Rizzi_2022_Brain.Connect__

BACKGROUND: The response to cholinesterase inhibitors (ChEIs) treatment is variable in patients with Alzheimer's disease (AD). Patients and physicians would benefit if these drugs could be targeted at those most likely to respond in a clinical setting. Therefore, this study aimed to evaluate the ability of CSF AD biomarkers, hippocampal volumes (HV), and Default Mode Network functional connectivity (DMN FC) to predict clinical response to ChEIs treatment in mild AD. METHODS: We followed up on 39 mild AD patients using ChEIs at therapeutic doses. All subjects underwent clinical evaluation, neuropsychological assessment, MRI exam, and CSF biomarkers quantification at the first assessment. The Mini-Mental Status Examination (MMSE) was used to measure the global cognitive status before and after the follow-up. Were considered "Responders" those who have remained stable or improved the MMSE score between evaluations and "Non-Responders" those who have worsened the MMSE score. We have performed univariate and multivariate logistic regressions to predict the clinical response from each biomarker. RESULTS: 35.89% of patients were classified as "Responders" to ChEIs treatment after the follow-up. The multivariate model with measures of RHIPPO, adjusted for gender and interval between assessments, was significant (OR: 1.09 [CI95% 1.00 - 1.19], ro= 0.0392). This model achieved an accuracy of 77,60%. CONCLUSION: Our findings suggest that the functional connectivity of RHIPPO might be an early imaging biomarker to predict clinical response to ChEIs drugs in mild AD.