproportionate deficits in the visuospatial domain; they also showed preserved social sensitivity and endorsed more depressive symptoms than HCs. PCA patients had significant parietooccipital atrophy accompanied by widespread connectivity decreases within the visuospatial network, enhanced connectivity between some structures in SN, and enhanced connectivity between key nodes of the DMN compared to controls. Increased SN connectivity correlated with a measure of social sensitivity, and increased DMN connectivity correlated with short-term memory performance. Medial pulvinar connectivity increases in PCA were topographically similar to SN (anterior insula) connectivity increases, while lateral pulvinar connectivity increases were similar to DMN (posterior cingulate) connectivity increases. Conclusions: PCA is characterized by preserved to heightened connectivity in the SN and DMN despite decreased visuospatial network connectivity. The spatial similarity of medial and lateral pulvinar connectivity changes to those seen in the SN and DMN suggests a role for the pulvinar in intrinsic connectivity network changes in PCA. Keywords: Posterior cortical atrophy, Pulvinar, Alzheimer's disease, Functional connectivity, Default mode network, Salience network
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spelling doaj.art-1023d6612ecc4d7abf159575fb3937dc2022-12-21T19:12:07ZengElsevierNeuroImage: Clinical2213-15822019-01-0121Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?Carolyn A. Fredericks0Jesse A. Brown1Jersey Deng2Abigail Kramer3Rik Ossenkoppele4Katherine Rankin5Joel H. Kramer6Bruce L. Miller7Gil D. Rabinovici8William W. Seeley9Corresponding author.; Memory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USAMemory and Aging Center, University of California, 675 Nelson Rising Lane, San Francisco, CA 94143, USABackground: Posterior cortical atrophy (PCA) is a clinical variant of Alzheimer's disease (AD) that presents with progressive visuospatial symptoms. While amnestic AD is characterized by disrupted default mode network (DMN) connectivity with corresponding increases in salience network (SN) connectivity, a visuospatial network appears to be disrupted early in PCA. Based on PCA patients' clinical features, we hypothesized that, in addition to early decreased integrity within the visuospatial network, patients with PCA would show increases in SN connectivity despite relative preservation of DMN. As the lateral pulvinar nucleus of the thalamus has direct anatomical connections with striate and extrastriate cortex and DMN, and the medial pulvinar is anatomically interconnected with SN, we further hypothesized that lateral and medial pulvinar nuclei might be implicated in intrinsic connectivity changes in PCA. Methods: 26 patients with PCA and 64 matched controls were recruited through UCSF Memory and Aging Center research programs. Each completed a standardized neuropsychological battery, structural MRI, and task-free fMRI. Seed-based functional correlations were used to probe networks of interest, including those seeded by the medial and lateral pulvinar thalamic nuclei, across the whole brain, and functional data analyses were adjusted for brain atrophy. Results: Patients with PCA showed disproportionate deficits in the visuospatial domain; they also showed preserved social sensitivity and endorsed more depressive symptoms than HCs. PCA patients had significant parietooccipital atrophy accompanied by widespread connectivity decreases within the visuospatial network, enhanced connectivity between some structures in SN, and enhanced connectivity between key nodes of the DMN compared to controls. Increased SN connectivity correlated with a measure of social sensitivity, and increased DMN connectivity correlated with short-term memory performance. Medial pulvinar connectivity increases in PCA were topographically similar to SN (anterior insula) connectivity increases, while lateral pulvinar connectivity increases were similar to DMN (posterior cingulate) connectivity increases. Conclusions: PCA is characterized by preserved to heightened connectivity in the SN and DMN despite decreased visuospatial network connectivity. The spatial similarity of medial and lateral pulvinar connectivity changes to those seen in the SN and DMN suggests a role for the pulvinar in intrinsic connectivity network changes in PCA. Keywords: Posterior cortical atrophy, Pulvinar, Alzheimer's disease, Functional connectivity, Default mode network, Salience networkhttp://www.sciencedirect.com/science/article/pii/S2213158218303760
spellingShingle Carolyn A. Fredericks
Jesse A. Brown
Jersey Deng
Abigail Kramer
Rik Ossenkoppele
Katherine Rankin
Joel H. Kramer
Bruce L. Miller
Gil D. Rabinovici
William W. Seeley
Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
NeuroImage: Clinical
title Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
title_full Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
title_fullStr Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
title_full_unstemmed Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
title_short Intrinsic connectivity networks in posterior cortical atrophy: A role for the pulvinar?
title_sort intrinsic connectivity networks in posterior cortical atrophy a role for the pulvinar
url http://www.sciencedirect.com/science/article/pii/S2213158218303760
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