Voxel-wise and Pattern-based Analysis Approaches Reveal Associations Between CSF Pseudo-Diffusivity and Amyloid-β Biomarkers

Motivation: Traditional CSF flow imaging methods are limited by field of view or acquisition time, hindering comprehensive insights into CSF circulation abnormalities in Alzheimer's disease and its association with CSF Aβ levels. Goal(s): This study aimed to evaluate the relationship between CSF circulation and CSF Aβ levels using whole-brain CSF flow analyses. Approach: We performed voxel-wise and pattern-based analyses of CSF MΨ (a marker of effective CSF motility) using whole-brain low b-value diffusion MRI. Results: CSF MΨ exhibited significant correlations with CSF Aβ40 and Aβ42 levels, highlighting a potential mechanistic link between CSF dynamics and amyloid pathology. Impact: This study demonstrates that regional CSF flow patterns influence CSF Aβ levels, suggesting that elevated CSF flow may enhance Aβ clearance. It emphasizes that interindividual CSF flow variability may contribute to unexplained differences in CSF Aβ biomarker measurements.