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Longitudinal functional network connectivity changes across the clinical stages of C9orf72 hexanucleotide repeat expansion carriers.

Liwen Zhang·Suvi Häkkinen·Youjin Jung·Maria Luisa Mandelli·Dana Leichter·Chiadi U Onyike·Julio C Rojas·Jolina Lombardi·Maria Luisa Gorno-Tempini·Jennifer S Yokoyama·Virginia E Sturm·Joel Kramer·Brad F Boeve·Adam L Boxer·Leah K Forsberg·Hilary W Heuer·Kejal Kantarci·Eliana Marisa Ramos·Howard J Rosen·Bruce L Miller·William W Seeley·Taru M Flagan·Suzee E Lee·ARTFL/LEFFTDS/ALLFTD Consortia
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Abstract

INTRODUCTION: Intrinsic functional connectivity network abnormalities in C9orf72 hexanucleotide repeat expansion carriers emerge during the asymptomatic phase, yet longitudinal studies remain limited. We examined cross-sectional abnormalities and longitudinal connectivity changes across clinical stages. METHODS: We analyzed task-free functional magnetic resonance imaging (fMRI) and structural MRI data in 36 asymptomatic (aSxC9), 17 prodromal (proC9), and 29 symptomatic (SxC9) carriers, and 107 healthy controls (HCs). Functional networks previously found altered in C9orf72, including salience, sensorimotor, default mode, and medial pulvinar thalamic networks, were examined. Associations between longitudinal connectivity and gray matter decline with baseline neurofilament light chain (NfL) concentrations and symptom severity were assessed. RESULTS: aSxC9 and SxC9 showed longitudinal connectivity changes within specific networks. In aSxC9, connectivity changes correlated with baseline NfL. In proC9 and SxC9, changes in connectivity and gray matter were associated with baseline NfL and symptom severity. DISCUSSION: C9orf72 expansion carriers demonstrate stage-specific network connectivity changes.

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HumansC9orf72 ProteinMagnetic Resonance ImagingDNA Repeat ExpansionFemaleMaleLongitudinal StudiesMiddle AgedCross-Sectional StudiesGray MatterBrainHeterozygoteNerve NetProdromal SymptomsAgedC9orf72asymptomaticfrontotemporal dementiafunctional connectivitygray matter atrophylongitudinal changesprodromalresting‐state fMRIsymptomaticJournal Article

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Liwen Zhang, Suvi Häkkinen, Youjin Jung, Maria Luisa Mandelli, Dana Leichter, Chiadi U Onyike, Julio C Rojas, Jolina Lombardi, Maria Luisa Gorno-Tempini, Jennifer S Yokoyama, Virginia E Sturm, Joel Kramer, Brad F Boeve, Adam L Boxer, Leah K Forsberg, Hilary W Heuer, Kejal Kantarci, Eliana Marisa Ramos, Howard J Rosen, Bruce L Miller, William W Seeley, Taru M Flagan, Suzee E Lee, ARTFL/LEFFTDS/ALLFTD Consortia. 2026. Longitudinal functional network connectivity changes across the clinical stages of C9orf72 hexanucleotide repeat expansion carriers.. https://doi.org/10.1002/alz.71744

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