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Quantitative susceptibility mapping of the brain is associated with inflammatory changes in Alzheimer's disease

Seyyed Ali Hosseini1,2,3, Stijn Servaes1,2,3, Arthur C Macedo1,2,3

  • 1Translational Neuroimaging Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|February 9, 2026
PubMed

Insights

Quantitative susceptibility mapping (QSM) reveals increased paramagnetic substances in Alzheimer's disease (AD) brain tissue, reflecting inflammation rather than protein buildup. This MRI technique offers new insights for AD therapeutic development.

Area of Science:

  • Neuroimaging
  • Biomarkers
  • Alzheimer's Disease Research

Background:

  • Paramagnetic substance accumulation in brain tissue is linked to Alzheimer's disease (AD) and inflammation.
  • Quantitative susceptibility mapping (QSM) measures paramagnetic load, potentially serving as an indicator in AD.
  • The relationship between QSM, AD pathology (amyloid-beta and tau), and inflammation requires further investigation.

Purpose of the Study:

  • To assess the association between QSM, as a measure of paramagnetic load, and brain Aβ and tau aggregates.
  • To evaluate the correlation of QSM with inflammatory biomarkers in plasma and cerebrospinal fluid (CSF).
  • To investigate the longitudinal changes in QSM in individuals across the AD spectrum.

Main Methods:

  • Utilized MRI quantitative susceptibility mapping (QSM) and T1-weighted scans from 315 participants in the TRIAD cohort.
  • Assessed mean-cortical and subcortical susceptibility values at baseline and at 12 and 24-month follow-ups.
  • Correlated QSM values with AD-relevant plasma and CSF inflammatory biomarkers, as well as Aβ and tau levels.

Main Results:

  • AD patients exhibited significantly higher QSM than controls in specific brain regions (posterior cingulate cortex, precuneus, basal ganglia) at baseline.
  • Over 24 months, QSM increased in the anterior cingulate (MCI) and in the pallidum and hippocampus (dementia).
  • QSM correlated with several immune biomarkers (IL-10RB, PD-L1, SCF, TWEAK, CSF-1, CXCL9, HGF, CD40) but not with Aβ or tau biomarkers.

Conclusions:

  • QSM reflects tissue inflammation in Alzheimer's disease, rather than protein aggregation.
  • The magnitude of tissue susceptibility load measured by QSM provides insights into brain dysfunction.
  • QSM shows potential as a valuable tool for monitoring disease progression and in the development of AD therapeutics.
Keywords:
Alzheimer’s diseaseQSMbrain’ susceptibilityimmune biomarkersneuroinflammation

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