Early affective changes and increased connectivity in preclinical Alzheimer's disease

• Published in: Alzheimer's & dementia : diagnosis, assessment & disease monitoring Vol. 10; no. 1; pp. 471 - 479
• Main Authors: Fredericks, Carolyn A., Sturm, Virginia E., Brown, Jesse A., Hua, Alice Y., Bilgel, Murat, Wong, Dean F., Resnick, Susan M., Seeley, William W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2018; John Wiley & Sons, Inc; Wiley Blackwell (John Wiley & Sons); Elsevier; Wiley
• Subjects: Aging; Alzheimer's disease; Amyloid-PET; Dementia; Emotions; Functional connectivity; Magnetic resonance imaging; Neuroimaging; Neuropsychiatric symptoms; Neuropsychology; Older people; Personality; Preclinical Alzheimer's disease; Standard deviation; United States > US; Pittsburgh Pennsylvania; Functional connectivity; Amyloid-PET; Alzheimer's disease; Preclinical Alzheimer's disease; Neuropsychiatric symptoms
• ISSN: 2352-8729; 2352-8729
• DOI: 10.1016/j.dadm.2018.06.002

Affective changes precede cognitive decline in mild Alzheimer's disease and may relate to increased connectivity in a “salience network” attuned to emotionally significant stimuli. The trajectory of affective changes in preclinical Alzheimer's disease, and its relationship to this network, is unknown. One hundred one cognitively normal older adults received longitudinal assessments of affective symptoms, then amyloid-PET. We hypothesized amyloid-positive individuals would show enhanced emotional reactivity associated with salience network connectivity. We tested whether increased global connectivity in key regions significantly related to affective changes. In participants later found to be amyloid positive, emotional reactivity increased with age, and interpersonal warmth declined in women. These individuals showed higher global connectivity within the right insula and superior temporal sulcus; higher superior temporal sulcus connectivity predicted increasing emotional reactivity and decreasing interpersonal warmth. Affective changes should be considered an early preclinical feature of Alzheimer's disease. These changes may relate to higher functional connectivity in regions critical for social-emotional processing.