In a study of 128 participants in the Alzheimer’s Disease Neuroimaging Initiative, which is published in the February issue of the journal Brain, the team of researchers led by Mayo Clinic neurologist David Jones, M.D., proposed a disease model as a pathologic interaction within a complex system composed of large-scale brain networks and small-scale molecules. They looked into the activity of the default mode network or DMN (a brain system known for being active when we perform tasks involving memory or when invoking mental constructs), and related this activity to measures of Alzheimer’s proteins. Building on their previous work on DMN activity, the team found that a failure that starts in this system cascades through the brain via increases in activity. These increases in activity traditionally have been understood as a compensatory process; however, this new study suggests that they also may be propagating the disease process throughout brain systems — just like rerouting of power surges can cause blackouts in a power grid.
“We found that this load-shifting process itself may be a major culprit for the development of the Alzheimer’s disease,” says Dr. Jones, the study’s lead investigator and author. “It is not unlike a cascading failure of a power grid. When a hub goes down, other areas of the network are forced to compensate. If the burden shift is too high, it blows off the circuits, and the power is down. This type of failure in our large brain networks may be responsible for the development of the Alzheimer’s disease.”
These findings, Dr. Jones believes, support a system model that would open up new avenues of preventive therapeutic interventions targeting large-scale brain activity in the years or even decades before symptoms. “This would be akin to cardiologists encouraging the lowering of blood pressure decades before plaques ever develop in the arteries in the heart,” Dr. Jones says.
Co-authors include David S. Knopman, M.D.; Jeffrey L. Gunter, Ph.D.; Jonathan Graff-Radford; Vemuri Prashanthi, Ph.D.; Bradley Boeve , M.D.; Ronald C. Petersen, M.D., Ph.D.; Clifford R. Jack, Jr., M.D. of Mayo Clinic and Michael Weiner, M.D. of University of California, San Francisco.
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