Neurological reserve as a pivotal mechanism for psychiatric symptoms in Alzheimer’s disease
Patients with Alzheimer’s disease (AD) may experience and show a whole range of clinical symptoms. Of these, psychiatric symptoms such as apathy, depression and anxiety play a major role in that they are highly debilitating for patients and carers. The onset of these
symptoms may in part emerge as a consequence of cognitive dysfunction, i.e., being aware of their difficulties, patients develop these symptomatic traits. However, very often these symptoms are the direct consequence of the pathological processes of AD, which cause
neurostructural and neurofunctional changes to key networks responsible of behavioural control.
As with any other symptoms (e.g., memory decline), psychiatric dysfunction may be influenced by the neural resources each patient possesses. A major resource AD patients can rely on to slow down the progression of their symptomatology is cognitive reserve (CR).
CR is a construct according to which having engaged in mentally-stimulating activities during one’s life would improve and optimise the way brain networks are engaged during a certain task. CR accounts for the inter-individual differences in brain wiring, with people
with high CR having better optimised and more flexible brain networks compared to people with low CR. As a consequence, people with high CR can endure much more neuropathological burden before showing signs of cognitive decline, and experience then a much slower decline. Although CR has been extensively studied in association with cognitive functioning, very little is known about the role CR plays in association with psychiatric functioning.
This PhD will explore this link focusing on two major “passive” symptoms: anxiety and depression. The link between these symptoms and the brain will be investigated and this link will then be further explored as a function of measures of CR (e.g., years of educational
attainment). A sample of 150 patients with a clinical diagnosis of mild cognitive impairment or dementia of the Alzheimer’s type will be analysed by the student. Each dataset will have a complete demographic and neuropsychological characterisation, multimodal MRI and a psychiatric profile. The student will study which neural mechanisms govern behavioural control in various acute and chronic neurological conditions and, more specifically, in what way network failure is linked to anxiety and depression. The student will also familiarise themselves with the models of neurological reserve, including brain reserve and cognitive reserve and the mechanisms with which these are implemented by the brain in the presence of pathological processes. The student will then learn how to process and model a number of different MRI images to address the experimental questions.
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This project is open to self-funded students only.