Microstructural mapping of neural pathways in Alzheimer's disease using macrostructure-informed normative tractometry.

Introduction: Diffusion-weighted magnetic resonance imaging (dMRI) is sensitive to the microstructural properties of brain tissues and shows great promise in detecting the effects of degenerative diseases. However, many approaches analyze single measures averaged over regions of interest without considering the underlying fiber geometry.

Methods: We propose a novel macrostructure-informed normative tractometry (MINT) framework to investigate how white matter (WM) microstructure and macrostructure are jointly altered in mild cognitive impairment (MCI) and dementia. We compared MINT-derived metrics with univariate diffusion tensor imaging (DTI) metrics to examine how fiber geometry may impact the interpretation of microstructure.

Results: In two multisite cohorts from North America and India, we find consistent patterns of microstructural and macrostructural anomalies implicated in MCI and dementia; we also rank diffusion metrics' sensitivity to dementia.

Discussion: We show that MINT, by jointly modeling tract shape and microstructure, has the potential to disentangle and better interpret the effects of degenerative disease on the brain's neural pathways.

Highlights: Changes in diffusion tensor imaging metrics may be due to macroscopic changes. Normative models encode normal variability of diffusion metrics in healthy controls. Variational autoencoder applied on tractography can learn patterns of fiber geometry. WM microstructure and macrostructure are modeled with multivariate methods. Transfer learning uses pretraining and fine-tuning for increased efficiency.