Fig. 5: Link between myelination and AD pathology progression.

a, Left, myelination begins in the brain stem, progressing to sensory and motor fields, followed by association fibers. This results in dense myelination in regions undergoing myelination first, in comparison to regions myelinated later in development, which often display intermittent sparse myelination patterns. Right, an inverse relationship between progression of AD pathology and myelination. Pathology usually begins in the anterior temporal mesocortex, progressing to the association fibers, followed by sensory and motor fields. b, Diagram showing an inverse relationship between regions with high rates of myelination (left) and high rates of aerobic glycolysis (right). Sparsely myelinated brain regions often contain complex intracortical circuits, exhibiting higher rates of metabolism and aerobic glycolysis. Figure created using BioRender.com.