Longitudinal Spatial Relationships Between Atrophy and Hypometabolism Across the Alzheimer's Disease Continuum

Background: The A/T/N framework allows for the assessment of pathology-specific markers of MRI-derived structural atrophy and hypometabolism on 18FDG-PET. However, how these measures relate to each other locally and distantly across pathology-defined A/T/N groups is currently unclear. Objective: To determine the regions of association between atrophy and hypometabolism in A/T/N groups both within and across time points. Methods: We examined multivariate multimodal neuroimaging relationships between MRI and 18FDG-PET among suspected non-Alzheimer's disease pathology (SNAP) (A-T/N+; n = 14), Amyloid Only (A+T-N-; n = 24) and ProbableAD(A+T+N+; n = 77) groups. Sparse canonical correlation analyses were employed to model spatially disjointed regions of association betweenMRIand (18)FDG-PET data. These relationships were assessed at three combinations of time points - cross-sectionally, between baseline visits and between month 12 (M-12) follow-up visits, as well as longitudinally between baseline and M-12 follow-up. Results: In the SNAP group, spatially overlapping relationships between atrophy and hypometabolism were apparent in the bilateral temporal lobes when both modalities were assessed at the M-12 timepoint. Amyloid-Only subjects showed spatially discordant distributed atrophy-hypometabolism relationships at all time points assessed. In Probable AD subjects, local correlations were evident in the bilateral temporal lobes when both modalities were assessed at baseline and at M-12. Across groups, hypometabolism at baseline correlated with non-local, or distant, atrophy at M-12. Conclusion: These results support the view that local concordance of atrophy and hypometabolism is the result of a taumediated process driving neurodegeneration.