Over recent decades, the stakeholder arena for urban flood management has become well recognised as being complex and dynamic. Various stakeholders are involved before, during and after a flooding event, all of which have different interests and demands. Therefore, an initial stakeholder identification and analysis stage is required before detailed stakeholder engagement strategies can be developed and employed. Drawing on urban flood management in Zhuji, a typical medium-sized city that has suffered urban flooding in China, this research project used a mixed-method research methodology within a single case-study approach to explore the current stakeholder arena for urban flood management in a medium-sized Chinese city. By combining stakeholder salience analysis with social network analysis, this study tries to create a more nuanced insight into the stakeholder arena, so that stakeholder participation in urban flood management can be improved. This thesis produces several findings. First, it provides empirical evidence to show that traditional one-dimensional stakeholder analysis methods such as the level of interest and influence; cooperation and competition; cooperation and threat; and stakeholder interest and power cannot provide an in-depth understanding of a complex and dynamic stakeholder arena, as exists for urban flood management. By way of contrast, the proposed stakeholder analysis approach, which combines both stakeholder salience and network analyses, can create a multi-dimensional understanding of urban flood management stakeholders and allows the initial problem space to be recast into a more detailed or nuanced understanding of the problems presented. This improved understanding of the stakeholder arena and the related problem space provides a more solid information foundation upon which new stakeholder and community engagement practices can be developed. Second, this thesis argues that the Mitchell et al. (1997) salience model experiences limitations in practice. Only five of the seven salience groups were identified in the present research project, with both the Dangerous and Demanding stakeholder groups missing. This indicates that the identification of urban flood management stakeholders in a medium-sized Chinese city is highly dependent on their legitimate claims. Third, the social network analysis used in this project not only explores the relationships between stakeholders, but also provides an opportunity to present other one-dimensional stakeholder attitudes. This enhancement of the data beyond one-dimensional visual representations to dynamic and interactive processes not only better assists policy-makers in developing new and improved engagement practices, it also allows engagement practitioners to educate stakeholders and interactively improve understanding of the situation among those stakeholders. This understanding, in turn, is assumed to facilitate collaborative problem solving.

Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) have been difficult to differentiate in clinical settings, as these two disorders are phenotypically similar and both exhibit atypical attention and executive functioning. Mischaracterizations between these two disorders can lead to inappropriate medication regimes, significant delays in special services, and personal distress to families and caregivers. There is evidence that ASD and ADHD are biologically different for attentional and executive functioning mechanisms, as only half of individuals with co-occurring ASD and ADHD respond to stimulant medication. Further, neurobehavioral work has supported these biological differences for ASD and ADHD, with both shared and distinct functional connectivity. In specific, two brain networks have been implicated in these disorders: the salience network (SN) and frontoparietal network (FPN). The SN is a network anchored by bilateral anterior insula and the dorsal anterior cingulate cortex and has been implicated in “bottom-up” attentional processes for both internal and external events. The FPN is anchored by lateral prefrontal cortex areas and the parietal lobe and plays a roll in “top-down” executive processes. Functional connectivity subgroups differentiated ASD from ADHD with between SN-FPN connectivity patterns, but not by within-SN or within-FPN connectivity patterns. Further, subgroup differences in ASD+ADHD comorbidity vs. ASD only were found for within-FPN connectivity. / Master of Science / Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) have been difficult to differentiate in clinical settings, as these two disorders are similar and both exhibit attention and executive functioning difficulties. ASD and ADHD have shared and distinct functional brain network connectivity related to attention and executive functioning. Two brain networks have been implicated in these disorders: the salience network (SN) and frontoparietal network (FPN). The SN is a network that has been implicated in “bottom-up” attentional processes for both internal and external events. The FPN plays a roll in “top-down” executive processes. This study found that functional connectivity patterns between the SN and FPN differentiated ASD from ADHD. Further, connectivity patterns in children with co-occurring ASD and ADHD were characterized by within-FPN connectivity.

The study’s objective was to assess whether resting-state regional functional connectivity and current source density (CSD) measured during smoking abstinence predict smoking progression across 18 months, depressive traits, and nicotine-enhanced reward sensitivity (NERS) in young light-nicotine (NIC) smokers using low-resolution brain electromagnetic tomography analysis (LORETA). A secondary goal was to assess whether depressive traits moderate the ability of connectivity and regional CSD to predict NERS. Brain regions of interest (ROIs) hypothesized to predict smoking progression, NERS, and depressive traits include structures with high-density nicotinic acetylcholine receptors (nAChRs) and reward-related areas. A total of N=108, 14-hour NIC-deprived young (age 18-24) light (5-35 NIC uses/week) smokers underwent electroencephalogram (EEG) recording while at rest (i.e., viewed a white crosshair on a black background) for 8 minutes then completed the PRT, an assessment of reward sensitivity, after smoking a placebo (0.05 mg NIC) and NIC (0.8 mg NIC) cigarette using a within-subjects design allowing for the assessment of NIC-induced changes in reward sensitivity. All EEG power and LORETA activity bands underwent regression analysis to discover if EEG-assessed brain activity can predict smoking progression, depressive traits, NERS, and their potential interaction. Localized brain regions include 1) reward-related structures, 2) depressive trait-related structures, and 3) large-scale neural (e.g., salience network (SN), default mode network (DMN), executive control network (ECN)) and substance use disorder networks (e.g., orbital frontal cortex (OFC), insula, dorsal lateral prefrontal cortex (dlPFC) anterior cingulate cortex (ACC)). Weaker resting-state connectivity (rsC) between the insula and ACC (i.e., SN) predicted greater smoking progression at 18 months (theta1 and theta2) and greater depressive traits (delta and theta1), while greater rsC within the SN predicted greater NERS (alpha2 and beta 2/3[23.19 – 25.14 Hz]). Greater NERS was also predicted by greater alpha2 connectivity between the 1) ACC and posterior cingulate cortex (PCC) and 2) ACC and left dlPFC. Greater depressive traits were also predicted by 1) weaker delta and theta2 connectivity between the bilateral insula, 2) weaker delta, theta1, and theta2 between the insula and dlPFC, 3) weaker delta and theta1 between the insula and subgenual cortex, 4) greater theta2 in the right vs. left default mode, and 5) greater delta (2.44 – 3.41 Hz) in the left vs. right default mode network. Both greater depressive traits and greater NERS were predicted by weaker 1) theta2/alpha1 (6.59 – 9.52 Hz) between the insula and dlPFC and 2) alpha1 (7.5 – 9.5 Hz) between the left orbital frontal cortex and right dlPFC. These findings provide the first evidence that differences in EEG-assessed brain connectivity in young light smokers are associated with nicotine-enhanced reward sensitivity, depressive traits, and smoking progression. Notably, weaker low-frequency rsC within the salience network predicted depressive traits and smoking progression, while greater high-frequency rsC predicted greater nicotine-enhanced reward sensitivity. These findings suggest that salience network rsC and drug-enhanced reward sensitivity may be useful tools and potential endophenotypes for reward sensitivity and drug-dependence research.

Over the last 20 years, there has been increasing research on the negative effects of discrimination on the mental and physical health of people of color. As mental health has an important relationship with the functional connectivity of brain networks, it is vital to further understand this. One way to measure functional brain connectivity is by observing the activity of the brain’s resting state networks (RSN) while a participant is at rest. Previous studies investigating connectivity have demonstrated a relationship between altered connectivity of RSNs and neuropsychiatric disorders, including Alzheimer’s disease, depression, and anxiety. The RSN of interest in this analysis is the salience network (SN). This network, anchored in the anterior insula and dorsal anterior cingulate cortex, is involved in the responses to “salient” stimuli that are infrequent in space or time, compete for an individual’s attention, and are surprising or emotionally engaging, such as an act of discrimination. The aim of this study was to use a seed-based correlation analysis to examine the relationship between perceived discrimination and the functional connectivity of the SN in black and white participants and to evaluate the differences in SN functional connectivity between black and white participants. Resting state functional connectivity was measured by using the functional magnetic resonance imaging (fMRI) data collected from 18 healthy older adults partaking in two different studies investigating aging, cognition, and the accompanying changes in neuroanatomy. The Analysis of Functional NeuroImages (AFNI) software was used to examine the correlations in activation in the primary nodes of the SN with activation in clusters in the other primary nodes. Perceived discrimination was measured using the Experiences of Discrimination Scale (EOD), a self-report measuring the frequency of instances of discrimination and the perceived reason behind the discrimination. Preliminary results from this analysis demonstrated that black participants, when compared to the white participants, demonstrated greater functional connectivity between the left and right insula and decreased functional connectivity between the right anterior cingulate cortex and the right insula. Black participants demonstrated a positive association between perceived overall discrimination and functional connectivity between the right and left insula and a negative association between perceived overall discrimination and functional connectivity between the right anterior cingulate cortex and the left insula. The white participants demonstrated a negative association between perceived overall discrimination and functional connectivity between the left and the right insula. Considering the inability for these results to survive correction for multiple comparisons, a larger sample size is necessary to obtain true statistical significance. Although existing research has implicated functional connectivity changes in the regions of the salience network in populations experiencing social exclusion, anxiety, and depression, further analyses are necessary to expand the limited research available regarding the effects of overall and race-based discrimination on the resting state functional connectivity of neural networks involved in emotional processing.

In addition to mood symptoms, major depressive disorder (MDD) is characterized by cognitive impairments that can have detrimental impacts on quality of life and daily function, and have been found to persist into remission. In particular, altered affective cognition (e.g. biased attention to negative stimuli) has been reported in MDD, and may continue into remission. Unfortunately, current pharmacotherapies do not adequately address cognitive dysfunction in acute or remitted MDD. Understanding the neurobiological underpinnings of affective cognitive dysfunction in remitted MDD may help inform the development of new interventions to address this lingering problem and the associated poorer functional outcomes. The triple network model posits that altered functioning of three key networks implicated in normal cognitive function – the default mode network (DMN), central executive network (CEN) and salience network (SN) – underlies cognitive dysfunction in a variety of psychiatric illnesses, including MDD. Though notable exceptions exist, work in acutely depressed MDD patients has found evidence of DMN hyperconnectivity, CEN hypoconnectivity and abberant SN connectivity both at rest and during the completion of various cognitive tasks. The evidence for triple network connectivity alterations persisting into remission is less robust, and warrants further investigation. Furthermore, there is a paucity of studies examining remitted MDD connectivity during affective tasks. As such, the primary objectives of this thesis were to: 1) compare resting-state and task triple network connectivity profiles in remitted MDD patients (rMDDs) and healthy volunteers (HVs) at rest, during an affective (emotional Stroop [eStroop]) task, and during rest vs. the task and, 2) assess the relationship between DMN and CEN connectivity and measures of daily functioning, quality of life and/or negative, self-relational rumination in the rMDD cohort. Behaviourally, there were findings of an affective attentional bias and impaired processing speed in the rMDD vs. HVs, as revealed by a computerized cognitive test battery. However, we found no evidence of DMN hyperconnectivity or CEN hyperconnectivity in the rMDD study sample. We did find evidence of altered intrinsic CEN and CEN-SN connectivity between the rest and task conditions that seemed driven by the rMDD sample, as well as positive CEN-DMN correlations across the entire sample both at rest and during the eStroop task. Suprisingly, we also found higher intrinsic DMN connectivity during the eStroop task vs. at rest across the whole sample. Finally, we found a positive relationship between task-based CEN connectivity and hopeless rumination, and a significant negative relationship between resting state and task-based DMN connectivity and psychosocial dysfunction in the rMDD sample. These findings contribute to our understanding of large-scale intrinsic network connectivity alterations during remitted depression, and their relationship to functional outcomes.

This study investigated the effects of lesion presence within larger brain networks (e.g., default mode network (DMN), salience network (SN), and mentalizing network (MN)) in the chronic phase of a pediatric traumatic brain injury (TBI) and the effect on social function. We compared children with a TBI to children with an orthopedic injury (OI) with three different aims. The first aim was to determine whether network volume differed by group (e.g., TBI vs. OI). Second, investigate if lesion presence in a sub component region of the network resulted in total network volume loss for that network. Finally, learn whether network volume would predict outcome on the Behavior Assessment System for Children, Second Edition (BASC-2). Approximately 184 participants (65% male; 70% Caucasian) between the ages of 6-17 years completed testing and a structural MRI scan in the chronic stage (at least one-year post-injury) of the injury. Injury severity included complicated mild, moderate, and severe TBI. Radiological findings were analyzed using recommendations from the Common Data Elements' core (presence or absence of a lesion) and supplementary (lesion type and location) recommendations. Volumetrics for all participants were obtained with FreeSurfer to quantify total network volumes for the DMN, SN, and MN. The parent of each participant completed a behavioral measure for externalizing and internalizing behaviors. Three sets of statistical analyses were completed, including multivariate analysis of covariance, analysis of covariance, and multiple regression, for each of the three aims of the study, respectively. There were significant differences in total DMN volume between the two groups and participants with lesions solely in the MN had lower total MN volume. Moreover, lower total MN volume was associated with worse functioning on measures of externalizing and internalizing behaviors. The larger implications, including developmental and social implications, of these findings are discussed.

Despite the interest in the neuroimaging of working memory, little is still known about the neurobiology of complex working memory in tasks that require simultaneous manipulation and storage of information. In addition to the central executive network, we assumed that the recently described salience network [involving the anterior insular cortex (AIC) and the anterior cingulate cortex (ACC)] might be of particular importance to working memory tasks that require complex, effortful processing. Method: Healthy participants (n = 26) and participants suffering from working memory problems related to the Kleine–Levin syndrome (KLS) (a specific form of periodic idiopathic hypersomnia; n = 18) participated in the study. Participants were further divided into a high- and low-capacity group, according to performance on a working memory task (listening span). In a functional magnetic resonance imaging (fMRI) study, participants were administered the reading span complex working memory task tapping cognitive effort. Principal findings: The fMRI-derived blood oxygen level dependent (BOLD) signal was modulated by (1) effort in both the central executive and the salience network and (2) capacity in the salience network in that high performers evidenced a weaker BOLD signal than low performers. In the salience network there was a dichotomy between the left and the right hemisphere; the right hemisphere elicited a steeper increase of the BOLD signal as a function of increasing effort. There was also a stronger functional connectivity within the central executive network because of increased task difficulty. Conclusion: The ability to allocate cognitive effort in complex working memory is contingent upon focused resources in the executive and in particular the salience network. Individual capacity during the complex working memory task is related to activity in the salience (but not the executive) network so that high-capacity participants evidence a lower signal and possibly hence a larger dynamic response.

Synchronized oscillations of ensembles of neurons in the brain underlie human cognition and behaviors. Neuronal network oscillations can be described by the physics of coupled dynamical systems. This dissertation examines the dynamic network activities in two distinct neurocognitive networks, the salience network (SN) and the ventral temporal cortex-dorsolateral prefrontal cortex (VTC-DLPFC) network, during perceptual decision-making (PDM). The key nodes of the SN include the right anterior insula (rAI), left anterior insula (lAI), and dorsal anterior cingulate cortex (dACC) in the brain. When and how a sensory signal enters and organizes within the SN before reaching the central executive network including the prefrontal cortex has been a mystery. Second, prior studies also report that perception of visual objects (face and house) involves a network of the VTC—the fusiform face area (FFA) and para-hippocampal place area (PPA)—and the DLPFC. How sensory information enters and organizes within the VTC-DLPFC network is not well understood, in milliseconds time-scale of human’s perception and decision-making. We used clear and noisy face/house image categorization tasks and scalp electroencephalography (EEG) recordings to study the dynamics of these networks. We demonstrated that beta (13–30 Hz) oscillation bound the SN, became most active around 100 ms after the stimulus onset, the rAI acted as a main outflow hub within the SN, and the SN activities were negatively correlated with the difficult tasks. We also uncovered that the VTC-DLPFC network activities were mediated by beta (13-30 Hz) and gamma (30-100 Hz) oscillations. Beta activities were enhanced in the time frame 125-250 ms after stimulus onset, the VTC acted as main outflow hub, and network activities were negatively correlated with the difficult tasks. In contrast, gamma activities were elevated in the time frame 0-125 ms, the DLPFC acted as a main outflow hub, and network activities—specifically the FFA-PPA pair—were positively correlated with the difficult tasks. These findings significantly enhance our understanding of how sensory information enters and organizes within the SN and the VTC-DLPFC network, respectively in PDM.

Abstract Frontotemporal lobar degeneration (FTLD) is the second most common neurodegenerative disease leading to early-onset dementia with an estimated worldwide prevalence of 10 to 30 cases per 100000 individuals in the age group of 46 to 65 years. Behavioral variant frontotemporal dementia (bvFTD) is the most common FTLD subtype. It is characterized by a progressive deterioration of behavior and personality as well as executive dysfunction. In Finland, almost 50 % of familial FTLD cases are attributable to the C9ORF72 mutation. bvFTD is associated with a characteristic pattern of brain atrophy detectable in structural MRI. However, these changes are typically not visible in the early stages of the disease. Resting-state functional MRI (RS-fMRI) is being increasingly used to evaluate changes in functional connectivity within neuronal networks in the brain but only a few RS-fMRI investigations of bvFTD patients have been published with inconsistent results. The object of this thesis was to investigate functional connectivity changes detected in the salience (SLN) and default mode networks (DMN) in bvFTD. Another aim was to clarify the role of other cognitive resting-state networks in this disease. A cohort of 26 bvFTD patients was studied, with 8 of these patients carrying the C9ORF72 expansion. Connectivity changes were detected in multiple clinically relevant cognitive networks. Decreased functional connectivity was observed in the SLN, which is associated with guiding of behavior. Increased activity was present in the DMN and the dorsal attention network (DAN). In C9ORF72 associated bvFTD, there was an abnormal linkage detected between the DMN and the thalamus. Currently, fMRI is generally used as a research tool and in a group setting. Different study methods have been used in the literature and also in the studies of this thesis, the analysis procedures differed to some extent. The variety of analysis methods may explain the heterogeneity in fMRI findings in bvFTD patients. There is a need for standardization of the fMRI methodology, larger study groups and also in the future the methodology should be improved so that single patient analysis would provide results to allow a confident diagnosis of this disease. / Tiivistelmä Otsa-ohimolohkorappeuma (Frontotemporal lobar degeneration, FTLD) on toiseksi yleisin etenevä dementiaan johtava sairaus, joka ilmaantuu usein jo työikäisenä. Otsalohkodementia on otsa-ohimolohkorappeuman yleisin alamuoto, jonka oireisto painottuu persoonan ja käyttäytymisen muutoksiin sekä toiminnan ohjauksen ongelmiin. Suomessa C9ORF72-toistojaksomutaatio selittää lähes 50 % perinnöllisistä otsa-ohimolohkorappeumista. Aivojen rakenteellisella magneettikuvauksella (MK) voidaan havaita rakenteellisia muutoksia, jotka ilmaantuvat kuitenkin vasta taudin edettyä vaikeampaan vaiheeseen. Aivojen lepotilan toiminnallinen magneettikuvaus (TMK) mahdollistaa aivojen hermoverkkojen toiminnan eli konnektiviteetin kartoituksen. Aiemmin TMK:a on tutkittu esim. Alzheimerin taudissa. Otsalohkodementiassa TMK:sta on julkaistu ainoastaan yksittäisiä tutkimuksia ja tulokset ovat olleet osin ristiriitaisia. Väitöskirjatutkimuksen tarkoituksena on ollut selvittää valve-lepotilan hermoverkossa ja olennaisen tunnistavassa hermoverkossa tapahtuvia muutoksia otsalohkodementiaa sairastavilla potilailla. Toisena tavoitteena on ollut tutkia muissa kognitiivisissa hermoverkoissa tapahtuvia muutoksia. Otsalohkodementiaa sairastaville potilaille (n= 26) sekä ikä- ja sukupuolivakioiduille kontrolleille on tehty kliininen tutkimus ja rakenteellinen sekä toiminnallinen aivojen magneettikuvaus. Kahdeksalla potilaalla todettiin C9ORF72-toistojaksomutaatio. Useiden kognitiivisten hermoverkkojen toiminnassa havaittiin muutoksia, jotka korreloivat potilaiden kliinisiin oireisiin. Alentunutta konnektiviteettia todettiin olennaisen tunnistavassa hermoverkossa, joka osallistuu käyttäytymisen säätelyyn. Lisääntynyttä konnektiviteettia esiintyi valve-lepotilan hermoverkossa ja tarkkaavaisuus hermoverkossa. Potilailla, joilla on C9ORF72-mutaatio, havaittiin epänormaali yhteys valve-lepotilan hermoverkon ja talamuksen välillä. TMK:ta käytetään tällä hetkellä lähinnä tutkimustyökaluna. Analyysityökaluissa on ollut vaihtelevuutta eri julkaisuissa ja osin myös tämän väitöskirjan osatöissä. Julkaistut TMK-löydökset otsalohkodementiassa ovat osin ristiriitaisia ja se saattaa selittyä erilaisilla analyysimenetelmillä. Metodologiaa tulisi standardisoida ja lisäksi tarvitaan suurempia potilasryhmiä ja menetelmien kehittämistä, jotta TMK:n käyttö yksilötason kliinisessä diagnostiikassa olisi jatkossa mahdollista.

Introdução: Apesar de ser uma intervenção potencialmente promissora para melhorar a cognição em sujeitos com comprometimento cognitivo leve (CCL), os efeitos do treinamento aeróbio (TA) no metabolismo regional de glicose (MRG) no cérebro ainda são pouco conhecidos. Objetivo: Avaliar os efeitos do TA na cognição e no MRG cerebral em sujeitos com CCL, usando tomografia por emissão de pósitrons com 18F - fluordesoxiglicose (PET-18FDG). Métodos: Sessenta e cinco sujeitos com CCL realizaram um programa de TA de intensidade moderada, duas vezes por semana, durante 24 semanas. Uma avaliação cognitiva com a escala Alzheimer\'s Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) e outra do metabolismo cerebral em repouso com o PET-18FDG foram realizadas antes e depois da intervenção. A capacidade aeróbia foi comparada utilizando o consumo máximo de oxigênio (VO2 máx.) medido em mL/kg/min. Os dados de PET-18FDG foram analisados voxel por voxel com o programa SPM8 (limiar: p < 0,001 não corrigido, tamanho de agrupamento >= 50 voxels). Uma técnica de modelação de equações estruturais foi usada para criar um modelo para explorar as mudanças no MRG cerebral em repouso depois do programa de TA. Resultados: Comparações com testes t pareados revelaram melhora nos valores da escala ADAS-Cog (diferença média: -2,4 (3,5), p < 0,001) e no VO2 máx. (diferença média: 1,4 (2,3) mL/kg/min, p < 0,001). A análise metabólica do cérebro constatou uma redução bilateral do MRG em ambos os polos temporais anteriores, no giro frontal inferior esquerdo, no giro do cíngulo anterior esquerdo, no hipocampo direito, no giro frontal médio esquerdo e nos núcleos caudados bilaterais. Em contraste, houve um aumento do MRG no precuneus direito e no giro frontal inferior esquerdo. Um modelo de confirmação de fatores foi usado para criar variáveis latentes que refletem a rede de saliência (RS) e a rede de modo padrão (default mode network (DMN)) com base em regiões com mudanças no MRG encontradas depois do TA. Uma análise de caminhos foi utilizada para testar a hipótese de que o TA poderia induzir mudanças (diminuição) do MRG em regiões da RS. Essa redução pode refletir um aumento da eficiência da rede e, consequentemente, um melhor controle sobre outras redes. Em última instância, essa mudança induziria um aumento do MRG no precuneus, um importante nó da DMN. Os valores de adequação do modelo atingiram significância estatística, demonstrando que esse modelo explica a variância dos dados medidos. Conclusão: O TA melhorou a cognição e alterou o MRG em regiões da DMN e da rede de saliência em sujeitos com CCL / Background: Despite being a potentially promising intervention to improve cognition in subjects with mild cognitive impairment (MCI), the effects of aerobic training (AT) on regional brain glucose metabolism (rBGM) are not yet entirely understood. Objective: To evaluate the effects of AT on cognition and rBGM in subjects with MCI using 18FDG-PET. Methods: Sixty-five subjects with MCI performed a twice-a-week, moderate intensity, AT program for 24 weeks. Assessment with the ADAS-Cog (Alzheimer\'s Disease Assessment Scale - Cognitive Subscale) and evaluation of rBGM with 18FDG-PET were performed before and after the intervention. Aerobic capacity was compared using the relative maximal oxygen consumption (VO2 max) measured in mL/Kg/min. 18FDG-PET data were analyzed on a voxel-by-voxel basis with SPM8 (threshold: uncorrected p < 0.001, cluster size >= 50 voxels). Structural equation modeling was used to create a model to explore the changes of resting-state rBGM after the AT program. Results: Comparisons using paired t-tests revealed improvements in the ADAS-Cog (mean difference: -2.4 (3.5), p < 0.001) and VO2 max scores (mean difference: 1.4 (2.3) mL/kg/min, p < 0.001). Brain metabolic analysis revealed a bilateral reduction of rBGM in both anterior temporal poles, left inferior frontal gyrus, left anterior cingulate cortex, right hippocampus, left middle frontal gyrus and bilateral caudate nuclei. In contrast, there was an increase in rBGM in the right precuneus and left inferior frontal gyrus. Confirmatory factor analysis was used to create latent variables reflecting the salience network (SN) and default mode network (DMN) based on regions with rBGM changes found after the AT. A path model analysis was used to test the hypothesis that AT would induce rBGM changes (decrease) in regions of the SN. This decrement may reflect improved efficacy and consequently, better control over other networks. Ultimately, these changes would induce an increment in rBGM in the precuneus, an important node of the DMN. Values of model fit reached statistical significance, demonstrating that this model explain the variance of the measured data. Conclusion: AT improved cognition and changed rBGM measured with 18FDG-PET in nodes od the DMN and SN in subjects with MCI