# Observations of Triple Network Model Connectivity Changes by Functional Magnetic Resonance Imaging in a Single Early-Stage Dementia Participant Pre- and Post-craniosacral Therapy: A Case Report

## TL;DR

This case report explores how craniosacral therapy may affect brain network connectivity in a person with early-stage dementia using functional MRI.

## Contribution

The study is the first to report rs-fMRI changes in the triple network model following craniosacral therapy in early-stage dementia.

## Key findings

- CST was associated with increased connectivity in the central executive and salience networks.
- Reduced variability was observed in the default mode network after CST.
- These changes suggest potential reorganization of brain network dynamics.

## Abstract

Resting-state functional magnetic resonance imaging (rs-fMRI) is a noninvasive imaging technique that measures spontaneous brain activity to map functional connectivity within and between brain networks characterized as the triple network model (TNM). In Alzheimer's disease (AD), rs-fMRI has been used to detect early network disruptions, track disease progression, and evaluate therapeutic interventions. While craniosacral therapy (CST) has shown clinical benefits for conditions like chronic pain and migraine, its impact on TNM connectivity in AD, as evidenced by rs-fMRI, has not been explored. This case report involves a 79-year-old man with early-stage AD who presented with mild delusions, anxiety, irritability, and nighttime behaviors and a Mini-Mental State Examination (MMSE) score of 24 and a Clinical Dementia Rating (CRD) of 0.5, indicating a mild neurocognitive disorder. Preliminary rs-fMRI data revealed changes in the default mode network (DMN), salience network (SN), and central executive network (CEN) following CST. These changes suggest greater connectivity within the CEN and SN, alongside reduced variability in the DMN following CST. These observations suggest potential reorganization of TNM dynamics. The clinical relevance of these findings remains under evaluation. The observations from this single case report limit the ability to draw definitive conclusions about the impact of CST on TNM connectivity in early-stage AD. A further study is needed to determine if the TNM changes observed by rs-fMRI can be replicated in additional participants and if the changes are correlated with clinical outcomes. Further studies with larger cohorts, extended treatment durations, and longer follow-up periods are needed to explore the potential clinical benefits of CST in this population.