Identifying Distinct Spatiotemporal Patterns of Juxtacortical Microstructure in Alzheimer Disease Using Diffusion MRI–derived Free Water Fraction

医学 海马体 磁共振弥散成像 痴呆 阿尔茨海默病 前瞻性队列研究 核医学 认知功能衰退 疾病 海马结构 口语流利性测试 载脂蛋白E 认知障碍 内科学 磁共振成像 阶段(地层学) 有效扩散系数 匹兹堡化合物B 正电子发射断层摄影术 心脏病学 中枢神经系统疾病 神经学 退行性疾病 颞叶 病理 肿瘤科 神经影像学 内分泌学 扩散成像
作者
Junfang Zhang,Xinyuan Yang,Yan Wang,Xiaomeng Xu,Yingting Zheng,Qi Huang,Wenjing Wang,Wei Xu,Yihui Guan,Jun Liu,Yulei Deng,Fang Xie,Binyin Li
出处
期刊:Radiology [Radiological Society of North America]
卷期号:317 (1): e243423-e243423 被引量:4
标识
DOI:10.1148/radiol.243423
摘要

Background The free water fraction (FWF) is a potential imaging marker in Alzheimer disease (AD). Purpose To evaluate juxtacortical FWF, its association with neuropathologic severity, and its spatiotemporal pattern using MRI and PET in participants with AD or normal cognition. Materials and Methods This secondary analysis of a prospective study was conducted from November 2021 to July 2024, including diffusion MRI to assess FWF, fluorine 18 (18F) florbetapir PET to assess amyloid-β (Aβ), and 18F-MK-6240 PET to assess tau accumulation. Two independent subtype and stage inference (SuStaIn) models analyzed only juxtacortical FWF change or integrated FWF and Aβ. Results A total of 359 participants (mean age, 69 years ± 8 [SD]; age range, 40-86 years; 223 female) were included (161 with normal cognition, 85 with mild cognitive impairment due to AD, and 113 with dementia due to AD). Compared with controls, participants with AD had increased FWF (false discovery rate [FDR]-corrected P < .001 to P = .049), which was associated with higher global cortical Aβ and tau deposition (P < .001 to P = .04 for Aβ; P < .001 to P = .01 for tau; all FDR-corrected). The first SuStaIn model identified two distinct spatiotemporal trajectories of FWF: The orbitofrontal-first subtype had smaller left and right hippocampus volumes (left, b = -0.1 and P = .007; right, b = -0.08 and P = .03) and worse cognitive performance (verbal fluency test, b = -0.21 and P = .01; shape-trail test part A, b = 0.16 and P < .001) compared with the precuneus-first subtype. The second SuStaIn model integrating FWF and Aβ identified two subtypes: The amyloid-first subtype had higher levels of amyloid deposition in the cortex (b = -0.3 and P < .001), whereas the FWF-first subtype had lower left cortical thickness (b = -0.05 and P = .01) and worse cognitive performance (verbal fluency test, b = -0.17 and P = .02; shape-trail test part A, b = 0.20 and P < .001). Conclusion Juxtacortical FWF was higher in participants with AD compared with cognitively normal controls and associated with Aβ, tau, and neurodegeneration biomarkers. Distinct spatiotemporal progression patterns of FWF had distinct cognitive performance profiles. Clinical trial registration no. NCT05623124 © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Schoonheim in this issue.
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