Cited by 66Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsFunctional Brain Connectivity Studies

Detecting Early Cognitive Decline in Alzheimer’s Disease with Brain Synaptic Structural and Functional Evaluation

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Ribarič, Samo·2023·Biomedicines

Abstract

Early cognitive decline in patients with Alzheimer’s (AD) is associated with quantifiable structural and functional connectivity changes in the brain. AD dysregulation of Aβ and tau metabolism progressively disrupt normal synaptic function, leading to loss of synapses, decreased hippocampal synaptic density and early hippocampal atrophy. Advances in brain imaging techniques in living patients have enabled the transition from clinical signs and symptoms-based AD diagnosis to biomarkers-based diagnosis, with functional brain imaging techniques, quantitative EEG, and body fluids sampling. The hippocampus has a central role in semantic and episodic memory processing. This cognitive function is critically dependent on normal intrahippocampal connections and normal hippocampal functional connectivity with many cortical regions, including the perirhinal and the entorhinal cortex, parahippocampal cortex, association regions in the temporal and parietal lobes, and prefrontal cortex. Therefore, decreased hippocampal synaptic density is reflected in the altered functional connectivity of intrinsic brain networks (aka large-scale networks), including the parietal memory, default mode, and salience networks. This narrative review discusses recent critical issues related to detecting AD-associated early cognitive decline with brain synaptic structural and functional markers in high-risk or neuropsychologically diagnosed patients with subjective cognitive impairment or mild cognitive impairment.

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  • Synapse dysfunction/loss is one of the earliest pathological hallmarks in the brain.

    “synapse dysfunction/loss is (1) one of the earliest pathological hallmarks in the brain”

    From PLCG2 downregulation impairs synaptic function and increases Alzheimer’s disease hallmarks in neuronal cultures (2026) · cites this paper as [15]

    Section 2.2 identifies synaptic loss as an early brain pathological change in Alzheimer’s disease and says reduced synaptic plasticity precedes neuronal death. The source supports the claim for Alzheimer’s disease, but not as an unqualified statement about brain pathology generally. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Synapse dysfunction/loss is the strongest marker of cognitive decline.

    “and (2) the strongest marker of cognitive decline13–15”

    From PLCG2 downregulation impairs synaptic function and increases Alzheimer’s disease hallmarks in neuronal cultures (2026) · cites this paper as [15]

    Section 1.1 (Brain Synapses) links synaptic loss to measured cognitive decline in patients with Alzheimer’s disease, and Section 2.2 calls it an early cause of AD-related cognitive decline. The paper does not establish that synaptic dysfunction or loss is the strongest marker relative to other markers, or extend that ranking beyond AD. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Authors
Ribarič, S.
Affiliations
University of Ljubljana (SI)
Corresponding author
Ribarič, Samo
Venue
Biomedicines
Publisher
MDPI AG
Published
2023-01-26
Volume
11
Issue
2
Pages
355
ISSN
2227-9059 (ISSN-L)
OpenAlex
W4318207623
Cited by
66
References
308
Citations by year
2026: 18 · 2025: 31 · 2024: 13 · 2023: 4
FWCI
3.01
Type
journal article
Language
en
Open access
Locations
  • Biomedicines (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Javna Agencija za Raziskovalno Dejavnost RS (P3-0171)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
Keywords
Alzheimer's disease, early cognitive decline, synaptic density, hippocampus, functional connectivity, large-scale brain networks, amyloid-beta, tau protein, biomarkers, mild cognitive impairment, default mode network, salience network, quantitative EEG, neuroimaging

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