1. The neural underpinnings of attention network components in healthy ageing: a structural MRI study31
Speaker: Hanna Lu (PhD Candidate of Medical Sciences, CUHK)
Supervisor: Prof. Sandra S.M. Chan
Co-supervisor: Prof. Linda C.W. Lam 36

2. Introduction There are only two things certain in life:
death and taxes.
But,I'd like to add a third certainty: ageing
Hong Kong:
Aspects of ageing:
-- Biological
-- Psychological
Social
Emotion
Cognition
Personality
% (1 in 8, is an elderly)
“aged society”
% (1 in 5, is an elderly)
% (1 in 4, is an elderly)
“super-aged society”
Healthy ageing

3. A “GATE” to understand Healthy ageing
Healthy ageing: age-related changes of cognition
MCI / MND
MND: an updated diagnosis in DSM-5*: an evolution of “MCI”
Dementia
Complex attention:
sustained attention, divided attention, selective attention, processing speed.
Fig 1. MND as a concept
(revised graph based on Petersen, R. C., et al., 2004)
Attention network theory
* MCI=Mild Cognitive Impairment; MND= Mild Neurocognitive Disorders
DSM-5: Fifth Edition of the Diagnosis and Statistical Manual of Mental Disorders

4. Attention Network + + + + + * + + * or * *
 Cue types: No cue, Center cue, Double Cue, Spatial cue (Up and Down) + * or * *
M. I. Posner (1990), three components of attention network: *
Alerting
Orienting
Executive control
Alerting
Orienting
What
Where +
cue
How + *
Target ≤ 1700 ms +
100 ms
Tailor-made test: attention network test (ANT) + *
Platform: E-Prime 2.0.
Good reliability and validity
Index: Accuracy and Reaction time (RT) + *
100 ms *
 Flanker type:
Congruent
Incongruent
Neutral +
Executive
Control
Functional neuroimaging studies: evidence of anatomical basis

5. + * Alerting Center Cue: 200msec No Cue PFC Posterior parietal area
Frontal areas
Alerting
Thalamus
Center Cue: 200msec
No Cue + *
PFC
Picture revised on: Carter R, Frith C D. Mapping the mind[M]. University of California Press, 1998.

6. + * Orienting Spatial Cue: Random, last 200msec PFC
Superior parietal area
Frontal eye fields (FEF)
Orienting
Temporal Parietal Junction (TPJ)
Spatial Cue:
Random, last 200msec + *
PFC

7. + Executive Control Incongruent: 500msec Click or ≥2 sec PFC
Cingulate cortex
Prefrontal cortex
Executive
Control
Basal ganglia
Incongruent: 500msec
Click or ≥2 sec +
PFC

8. Research question & Hypothesis
Does the “Attention network-brain” correlates demonstrate the similar pattern as functional MRI did?
Objective:
To investigate the gray matter volume (GMV) correlates with ANT indices in healthy older adults.
Hypothesis:
The “Attention network-GMV” correlates would demonstrate the specific neural underpinnings as fMRI did.

9. Materials & Methods Design: cross-sectional study
Global
Design: cross-sectional study
Participants: 30 healthy Chinese older adults
Attention
Short-term memory
Executive function
Neuropsychological battery
Attention network test (ANT)
Structural MRI (T1 images)

10. Morphological analysis: gray matter volume (GMV)
T1 images processing:
BrainSuite 14a (following UCLA processing pipeline)
Regional GMV: calculated based on 70 ROIs
Pearson’s correlation:
Between ANT indices and regional GMV.
Covariates: age, gender, education and total intracranial volume (TIV) L R

11. Alerting and GMV L_Superior parietal gyrus r=-0.385, p=0.027
R_Superior temporal gyrus
r=-0.383, p=0.028
L_Supra marginal gyrus
r=-0.436, p=0.011
L_Inferior temporal gyrus
r=-0.373, p=0.032 - r

12. Orienting and GMV L_middle occipital gyrus R_Superior temporal gyrus
r=0.375, p=0.031
R_Superior temporal gyrus
r=0.375, p=0.031
R_Inferior temporal gyrus
r=0.486, p=0.004 r

13. L_Orbital Inferior frontal gyrus
Executive control and GMV
L_Superior temporal gyrus
r=-0.368, p=0.032
R_Superior temporal gyrus
r=-0.402, p=0.018
L_Cingulate gyrus
r=-0.496, p=0.003
L_Fusiform gyrus (BA37)
r=-0.584, p<0.001
L_Orbital Inferior frontal gyrus
(BA11 and BA47)
r=-0.433, p=0.010 r -

14. Conclusion Specific patterns of “Attention network-Brain” correlates.
Generally, the patterns are similar with fMRI
Overlapped regions in healthy older adults
such as MTL, needed further exploration.
Alerting related regions
Alerting related GMV
Orienting related regions
Orienting related GMV
Executive control related regions
Executive control related GMV

15. Limitation & Future prospective
Major limitations:
(1) Cross-sectional study design
(2) A relative small sample size
Future directions:
(1) Explore the interaction between age and cognitive status
(2) Combined functional MRI (task-free fMRI)

16. Acknowledgement & Reference
This study is supported by Lui Che Woo Institute of Innovation Medicine grant at CUHK
We thank all the participants and colleagues from CUHK 
Reference：
Lam, L. C. W., et al., International Psychogeriatrics,2008, 20(1), 135–48.
Sachdev, et al. (2014). Classifying neurocognitive disorders: the DSM-5 approach. Nature Reviews Neurology.
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of internal medicine, 256(3),
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