{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T11:48:28Z","timestamp":1792928908295,"version":"4.5.0"},"reference-count":61,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"UKRI Medical Research Council","award":["MR\/S03546X\/1"],"award-info":[{"award-number":["MR\/S03546X\/1"]}]},{"name":"UKRI Medical Research Council","award":["MR\/T046422\/1"],"award-info":[{"award-number":["MR\/T046422\/1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alzheimer's disease (AD) exhibits substantial clinical and biological heterogeneity, complicating efforts in treatment and intervention development. While new computational methods offer insights into AD subtyping and disease staging, the reproducibility of these subtypes across datasets remains understudied, particularly concerning the robustness of subtype definitions when validated on diverse databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates the robustness of the AD progression subtypes identified by the Subtype and Stage Inference (SuStaIn) algorithm on a larger and more diverse cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted T1-weighted MRI data for 5444 subjects from ANMerge, OASIS, and ADNI datasets, forming four independent cohorts. Each cohort was analyzed with SuStaIn under two conditions: one using the full cohort, including cognitively normal controls, and another excluding controls to test subtype robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results confirm the three primary atrophy subtypes identified in earlier studies: Typical, Cortical, and Subcortical, as well as the emergence of rare and atypical AD variants such as posterior cortical atrophy. Notably, each subtype displayed varying robustness to the inclusion of controls, with certain subtypes, like the Subcortical subtype, more influenced by cohort composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This investigation underscores SuStaIn's reliability for defining stable AD subtypes and suggests its utility in clinical stratification for trials and diagnosis. However, our findings also highlight the need for improved dataset ethnic and demographic diversity, particularly in terms of ethnic representation, to enhance generalizability and support broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251415019","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:10:31Z","timestamp":1769602231000},"page":"426-442","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["How reproducible are data-driven subtypes of Alzheimer's disease atrophy?"],"prefix":"10.1177","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6729-9505","authenticated-orcid":false,"given":"Emma","family":"Prevot","sequence":"first","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1299-890X","authenticated-orcid":false,"given":"Cameron","family":"Shand","sequence":"additional","affiliation":[{"name":"UCL Hawkes Institute and Department of Computer Science, University College London, Gower Street, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for Alzheimer\u2019s Disease Neuroimaging Initiative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-3909","authenticated-orcid":false,"given":"Neil","family":"Oxtoby","sequence":"additional","affiliation":[{"name":"UCL Hawkes Institute and Department of Computer Science, University College London, Gower Street, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization (WHO). Dementia https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dementia (2023 accessed March 15 2023)."},{"key":"e_1_3_3_3_2","unstructured":"Alzheimer\u2019s Disease International. Dementia statistics https:\/\/www.alzint.org\/about\/dementia-facts-figures\/dementia-statistics\/ (2024)."},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Economic burden of Alzheimer disease and managed care considerations. 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