Cortical thickness differs up to 7 years before amyloid PET positivity in cognitively normal individuals

Cognitively healthy adults who later become amyloid PET-positive show thicker cortex and less thinning up to 7 years prior, indicating cortical changes may be an earlier biomarker than amyloid.

• Thicker cortex and reduced thinning were detectable up to 7 years before PET conversion to amyloid positivity.
• Some cortical thickness changes persisted after accounting for quantitative amyloid levels, suggesting partial independence from Aβ.
• The timing of thickness changes tracked amyloid accumulation, and spatial patterns moderately matched amyloid deposition.

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