The Cognitive Connectome in Dementia with Lewy Bodies

ObjectivesCognition plays a central role for diagnosing and characterizing dementia with Lewy bodies (DLB). However, the complex associations among cognitive functions are largely unknown in DLB. To fill this gap, we compared the cognitive connectome of DLB patients, healthy controls (HC) and patients with Alzheimers disease (AD). MethodsWe obtained data from the National Alzheimers Coordinating Center (NIA/NIH Grant U24-AG072122). We built separate cognitive connectomes for DLB (n=104), HC (n= 3703), and AD (n=1985) groups using pairwise correlations between 24 cognitive variables mapping multiple cognitive functions. The cognitive connectomes in DLB, HC, and AD groups were compared using standard global and nodal graph measures of centrality, integration, and segregation. ResultsIn global connectome measures, DLB patients showed a higher global efficiency (integration) and lower transitivity (segregation) than HCs and AD. Nodal connectome measures showed a higher global efficiency in most cognitive functions in DLB compared to HCs. Additionally, we found a lower local efficiency (segregation) and nodal strength (centrality) in memory variables and a higher participation coefficient in executive variables (centrality) in DLB compared with both HCs and AD. ConclusionsThe cognitive connectome in DLB showed a signature dedifferentiation pattern of aberrant correlations. Executive, processing speed and attention functions played a central role in the cognitive connectome of DLB patients. Furthermore, the role of executive and memory functions in the cognitive connectome distinguished DLB and AD patients. These findings may help advance our understanding of the clinical phenotype in DLB, and continue to improve the challenging differential diagnosis between DLB and AD.