Low cerebral blood flow, particularly in the hippocampus, parietal lobes, and posterior cingulate gyrus, is the primary brain imaging predictor of Alzheimer's disease.
"The number one brain imaging predictor of Alzheimer's disease is low blood flow, especially in the hippocampus and in the back half of your brain, the parietal lobes, and an area called the posterior cingulate gyrus." (said at 0:08:25)
While hypoperfusion and hypometabolism in the posterior cingulate cortex, parietal lobes, and hippocampus are well-recognized neurodegenerative patterns in Alzheimer's disease (AD), low cerebral blood flow is not the primary or "number one" neuroimaging predictor of AD. Under the established National Institute on Aging and Alzheimer's Association (NIA-AA) diagnostic and research frameworks, the primary Core-1 and Core-2 diagnostic imaging biomarkers for Alzheimer's disease are amyloid-beta PET and tau PET. Functional imaging measures such as regional perfusion or FDG-PET metabolism reflect downstream neurodegeneration ('N') or vascular changes ('V') rather than the primary disease-defining biomarkers.
- context: Glucose metabolism in posterior cingulate cortex has supplementary value to predict the pr… (GeroScience 2024)
"Amyloid-β (Aβ) and tau are important biomarkers to predict the progression of cognitively unimpaired (CU) to dementia due to Alzheimer's disease (AD), according to the diagnosis framework from the US National Institute on Aging and the Alzheimer's Association (NIA-AA)... As a typical characteristic of neurodegeneration in the diagnosis framework, the hypometabolism of the posterior cingulate cortex (PCC) has significant clinical value in the early prediction and prevention of AD. In this paper, we proposed the glucose metabolism in the PCC as a biomarker supplement to Aβ and tau biomarkers." (abstract, results, passage verified)
pubmedfull study (doi) - contradicts: The 2024 NIA-AA biological definition of Alzheimer's disease: linking biomarkers to clinic… (Frontiers in dementia 2026)
"The 2024 framework defines AD by its underlying pathology rather than clinical symptoms, recognizing that biomarker evidence alone can establish diagnosis. It expands the traditional AT (N) model into a multimodal profile (AT 1 T 2 NISV), in which Core-1 biomarkers (A and T 1 ) are diagnostic, while Core-2 biomarkers (T 2 ) support biological staging. Non-specific but mechanistically important processes (N, neurodegeneration; I, inflammation) and common co-pathologies (S, α -synuclein; V, vascular injury) are also incorporated" (abstract, results, passage verified)
pubmedfull study (doi)