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Advanced Diffusion MRI Tract Signatures in Alzheimer’s Disease, Dementia with Lewy Bodies, and the FTD/PPA Spectrum
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DOI：10.1016/j.neuroimage.2026.121984.png)
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Abstract
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• AD, DLB, and the FTD/PPA spectrum show overlapping yet distinct tract-level neurodegeneration, highlighting the need for sensitive non-invasive imaging biomarkers. • Advanced diffusion MRI models (DTI, NODDI, FBA) improve detection and monitoring of white-matter degeneration across these dementia syndromes. • Canonical DTI findings reveal syndrome-specific alterations, including fornix and cingulum involvement in AD/DLB, uncinate fasciculus degeneration in FTD, and arcuate fasciculus disruption in PPA. • Advanced multi-shell dMRI methods reveal neurite and free-water alterations and improve sensitivity to clinical severity, molecular imaging biomarkers, and disease progression. • Across 54 studies, NODDI- and FBA-derived metrics demonstrate microstructural specificity compared to conventional DTI. • Adoption of advanced dMRI models remains uneven, with greatest use in AD, emerging application in DLB and FTD, and limited studies in PPA. • Practical implementation is increasingly feasible using multi-shell acquisitions on modern 3T scanners with established processing frameworks (MRtrix, DIPY, AMICO, FSL).
Keywords:
advanced diffusion MRI
neurodegeneration
primary progressive aphasia
frontotemporal dementia
Alzheimer's disease
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