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| Contribution to a book | DZNE-2025-00653 |
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2025
Elsevier
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Please use a persistent id in citations: doi:10.1016/B978-0-12-822240-9.00015-6
Abstract: Advances in magnetic resonance imaging (MRI) technology have profoundly transformed our ability to accurately measure brain structures and conduct long-term monitoring of their changes, elucidating the intricate interplay between brain structure, cognition, and health status in response to aging and neurodegeneration. To date, it is clear that volumetric MRI measurements explain a significant portion of the heterogeneity in individuals' cognitive performance and reflect the impact of pathology on the brain. However, recent findings from disease-modifying treatments (DMTs) have demonstrated that slowing cognitive decline does not equate to slowing of brain atrophy. This indicates that we need other measures than atrophy over time to uncover the impact of disease and treatment on cognition more comprehensively. In this chapter, we focus on MRI measures related to synaptic function, reserve and clearance. We discuss how brain reserve, cognitive reserve and vascular reserve can be captured with advanced MRI and may shed light on the observed disparities between MRI-based atrophy and cognition. We then elaborate on how advanced MRI readouts currently enable us to tap into brain waste clearance. Taken together, we highlight that advanced MRI can contribute to a comprehensive assessment of how Alzheimer's disease impacts on the brain physiology beyond atrophy over time.
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