Neuroimaging Applications in Alzheimer's Disease

The use of neuroimaging in Alzheimer’s disease has transformed early detection, risk stratification and therapeutic monitoring. Structural magnetic resonance imaging (MRI) reveals patterns of cortical and hippocampal atrophy that correlate with cognitive decline, while molecular imaging techniques such as positron emission tomography (PET) enable in vivo visualisation of amyloid-β deposition and tau pathology. Advanced analytical approaches, including radiomics and machine-learning algorithms, extract quantitative imaging features that can predict disease conversion and progression with increasing accuracy. Integration of neuroimaging data with fluid biomarkers and genetic risk factors such as apolipoprotein E ε4 enhances prognostic models and informs patient selection for clinical trials. Emerging biomarkers such as white matter hyperintensities and functional connectivity metrics complement established measures of neurodegeneration and promise a more comprehensive characterisation of preclinical and prodromal disease stages. Collectively, these developments support secondary prevention strategies and personalised interventions by identifying at-risk individuals before the onset of overt symptoms.

Research from Nature Portfolio

Longitudinal follow-up of amnestic mild cognitive impairment patients stratified by amyloid PET status demonstrated that individuals with significant cerebral β-amyloid accumulation experienced a threefold increased risk of progression to dementia over three years. This study also revealed accelerated cortical thinning in precuneus and temporal regions among amyloid-positive participants, emphasising the prognostic value of combined molecular and structural imaging in mild cognitive impairment. These findings underscore the importance of amyloid imaging for patient stratification and monitoring of disease dynamics in clinical settings.

Neuroimaging Applications in Alzheimer's Disease publication trend

The graph below shows the total number of articles in neuroimaging applications in alzheimer's disease across all publications each year (not limited to Nature Index journals).

Technical terms

Positron emission tomography (PET): A molecular imaging technique that uses radioactive tracers to visualise and quantify pathological proteins such as amyloid-β and tau in the brain.

Magnetic resonance imaging (MRI): A non-invasive imaging modality that employs magnetic fields and radio waves to generate detailed anatomical and tissue contrast images of the brain.

Radiomics: A computational approach that extracts high-dimensional quantitative features from medical images to characterise tissue heterogeneity and disease patterns.

β-amyloid (Aβ): Misfolded protein fragments that accumulate extracellularly in the brain and form plaques, a hallmark of Alzheimer’s disease pathology.

Cortical thickness: A measure of the distance between the white-matter and pial surfaces across the cerebral cortex, used as a biomarker of neurodegeneration.

White matter hyperintensity (WMH): Areas of increased signal on T2-weighted MRI that reflect small vessel disease and are associated with vascular contributions to cognitive impairment.

References

1. Innovative Multivariable Model Combining MRI Radiomics and Plasma Indexes Predicts Alzheimer’s Disease Conversion: Evidence from a 2-Cohort Longitudinal Study. Research (2024).
2. Machine learning prediction of future amyloid beta positivity in amyloid-negative individuals. Alzheimer's Research & Therapy (2024).
3. Rates of cortical thinning in Alzheimer’s disease signature regions associate with vascular burden but not with β-amyloid status in cognitively normal adults at age 70. Journal of Neurology Neurosurgery & Psychiatry (2024).
4. Secondary prevention of Alzheimer’s dementia: neuroimaging contributions. Alzheimer's Research & Therapy (2018).
5. Longitudinal outcomes of amyloid positive versus negative amnestic mild cognitive impairments: a three-year longitudinal study. Scientific Reports (2018).