Mild cognitive impairment and fMRI studies of brain functional connectivity: the state of the art

In the last 15 years, many articles have studied brain connectivity in Mild Cognitive Impairment patients with fMRI techniques, seemingly using different connectivity statistical models in each investigation to identify complex connectivity structures so as to recognize typical behavior in this type of patient. This diversity in statistical approaches may cause problems in results comparison. This paper seeks to describe how researchers approached the study of brain connectivity in MCI patients using fMRI techniques from 2002 to 2014. The focus is on the statistical analysis proposed by each research group in reference to the limitations and possibilities of those techniques to identify some recommendations to improve the study of functional connectivity. The included articles came from a search of Web of Science and PsycINFO using the following keywords: f MRI, MCI, and functional connectivity. Eighty-one papers were found, but two of them were discarded because of the lack of statistical analysis. Accordingly, 79 articles were included in this review. We summarized some parts of the articles, including the goal of every investigation, the cognitive paradigm and methods used, brain regions involved, use of ROI analysis and statistical analysis, emphasizing on the connectivity estimation model used in each investigation. The present analysis allowed us to confirm the remarkable variability of the statistical analysis methods found. Additionally, the study of brain connectivity in this type of population is not providing, at the moment, any significant information or results related to clinical aspects relevant for prediction and treatment. We propose to follow guidelines for publishing fMRI data that would be a good solution to the problem of study replication. The latter aspect could be important for future publications because a higher homogeneity would benefit the comparison between publications and the generalization of results.