Resting-State Connectivity of Auditory and Reward Systems in Alzheimer's Disease and Mild Cognitive Impairment

Music-based interventions have become increasingly widely adopted for dementia and related disorders. Previous research shows that music engages reward-related regions through functional connectivity with the auditory system. Here we characterize intrinsic connectivity of the auditory and reward systems in healthy aging, mild cognitive impairment (MCI) - a predementia phase of cognitive dysfunction, and Alzheimers disease (AD). Using resting-state fMRI data from the Alzheimers Database Neuroimaging Initiative, we tested functional connectivity within and between auditory and reward systems in older adults with MCI, AD, and age-matched healthy controls (N=105). Seed-based correlations were assessed from regions of interest (ROIs) in the auditory network, i.e. anterior superior temporal gyrus (aSTG), posterior superior temporal gyrus (pSTG), Heschls Gyrus, and reward network (i.e., nucleus accumbens, caudate, putamen, and orbitofrontal cortex [OFC]). AD individuals were lower in both within-network and between-network functional connectivity in the auditory network and reward networks compared to MCI and healthy controls. Furthermore, graph theory analyses showed that MCI individuals had higher clustering, local efficiency, degrees, and strengths than both AD individuals and healthy controls. Together, the auditory and reward systems show preserved within- and between-network connectivity in MCI relative to AD. These results suggest that music-based interventions have the potential to make an early difference in individuals with MCI, due to the preservation of functional connectivity in reward-related regions and between auditory and reward networks at that initial stage of neurodegeneration.