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Table 4 Detailed brain changes correlates of neuropsychiatric symptoms in AD

From: Brain mechanisms underlying neuropsychiatric symptoms in Alzheimer’s disease: a systematic review of symptom-general and –specific lesion patterns

NPS items

Neuroimaging markers

Author, year

Subject (Number)

Diagnostic criteria

Scale

Structures associated

References no.

Apathy

Atrophy

Apostolova, 2007

AD (N = 35)

NINCDS-ADRDA

NPI

Bilateral anterior cingulate and left medial frontal cortex

[45]

Bruen, 2008

Mild AD (N = 31)

NINCDS-ADRDA

NPI

Anterior cingulate and frontal cortex bilaterally, the head of the left caudate nucleus and in bilateral putamen

[46]

Cortical thinning

Donovan, 2014

HC (N = 229), MCI (N = 395), AD (N = 188)

NINCDS-ADRDA

NPI

Inferior temporal region

[47]

Apostolova, 2007

AD (N = 35)

NINCDS-ADRDA

NPI

Left cingulate

[45]

Tunnard, 2011

AD (N = 111)

NINCDS-ADRDA and DSM- IV criteria

NPI

Left caudal anterior cingulate cortex and left lateral orbitofrontal cortex, as well as left superior and ventrolateral frontal regions

[48]

FA

Tighe, 2012

MCI (N = 22), mild AD (N = 23)

NINCDS-ADRDA, CDR

NPI

Anterior cingulum

[49]

Kim, 2011

Very mild or mild probable AD (N = 51)

NINCDS-ADRDA

NPI

Left anterior cingulum

[50]

Ota, 2012

AD (N = 21)

NINCDS-ADRDA

Apathy Scale

Right anterior cingulate, right thalamus, and bilateral parietal regions

[51]

Mori, 2014

Aβ-positive AD (N = 28)

NINCDS-ADRDA

NPI

Bilateral frontal and right anterior cingulate

[52]

Hypometabolism

Marshall, 2007

AD (N = 41)

NINCDS-ADRDA

NPI

Bilateral anterior cingulate region extending inferiorly to the medial orbitofrontal region and the bilateral medial thalamus

[53]

Holthoff, 2005

AD (N = 53)

NINCDS-ADRDA

NPI

Left orbitofrontal regions

[54]

Neurofibrillary tangle

Marshall, 2006

AD (N = 29)

CERAD

NPI

Anterior cingulate

[55]

Tekin, 2001

AD (N = 31)

CERAD

NPI

Left anterior cingulate

[56]

Depression

Atrophy

Son, 2013

AD (N = 49)

DSM IV-TR criteria

GDS

Left inferior temporal gyrus

[40]

Zahodne, 2013

MCI (N = 334)

Petersen criteria

NPI

Anterior cingulate cortex

[57]

Morra, 2009

AD (N = 100), MCI (N = 200), HC (N = 100)

NINCDS-ADRDA, CDR

GDS

Right hippocampal

[58]

Cortical thickness

Lebedev, 2014

Mild AD/LBD (N = 71)

NINCDS-ADRDA

MADRS

Prefrontal and temporal areas

[59]

Zahodne, 2013

MCI (N = 334)

Petersen criteria

NPI

Entorhinal cortex

[57]

Lebedeva, 2014

AD (N = 189)

NINCDS-ADRDA, DSM-IV/ICD-10

CSDD, GDS

Left parietal and temporal brain regions, including supramarginal, superior and inferior temporal and fusiform gyri, right posterior cingulate and precuneus

[60]

Gray matter hypodensities

Brommelhoff, 2011

AD (N = 192)

NINCDS-ADRDA

History of depression

Caudate nucleus and lentiform nucleus

[61]

White matter atrophy

Lee, 2012

MCI (N = 243)

Petersen

NPI

Frontal, parietal, and temporal

[62]

Chung, 2015

aMCI (N = 78)

Petersen

GDS/NPI

bilateral frontal cortex

[63]

Hypometabolism

Lee, 2017

MCI (N = 36)

Petersen

HRSD

Right superior frontal gyrus

[64]

Hirono, 1998

AD (N = 53)

DSM-IV, NINCDS-ADRDA

NPI

Bilateral superior frontal and left anterior cingulate cortices

[65]

Holthoff, 2005

AD (N = 53)

NINCDS-ADRDA

NPI

Dorsolateral prefrontal regions.

[54]

Anxiety

Atrophy

Poulin, 2011

Very mild and mild AD (N1 = 90; N2 = 174)

NINCDS-ADRDA

NPI

Amygdala

[66]

Mah, 2015

aMCI (N = 376)

Petersen

NPI

Entorhinal cortical

[67]

Tagai, 2014

Mild AD (N = 26)

NINCDS-ADRDA

Behave-AD

Right precuneus and inferior parietal lobule

[68]

Nour, 2020

AD (N = 35)

NINCDS-ADRDA

NPI

left parahippocampal, posterior cingulate gyrus, left insula and bilateral putamen

[69]

White matter hyperintensities

Berlow, 2010

AD (N = 37)

NINCDS-ADRDA

NPI

[70]

 

Bensamoun, 2016

HC (N = 230), MCI (N = 308), AD (N = 119)

NINCDS-ADRDA

NPI

All diagnostic groups: frontal, cingulate, and global cerebral; MCI subgroup: frontal and global cerebral

[71]

Hyperperfusion

Tagai, 2014

Mild AD (N = 26)

NINCDS-ADRDA

Behave-AD

Bilateral anterior cingulate cortices

[68]

Hashimoto, 2006

AD (N = 41)

NINCDS-ADRDA

NPI

Bilateral entorhinal cortex. Anterior parahippocampal gyrus, left anterior superior temporal gyrus and insula

[72]

Delusion

Atrophy

Serra, 2010

AD (N = 27), aMCI (N = 19), HC (N = 23)

NINCDS-ADRDA

NPI

Right hippocampus

[73]

Geroldi, 2002

Mild AD (N = 41)

Standardized clinical, neuropsychological, and instrumental evaluation

NPI

Left frontal and right temporal lobe

[74]

Geroldi, 2000

AD (N = 41)

Standardized clinical, neuropsychological, and instrumental evaluation

NPI

Right medial temporal lobe

[75]

Cortical thickness

Whitehead, 2012

AD (N = 113)

NINCDS-ADRDA, DSM-IV

NPI

Left medial orbitofrontal and left superior temporal region

[76]

FA

Nakaaki, 2013

AD (N = 25)

NINCDS-ADRDA

NPI

Left parieto-occipital region, body of the corpus callosum, superior temporal gyrus

[77]

WMH

Anor, 2017

AD/VaD (N = 180)

NIA-AA

NPI

Right frontal

[78]

White matter changes

Lee, 2006

AD (N = 55)

NINCDS-ADRDA

BRSD

Bilateral frontal, parieto-occipital and left basal gangli

[79]

Hypermetabolism

Mentis, 1995

AD (N = 24), HC (N = 17)

NINCDS-ADRDA

Sustained reduplicative delusions of misidentification

Sensory association cortices (superior temporal and inferior parietal)

[80]

Hirono, 1998

AD (N = 65)

NINCDS-ADRDA, DSM-IV

Behave-AD /NPI

Left inferior temporal gyrus

[81]

Hypometabolism

Mentis, 1995

AD (N = 24), HC (N = 17)

NINCDS-ADRDA

Sustained reduplicative delusions of misidentification

Paralimbic (orbitofrontal and cingulate areas bilaterally) and left medial temporal areas

[80]

Sultzer, 2003

AD (N = 25)

NINCDS-ADRDA, NIA-AA

Neurobehavioral Rating Scale

Prefrontal and anterior cingulate regions

[82]

Sultzer, 2014

AD (N = 88)

NINCDS-ADRDA, NIA-AA

NPI

Right lateral frontal cortex, orbitofrontal cortex, and bilateral temporal cortex

[34]

Hirono, 1998

AD (N = 65)

NINCDS-ADRDA, DSM-IV

Behave-AD /NPI

Left medial occipital region

[81]

Mega, 2000

AD (N = 20)

NINCDS-ADRDA

NPI

Right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex

[83]

Hallucination

Atrophy

Blanc, 2014

AD (N = 78)

NINCDS-ADRDA

NPI

Anterior part of the right insula, left superior frontal gyrus and lingual gyri

[84]

Holroyd, 2000

AD (N = 14)

NINCDS-ADRDA

Subjects/caregiver reported

Occipital lobe

[85]

Cortical thickness

Donovan, 2014

HC (N = 229), MCI (N = 395), AD (N = 188)

NINCDS-ADRDA

NPI

Supramarginal

[47]

White matter lesions

Lin, 2006

AD (N = 10)

NINCDS-ADRDA

Subjects/caregiver reported

Occipital lobe

[86]

Hypometabolism

Blanc, 2014

AD (N = 78)

NINCDS-ADRDA

NPI

Right ventral and dorsolateral prefrontal area

[84]

Hypoperfusion

Kotrla, 1995

AD (N = 46)

HRSD, DSM-III-R, Behave-AD

HRSD, DSM-III-R, Behave-AD

Parietal lobe

[87]

Hypoperfusion

Mega, 2000

AD (N = 20)

NINCDS-ADRDA

NPI

Right and left dorsolateral frontal, left anterior cingulate, and left ventral striatal regions along with the left pulvinar and dorsolateral parietal cortex

[83]

Atrophy

Bruen, 2008

Mild AD (N = 31)

NINCDS-ADRDA

NPI

Left insula, and in anterior cingulate cortex bilaterally

[46]

Trzepacz, 2013

AD/MCI (N = 462)

NINCDS-ADRDA

NPI

Frontal, insular, amygdala, cingulate, and hippocampal regions

[88]

Hsu, 2015

AD (N = 129), MCI (N = 31)

NIA-AA

NPI

Posterior cingulate and parieto-occipital sulcus and sulci of the parietal lobes and precuneus

[89]

FA

Tighe, 2012

MCI (N = 22), mild AD (N = 23)

NINCDS-ADRDA, CDR

NPI

Anterior cingulum

[49]

Increased functional connectivity

Balthazar, 2014

Mild to moderate AD (N = 20)

NINCDS-ADRDA

NPI

Anterior cingulate cortex and right insula areas

[90]

Neurofibrillary tangles

Tekin, 2001

AD (N = 31)

CERAD

NPI

Left orbitofrontal cortex and left anterior cingulate

[56]

Hypometabolism

Weissberger, 2017

AD (N = 88)

NINCDS-ADRDA, NIA-AA

NPI

Right temporal, middle, and superior gyri, Right calcarine cortex, Right lingual gyrus, Right fusiform gyrus, Right cuneus, Bilateral cingulate, middle, and posterior

[91]

Irritability

Atrophy

Poulin, 2011

Very mild and mild AD (N1 = 90; N2 = 174)

NINCDS-ADRDA

NPI

Amygdala

[66]

FA

Tighe, 2012

MCI (N = 22), mild AD (N = 23)

NINCDS-ADRDA, CDR

NPI

Anterior cingulum

[49]

Increased functional connectivity

Balthazar, 2014

Mild to moderate AD (N = 20)

NINCDS-ADRDA

NPI

Anterior cingulate cortex and right insula areas

[90]

Bensamoun, 2016

HC (N = 230), MCI (N = 308), AD (N = 119)

NINCDS-ADRDA

NPI

All diagnostic groups: frontal, cingulate, parietal and global cerebral; AD:parietal

[71]

Hypometabolism

Weissberger, 2017

AD (N = 88)

NINCDS-ADRDA, NIA-AA

NPI

Right temporal, middle, and superior gyri, Right insula, Right precentral and postcentral gyri, Right frontal, middle, and inferior

[91]

Aberrant Motor Behavior

Atrophy

Poulin, 2011

Very mild and mild AD (N1 = 90; N2 = 174)

NINCDS-ADRDA

NPI

Amygdala

[66]

Increased functional connectivity

Balthazar, 2014

Mild to moderate AD (N = 20)

NINCDS-ADRDA

NPI

Anterior cingulate cortex and right insula areas

[90]

Hypometabolism

Meguro, 1997

Moderately severe AD (N = 10)

NINCDS-ADRDA

Subjects/caregiver reported

Striatum and the frontal and temporal lobes

[92]

Hypermetabolism

Reilly, 2011

AD (N = 135)

DSM-IV

NPI

Orbitofrontal cortex

[93]

Neurofibrillary tangles

Tekin, 2001

AD (N = 31)

CERAD

NPI

Left orbitofrontal cortex

[56]

Euphoria

Increased functional connectivity

Balthazar, 2014

Mild to moderate AD (N = 20)

NINCDS-ADRDA

NPI

Anterior cingulate cortex and right insula areas

[90]

Disinhibition

Atrophy

Serra, 2010

AD (N = 27)

NINCDS-ADRDA

NPI

Bilateral cingulate and right middle frontal gyri

[73]

Increased functional connectivity

Balthazar, 2014

Mild to moderate AD (N = 20)

NINCDS-ADRDA

NPI

Anterior cingulate cortex and right insula areas

[90]

Sleep disturbance

FA

Tighe, 2012

MCI (N = 22), mild AD (N = 23)

NINCDS-ADRDA, CDR

NPI

Anterior cingulum

[49]

Hypometabolism

Liguori, 2017

AD (N = 18)

NIA-AA

Polysomnography

Hypothalamic

[94]

Hyperperfusion

Ismail, 2009

AD (N = 55)

NINCDS-ADRDA

NPI, CSDD

Right middle frontal gyrus

[95]

Appetite disturbance

Atrophy

Grundman, 1996

AD (N = 58), HC (N = 16)

NINCDS-ADRDA

Body mass index

Mesial temporal cortex

[96]

Hypometabolism

Hu, 2002

AD (N = 27)

NINCDS-ADRDA

Body mass index

Anterior cingulate cortex

[97]

Hypoperfusion

Ismail, 2008

AD (N = 66)

NINCDS-ADRDA

NPI

left anterior cingulate and left orbitofrontal cortices

[98]

  1. Abbreviations: AD Alzheimer’s disease, aMCI amnestic mild cognitive impairment, LBD Lewy body dementia, VaD vascular dementia, HC healthy controls, NPS neuropsychiatric symptom, WMH white matter hyperintensities, GDS Geriatric Depression Scale, MADRS Montgomery-Asberg Depression Rating Scale, HRSD Hamilton Rating Scale for Depression, Behave-AD Behavioral Pathology in Alzheimer’s Disease Scale, CDR Clinical Dementia Rating, DSM-IV Diagnostic and Statistical Manual of Mental Disorders, forth version, ICD-10 International Statistical Classification of Disease, tenth version, NIA-AA National Institute on Aging-Alzheimer’s Association workgroups, CERAD Consortium to Establish a Registry for AD