Heart failure decouples the precuneus in association with social cognition and executive functions
Poster No:
285
Submission Type:
Abstract Submission
Authors:
Matthias Schroeter1,2, Janis Godulla3, Friederike Thiel3, Birol Taskin3, Frank Beutner4, Andrej Teren4, Julia Camilleri5, Simon Eickhoff6, Arno Villringer3, Karsten Mueller7
Institutions:
1Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Saxony, 2Cognitive Neurology Clinic, University Hospital Leipzig, Leipzig, Germany, 3Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, , 4Heart Center Leipzig, Leipzig, , 5Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany, Duesseldorf, Germany, 6Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, North Rhine–Westphalia Land, 7Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Sachsen
First Author:
Matthias Schroeter, MD, PhD
Max Planck Institute for Human Cognitive and Brain Sciences|Cognitive Neurology Clinic, University Hospital Leipzig
Leipzig, Saxony|Leipzig, Germany
Max Planck Institute for Human Cognitive and Brain Sciences|Cognitive Neurology Clinic, University Hospital Leipzig
Leipzig, Saxony|Leipzig, Germany
Co-Author(s):
Julia Camilleri
Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
Duesseldorf, Germany
Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
Duesseldorf, Germany
Simon Eickhoff
Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf
Düsseldorf, North Rhine–Westphalia Land
Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf
Düsseldorf, North Rhine–Westphalia Land
Introduction:
Aging increases the risk to develop Alzheimer's disease. Cardiovascular diseases might accelerate this process. Our study (Schroeter et al. 2023) aimed at investigating the impact of heart failure on brain connectivity using functional magnetic resonance imaging at resting state.
Methods:
Brain connectivity alterations were investigated with functional magnetic resonance imaging during rest and related to heart failure and cognitive performance. Furthermore, meta-analytical data-mining approaches were conducted in the BrainMap and Neurosynth databases to extract cognitive functions associated with decoupled networks. Finally, a long-term follow-up investigation in our cohort after approximately nine years validated impairments in the long run.
Results:
Here we show brain connectivity alterations related to heart failure and cognitive performance. Heart failure decreases brain connectivity in the precuneus. Precuneus disconnectivity was associated with biomarkers of heart failure, i.e., left ventricular ejection fraction and N-terminal prohormone of brain natriuretic peptide, and cognitive performance, predominantly executive function. Meta-analytical data-mining approaches as conducted in the BrainMap and Neurosynth databases revealed that social and executive cognitive functions are mainly associated with those neural networks. Remarkably, the precuneus, as identified in our study in a mid-life cohort, represents one central functional hub affected by Alzheimer's disease (Schroeter et al. 2009). A long-term follow-up investigation in our cohort after approximately nine years revealed more severe cognitive impairment in the group with heart failure than controls, where social cognition was the cognitive domain mainly affected, and not memory such as in Alzheimer's disease.
Figure: Heart failure (HF) decreases brain connectivity in association with biomarker changes and cognitive decline. (A) Connectivity is decreased in heart failure (HF) in the precuneus using global correlation (GCOR) as a centrality measure (red color). Results were obtained using a two-sample t-test between patients with and without HF. The precuneus was also obtained when predicting conversion from the risk-state mild cognitive impairment to Alzheimer's dementia (green color; Schroeter et al. 2009). The overlap between the connectivity finding and the meta-analysis is shown in blue color. (B) Across all patients, a significant correlation was obtained between GCOR and HF-related biomarkers, i.e., left ventricular ejection fraction (LVEF), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the precuneus. Lower LVEF and higher NT-proBNP, both indicating HF, were associated with decreased GCOR. (C) Using the precuneus in a seed-based correlation analysis, decreased precuneus connectivity was found with lower cognitive performance in HF. In particular, an interaction between the factors HF and cognitive performance was obtained showing a significant group difference (HF vs. no-HF) with respect to decreased precuneus connectivity associated with lower cognitive performance in HF (red color). All analyses (A, B, C) were performed using age, sex, and body mass index as nuisance covariates. Significant results in the voxel-wise analyses were obtained with nonparametric permutation analysis using 10,000 permutations and threshold-free cluster enhancement (TFCE) with family-wise error correction (p<0.05). x, y, z-coordinates of the Montreal Neurological Institute (MNI) stereotactic space. L left, R right.
Figure: Heart failure (HF) decreases brain connectivity in association with biomarker changes and cognitive decline. (A) Connectivity is decreased in heart failure (HF) in the precuneus using global correlation (GCOR) as a centrality measure (red color). Results were obtained using a two-sample t-test between patients with and without HF. The precuneus was also obtained when predicting conversion from the risk-state mild cognitive impairment to Alzheimer's dementia (green color; Schroeter et al. 2009). The overlap between the connectivity finding and the meta-analysis is shown in blue color. (B) Across all patients, a significant correlation was obtained between GCOR and HF-related biomarkers, i.e., left ventricular ejection fraction (LVEF), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the precuneus. Lower LVEF and higher NT-proBNP, both indicating HF, were associated with decreased GCOR. (C) Using the precuneus in a seed-based correlation analysis, decreased precuneus connectivity was found with lower cognitive performance in HF. In particular, an interaction between the factors HF and cognitive performance was obtained showing a significant group difference (HF vs. no-HF) with respect to decreased precuneus connectivity associated with lower cognitive performance in HF (red color). All analyses (A, B, C) were performed using age, sex, and body mass index as nuisance covariates. Significant results in the voxel-wise analyses were obtained with nonparametric permutation analysis using 10,000 permutations and threshold-free cluster enhancement (TFCE) with family-wise error correction (p<0.05). x, y, z-coordinates of the Montreal Neurological Institute (MNI) stereotactic space. L left, R right.
Conclusions:
In sum, our results indicate consistently an association between heart failure and decoupling of the precuneus from other brain regions being associated with social and executive functions. Results are consistent with other studies focusing on connectivity (Mueller et al. 2023) and structural alterations (Horstmann et al. 2010; Mueller et al. 2020) due to heart failure. Further longitudinal studies are warranted elucidating etiopathological mechanisms.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Emotion, Motivation and Social Neuroscience:
Social Cognition 2
Keywords:
Aging
Cognition
Degenerative Disease
DISORDERS
FUNCTIONAL MRI
Meta- Analysis
Other - heart failure
1|2Indicates the priority used for review
·Figure: Heart failure (HF) decreases brain connectivity in association with biomarker changes and cognitive decline.
Provide references using author date format
Horstmann A, Frisch S, Jentzsch RT, Müller K, Villringer A, Schroeter ML. Resuscitating the heart but losing the brain: brain atrophy in the aftermath of cardiac arrest. Neurology. 2010 Jan 26;74(4):306-12. doi: 10.1212/WNL.0b013e3181cbcd6f.
Mueller K, Thiel F, Beutner F, Teren A, Frisch S, Ballarini T, Möller HE, Ihle K, Thiery J, Schuler G, Villringer A, Schroeter ML. Brain Damage With Heart Failure: Cardiac Biomarker Alterations and Gray Matter Decline. Circ Res. 2020 Mar 13;126(6):750-764. doi: 10.1161/CIRCRESAHA.119.315813.
Mueller K, Thiel F, Taskin B, Beutner F, Teren A, Dubovoy VK, Möller HE, Villringer A, Schroeter ML. Brain dysconnectivity with heart failure. Brain Commun. 2023 Mar 30;5(2):fcad103. doi: 10.1093/braincomms/fcad103.
Schroeter ML, Stein T, Maslowski N, Neumann J. Neural correlates of Alzheimer's disease and mild cognitive impairment: a systematic and quantitative meta-analysis involving 1351 patients. Neuroimage. 2009 Oct 1;47(4):1196-206. doi: 10.1016/j.neuroimage.2009.05.037.
Schroeter ML, Godulla J, Thiel F, Taskin B, Beutner F, Dubovoy VK, Teren A, Camilleri J, Eickhoff S, Villringer A, Mueller K. Heart failure decouples the precuneus in interaction with social cognition and executive functions. Sci Rep. 2023 Jan 23;13(1):1236. doi: 10.1038/s41598-023-28338-0.