Difference in the spatial pattern of brain atrophy associated with Alzheimer’s and LATE neuropathology

Motivation: Alzheimer’s disease neuropathologic change (AD-NC) and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) are common age-related pathologies and are associated with brain atrophy, especially in the medial temporal lobe. However, the difference in atrophy patterns associated with the two pathologies is not well known. Goal(s): To investigate the difference in brain atrophy patterns associated with AD-NC and LATE-NC. Approach: Ex-vivo MRI and detailed neuropathology were combined in a large number of community-based older adults that came to autopsy. Results: LATE-NC stages 2 or 3 are associated with more atrophy in the anterior portion of the hippocampus compared to moderate or severe AD-NC. Impact: Atrophy in the anterior portion of the hippocampus is more severe with LATE-NC stages 2 or 3 than with moderate or severe AD-NC.