Magnetic resonance imaging evidence for presymptomatic change in thalamus and caudate in familial Alzheimer’s disease
Open accessAbstract
Amyloid imaging studies of presymptomatic familial Alzheimer's disease have revealed the striatum and thalamus to be the earliest sites of amyloid deposition. This study aimed to investigate whether there are associated volume and diffusivity changes in these subcortical structures during the presymptomatic and symptomatic stages of familial Alzheimer's disease. As the thalamus and striatum are involved in neural networks subserving complex cognitive and behavioural functions, we also examined the diffusion characteristics in connecting white matter tracts. A cohort of 20 presenilin 1 mutation carriers underwent volumetric and diffusion tensor magnetic resonance imaging, neuropsychological and clinical assessments; 10 were symptomatic, 10 were presymptomatic and on average 5.6 years younger than their expected age at onset; 20 healthy control subjects were also studied. We conducted region of interest analyses of volume and diffusivity changes in the thalamus, caudate, putamen and hippocampus and examined diffusion behaviour in the white matter tracts of interest (fornix, cingulum and corpus callosum). Voxel-based morphometry and tract-based spatial statistics were also used to provide unbiased whole-brain analyses of group differences in volume and diffusion indices, respectively. We found that reduced volumes of the left thalamus and bilateral caudate were evident at a presymptomatic stage, together with increased fractional anisotropy of bilateral thalamus and left caudate. Although no significant hippocampal volume loss was evident presymptomatically, reduced mean diffusivity was observed in the right hippocampus and reduced mean and axial diffusivity in the right cingulum. In contrast, symptomatic mutation carriers showed increased mean, axial and in particular radial diffusivity, with reduced fractional anisotropy, in all of the white matter tracts of interest. The symptomatic group also showed atrophy and increased mean diffusivity in all of the subcortical grey matter regions of interest, with increased fractional anisotropy in bilateral putamen. We propose that axonal injury may be an early event in presymptomatic Alzheimer's disease, causing an initial fall in axial and mean diffusivity, which then increases with loss of axonal density. The selective degeneration of long-coursing white matter tracts, with relative preservation of short interneurons, may account for the increase in fractional anisotropy that is seen in the thalamus and caudate presymptomatically. It may be owing to their dense connectivity that imaging changes are seen first in the thalamus and striatum, which then progress to involve other regions in a vulnerable neuronal network.
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Previous DTI studies in autosomal-dominant Alzheimer's disease did not estimate years from symptom onset (EYO), which reduced the sensitivity to detect DTI changes that occur in close proximity to the onset of dementia symptoms.
“or did not estimate years from symptom onset (EYO) (Ringman et al., 2007; Ryan et al., 2013; Parra et al., 2015), which reduced the sensitivity to detect DTI changes that occur in close proximity to the onset of dementia symptoms.”
From White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease (2018) · cites this paper as Ryan et al., 2013
The Materials and methods (Subjects; page unavailable) explicitly says Ryan et al. calculated estimated time to symptom onset for presymptomatic mutation carriers using each participant’s age and their parent’s age at symptom onset. Table 1 also reports years from estimated age at onset. This contradicts the claim that the study did not estimate EYO; the paper does not establish the claimed loss of sensitivity from failing to do so. (LLM, conf=0.92)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredPrevious DTI studies in autosomal-dominant Alzheimer's disease lacked sufficient statistical power, considering relatively low sample sizes (n = 8 to 18 asymptomatic carriers), to detect the subtle pre-symptomatic phase.
“However, these studies either lacked sufficient statistical power considering the relatively low sample sizes (n = 8 to 18 of asymptomatic carriers) to detect subtle pre-symptomatic phase”
From White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease (2018) · cites this paper as Ryan et al., 2013
The Subjects section reports 10 presymptomatic carriers, and the Discussion says this study’s small sample limited statistical power. The paper does not establish the claimed 8–18-carrier range for previous DTI studies or say that those studies could not detect presymptomatic changes; its Discussion describes presymptomatic DTI changes in both this study and another study. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA few DTI studies on white matter alterations in autosomal-dominant Alzheimer's disease have been previously conducted.
“A few DTI studies on white matter alterations in autosomal-dominant Alzheimer’s disease have been previously conducted (Ringman et al., 2007; Ryan et al., 2013; Parra et al., 2015; Sanchez-Valle et al., 2016).”
From White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease (2018) · cites this paper as Ryan et al., 2013
Thalamic regions atrophy even in presymptomatic human carriers of PSEN1 mutations.
“Thalamic regions atrophy even in presymptomatic human carriers of PSEN1 mutations70.”
From Magnetic resonance microscopy maps widespread effects of Alzheimer’s disease on brain structures and behavior in mice (2026) · cites this paper as [70]
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- Authors
- Ryan, N. S., Keihaninejad, S., Shakespeare, T. J., Lehmann, M., Crutch, S. J., Malone, I. B., Thornton, J. S., Mancini, L., Hyare, H., Yousry, T., Ridgway, G. R., Zhang, H., Modat, M., Alexander, D. C., Rossor, M. N., Ourselin, S., & Fox, N. C.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- UCL Queen Square Institute of Neurology (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- MRC Prion Unit (GB)
- Wellcome Centre for Human Neuroimaging (GB)
- University College London (GB)
- Corresponding author
- Ryan, Natalie S.
- ORCID
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-03-22
- Volume
- 136
- Issue
- 5
- Pages
- 1399-1414
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC3634199
- OpenAlex
- W2099166256
- Cited by
- 205
- References
- 92
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 13 · 2023: 13 · 2022: 7 · 2021: 15 · 2020: 18 · 2019: 7 · 2018: 18 · 2017: 17 · 2016: 23 · 2015: 27 · 2014: 22 · 2013: 8
- FWCI
- 18.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Brain (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Trust (091593/Z/10/Z)
- National Institute for Health and Care Research (NF-SI-0512-10033, NF-SI-0508-10123)
- Medical Research Council (MR/J014257/1, MR/K000608/1)
- Engineering and Physical Sciences Research Council (EP/J020990/1, EP/G007748/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Keywords
- familial Alzheimer's disease, preclinical Alzheimer's disease, thalamus, caudate nucleus, putamen, hippocampus, white matter tracts, fractional anisotropy, mean diffusivity, axonal injury, subcortical atrophy, amyloid deposition, fornix, cingulum, corpus callosum
- MeSH terms
- Adult, Alzheimer Disease, Caudate Nucleus, Female, Humans, Male, Middle Aged, Mutation, Thalamus, Cohort Studies, Diffusion Magnetic Resonance Imaging, Asymptomatic Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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