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Neural correlates of attention-executive dysfunction in lewy body dementia and Alzheimer's disease.

Published version
Peer-reviewed

Repository DOI


Type

Article

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Authors

Firbank, Michael 
Kobeleva, Xenia 
Cherry, George 
Killen, Alison 
Gallagher, Peter 

Abstract

Attentional and executive dysfunction contribute to cognitive impairment in both Lewy body dementia and Alzheimer's disease. Using functional MRI, we examined the neural correlates of three components of attention (alerting, orienting, and executive/conflict function) in 23 patients with Alzheimer's disease, 32 patients with Lewy body dementia (19 with dementia with Lewy bodies and 13 with Parkinson's disease with dementia), and 23 healthy controls using a modified Attention Network Test. Although the functional MRI demonstrated a similar fronto-parieto-occipital network activation in all groups, Alzheimer's disease and Lewy body dementia patients had greater activation of this network for incongruent and more difficult trials, which were also accompanied by slower reaction times. There was no recruitment of additional brain regions or, conversely, regional deficits in brain activation. The default mode network, however, displayed diverging activity patterns in the dementia groups. The Alzheimer's disease group had limited task related deactivations of the default mode network, whereas patients with Lewy body dementia showed heightened deactivation to all trials, which might be an attempt to allocate neural resources to impaired attentional networks. We posit that, despite a common endpoint of attention-executive disturbances in both dementias, the pathophysiological basis of these is very different between these diseases.

Description

Keywords

Alzheimer's disease, Lewy body dementia, attention, attention network test, executive, functional MRI, Aged, Alzheimer Disease, Attention, Brain, Cholinesterase Inhibitors, Cues, Executive Function, Female, Humans, Lewy Body Disease, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Nootropic Agents, Photic Stimulation, Reaction Time, Visual Perception

Journal Title

Human Brain Mapping

Conference Name

Journal ISSN

1065-9471
1097-0193

Volume Title

37

Publisher

Wiley-Blackwell
Sponsorship
This work was supported by an Intermediate Clinical Fellowship . Grant Number: (WT088441MA) to John‐Paul Taylor the National Institute for Health Research (NIHR), and Newcastle Biomedical Research Unit (BRU) based at Newcastle upon Tyne Hospitals NHS Trust, Newcastle University.