Differentiating amyloid beta spread in autosomal dominant and sporadic Alzheimer’s disease

Amyloid-beta (Aβ) deposition is one of the hallmark pathologies in both sporadic Alzheimer’s disease (sAD) and autosomal dominant Alzheimer’s disease (ADAD), the latter of which is caused by mutations in genes involved in Aβ processing. Despite Aβ deposition being a centerpiece to both sAD and ADAD, some differences between these AD subtypes have been observed with respect to the spatial pattern of Aβ. Previous work has shown that the spatial pattern of Aβ in individuals spanning the sAD spectrum can be reproduced with high accuracy using an epidemic spreading model (ESM), which simulates the diffusion of Aβ across neuronal connections and is constrained by individual rates of Aβ production and clearance. However, it has not been investigated whether Aβ deposition in the rarer ADAD can be modeled in the same way, and if so, how congruent the spreading patterns of Aβ across sAD and ADAD are. We leverage the ESM as a data-driven approach to probe individual-level variation in the spreading patterns of Aβ across three different large-scale imaging datasets (2 SAD, 1 ADAD). We applied the ESM separately to the Alzheimer’s Disease Neuroimaging initiative (N=737), the Open Access Series of Imaging Studies (N=510), and the Dominantly Inherited Alzheimer’s Network (N=249), the latter two of which were processed using an identical pipeline. We assessed inter- and intra-individual model performance in each dataset separately, and further identified the most likely epicenter of Aβ spread for each individual. Using epicenters defined in previous work in sAD, the ESM provided moderate prediction of the regional pattern of Aβ deposition across all three datasets. We further find that, while the most likely epicenter for most Aβ-positive subjects overlaps with the default mode network, 13% of ADAD individuals were best characterized by a striatal origin of Aβ spread. These subjects were also distinguished by being younger than ADAD subjects with a DMN Aβ origin, despite having a similar estimated age of symptom onset. Together, our results suggest that most ADAD patients express Aβ spreading patters similar to those of sAD, but that there may be a subset of ADAD patients with a separate, striatal phenotype.