The selective vulnerability and susceptibility of cerebellar subdivisions in Alzheimer's disease: A study from the Alzheimer's Disease Neuroimaging Initiative

Abstract

Abstract Background The cerebellum undergoes substantial alternations in Alzheimer's disease (AD) both pathologically and morphologically. However, there were few studies focusing on morphological changes occurring within distinct subregions of the cerebellum in AD. In this vein, we aimed to investigate the selective vulnerability and susceptibility of cerebellar subdivisions in AD and the impacts of their volume alterations on cognition. Methods We screened data from 44 patients with AD and 61 healthy controls (HCs) from the AD Neuroimaging Initiative-2 database. T1-weighted images were utilized to determine volumetric changes. A standardized pipeline was implemented for cerebellar parcellation and volume calculation. The relationships between volumetric changes in cerebellar subunits and cognition were explored. Results AD group had higher Alzheimer's disease Assessment Scale–Cognitive Subscale (ADAS-Cog) scores compared to the HCs, whereas their Mini-Mental State Examination scores were lower than the HCs. After adjusting for age, gender, duration of education, and intracranial volume and conducting false discovery rate correction, six out of the 28 subunits exhibited significant difference between groups including lobules bilateral Crus I, Left V, bilateral VIIB, Right VIIIA. Specifically, the volume of bilateral Crus I, Left V lobules in AD group were smaller, whereas the rest of the subunits with group difference were volumetrically larger in AD group. The volume of the Left V lobule in the AD group showed a negative correlation with ADAS-Cog scores. Conclusions In summary, the study highlighted that certain cerebellar subdivisions were susceptible to AD, and revealed the potential impacts of volume alterations in these regions on cognition.