Connectome-Based Modeling of Mutation-Specific Amyloid-$β$ Aggregation in Familial Alzheimer's Disease
Familial amyloid-$β$ (A$β$) variants alter aggregation kinetics, but their interaction with structural brain connectivity remains incompletely understood. We developed a mutation-aware mechanistic model coupling a coarse-grained monomer--oligomer--fibril aggregation--fragmentation system to graph diffusion on the 540-node Budapest Reference Connectome component. Experimental A$β_{42}$ nucleation scores scaled primary nucleation rates for seven variants relative to wild type. Robustness was examined using mutation-score uncertainty, alternative kinetic mappings, global sensitivity analysis, seed and edge-weight perturbations, degree-preserving randomized connectomes, spatial propagation analysis, synthetic ABC-SMC parameter recovery, posterior prediction, and Chemical Langevin simulations. E22G showed the earliest threshold crossing and greatest cumulative oligomer burden, whereas A2V was delayed under the selected mapping. Mutation rankings persisted across tested network perturbations, although regional burden patterns depended on topology. Connectome distance from seed regions was associated with later oligomer arrival (Spearman $ρ\approx0.92$). Under inferred parameter uncertainty, the mean timing-rank correlation was 0.990 and cumulative-burden ordering was preserved in every posterior draw, while exact peak-amplitude ordering was less stable. Stochastic ensemble medians retained the deterministic ordering despite overlap among trajectories. Within this proof-of-concept framework, mutation-dependent kinetics primarily influence aggregation timing and cumulative burden, while connectivity shapes spatial propagation. Nominal background rates, model-time units, and synthetic parameter recovery limit interpretation to mechanistic comparisons rather than clinically calibrated prediction.