A clinical question: Does microstructure change(DTI metrics) always occur before macroscopic change(T1 metrics, like thickness, volume) in grey matter in neurodegenerative disease?

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Hi,

I have a very clinical question: Does microstructure change(DTI metrics) always occur before macroscopic change(T1 metrics, like thickness, volume) in grey matter in neurodegenerative disease?

Like in Alzheimer’s disease, researchers found that the microstructure change will occur before macrostructure change. Recently, I am working on another kind of neurodegenerative disease, but the results shows that the macrostructure change can be detected in cortical volume, thickness and subcortical structure; Alternatively, I did the same analysis for DTI metrics for the cortical and subcortical structure (I have did something to avoid the partial volume effect caused by CSF and the limited dMRI resolution 2mm), and I found nothing after multiple correction (even not with MD, which has been demonstrated the most sensitive metric in AD).

So I made a bold hypothesis:
For our cohort or this disease (not have done this in literatures), the microstructure change happens after the macroscopic change ?

The clinician that I cooperate with does not agree with me based on his knowledge from AD, I am not clinician, so can some specialist give me some propositions?

Thanks in advance