Acute Affective Reactivity and Quality of Life in Older Adults with Amnestic Mild Cognitive Impairment: A Functional MRI Study

• Published in: The American journal of geriatric psychiatry 2017-11, Vol.25 (11), p.1225-1233
• Main Authors: Ren, Ping, Heffner, Kathi L., Jacobs, Alanna, Lin, Feng
• Format: Article
• Language: English
• Subjects: affective reactivity; Affective Symptoms - diagnostic imaging; Affective Symptoms - physiopathology; Aged; Aged, 80 and over; Amnesia - diagnostic imaging; Amnesia - physiopathology; Case-Control Studies; Cognitive ability; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - physiopathology; Female; Functional Neuroimaging - methods; Gyrus Cinguli - diagnostic imaging; Gyrus Cinguli - physiopathology; Humans; low-frequency fluctuation; Magnetic Resonance Imaging; Male; Middle Aged; mild cognitive impairment; NMR; Nuclear magnetic resonance; Older people; prefrontal cortex; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - physiopathology; Quality of Life; resting-state fMRI
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1016/j.jagp.2017.06.019

•Mild cognitive impairment patients had diminished QoL.•Prefrontal cortex's reactivity to cognitive challenge related to QoL.•Prefrontal cortex's reactivity linked negative affective reactivity with QoL. Poor quality of life (QoL) is a major concern among older adults with amnestic mild cognitive impairment (MCI). Maladaptive affective regulation and its relevant frontal dysfunction that are often observed in older adults with MCI may provide an insight into the understanding of their QoL. In this case-controlled study, participants (MCI patients, N = 18; healthy comparisons [HC], N = 21) completed cognitive tasks, and underwent resting-state functional magnetic resonance imaging (rs-fMRI) immediately before and after the tasks. The amplitude of low-frequency fluctuations (ALFF) of rs-fMRI signals was calculated to examine the brain's spontaneous activity. The change in valence from the Self-Assessment Manikin indexed affective reactivity. QoL was assessed using Quality of Life-AD measure. Multiple mediator model was used to examine the mediating effect of frontal regions' ALFF reactivity between the affective reactivity and QoL. The MCI group had significantly worse QoL and more negative affective reactivity than HC group. Less negative affective reactivity was significantly associated with better QoL in MCI not HC. ALFF in the anterior cingulate cortex, medial prefrontal cortex (MPFC), and superior frontal gyrus (SFG) increased significantly less after cognitive tasks in MCI than HC. For the entire sample, greater increases of ALFF in MPFC and SFG were significantly associated with better QoL, and SFG alone significantly mediated the association between affective reactivity and QoL. Enhancing SFG activation, especially among those with MCI, may provide a therapeutic target for addressing the negative impact of maladaptive affective regulation on QoL.