Bridging Reduced Grip Strength and Altered Executive Function: Specific Brain White Matter Structural Changes in Patients with Alzheimer's Disease

Shan-Wen Liu; Xiao-Ting Ma; Shuai Yu; Xiao-Fen Weng; Meng Li; Jiangtao Zhu; Chun-Feng Liu; Hua Hu

doi:10.2147/CIA.S438782

Bridging Reduced Grip Strength and Altered Executive Function: Specific Brain White Matter Structural Changes in Patients with Alzheimer's Disease

Clin Interv Aging. 2024 Jan 16:19:93-107. doi: 10.2147/CIA.S438782. eCollection 2024.

Authors

Shan-Wen Liu¹, Xiao-Ting Ma¹, Shuai Yu², Xiao-Fen Weng³, Meng Li⁴, Jiangtao Zhu⁴, Chun-Feng Liu¹, Hua Hu¹

Affiliations

¹ Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China.
² Department of Neurology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215000, People's Republic of China.
³ Department of Geriatric Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215000, People's Republic of China.
⁴ Department of Imaging, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China.

Abstract

Objective: To investigate the correlation between specific fiber tracts and grip strength and cognitive function in patients with Alzheimer's disease (AD) by fixel-based analysis (FBA).

Methods: AD patients were divided into AD with low grip strength (AD-LGS, n=29) and AD without low grip strength (AD-nLGS, n=25), along with 31 normal controls (NC). General data, neuropsychological tests, grip strength and cranial magnetic resonance imaging (MRI) scans were collected. FBA evaluated white matter (WM) fiber metrics, including fiber density (FD), fiber cross-sectional (FC), and fiber density and cross-sectional area (FDC). The mean fiber indicators of the fiber tracts of interest (TOI) were extracted in cerebral region of significant statistical differences in FBA to further compare the differences between groups and analyze the correlation between fiber properties and neuropsychological test scores.

Results: Compared to AD-nLGS group, AD-LGS group showed significant reductions in FDC in several cerebral regions. In AD patients, FDC values of bilateral uncinate fasciculus and left superior longitudinal fasciculus were positively correlated with Clock Drawing Test scores, while FDC of splenium of corpus callosum, bilateral anterior cingulate tracts, forceps major, and bilateral inferior longitudinal fasciculus were positively correlated with the Executive Factor Score of Memory and Executive Screening scale scores.

Conclusion: Reduced grip strength in AD patients is associated with extensive impairment of WM structural integrity. Changes in FDC of specific WM fiber tracts related to executive function play a significant mediating role in the reduction of grip strength in AD patients.

Keywords: Alzheimer disease; cognition function; fixel-based analysis; grip strength; white matter.

MeSH terms

Alzheimer Disease* / diagnostic imaging
Executive Function
Galactosylceramides*
Hand Strength
Humans
White Matter* / diagnostic imaging

Substances

N-lignocerylgalactosylsphingosine
Galactosylceramides

Grants and funding

This work was supported by Application of Clinical Technology in Elderly Health Research Project in Jiangsu Province (LD2021031); Suzhou Science and Technology Plan Medical and Health Care Science and Technology Innovation Applied Basic Research (SKY2022161); Research Project of Neurological Diseases in the Second Affiliated Hospital of Suzhou University, Research Center (ND2023A01); Jiangsu Provincial Medical Key Discipline for the 14th Five-Year Plan (ZDXK202217). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.