. Region-specific hierarchy between atrophy, hypometabolism, and β-amyloid (Aβ) load in Alzheimer's disease dementia. J Neurosci. 2012 Nov 14;32(46):16265-73. PubMed.


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  1. In this paper, La Joie et al. provide convincing evidence for distinct
    patterns of brain changes (atrophy, hypometabolism, and amyloid
    deposition) across different brain regions in Alzheimer’s disease.

    Although the presence of regional discrepancies requires more
    complicated explanations, an understanding of why these discrepancies
    exist has important implications. For instance, if anterior regions
    are, in fact, resistant to amyloid-related toxicity, an understanding of
    how anterior regions avoid deleterious effects may reveal ways in
    which amyloid might be combated. These regional discrepancies also
    highlight the potential relevance of non-amyloid etiologies, such as
    neurofibrillary tangles, comorbidities, etc., which are important
    considerations for a field that is highly focused on amyloid.

  2. In this study, multimodal imaging data from the same subjects provide the authors with a unique opportunity to investigate the regional specificity of different Alzheimer’s disease pathologies. The study presents an approach to systematically put the multimodal imaging data on the same scale so that comparisons between scans are valid. This is important when comparing across modalities, and allowed the authors to investigate the regional differences between modalities. The results neatly tie together the findings in the existing literature and propose a new methodology to investigate regional hierarchy of AD pathologies. It is, however, important to remember that the modality-specific regional differences they found may be due to the differences in the specificity of the imaging technology in detecting the pathological signal. Moving forward, there is a need to employ such methodologies in subjects with longitudinal follow-up as well as in subjects covering the entire cognitive spectrum to improve our understanding of the disease.

    View all comments by Prashanthi Vemuri

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