Purpose To determine whether individuals with subjective cognitive decline (SCD) exhibit functional and structural brain alterations by using resting-state functional and structural magnetic resonance (MR) imaging. Materials and Methods This study received institutional review board approval, and all participants gave informed consent. Resting-state functional MR imaging and structural MR imaging techniques were used to measure amplitude of low-frequency fluctuations (ALFF) and regional gray matter volume in 25 subjects with SCD (mean age, 65.52 years ± 6.12) and 61 control subjects (mean age, 64.11 years ± 8.59). Voxel-wise general linear model analyses were used to examine between-group differences in ALFF or in gray matter volume and to further determine the brain-behavioral relationship. Results Subjects with SCD exhibited higher ALFF values than did control subjects in the bilateral inferior parietal lobule (left: 0.44 ± 0.25 vs 0.27 ± 0.18, respectively; P = .0003; right: 1.46 ± 0.45 vs 1.10 ± 0.37, respectively; P = .0015), right inferior (0.45 ± 0.15 vs 0.37 ± 0.08, repectively; P = .0106) and middle (1.03 ± 0.32 vs 0.83 ± 0.20, respectively; P = .0008) occipital gyrus, right superior temporal gyrus (0.11 ± 0.07 vs 0.07 ± 0.04, respectively; P = .0016), and right cerebellum posterior lobe (0.51 ± 0.27 vs 0.39 ± 0.15, respectively; P = .0010). In the SCD group, significant correlations were found between Auditory Verbal Learning Test recognition scores and ALFF in the left inferior parietal lobe (r = -0.79, P < .001) and between Auditory Verbal Learning Test immediate recall scores and ALFF values in the right middle occipital gyrus (r = -0.64, P = .002). Nonsignificant group differences were found in gray matter volume (P > .05, corrected). Conclusion Individuals with SCD had altered spontaneous functional activity, suggesting that resting-state functional MR imaging may be a noninvasive method for characterizing SCD. (©) RSNA, 2016 Online supplemental material is available for this article.

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Individuals diagnosed with mild cognitive impairment (MCI) are at high risk of transition to Alzheimer's disease (AD). However, little is known about functional characteristics of the conversion from MCI to AD. Resting-state functional magnetic resonance imaging was performed in 25 AD patients, 31 MCI patients, and 42 well-matched normal controls at baseline. Twenty-one of the 31 MCI patients converted to AD at approximately 24 months of follow-up. Functional connectivity strength (FCS) and seed-based functional connectivity analyses were used to assess the functional differences among the groups. Compared to controls, subjects with MCI and AD showed decreased FCS in the default-mode network and the occipital cortex. Importantly, the FCS of the left angular gyrus and middle occipital gyrus was significantly lower in MCI-converters as compared with MCI-nonconverters. Significantly decreased functional connectivity was found in MCI-converters compared to nonconverters between the left angular gyrus and bilateral inferior parietal lobules, dorsolateral prefrontal and lateral temporal cortices, and the left middle occipital gyrus and right middle occipital gyri. We demonstrated gradual but progressive functional changes during a median 2-year interval in patients converting from MCI to AD, which might serve as early indicators for the dysfunction and progression in the early stage of AD.

Background: Subjective cognitive decline (SCD) is the earliest symptomatic manifestation of preclinical Alzheimer’s disease (AD). Gut microbiota may serve as a susceptibility factor for AD. Altered gut microbiota has been reported in patients with mild cognitive impairment (MCI) and AD dementia. However, whether gut microbial compositions changed in SCD remains largely unknown. Objective: To characterize the gut microbiota in SCD. Methods: In this study, a total of 105 participants including 38 normal controls (NC), 53 individuals with SCD, and 14 patients with cognitive impairment (CI) were recruited. Gut microbiota of all participants isolated from fecal samples were investigated using 16S ribosomal RNA (rRNA) Illumina Miseq sequencing technique. The gut microbial compositions were compared among the three groups, and the association between altered gut microbiota and cognitive performance was analyzed. To validate the alteration of gut microbiota in SCD, we conducted amyloid positron emission tomography (PET) in selected participants and further compared the gut microbiota among subgroups. Results: The abundance of phylum Firmicutes, class Clostridia, order Clostridiales, family Ruminococcaceae, and genus Faecalibacterium showed a trend toward a progressive decline from NC to SCD and CI. Specifically, the abundance of the anti-inflammatory genus Faecalibacterium was significantly decreased in SCD compared with NC. In addition, altered bacterial taxa among the three groups were associated with cognitive performance. The findings were validated in SCD participants with positive amyloid evidence. Conclusion: The composition of gut microbiota is altered in individuals with SCD. This preliminary study will provide novel insights into the pathophysiological mechanism of AD.

Network analysis has been widely used in studying Alzheimer's disease (AD). However, how the white matter network changes in cognitive impaired patients with subjective cognitive decline (SCD) (a symptom emerging during early stage of AD) and amnestic mild cognitive impairment (aMCI) (a pre-dementia stage of AD) is still unclear. Here, structural networks were constructed respectively based on FA and FN for 36 normal controls, 21 SCD patients, and 33 aMCI patients by diffusion tensor imaging and graph theory. Significantly lower efficiency was found in aMCI patients than normal controls (NC). Though not significant, the values in those with SCD were intermediate between aMCI and NC. In addition, our results showed significantly altered betweenness centrality located in right precuneus, calcarine, putamen, and left anterior cingulate in aMCI patients. Furthermore, association was found between network metrics and cognitive impairment. Our study suggests that the structural network properties might be preserved in SCD stage and disrupted in aMCI stage, which may provide novel insights into pathological mechanisms of AD.