{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:58:49Z","timestamp":1785189529284,"version":"3.55.0"},"posted":{"date-parts":[[2026,7,1]]},"group-title":"Neurology","reference-count":66,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Structural MRI is routinely acquired in the clinical assessment of Alzheimer\u2019s disease, yet quantitative morphometric indices derived from these scans remain largely confined to research settings. Here we present PHASE\u2013AD \u2014 a framework that translates such indices into clinically interpretable classifications of atrophy subtype and stage that jointly capture atrophy progression while accounting for inter-individual atrophy heterogeneity. PHASE\u2013AD is trained on MRI scans from 8,415 participants and robustly captures limbic-predominant and hippocampal-sparing atrophy subtypes that were identified across seven independent datasets. Two cross-validation schemes revealed high robustness across different field strength and scanner manufacturer configurations. Atrophy classifications were associated with diverging clinical profiles and tau accumulation patterns. In prospective designs mirroring contemporary AD trials, they stratified longitudinal cognitive trajectories and outperformed semi-quantitative visual MRI assessments as a clinically established comparator. These findings support the integration of automated atrophy subtyping and staging into clinical practice and pharmacological trials.<\/jats:p>","DOI":"10.64898\/2026.06.26.26356678","type":"posted-content","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:30:11Z","timestamp":1783193411000},"source":"Crossref","is-referenced-by-count":0,"title":["Subtyping and staging of Alzheimer\u2019s disease from routine structural MRI with PHASE\u2013AD"],"prefix":"10.64898","author":[{"given":"Hannah","family":"Baumeister","sequence":"first","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany"},{"name":"Neurodegenerative Research Unit, Department of Clinical Sciences Malm\u00f6, Lund University, Lund, Sweden"},{"name":"Science for Life Laboratory (SciLifeLab), Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falk","family":"L\u00fcsebrink","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Kleineidam","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany"},{"name":"Department of Old Age Psychiatry and Cognitive Disorders, University Hospital Bonn and University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schmid","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany"},{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn and University of Bonn, 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