Evaluation of an in vivo biomarker of arteriolosclerosis (ARTS) and its associations with cognition and multimodal ATN(V) biomarkers in a cardiometabolic-risk enriched community cohort.

OBJECTIVE

To evaluate associations between an in vivo (MRI) marker of arteriolosclerosis (ARTS) and multimodal neuroimaging and plasma ATN(V) biomarkers.

METHODS

Among 238 participants with both amyloid and tau PET scans within one year of MRI, we examined multivariable adjusted models relating ARTS with structural MRI (cortical thickness/volume, white matter hyperintensities [WMH]), diffusion MRI (fractional anisotropy [FA], mean diffusivity [MD], NODDI free water [FW]), cerebral blood flow, plasma biomarkers (p-tau217, Aβ42/40, neurofilament light, glial fibrillary acidic protein [GFAP]), and PET imaging.

RESULTS

As expected, ARTS was most strongly linked to age and greater WMH burden and diffusion-based indices of microstructural disruption (FA, MD, FW). ARTS was elevated in ATN biomarker-positive groups (highest in A+T+N+) and was associated with greater neurodegeneration and higher plasma biomarker levels, GFAP in particular.

CONCLUSIONS

ARTS relates to other markers of vascular brain injury, neurodegeneration, amyloid and tau pathology within the ATN(V) framework, and inflammation.