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Distinct tau PET patterns in atrophy-defined subtypes of Alzheimer's disease

Research output: Contribution to journalArticle

Rik Ossenkoppele, Chul Hyoung Lyoo, Carole H Sudre, Danielle van Westen, Hanna Cho, Young Hoon Ryu, Jae Yong Choi, Ruben Smith, Olof Strandberg, Sebastian Palmqvist, Erik Westman, Richard Tsai, Joel Kramer, Adam L Boxer, Maria L Gorno-Tempini, Renaud La Joie, Bruce L Miller, Gil D Rabinovici, Oskar Hansson

Original languageEnglish
JournalAlzheimer's & Dementia
Publication statusE-pub ahead of print - 28 Oct 2019

Bibliographical note

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

King's Authors


INTRODUCTION: Differential patterns of brain atrophy on structural magnetic resonance imaging (MRI) revealed four reproducible subtypes of Alzheimer's disease (AD): (1) "typical", (2) "limbic-predominant", (3) "hippocampal-sparing", and (4) "mild atrophy". We examined the neurobiological characteristics and clinical progression of these atrophy-defined subtypes.

METHODS: The four subtypes were replicated using a clustering method on MRI data in 260 amyloid-β-positive patients with mild cognitive impairment or AD dementia, and we subsequently tested whether the subtypes differed on [18F]flortaucipir (tau) positron emission tomography, white matter hyperintensity burden, and rate of global cognitive decline.

RESULTS: Voxel-wise and region-of-interest analyses revealed the greatest neocortical tau load in hippocampal-sparing (frontoparietal-predominant) and typical (temporal-predominant) patients, while limbic-predominant patients showed particularly high entorhinal tau. Typical patients with AD had the most pronounced white matter hyperintensity load, and hippocampal-sparing patients showed the most rapid global cognitive decline.

DISCUSSION: Our data suggest that structural MRI can be used to identify biologically and clinically meaningful subtypes of AD.

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