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Ventricular volume (VV) is a powerful global indicator of brain tissue loss on MRI in normal aging and dementia. VV is used by radiologists in clinical practice and has one of the highest obtainable effect sizes for tracking brain change in clinical trials, but it is crucial to relate VV to structural alterations underlying clinical symptoms. Here we identify patterns of thinner cortical gray matter (GM) associated with dynamic changes in lateral VV at 1-year (N=677) and 2-year (N=536) intervals, in the ADNI cohort. People with faster VV loss had thinner baseline cortical GM in temporal, inferior frontal, inferior parietal, and occipital regions (controlling for age, sex, diagnosis). These findings show the patterns of relative cortical atrophy that predict later ventricular enlargement, further validating the use of ventricular segmentations as biomarkers. We may also infer specific patterns of regional cortical degeneration (and perhaps functional changes) that relate to VV expansion.

Mapping Dynamic Changes in Ventricular Volume onto Baseline Cortical Surfaces in Normal Aging, MCI, and Alzheimer’s Disease