Episodic memory network characteristics in patients with amnestic mild cognitive impairment accompanied by executive function impairment

Objective To explore the functional connectivity (FC) characteristics of the episodic memory network (EMN) in amnestic mild cognitive impairment (aMCI) patients with different levels of executive function (EF). Methods This study included 76 participants from the Alzheimer's Disease Neuroimaging Initiative database, comprising 23 healthy controls (HCs) and 53 aMCI patients. Based on EF levels, aMCI patients were categorized into aMCI‐highEF and aMCI‐lowEF groups. Cognitive function scores, pathological markers (cerebrospinal fluid β‐amyloid, total tau protein, phosphorylated tau protein, AV45‐PET, and FDG‐PET), and functional magnetic resonance imaging were collected and compared among the three groups. Seed‐based FC analysis was used to examine differences in the EMN among the groups, and partial correlation analysis was employed to investigate the relationship between changes in FC and cognitive function scores as well as pathological markers. Results Compared to the aMCI‐highEF group, the aMCI‐lowEF group exhibited more severe cognitive impairment, decreased cerebral glucose metabolism, and elevated AV45 levels. Significant FC differences in the left superior temporal gyrus (STG) of the EMN were observed among the three groups. Post hoc analysis revealed that the aMCI‐lowEF group had increased FC in the left STG compared to the HCs and aMCI‐highEF groups, with statistically significant differences. Correlation analysis showed a significant negative correlation between the differences in FC in the left STG of aMCI‐highEF and aMCI‐lowEF groups and Rey Auditory Verbal Learning Test forgetting scores. Receiver operator characteristic curve analysis indicated an area under the curve of 0.741 for distinguishing between aMCI‐highEF and aMCI‐lowEF groups based on FC of left STG, with a sensitivity of 0.808 and a specificity of 0.667. Conclusion aMCI‐lowEF exhibits characteristic changes in FC within the EMN, providing theoretical support for the role of EF in mediating EMN alterations and, consequently, impacting episodic memory function. The study found that amnestic mild cognitive impairment (aMCI) patients with lower executive function (aMCI‐lowEF) exhibit more severe cognitive impairment, decreased cerebral glucose metabolism, and elevated AV45 levels compared to those with higher executive function (aMCI‐highEF). Significant increased functional connectivity in the left superior temporal gyrus of the episodic memory network (EMN) were observed in aMCI‐lowE