Neuropsychiatric symptoms are commonly observed as brain pathology progresses with dementia. Behavioral and affective disturbances underly the distinct neuroanatomical basis of typical symptoms of cognitive impairment; however it remains unclear whether enriched intellectual experience, such as educational attainment, can mitigate the effect of brain structural patterns on neuropsychiatric symptom severity. We utilized the Open Access Series of Imaging Studies (OASIS-3) dataset, which includes brain structural MRI and behavioral symptom evaluation. We included 904 older adults who were mostly cognitively normal, clinically diagnosed with very mild to moderate Alzheimer’s disease, or other types of dementia. Canonical correlation analysis was used to identify the patterns of multivariate association between the gray matter structure and neuropsychiatric symptom severity. First, we identified two canonical modes capturing the distinct neuroanatomical basis of common and mood-specific factors of neuropsychiatric symptoms. The first common pattern reflected a smaller volume in the amygdala and adjacent temporal regional thickness. The second mood-specific pattern reflected patterns in lateral and orbital prefrontal regional thickness. In the external correlational analysis, the two canonical correlations reflected global brain volume and white matter lesions; however, the second pattern was not associated with functional impairments or cognitive function. Moreover, older adults with higher education showed an attenuated severity of behavioral symptoms, even with the presence of a brain structural pattern. Our findings suggest that educational attainment, as a proxy of cognitive reserve, can mitigate the severity of behavioral and affective symptoms of dementia.

随着痴呆症的脑部病理进展，通常会观察到神经精神症状。行为和情感障碍是认知障碍典型症状的独特神经解剖学基础。然而，尚不清楚的是，丰富的知识经验（例如学历）是否可以减轻大脑结构模式对神经精神症状严重程度的影响。我们利用了影像研究的开放获取系列（OASIS-3）数据集，其中包括脑结构MRI和行为症状评估。我们纳入了904位年龄较大的成年人，这些成年人大多认知正常，临床上被诊断出患有轻度至中度的阿尔茨海默氏病或​​其他类型的痴呆症。典型相关分析用于确定灰质结构与神经精神症状症状严重程度之间的多元关联模式。首先，我们确定了两种典型的模式来捕获神经精神症状的常见和特定于情绪的因素的独特的神经解剖学基础。第一个共同模式反映出杏仁核和邻近颞区厚度较小的体积。第二种特定于情绪的模式反映了外侧和眶前额叶区域厚度的模式。在外部相关性分析中，这两个典型的相关性反映了整体脑容量和白质病变。然而，第二种模式与功能障碍或认知功能无关。此外，受过高等教育的老年人的行为症状严重程度有所减轻，即使存在大脑结构模式。我们的研究结果表明，作为认知储备的代表，受教育程度可以减轻痴呆的行为和情感症状的严重性。