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@ARTICLE{CorriveauLecavalier:275842,
author = {Corriveau-Lecavalier, Nick and Adams, Jenna N and Fischer,
Larissa and Molloy, Eóin N. and Maass, Anne},
title = {{C}erebral hyperactivation across the {A}lzheimer's disease
pathological cascade.},
journal = {Brain communications},
volume = {6},
number = {6},
issn = {2632-1297},
address = {[Oxford]},
publisher = {Oxford University Press},
reportid = {DZNE-2025-00077},
pages = {fcae376},
year = {2024},
abstract = {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.},
subtyp = {Review Article},
keywords = {Alzheimer’s disease (Other) / amyloid (Other) / cerebral
hyperactivation (Other) / fMRI (Other) / tau (Other)},
cin = {AG Maaß},
ddc = {610},
cid = {I:(DE-2719)1311001},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39513091},
pmc = {pmc:PMC11542485},
doi = {10.1093/braincomms/fcae376},
url = {https://pub.dzne.de/record/275842},
}