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Fischer, Larissa ORCID logoORCID: https://orcid.org/0009-0001-9936-2954; Parker, Dana ORCID logoORCID: https://orcid.org/0000-0002-9822-412X; Maboudian, Samira ORCID logoORCID: https://orcid.org/0000-0003-4929-775X; Fonseca, Corrina ORCID logoORCID: https://orcid.org/0000-0002-4156-1037; Tato-Fernández, Claudia ORCID logoORCID: https://orcid.org/0009-0008-8448-8678; Annen, Lucie; Arunachalam, Prithvi ORCID logoORCID: https://orcid.org/0000-0002-0798-6250; Bacci, Julia R. ORCID logoORCID: https://orcid.org/0009-0005-7408-0984; Barboure, Michelle ORCID logoORCID: https://orcid.org/0000-0002-0779-1592; Capelli, Serena ORCID logoORCID: https://orcid.org/0000-0002-8450-3806; Karagianni, Stamatia ORCID logoORCID: https://orcid.org/0009-0006-2505-770X; Collij, Lyduine E. ORCID logoORCID: https://orcid.org/0000-0001-6263-1762; Edison, Paul; Fox, Nick C. ORCID logoORCID: https://orcid.org/0000-0002-6660-657X; Franzmeier, Nicolai ORCID logoORCID: https://orcid.org/0000-0001-9736-2283; Grothe, Michel J. ORCID logoORCID: https://orcid.org/0000-0003-2600-9022; Jagust, William J. ORCID logoORCID: https://orcid.org/0000-0002-4458-113X; Maass, Anne ORCID logoORCID: https://orcid.org/0000-0002-7889-795X; Malpetti, Maura ORCID logoORCID: https://orcid.org/0000-0001-8923-9656; Paterson, Ross W. ORCID logoORCID: https://orcid.org/0000-0001-9372-3635; Sogorb-Esteve, Aitana ORCID logoORCID: https://orcid.org/0000-0002-7869-8192 und Schöll, Michael ORCID logoORCID: https://orcid.org/0000-0001-7800-1781 (2025): Longitudinal biomarker studies in human neuroimaging: capturing biological change of Alzheimer’s pathology. In: Alzheimer's Research & Therapy, Bd. 18, 13 [PDF, 1MB]

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Abstract

Despite extensive research, open questions about the biological underpinnings of Alzheimer’s disease (AD) remain. Neuroimaging biomarkers based on positron emission tomography (PET) and magnetic resonance imaging (MRI) offer in vivo insights into these complex biological changes and interactions. However, most evidence to date comes from cross-sectional studies, limiting our understanding of disease progression. Longitudinal studies enable the investigation of biological changes within individuals, revealing how pathology evolves over time. With this review, we provide an overview of how longitudinal imaging biomarker studies have advanced the field and how they can contribute to future research. We highlight longitudinal biomarker studies that have provided critical insights into disease trajectories, staging, and individual variability. We further assess longitudinal multimodal studies which have elucidated interactions between AD-specific pathology, amyloid-β and tau, and broader biological changes like neurodegeneration, neuronal dysfunction, vascular disease, and inflammation. Further, we discuss associations of brain changes with symptomatology and clinical outcomes and conclude with challenges and future directions.

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