Network Diffusion Model of Progression Predicts Longitudinal Patterns of Atrophy and Metabolism in Alzheimer's Disease

Alzheimer's disease pathology (AD) originates in the hippocampus and subsequently spreads to temporal, parietal, and prefrontal association cortices in a relatively stereotyped progression. Current evidence attributes this orderly progression to transneuronal transmission of misfolded proteins along the projection pathways of affected neurons. A network diffusion model was recently proposed to mathematically predict disease topography resulting from transneuronal transmission on the brain's connectivity network. Here, we use this model to predict future patterns of regional atrophy and metabolism from baseline regional patterns of 418 subjects. The model accurately predicts end-of-study regional atrophy and metabolism starting from baseline data, with significantly higher correlation strength than given by the baseline statistics directly. The model's rate parameter encapsulates overall atrophy progression rate; group analysis revealed this rate to depend on diagnosis as well as baseline cerebrospinal fluid (CSF) biomarker levels. This work helps validate the model as a prognostic tool for Alzheimer's disease assessment.