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Cortical microstructural changes along the Alzheimer's disease continuum.

Victor Montal1, Eduard Vilaplana1, Daniel Alcolea1

  • 1Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|October 29, 2017
PubMed
Summary
This summary is machine-generated.

Alzheimer's disease (AD) progression shows a biphasic trajectory. Early stages involve increased cortical thickness and decreased mean diffusivity (MD) and free water (FW), while later stages show the opposite, impacting biomarker selection for clinical trials.

Keywords:
Alzheimer's disease continuumAmyloidBiomarkersCSFCortical microstructureMRITau

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Area of Science:

  • Neuroimaging
  • Biomarkers
  • Alzheimer's Disease Research

Background:

  • Cortical mean diffusivity (MD) and free water fraction (FW) are potential biomarkers for Alzheimer's disease (AD).
  • Understanding microstructural and macrostructural changes across the AD continuum is crucial for biomarker validation and clinical trial design.

Purpose of the Study:

  • To investigate the biphasic trajectory of cortical microstructural and macrostructural changes in Alzheimer's disease.
  • To assess changes in cortical mean diffusivity (MD), free water fraction (FW), and cortical thickness (CTh) along the AD continuum.

Main Methods:

  • Included 254 healthy controls (classified by NIA-AA stages 0, 1, 2/3), 41 mild cognitive impairment patients, and 31 AD dementia patients.
  • Utilized 3 Tesla magnetic resonance imaging (MRI) and lumbar puncture for data acquisition.
  • Assessed cortical MD, cortical FW, and cortical thickness (CTh) across different stages of AD.

Main Results:

  • A biphasic trajectory of microstructural and macrostructural changes was observed.
  • Stage 1 participants showed increased CTh and decreased MD and FW compared to Stage 0.
  • Stage 2/3 participants exhibited decreased CTh and increased cortical MD and FW, with more widespread changes in symptomatic stages.

Conclusions:

  • The findings support a biphasic model of AD progression.
  • These insights may influence patient selection for clinical trials.
  • Magnetic resonance imaging (MRI) metrics could serve as surrogate markers for tracking disease modification.