Cortical microstructural correlates of astrocytosis in autosomal-dominant Alzheimer disease.

Objective: To study the macrostructural and microstructural MRI correlates of brain astrocytosis, measured with ¹¹ C-deuterium-L-deprenyl ( ¹¹ C-DED)-PET, in familial autosomal-dominant Alzheimer disease (ADAD).
Methods: The total sample (n = 31) comprised ADAD mutation carriers (n = 10 presymptomatic, 39.2 ± 10.6 years old; n = 3 symptomatic, 55.5 ± 2.0 years old) and noncarriers (n = 18, 44.0 ± 13.7 years old) belonging to families with mutations in either the presenilin-1 or amyloid precursor protein genes. All participants underwent structural and diffusion MRI and neuropsychological assessment, and 20 participants (6 presymptomatic and 3 symptomatic mutation carriers and 11 noncarriers) also underwent ¹¹ C-DED-PET.
Results: Vertex-wise interaction analyses revealed a differential relationship between carriers and noncarriers in the association between ¹¹ C-DED binding and estimated years to onset (EYO) and between cortical mean diffusivity (MD) and EYO. These differences were due to higher ¹¹ C-DED binding in presymptomatic carriers, with lower binding in symptomatic carriers compared to noncarriers, and to lower cortical MD in presymptomatic carriers, with higher MD in symptomatic carriers compared to noncarriers. Using a vertex-wise local correlation approach, ¹¹ C-DED binding was negatively correlated with cortical MD and positively correlated with cortical thickness.
Conclusions: Our proof-of-concept study is the first to show that microstructural and macrostructural changes can reflect underlying neuroinflammatory mechanisms in early stages of Alzheimer disease (AD). The findings support a role for neuroinflammation in AD pathogenesis, with potential implications for the correct interpretation of neuroimaging biomarkers as surrogate endpoints in clinical trials.
(Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)