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NEURAL CONNECTIVITY CHANGES IN DEMENTIA WITH LEWY BODIES – A SYSTEMATIC REVIEW
Abstract
Aims
Studies on dementia with Lewy bodies (DLB) have mainly focussed on the deterioration of distinct cortical and subcortical regions related to the deposition of Lewy bodies. In view of the proposed trans-synaptic spread of the alpha-synuclein-pathology, investigating the disease in this segregated fashion only, would be detrimental to our understanding of its progression. Over the past two decades, an increasing number of studies have examined the effects of the disease on structural and functional brain connectivity. Here, we aim to summarize the current state of research on connectivity changes in DLB compared to healthy age-matched controls and other dementias.
Methods
In August 2021, we conducted a search of relevant peer-reviewed literature across several electrophysiological and imaging modalities on PubMed, following PRISMA guidelines.
Results
Out of 337 identified articles, 38 articles were selected and systematically reviewed. Positron emission tomography (PET), magnetic resonance imaging (MRI), and electroencephalography (EEG) assessments of patients revealed widespread abnormalities within and across brain networks in DLB. Most changes occurred within the default mode network and its connections to other cortical regions. Further, advanced mathematical analysis methods demonstrated disease-related changes in local and global network efficiency measures. A subset of studies revealed correlations between connectivity measures and cognitive impairments.
Conclusions
This review shows that the exploration of structural and functional connectivity changes in DLB allows reconstructing the spread of the disease along neural tracts. This knowledge may help to understand clinical presentations and to identify targets for future disease-modifying treatments in DLB.