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Copathologies of Limbic-Predominant Age-Related TDP-43 Encephalopathy and Alzheimer Disease: [ 18 F]FDG PET Statistical Mapping and Quantitative MRI Volumetry
Pei Ing Ngam, Yoshimi Anzai, Christine J. Cliatt Brown, Nicholas Alonzo Frost, Michelle Keown Sorweid, Tanyaluck Thientunyakit, Satoshi Minoshima, for the Alzheimer’s Disease Neuroimaging Initiative. Journal of Nuclear Medicine, 2026-01-22
Topic: Amyloid, tau and blood-test diagnosis
Of the 944 clinical cases, 13.0% were characterized as probable LATE (2.4% pure LATE and 10.6% LATE+AD) and 23.7% were characterized as probable AD without LATE. MRI volumetry revealed that the medial temporal lobe was most affected in pure LATE cases (P < 0.001), whereas the orbitofrontal gyrus and lateral temporal lobe were most vulnerable in mixed LATE+AD cases (P = 0.001; P < 0.001). Post hoc analysis identified the entorhinal cortex and amygdala as key regions for distinguishing mixed LATE+AD cases from pure LATE and pure AD cases, respectively (P = 0.05; P < 0.001). Subgroup analysis of the probable LATE+AD group demonstrated additive or synergistic effects of both pathologies, with three quarters of cases exhibiting concordant lateralized metabolic brain changes, predominantly left-sided, based on LATE and AD z score products (P < 0.001). A similar pattern of left-dominant brain atrophy was observed in MRI volumetry. Substantial numbers of our patients exhibited LATE features that were characterized objectively using scans from autopsy-proven cases. These LATE cases were associated with specific regional atrophy measured by quantitative MRI. Cases with LATE+AD copathologies demonstrated synergistic hemispheric involvement. Further investigations of such synergistic changes between LATE and AD are warranted.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ngam, P. I., Anzai, Y., Brown, C. J. C., Frost, N. A., Sorweid, M. K., Thientunyakit, T., et al. (2026). Copathologies of Limbic-Predominant Age-Related TDP-43 Encephalopathy and Alzheimer Disease: [ 18 F]FDG PET Statistical Mapping and Quantitative MRI Volumetry. Journal of Nuclear Medicine. https://doi.org/10.2967/jnumed.125.270614
Vancouver
Ngam PI, Anzai Y, Brown CJC, Frost NA, Sorweid MK, Thientunyakit T, et al. Copathologies of Limbic-Predominant Age-Related TDP-43 Encephalopathy and Alzheimer Disease: [ 18 F]FDG PET Statistical Mapping and Quantitative MRI Volumetry. Journal of Nuclear Medicine. 2026. doi:10.2967/jnumed.125.270614. PMID: 41571430.
BibTeX
@article{ngam2026-41571430,
author = {Ngam, Pei Ing and Anzai, Yoshimi and Brown, Christine J. Cliatt and Frost, Nicholas Alonzo and Sorweid, Michelle Keown and Thientunyakit, Tanyaluck and Minoshima, Satoshi and {Alzheimer’s Disease Neuroimaging Initiative}},
title = {{Copathologies of Limbic-Predominant Age-Related TDP-43 Encephalopathy and Alzheimer Disease: [ 18 F]FDG PET Statistical Mapping and Quantitative MRI Volumetry}},
journal = {Journal of Nuclear Medicine},
year = {2026},
doi = {10.2967/jnumed.125.270614},
pmid = {41571430},
url = {https://doi.org/10.2967/jnumed.125.270614}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Of the 944 clinical cases, 13.0% were characterized as probable LATE (2.4% pure LATE and 10.6% LATE+AD) and 23.7% were characterized as probable AD without LATE.
- MRI volumetry revealed that the medial temporal lobe was most affected in pure LATE cases (P < 0.001), whereas the orbitofrontal gyrus and lateral temporal lobe were most vulnerable in mixed LATE+AD cases (P = 0.001; P < 0.001).
- Post hoc analysis identified the entorhinal cortex and amygdala as key regions for distinguishing mixed LATE+AD cases from pure LATE and pure AD cases, respectively (P = 0.05; P < 0.001).
- Subgroup analysis of the probable LATE+AD group demonstrated additive or synergistic effects of both pathologies, with three quarters of cases exhibiting concordant lateralized metabolic brain changes, predominantly left-sided, based on LATE and AD z score products (P < 0.001).
- A similar pattern of left-dominant brain atrophy was observed in MRI volumetry.
Why it matters
Among 944 clinical cases, scans showed that pure LATE mainly affected the medial temporal lobe, while mixed LATE plus Alzheimer's disease affected the orbitofrontal and lateral temporal regions, with some cases showing combined effects of both pathologies. The authors say these findings help characterize LATE features objectively using scans from autopsy-proven cases, and that further investigation of the combined effects is warranted.
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Study details
- Participants944
- Effect size13.0%; 2.4%; 10.6%
- Evidence strengthLow
How this study scored 46/100
Published in a peer-reviewed journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Nuclear Medicine) |
| Journal's citation record | 2 / 4 | Journal of Nuclear Medicine: journal h-index 230 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 944 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 4 / 6 | Cited 9.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author for the Alzheimer’s Disease Neuroimaging Initiative: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Utah: institution h-index 1,238 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41571430) |
| Free to read | 2 / 2 | Free to read |
| Total | 46 / 100 | — |
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