# Early diagnosis of Alzheimer’s Disease: Graph theoretical analysis of cerebellar network features based on 18F-AV45 PET

**Authors:** Ruyi Li, Shaoping Jiang, Zhaoke Pi, Guisu Chen

PMC · DOI: 10.1371/journal.pone.0342738 · PLOS One · 2026-02-17

## TL;DR

This study uses PET imaging and network analysis to detect early Alzheimer’s changes in the cerebellum, showing potential for early diagnosis.

## Contribution

The study introduces cerebellar amyloid network features for early Alzheimer’s detection using graph theory and machine learning.

## Key findings

- Cerebellar network connectivity changes were observed across different cognitive stages of Alzheimer’s.
- Machine learning models achieved high accuracy in distinguishing Alzheimer’s from normal cognition.
- Betweenness centrality changes in cerebellar regions indicate early amyloid plaque deposition.

## Abstract

Pathological and neuroimaging changes in the cerebellum of Alzheimer’s disease (AD) patients have been well documented. However, the changes in cerebellar amyloid plaque deposition connectivity networks during AD progression based on positron emission tomography (PET) imaging remain unclear. We selected 18F-florbetapir PET (18F-AV45 PET) imaging data from the Alzheimer’s disease neuroimaging initiative (ADNI) dataset (n = 612) and employed graph theoretical analysis to examine amyloid plaque deposition connectivity, comparing the connectivity differences across cognitively normal (CN), early mild cognitive impairment (EMCI), late mild cognitive impairment (LMCI), and AD groups. In addition, we combined graph theoretical features with the standardized uptake value ratio (SUVR) of regions of interest and applied them to machine learning models for the early diagnosis of AD. As cognitive decline progressed, significant changes in cerebellar network connectivity were observed across groups. Regarding local connectivity, changes in betweenness centrality were evident in multiple cerebellar regions at different cognitive stages. Cerebellar amyloid networks revealed early changes in amyloid plaque deposition connectivity. The machine learning model achieved an area under the curve (AUC) of 0.950 for distinguishing AD from CN, 0.995 for CN vs. EMCI, 0.964 for EMCI vs. LMCI and 0.632 for LMCI vs. AD. These findings provide new insights into the cerebellar pathological features of AD and highlight the potential of this approach for early identification and prediction of AD progression.

## Linked entities

- **Diseases:** Alzheimer’s disease (MONDO:0004975)
- **Species:** Homo sapiens (taxon 9606)

## Full-text entities

- **Genes:** MAPT (microtubule associated protein tau) [NCBI Gene 4137] {aka DDPAC, FTD1, FTDP-17, MAPTL, MSTD, MTBT1}, App (amyloid beta precursor protein) [NCBI Gene 11820] {aka Abeta, Abpp, Adap, Ag, Cvap, E030013M08Rik}, Psen1 (presenilin 1) [NCBI Gene 19164] {aka Ad3h, PS-1, PS1, S182}, APP (amyloid beta precursor protein) [NCBI Gene 351] {aka AAA, ABETA, ABPP, AD1, APPI, CTFgamma}, ITIH2 (inter-alpha-trypsin inhibitor heavy chain 2) [NCBI Gene 3698] {aka H2P, ITI-HC2, SHAP}
- **Diseases:** metabolic dysfunction (MESH:D008659), damage to the posterior vermis (MESH:C536293), AD (MESH:D000544), EMCI (MESH:D060825), neuropsychiatric disorders (MESH:D001523), atrophy (MESH:D001284), neurodegeneration (MESH:D019636), inflammation (MESH:D007249), Parkinson's disease (MESH:D010300), -emotional syndrome (MESH:D013577), CN (MESH:D003072), amyloid plaque (MESH:D058225), impairments in working memory (MESH:D008569), neuronal loss (MESH:D009410), gait impairments (MESH:D020234), depressive disorder (MESH:D003866), amyloid (MESH:C000718787), dementia (MESH:D003704)
- **Chemicals:** 18F-AV45 (MESH:C545186), 18F-FDG (MESH:D019788)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** E280A, (AUC) of 0

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12912619/full.md

## References

55 references — full list in the complete paper: https://tomesphere.com/paper/PMC12912619/full.md

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Source: https://tomesphere.com/paper/PMC12912619