AbstractBackgroundIncreased Amyloid‐beta (Aβ) is associated with the neuropathological features of Alzheimer’s disease (AD), and it has been suggested to amplify tau spreading in the brain that leads to neurodegeneration. However, little is known about how the pattern of tau spreading overlaps with that of cortical microstructural neurodegeneration in the preclinical stages of the disease. Here, we utilized molecular imaging and neurite orientation dispersion and density imaging (NODDI) to identify the spreading pattern of tau pathology with the disease progression in cross‐sectional data and interaction with the degradation of cortical neurite microstructures.MethodsThe study consisted of normal controls (CN) and patients with mild cognitive impairments (MCI) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (Table 1). All participants had structural and multi‐shell diffusion magnetic resonance imaging (MRI), and positron emission tomography (PET) scans using 18F‐florbetapir (AV45) for and 18F‐flortaucipir (AV1451) for tau. The preprocessed PET images were used to generate the standardized uptake value ratio (SUVR) values in each hemisphere consisting of 180 cerebral cortical brain regions defined by the Glasser atlas. The preprocessed dMRI data were used to compute cortical NODDI coefficients (neurite density (intracellular volume fraction; ICVF), orientation dispersion index (ODI), and isotropic volume fraction (FISO)). The tau and NODDI microstructural values are then normalized compared to the Aβ− CN group by adjusting the values for age and sex. The tau spreading order was defined based on the frequencies of the normalized tau values that exceeded the given threshold and compared the patterns with the neurite microstructures.ResultsWe found a sharp increase of tau deposition in patients with Aβ+ MCI, and the medial temporal regions were identified as the earliest region to become tau positive and continue to spread to inferior temporal and inferior parietal regions. Most importantly, we found significant patterns of cortical ODI degradation with the tau spreading in the right entorhinal cortex (p = 0.004) and the right hippocampus (p = 0.02).ConclusionThe findings of this cross‐sectional study provide that regional cortical neurite imaging could provide higher sensitivity to changes in the pathological process of tau spreading in tau epicenters in AD.
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