Alzheimer's disease heterogeneity revealed by neuroanatomical normative modeling

Flavia Loreto, Serena Verdi, Seyed Mostafa Kia, Aleksandar Duvnjak, Haneen Hakeem, Anna Fitzgerald, Neva Patel, Johan Lilja, Zarni Win, Richard Perry, Andre F Marquand, James H Cole, Paresh Malhotra

Research output: Contribution to journalArticleScientificpeer-review

1 Citation (Scopus)

Abstract

INTRODUCTION: Overlooking the heterogeneity in Alzheimer's disease (AD) may lead to diagnostic delays and failures. Neuroanatomical normative modeling captures individual brain variation and may inform our understanding of individual differences in AD-related atrophy.

METHODS: We applied neuroanatomical normative modeling to magnetic resonance imaging from a real-world clinical cohort with confirmed AD ( n = 86). Regional cortical thickness was compared to a healthy reference cohort ( n = 33,072) and the number of outlying regions was summed (total outlier count) and mapped at individual- and group-levels.

RESULTS: The superior temporal sulcus contained the highest proportion of outliers (60%). Elsewhere, overlap between patient atrophy patterns was low. Mean total outlier count was higher in patients who were non-amnestic, at more advanced disease stages, and without depressive symptoms. Amyloid burden was negatively associated with outlier count.

DISCUSSION: Brain atrophy in AD is highly heterogeneous and neuroanatomical normative modeling can be used to explore anatomo-clinical correlations in individual patients.

Original languageEnglish
Article numbere12559
Pages (from-to)e12559
Number of pages13
JournalAlzheimer's & dementia (Amsterdam, Netherlands)
Volume16
Issue number1
DOIs
Publication statusPublished - 1 Jan 2024

Keywords

  • Alzheimer's disease
  • MRI
  • amyloid PET
  • heterogeneity
  • neuroanatomical normative modeling
  • neurodegeneration

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