Amyloid-β and tau pathologies relate to distinctive brain dysconnectomics in preclinical autosomal dominant Alzheimer’s disease
Authors: Guzmán-Vélez Edmarie , Diez Ibai , Schoemaker Dorothee , Pardilla-Delgado Enmanuelle , Vila-Castelar Clara , Fox-Fuller Joshua T. , Baena Ana , Sperling Reisa A. , Johnson Keith A. , Lopera Francisco , Sepulcre Jorge , Quiroz Yakeel T. 
Published: July 2021

ABSTRACTThe human brain is composed of functional networks that have a modular topology, where brain regions are organized into communities that form internally dense (segregated) and externally sparse (integrated) subnetworks that underlie higher-order cognitive functioning. It is hypothesized that amyloid-β and tau pathology in preclinical Alzheimer’s disease (AD) spread through functional networks, disrupting neural communication that results in cognitive dysfunction. We used high-resolution (voxel-level) graph-based network analyses to test whether in vivo amyloid-β and tau burden was associated with the segregation and integration of brain functional connections, and episodic memory, in cognitively-unimpaired Presenilin-1 E280A carriers who are expected to develop early-onset AD dementia in approximately 13 years on average. Compared to non-carriers, mutation carriers exhibited less functional segregation and integration in posterior default-mode network (DMN) regions, particularly the precuneus, and in the retrospenial cortex, which has been shown to link medial temporal regions and cortical regions of the DMN. Mutation carriers also showed greater functional segregation and integration in regions connected to the salience network, including the striatum and thalamus. Greater tau burden was associated with lower segregated and integrated functional connectivity of DMN regions, particularly the precuneus and medial prefrontal cortex. In turn, greater tau pathology was related to higher segregated and integrated functional connectivity in the retrospenial cortex, and the anterior cingulate cortex, a hub of the salience network. These findings enlighten our understanding of how AD-related pathology distinctly alters the brain’s functional architecture in the preclinical stage, possibly contributing to pathology propagation and ultimately resulting in dementia.SIGNIFICANCE STATEMENTAmyloid-β and tau pathologies in Alzheimer’s disease (AD) are hypothesized to propagate through functional networks. Research is needed to elucidate how AD-related pathologies alter the brain’s functional connections years before symptom-onset to help predict pathology accumulation and dementia risk. Using high-resolution (voxel-level) graph-based network analyses and PET imaging, we showed that greater tau burden was associated with largely dysconnectivity of posterior default-mode network brain regions, and increased connectivity of structures associated with the salience network and others that are critical for integrating information across neural systems in cognitively-unimpaired Presenilin-1 E280A carriers. Findings enlighten how amyloid-β and tau relate to distinct patterns of functional connectivity in regions that underlie memory functioning and are critical for information processing, helping predict disease progression.