Scale-free dynamics of cerebrospinal fluid regions is associated with Alzheimer's disease-related pathology

Cerebrospinal Fluid (CSF) clearance is one of the central mechanisms for removal of amyloid-β (Aβ) and tau proteins from the central nervous system that are closely linked to Alzheimer's Disease (AD) pathology. Conventional functional imaging studies in AD have primarily focused on activities in the brain while ignoring macroscopic cerebrospinal fluid (CSF) activities. In the current study, we utilized a public dataset from the Alzheimer's Disease Neuroimaging Initiative. Our analysis spanned both brain and cerebrospinal fluid (CSF) areas. We compared the scale-free dynamics in fMRI signals across three groups: cognitively normal individuals (CN), people with Alzheimer's Disease (AD), and those with mild cognitive impairments (MCI). Scale-free dynamics are patterns of brain activity that remain consistent across different time scales. Our comparison focused on the Hurst exponent (H), a measure derived from detrended fluctuation analysis (DFA), to characterize these dynamics. This comparison revealed clusters in the fourth ventricle and subarachnoid space (medioventral channel along the spinal axis). In these CSF-filled structures, H was significantly higher in AD group comparing to CN. Moreover, H in these two clusters correlated with AD pathological biomarkers including CSF Aβ and tau in the AD group. These findings suggested scale-free properties of macroscopic CSF flow as a potential imaging biomarker for AD. This biomarker can be readily acquired from common resting-state fMRI scans and therefore may be valuable for AD diagnosis.