Metabolic brain network reorganization precedes clinical conversion in Alzheimer's disease

Researchers analyzed baseline FDG-PET scans from 127 cognitively unimpaired ADNI participants, stratifying them by amyloid and tau status and tracking who later converted to Alzheimer's disease. Using metabolic brain network analysis, they identified reorganization patterns that preceded clinical conversion, suggesting these network changes are an early vulnerability marker. The approach was more sensitive than conventional hypometabolism analysis, which typically shows limited changes in preclinical stages. These findings could inform future screening strategies and clinical trial enrichment by identifying high-risk individuals before cognitive decline emerges. Validation in larger, more diverse cohorts is needed before translation to clinical practice.