Neuroanatomical correlates and predictors of psychotic symptoms in Alzheimer's disease : a systematic review and meta-analysis

Scarfo, Sara and Marsella, Antonella M.A. and Grigoriadou, Loulouda and Moshfeghi, Yashar and McGeown, William (2024) Neuroanatomical correlates and predictors of psychotic symptoms in Alzheimer's disease : a systematic review and meta-analysis. Neuropsychologia, 204. 109006. ISSN 0028-3932 (https://doi.org/10.1016/j.neuropsychologia.2024.10...)

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Abstract

Background: Psychotic symptoms (hallucinations and delusions) are a type of neuropsychiatric symptom found during Alzheimer's Disease (AD). Objective: This systematic review aims to comprehensively capture, analyse, and evaluate the body of evidence that has investigated associations between brain regions/networks and psychotic symptoms in AD. Methods: The protocol, created according to the PRISMA guidelines, was pre-registered on OSF (https://osf.io/tg8xp/). Searches were performed using PubMed, Web of Science and PsycInfo. A partial coordinate-based meta-analysis (CBMA) was performed based on data availability. Results: Eighty-two papers were selected: delusions were found to be associated mainly with right frontotemporal brain regions and the insula; hallucinations mainly with fronto-occipital areas; both were frequently associated with the anterior cingulate cortex. The CBMA, performed on the findings of fourteen papers on delusions, identified a cluster in the frontal lobe, one in the putamen, and a smaller one in the insula. Conclusions: The available evidence highlights that key brain regions, predominantly in the right frontal lobe, the anterior cingulate cortex, and temporo-occipital areas, appear to underpin the different manifestations of psychotic symptoms in AD and MCI. The fronto-temporal areas identified in relation to delusions may underpin a failure to assimilate correct information and consider alternative possibilities (which might generate and maintain the delusional belief), and dysfunction within the salience network (anterior cingulate cortex and insula) may suggest a contribution for how internal and external stimuli are identified; the fronto-occipital areas linked to hallucinations may indicate diminished sensory processing and non-optimal predictive processing, that together contribute to misinterpretation of stimuli and misperceptions; the fronto-temporal and occipital areas, as well as the anterior cingulate cortex were linked to the psychotic cluster.

ORCID iDs

Scarfo, Sara ORCID logoORCID: https://orcid.org/0009-0000-7052-5732, Marsella, Antonella M.A., Grigoriadou, Loulouda, Moshfeghi, Yashar ORCID logoORCID: https://orcid.org/0000-0003-4186-1088 and McGeown, William ORCID logoORCID: https://orcid.org/0000-0001-7943-5901;
CORE (COnnecting REpositories)