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The aim was to explore NVC as a correlation between the functional connectivity and cerebral blood flow within the large\u2010scale resting\u2010state functional magnetic resonance imaging brain networks in a sample of ALS patients compared to healthy controls (HCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010eight ALS patients (30 males; mean age 60.64\u2009\u00b1\u20099.62\u2009years) and 32 HC subjects (14 males; mean age 55.06\u2009\u00b1\u200916\u2009years) were enrolled and underwent 3\u2009T magnetic resonance imaging. ALS patients were screened by clinical and neuropsychological scales and were retrospectively classified as very fast progressors (VFPs), fast progressors and slow progressors (SPs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Neurovascular coupling reduction within the default mode network (DMN) (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) was revealed in ALS patients compared to HCs, observing, for this network, significant NVC differences between VFP and SP groups. Receiver operating characteristic curve analysis showed that impaired NVC in the DMN at baseline best discriminated VFPs and SPs (area under the curve 75%). Significant correlations were found between NVC and the executive (<jats:italic>r<\/jats:italic>\u2009=\u20090.40, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), memory (<jats:italic>r<\/jats:italic>\u2009=\u20090.32, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), visuospatial ability (<jats:italic>r<\/jats:italic>\u2009=\u20090.40, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and non\u2010ALS\u2010specific (<jats:italic>r<\/jats:italic>\u2009=\u20090.40, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) subscores of the Edinburgh Cognitive and Behavioural ALS Screen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The reduction of brain NVC in the DMN may reflect largely distributed abnormalities of the neurovascular unit. NVC alterations in the DMN could play a role in anticipating a faster clinical progression in ALS patients, aiding patient selection and monitoring during clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16540","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T07:40:01Z","timestamp":1731397201000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Brain neurovascular coupling in amyotrophic lateral sclerosis: Correlations with disease progression and cognitive impairment"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3790-8018","authenticated-orcid":false,"given":"Francesca","family":"Trojsi","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences MRI Research Center, Universit\u00e0 degli Studi della Campania Luigi Vanvitelli  Naples Italy"},{"name":"First Division of Neurology and 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