Alzheimer’s disease (AD) is the most common cause of dementia in older
adults. Neuropathological and imaging studies have demonstrated a progressive
and stereotyped accumulation of protein aggregates, but the underlying molecular
and cellular mechanisms driving AD progression and vulnerable cell populations
affected by disease remain coarsely understood. The current study harnesses
single cell and spatial genomics tools and knowledge from the BRAIN Initiative
Cell Census Network to understand the impact of disease progression on middle
temporal gyrus cell types. We used image-based quantitative neuropathology to
place 84 donors spanning the spectrum of AD pathology along a continuous disease
pseudoprogression score and multiomic technologies to profile single nuclei from
each donor, mapping their transcriptomes, epigenomes, and spatial coordinates to
a common cell type reference with unprecedented resolution. Temporal analysis of
cell-type proportions indicated an early reduction of Somatostatin-expressing
neuronal subtypes and a late decrease of supragranular
intratelencephalic-projecting excitatory and Parvalbumin-expressing neurons,
with increases in disease-associated microglial and astrocytic states. We found
complex gene expression differences, ranging from global to cell type-specific
effects. These effects showed different temporal patterns indicating diverse
cellular perturbations as a function of disease progression. A subset of donors
showed a particularly severe cellular and molecular phenotype, which correlated
with steeper cognitive decline. We have created a freely available public
resource to explore these data and to accelerate progress in AD research
atSEA-AD.org.