Entorhinal-Hippocampal Circuit Integrity Is Related to Mnemonic Discrimination and Amyloid-β Pathology in Older Adults

Amyloid-Beta Deposition in Basal Frontotemporal Cortex Is Associated with Selective Disruption of Temporal Mnemonic Discrimination

Cerebral amyloid-beta (Aβ) accumulation, a hallmark pathology of Alzheimer's disease (AD), precedes clinical impairment by two to three decades. However, it is unclear whether Aβ contributes to subtle memory deficits observed during the preclinical stage. The heterogeneous emergence of Aβ deposition may selectively impact certain memory domains, which rely on distinct underlying neural circuits. In this context, we tested whether specific domains of mnemonic discrimination, a neural computation essential for episodic memory, exhibit specific deficits related to early Aβ deposition. We tested 108 cognitively unimpaired human older adults (66% female) who underwent 18F-florbetapir positron emission tomography (Aβ-PET) and a control group of 35 young adults, on a suite of mnemonic discrimination tasks taxing object, spatial, and temporal domains. We hypothesized that Aβ pathology would be selectively associated with temporal discrimination performance due to Aβ's propensity to accumulate in the basal frontotemporal cortex, which supports temporal processing. Consistent with this hypothesis, we found a dissociation in which generalized age-related deficits were found for object and spatial mnemonic discrimination, while Aβ-PET levels were selectively associated with deficits in temporal mnemonic discrimination. Furthermore, we found that higher Aβ-PET levels in the medial orbitofrontal and inferior temporal cortex, regions supporting temporal processing, were associated with greater temporal mnemonic discrimination deficits, pointing to the selective vulnerability of circuits related to temporal processing early in AD progression. These results suggest that Aβ accumulation within basal frontotemporal regions may disrupt temporal mnemonic discrimination in preclinical AD, and future work is needed to determine whether assessing temporal mnemonic discrimination can aid in predicting emerging AD progression.

How age and culture impact the neural correlates of memory retrieval

Culture can shape memory, but little research has investigated age effects. The present study examined the neural correlates of memory retrieval for old, new, and similar lures in younger and older Americans and Taiwanese. A total of 207 participants encoded pictures of objects and, during fMRI scanning, completed a surprise object recognition task testing discrimination of similar and new from old items. Results show that age and culture impact discrimination of old from new items. Taiwanese performed worse than Americans, with age effects more pronounced for Taiwanese. The cultural differences in the engagement of left inferior frontal gyrus (LIFG) in younger adults (i.e., greater activity for old [for Taiwanese] or new items [for Americans]) were eliminated with age. The results are interpreted as reflecting cultural differences in orientation to novelty versus familiarity for younger, but not older, adults, with the LIFG supporting interference resolution at retrieval. Support is not as strong for cultural differences in pattern separation processes. Although Americans had higher levels of memory discrimination than Taiwanese, neither cultural nor age differences were found in hippocampal activity, which is surprising given the region's role in pattern separation. The findings suggest ways in which cultural life experiences and concomitant information processing strategies can contribute to consistent effects of age across cultures or contribute to different trajectories with age in terms of memory.

The amyloid beta 42/38 ratio as a plasma biomarker of early memory deficits in cognitively unimpaired older adults

The amyloid beta (Aβ) 42/40 ratio has been widely studied as a biomarker in Alzheimer's disease (AD); however, other Aβ peptides could also represent relevant biomarkers. We measured levels of Aβ38/40/42 in plasma samples from cognitively-unimpaired older adults and determined the relationships between Aβ levels and amyloid positron-emission-tomography (PET) and performance on a learning and memory task. We found that all Aβ peptides individually and the Aβ42/40 ratio, but not the Aβ42/38 ratio, were significantly correlated with brain amyloid (Aβ-PET). Multiple linear modeling, adjusting for age, sex, education, APOE4 and Aβ-PET showed significant associations between the Aβ42/38 ratio and memory. Further, associations between the Aβ42/38 ratio and learning scores were stronger in males and in Aβ-PET-negative individuals. In contrast, no significant associations were detected between the Aβ42/40 ratio and any learning measure. These studies implicate the Aβ42/38 ratio as a biomarker to assess early memory deficits and underscore the utility of the Aβ38 fragment as an important biomarker in the AD field.

Cerebral hyperactivation across the Alzheimer's disease pathological cascade

Neuronal dysfunction in specific brain regions or across distributed brain networks is a known feature of Alzheimer's disease. An often reported finding in the early stage of the disease is the presence of increased functional MRI (fMRI) blood oxygenation level-dependent signal under task conditions relative to cognitively normal controls, a phenomenon known as 'hyperactivation'. However, research in the past decades yielded complex, sometimes conflicting results. The magnitude and topology of fMRI hyperactivation patterns have been found to vary across the preclinical and clinical spectrum of Alzheimer's disease, including concomitant 'hypoactivation' in some cases. These incongruences are likely due to a range of factors, including the disease stage at which the cohort is examined, the brain areas or networks studied and the fMRI paradigm utilized to evoke these functional abnormalities. Additionally, a perennial question pertains to the nature of hyperactivation in the context of Alzheimer's disease. Some propose it reflects compensatory mechanisms to sustain cognitive performance, while others suggest it is linked to the pathological disruption of a highly regulated homeostatic cycle that contributes to, or even drives, disease progression. Providing a coherent narrative for these empirical and conceptual discrepancies is paramount to develop disease models, understand the synergy between hyperactivation and the Alzheimer's disease pathological cascade and tailor effective interventions. We first provide a comprehensive overview of functional brain changes spanning the course from normal ageing to the clinical spectrum of Alzheimer's disease. We then highlight evidence supporting a close relationship between fMRI hyperactivation and in vivo markers of Alzheimer's pathology. We primarily focus on task-based fMRI studies in humans, but also consider studies using different functional imaging techniques and animal models. We then discuss the potential mechanisms underlying hyperactivation in the context of Alzheimer's disease and provide a testable framework bridging hyperactivation, ageing, cognition and the Alzheimer's disease pathological cascade. We conclude with a discussion of future challenges and opportunities to advance our understanding of the fundamental disease mechanisms of Alzheimer's disease, and the promising development of therapeutic interventions incorporating or aimed at hyperactivation and large-scale functional systems.

Intracranial EEGs evidenced visual object processing in the human medial temporal lobe subregions

The perirhinal cortex (PRC) and parahippocampal cortex (PHC) are core regions along the visual dual-stream. The specific functional roles of the PRC and PHC and their interactions with the downstream hippocampus cortex (HPC) are crucial for understanding visual memory. Our research used human intracranial EEGs to study the neural mechanism of the PRC, PHC, and HPC in visual object encoding. Single-regional function analyses found evidence that the PRC, PHC, and HPC are activated ∼100 ms within the broad-gamma band and that the PRC was more strongly activated than either the PHC or the HPC after an object stimulus. Inter-regional analyses showed strong bidirectional interactions of the PRC with both the PHC and HPC in the low-frequency band, whereas the interactions between the PHC and HPC were not significant. These findings demonstrated the core role of the PRC in encoding visual object information and supported the hypothesis of PRC-HPC-ventral object pathway. The recruitment of the PHC and its interaction with the PRC in visual object encoding also provide new insights beyond the traditional dorsal-stream hypothesis.

Amyloid-β deposition in basal frontotemporal cortex is associated with selective disruption of temporal mnemonic discrimination

Cerebral amyloid-beta (Aβ) accumulation, a hallmark pathology of Alzheimer's disease (AD), precedes clinical impairment by two to three decades. However, it is unclear whether Aβ contributes to subtle memory deficits observed during the preclinical stage. The heterogenous emergence of Aβ deposition may selectively impact certain memory domains, which rely on distinct underlying neural circuits. In this context, we tested whether specific domains of mnemonic discrimination, a neural computation essential for episodic memory, exhibit specific deficits related to early Aβ deposition. We tested 108 cognitively unimpaired human older adults (66% female) who underwent 18F-florbetapir positron emission tomography (Aβ-PET), and a control group of 35 young adults, on a suite of mnemonic discrimination tasks taxing object, spatial, and temporal domains. We hypothesized that Aβ pathology would be selectively associated with temporal discrimination performance due to Aβ's propensity to accumulate in the basal frontotemporal cortex, which supports temporal processing. Consistent with this hypothesis, we found a dissociation in which generalized age-related deficits were found for object and spatial mnemonic discrimination, while Aβ-PET levels were selectively associated with deficits in temporal mnemonic discrimination. Further, we found that higher Aβ-PET levels in medial orbitofrontal and inferior temporal cortex, regions supporting temporal processing, were associated with greater temporal mnemonic discrimination deficits, pointing to the selective vulnerability of circuits related to temporal processing early in AD progression. These results suggest that Aβ accumulation within basal frontotemporal regions may disrupt temporal mnemonic discrimination in preclinical AD, and may serve as a sensitive behavioral biomarker of emerging AD progression.

Effects of Age on Cross-Cultural Differences in the Neural Correlates of Memory Retrieval

Culture can shape memory, but little research investigates age effects. The present study examines the neural correlates of memory retrieval for old, new, and similar lures in younger and older Americans and Taiwanese. Results show that age and culture impact discrimination of old from new items. Taiwanese performed worse than Americans, with age effects more pronounced for Taiwanese. Americans activated the hippocampus for new more than old items, but pattern of activity for the conditions did not differ for Taiwanese, nor did it interact with age. The engagement of left inferior frontal gyrus (LIFG) differed across cultures. Patterns of greater activity for old (for Americans) or new (for Taiwanese) items were eliminated with age, particularly for older Americans. The results are interpreted as reflecting cultural differences in orientation to novelty vs. familiarity for younger, but not older, adults, with the LIFG supporting interference resolution at retrieval. Support is not as strong for cultural differences in pattern separation processes. Although Americans had higher levels of memory discrimination than Taiwanese and engaged the LIFG for correct rejections more than false alarms, the patterns of behavior and neural activity did not interact with culture and age. Neither culture nor age impacted hippocampal activity, which is surprising given the region's role in pattern separation. The findings suggest ways in which cultural life experiences and concomitant information processing strategies can contribute to consistent effects of age across cultures or contribute to different trajectories with age in terms of memory.

Cerebrovascular pathology mediates associations between hypoxemia during rapid eye movement sleep and medial temporal lobe structure and function in older adults

Obstructive sleep apnea (OSA) is common in older adults and is associated with medial temporal lobe (MTL) degeneration and memory decline in aging and Alzheimer's disease (AD). However, the underlying mechanisms linking OSA to MTL degeneration and impaired memory remains unclear. By combining magnetic resonance imaging (MRI) assessments of cerebrovascular pathology and MTL structure with clinical polysomnography and assessment of overnight emotional memory retention in older adults at risk for AD, cerebrovascular pathology in fronto-parietal brain regions was shown to statistically mediate the relationship between OSA-related hypoxemia, particularly during rapid eye movement (REM) sleep, and entorhinal cortical thickness. Reduced entorhinal cortical thickness was, in turn, associated with impaired overnight retention in mnemonic discrimination ability across emotional valences for high similarity lures. These findings identify cerebrovascular pathology as a contributing mechanism linking hypoxemia to MTL degeneration and impaired sleep-dependent memory in older adults.

Improvement of mnemonic discrimination with acute light exercise is mediated by pupil-linked arousal in healthy older adults

Physical exercise has positive impacts on hippocampal memory decline with aging. One of the postulated neurobiological mechanisms of the decline is reduced catecholaminergic projections from the locus coeruleus to the hippocampus. Recent human studies revealed that very light exercise rapidly enhances memory and pupil diameter, which suggests that light exercise may improve memory via neural circuits involved in the ascending arousal system, including the locus coeruleus, even in older adults. Thus, we aimed to clarify the effects of a single bout of light-intensity exercise (60% ventilatory threshold) on mnemonic discrimination performance, an index of hippocampal memory function, in healthy older adults using a randomized crossover design. Pupil diameter was measured during exercise as a physiological marker of the ascending arousal system. Discrimination of highly similar stimuli to the targets improved after exercise when compared to the resting control performance. Importantly, causal mediation analysis showed that pupil dilation during exercise mediated the memory improvement. These results suggest that brief light exercise rapidly enhances memory, possibly by upregulating the ascending arousal system.

Examining the diagnostic value of the mnemonic discrimination task for classification of cognitive status and amyloid-beta burden

Alzheimer's disease (AD) is the most common type of dementia, characterized by early memory impairments and gradual worsening of daily functions. AD-related pathology, such as amyloid-beta (Aβ) plaques, begins to accumulate many years before the onset of clinical symptoms. Predicting risk for AD via related pathology is critical as the preclinical stage could serve as a therapeutic time window, allowing for early management of the disease and reducing health and economic costs. Current methods for detecting AD pathology, however, are often expensive and invasive, limiting wide and easy access to a clinical setting. A non-invasive, cost-efficient platform, such as computerized cognitive tests, could be potentially useful to identify at-risk individuals as early as possible. In this study, we examined the diagnostic value of an episodic memory task, the mnemonic discrimination task (MDT), for predicting risk of cognitive impairment or Aβ burden. We constructed a random forest classification algorithm, utilizing MDT performance metrics and various neuropsychological test scores as input features, and assessed model performance using area under the curve (AUC). Models based on MDT performance metrics achieved classification results with an AUC of 0.83 for cognitive status and an AUC of 0.64 for Aβ status. Our findings suggest that mnemonic discrimination function may be a useful predictor of progression to prodromal AD or increased risk of Aβ load, which could be a cost-efficient, noninvasive cognitive testing solution for potentially wide-scale assessment of AD pathological and cognitive risk.

Probing neural circuit mechanisms in Alzheimer's disease using novel technologies

The study of Alzheimer's Disease (AD) has traditionally focused on neuropathological mechanisms that has guided therapies that attenuate neuropathological features. A new direction is emerging in AD research that focuses on the progressive loss of cognitive function due to disrupted neural circuit mechanisms. Evidence from humans and animal models of AD show that dysregulated circuits initiate a cascade of pathological events that culminate in functional loss of learning, memory, and other aspects of cognition. Recent progress in single-cell, spatial, and circuit omics informs this circuit-focused approach by determining the identities, locations, and circuitry of the specific cells affected by AD. Recently developed neuroscience tools allow for precise access to cell type-specific circuitry so that their functional roles in AD-related cognitive deficits and disease progression can be tested. An integrated systems-level understanding of AD-associated neural circuit mechanisms requires new multimodal and multi-scale interrogations that longitudinally measure and/or manipulate the ensemble properties of specific molecularly-defined neuron populations first susceptible to AD. These newly developed technological and conceptual advances present new opportunities for studying and treating circuits vulnerable in AD and represent the beginning of a new era for circuit-based AD research.

A comparison of behavioral paradigms assessing spatial memory in tree shrews

Impairments in spatial navigation in humans can be preclinical signs of Alzheimer's disease. Therefore, cognitive tests that monitor deficits in spatial memory play a crucial role in evaluating animal models with early stage Alzheimer's disease. While Chinese tree shrews (Tupaia belangeri) possess many features suitable for Alzheimer's disease modeling, behavioral tests for assessing spatial cognition in this species are lacking. Here, we established reward-based paradigms using the radial-arm maze and cheeseboard maze for tree shrews, and tested spatial memory in a group of 12 adult males in both tasks, along with a control water maze test, before and after bilateral lesions to the hippocampus, the brain region essential for spatial navigation. Tree shrews memorized target positions during training, and task performance improved gradually until reaching a plateau in all 3 mazes. However, spatial learning was compromised post-lesion in the 2 newly developed tasks, whereas memory retrieval was impaired in the water maze task. These results indicate that the cheeseboard task effectively detects impairments in spatial memory and holds potential for monitoring progressive cognitive decline in aged or genetically modified tree shrews that develop Alzheimer's disease-like symptoms. This study may facilitate the utilization of tree shrew models in Alzheimer's disease research.

Hippocampal network axons respond to patterned theta burst stimulation with lower activity of initially higher spike train similarity from EC to DG and later similarity of axons from CA1 to EC

Objective. Decoding memory functions for each hippocampal subregion involves extensive understanding of how each hippocampal subnetwork processes input stimuli. Theta burst stimulation (TBS) recapitulates natural brain stimuli which potentiates synapses in hippocampal circuits. TBS is typically applied to a bundle of axons to measure the immediate response in a downstream subregion like the cornu ammonis 1 (CA1). Yet little is known about network processing in response to stimulation, especially because individual axonal transmission between subregions is not accessible.Approach. To address these limitations, we reverse engineered the hippocampal network on a micro-electrode array partitioned by a MEMS four-chambered device with interconnecting microfluidic tunnels. The micro tunnels allowed monitoring single axon transmission which is inaccessible in slices orin vivo. The four chambers were plated separately with entorhinal cortex (EC), dentate gyrus (DG), CA1, and CA3 neurons. The patterned TBS was delivered to the EC hippocampal gateway. Evoked spike pattern similarity in each subregions was quantified with Jaccard distance metrics of spike timing.Main results. We found that the network subregion produced unique axonal responses to different stimulation patterns. Single site and multisite stimulations caused distinct information routing of axonal spikes in the network. The most spatially similar output at axons from CA3 to CA1 reflected the auto association within CA3 recurrent networks. Moreover, the spike pattern similarities shifted from high levels for axons to and from DG at 0.2 s repeat stimuli to greater similarity in axons to and from CA1 for repetitions at 10 s intervals. This time-dependent response suggested that CA3 encoded temporal information and axons transmitted the information to CA1.Significance. Our design and interrogation approach provide first insights into differences in information transmission between the four subregions of the structured hippocampal network and the dynamic pattern variations in response to stimulation at the subregional level to achieve probabilistic pattern separation and novelty detection.

Functional network structure supports resilience to memory deficits in cognitively normal older adults with amyloid-β pathology

Older adults may harbor large amounts of amyloid-β (Aβ) pathology, yet still perform at age-normal levels on memory assessments. We tested whether functional brain networks confer resilience or compensatory mechanisms to support memory in the face of Aβ pathology. Sixty-five cognitively normal older adults received high-resolution resting state fMRI to assess functional networks, 18F-florbetapir-PET to measure Aβ, and a memory assessment. We characterized functional networks with graph metrics of local efficiency (information transfer), modularity (specialization of functional modules), and small worldness (balance of integration and segregation). There was no difference in functional network measures between older adults with high Aβ (Aβ+) compared to those with no/low Aβ (Aβ-). However, in Aβ+ older adults, increased local efficiency, modularity, and small worldness were associated with better memory performance, while this relationship did not occur Aβ- older adults. Further, the association between increased local efficiency and better memory performance in Aβ+ older adults was localized to local efficiency of the default mode network and hippocampus, regions vulnerable to Aβ and involved in memory processing. Our results suggest functional networks with modular and efficient structures are associated with resilience to Aβ pathology, providing a functional target for intervention.