Increased Cortical Thickness in Alzheimer's Disease

• Published in: Annals of neurology Vol. 95; no. 5; pp. 929 - 940
• Main Authors: Phan, Tony X., Baratono, Sheena, Drew, William, Tetreault, Aaron M., Fox, Michael D., Darby, R. Ryan
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2024
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - pathology; Alzheimer's disease; Atrophy; Atrophy - pathology; Brain; Brain Cortical Thickness; Brain mapping; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - pathology; Cognitive ability; Cortex (cingulate); Cross-Sectional Studies; Dementia disorders; Female; Frontotemporal dementia; Gyrus Cinguli - diagnostic imaging; Gyrus Cinguli - pathology; Humans; Magnetic Resonance Imaging; Male; Medical imaging; Middle Aged; Neurodegenerative diseases; Neuroimaging; Neuroplasticity; Signs and symptoms; Thickness; Visual cortex
• ISSN: 0364-5134; 1531-8249; 1531-8249
• DOI: 10.1002/ana.26894

Patients with Alzheimer's disease (AD) have diffuse brain atrophy, but some regions, such as the anterior cingulate cortex (ACC), are spared and may even show increase in size compared to controls. The extent, clinical significance, and mechanisms associated with increased cortical thickness in AD remain unknown. Recent work suggested neural facilitation of regions anticorrelated to atrophied regions in frontotemporal dementia. Here, we aim to determine whether increased thickness occurs in sporadic AD, whether it relates to clinical symptoms, and whether it occur in brain regions functionally connected to-but anticorrelated with-locations of atrophy. Cross-sectional clinical, neuropsychological, and neuroimaging data from the Alzheimer's Disease Neuroimaging Initiative were analyzed to investigate cortical thickness in AD subjects versus controls. Atrophy network mapping was used to identify brain regions functionally connected to locations of increased thickness and atrophy. AD patients showed increased thickness in the ACC in a region-of-interest analysis and the visual cortex in an exploratory analysis. Increased thickness in the left ACC was associated with preserved cognitive function, while increased thickness in the left visual cortex was associated with hallucinations. Finally, we found that locations of increased thickness were functionally connected to, but anticorrelated with, locations of brain atrophy (r = -0.81, p < 0.05). Our results suggest that increased cortical thickness in Alzheimer's disease is relevant to AD symptoms and preferentially occur in brain regions functionally connected to, but anticorrelated with, areas of brain atrophy. Implications for models of compensatory neuroplasticity in response to neurodegeneration are discussed. ANN NEUROL 2024;95:929-940.