DTI versus NODDI White Matter Microstructural Biomarkers of Alzheimer's Disease

Diffusion MRI (dMRI) is a powerful tool to assess white matter (WM) microstructural abnormalities in Alzheimer's disease (AD). The fourth phase of the Alzheimer's Disease Neuroimaging Initiative (ADNI) now includes multiple multishell dMRI protocols, enabling both traditional and advanced dMRI model analyses. There is a need to evaluate whether multishell data offer deeper insights into WM pathology in AD than more widely available single-shell data by overcoming single-shell model limitations. Here, we fit single-shell DTI and multishell NODDI to dMRI data from 533 ADNI3/4 participants to assess their sensitivity to key clinical indicators of AD such as cognitive impairment, amyloid-beta and tau PET burden. Overall, we found that NODDI offered no major advantages in detecting cognitive impairment and tau pathology, but NODDI was marginally more sensitive to amyloid pathology.