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Cognitive resilience refers to an individual’s capacity to cope with brain aging and pathology and to delay cognitive decline, whereas existing techniques such as functional magnetic resonance imaging capture only macroscopic features without linking them to neurophysiological mechanisms. Recent studies have shown that overexpression of the MST1 gene exacerbates Alzheimer’s disease phenotypes by affecting neuronal activity and metabolism; however, its association with cognitive trajectories and imaging biomarkers remains to be further investigated. Multimodal imaging data using information from 116 individuals with mild cognitive impairment was obtained from the ADNI database and participants from the HABS database. The correlation coefficient between glucose metabolism and neuronal low-frequency fluctuations was calculated, and residuals were derived from regression models of correlation coefficient with amyloid protein. Unsupervised clustering was then applied, and mediation analysis was conducted to investigate the mediating role of limbic orbital frontal cortex residuals in the association between MST1 gene expression and cognitive trajectories. Clustering identifies five groups with distinct cognitive trajectories: the high and low cognitive resilience groups exhibit slower dementia progression with lower MST1 expression, whereas the high and low cognitive vulnerability groups show faster dementia progression with higher MST1 expression. No significant differences are observed in glucose metabolism or amyloid protein levels across groups, while the limbic orbital frontal cortex residuals partially mediate the effect of MST1 gene expression on cognitive trajectories. Residual biomarkers can track dementia progression and characterize MST1-related pathology, providing imaging markers for assessing cognitive resilience and monitoring disease at the molecular level. Sheng et al. characterize features associated with neuroinflammation-related genes and cognitive resilience using a neuroimaging biomarker. The pathological effect of the MST1 gene on cognitive resilience is mediated by the mismatch between metabolic fluctuation coupling in the limbic orbital frontal cortex and amyloid protein deposition. Cognitive resilience is the ability to retain the ability to acquire and process knowledge. Current research on cognitive resilience primarily focuses on how parts of the brain communicate with each other; however, finding other indicators would be helpful. We investigated alternative measures and compared these in people with dementia, a disease in which cognitive resilience is usually lost. We found an alternative measure for cognitive resilience that can be used to track the progress of dementia. This could be helpful to monitor the effect of treatments for dementia and provide more information about why dementia develops.
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Sheng et al. (2026) studied this question.
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