Network‐wise concordance of multimodal neuroimaging features across the Alzheimer's disease continuum

BACKGROUND: Concordance between cortical atrophy and cortical glucose hypometabolism within distributed brain networks was evaluated among cerebrospinal fluid (CSF) biomarker‐defined amyloid/tau/neurodegeneration (A/T/N) groups. METHOD: We computed correlations between cortical thickness and fluorodeoxyglucose metabolism within 12 functional brain networks. Differences among A/T/N groups (biomarker normal [BN], Alzheimer's disease [AD] continuum, suspected non‐AD pathologic change [SNAP]) in network concordance and relationships to longitudinal change in cognition were assessed. RESULTS: Network‐wise markers of concordance distinguish SNAP subjects from BN subjects within the posterior multimodal and language networks. AD‐continuum subjects showed increased concordance in 9/12 networks assessed compared to BN subjects, as well as widespread atrophy and hypometabolism. Baseline network concordance was associated with longitudinal change in a composite memory variable in both SNAP and AD‐continuum subjects. CONCLUSIONS: Our novel study investigates the interrelationships between atrophy and hypometabolism across brain networks in A/T/N groups, helping disentangle the structure–function relationships that contribute to both clinical outcomes and diagnostic uncertainty in AD.