Connectivity related to major brain functions in Alzheimer disease progression: microstructural properties of the cingulum bundle and its subdivision using diffusion-weighted MRI.

Abstract

Background: The cingulum bundle is a brain white matter fasciculus associated with the cingulate gyrus. It connects areas from the temporal to the frontal lobe. It is composed of fibers with different terminations, lengths, and structural properties, related to specific brain functions. We aimed to automatically reconstruct this fasciculus in patients with Alzheimer disease (AD) and mild cognitive impairment (MCI) and to assess whether trajectories have different microstructural properties in relation to dementia progression.

Methods: Multi-shell high angular resolution diffusion imaging-HARDI image datasets from the "Alzheimer's Disease Neuroimaging Initiative"-ADNI repository of 10 AD, 18 MCI, and 21 cognitive normal (CN) subjects were used to reconstruct three subdivisions of the cingulum bundle, using a probabilistic approach, combined with measurements of diffusion tensor and neurite orientation dispersion and density imaging metrics in each subdivision.

Results: The subdivisions exhibit different pathways, terminations, and structural characteristics. We found differences in almost all the diffusivity metrics among the subdivisions (p < 0.001 for all the metrics) and between AD versus CN and MCI versus CN subjects for mean diffusivity (p = 0.007-0.038), radial diffusivity (p = 0.008-0.049) and neurite dispersion index (p = 0.005-0.049).

Conclusion: Results from tractography analysis of the subdivisions of the cingulum bundle showed an association in the role of groups of fibers with their functions and the variance of their properties in relation to dementia progression.

Relevance statement: The cingulum bundle is a complex tract with several pathways and terminations related to many cognitive functions. A probabilistic automatic approach is proposed to reconstruct its subdivisions, showing different microstructural properties and variations. A larger sample of patients is needed to confirm results and elucidate the role of diffusion parameters in characterizing alterations in brain function and progression to dementia.

Key points: The microstructure of the cingulum bundle is related to brain cognitive functions. A probabilistic automatic approach is proposed to reconstruct the subdivisions of the cingulum bundle by diffusion-weighted images. The subdivisions showed different microstructural properties and variations in relation to the progression of dementia.