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Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab?
Saurabh Rohatgi, Shenghua Zhu, Esteban Calle, Jeremy N. Ford, Benjamin M. Kozak, Odette Ganem Chagui, Maryam Vejdani‐Jahromi, Harry R. Griffin et al.. American Journal of Neuroradiology, 2025-10-02
Topic: Brain proteins, microglia and lab models
ARIA-positive patients had significantly higher Fazekas scores compared with ARIA-negative patients (1.37 versus 1.0; P = .0262), indicating a greater DWMH burden. PVS grades in the basal ganglia were numerically higher in ARIA-positive patients (1.81 versus 1.56, P = .0733) but did not reach statistical significance. Simple logistic regression identified the Fazekas score as a significant predictor of ARIA (OR: 2.812; 95% CI, 1.076–8.438; P = .0343). The area under the receiver operating characteristic curve for the model was 0.640 (95% CI, 0.492–0.788; P = .078). Higher DWMH burden, as quantified by the Fazekas score, is significantly associated with ARIA risk in patients with AD treated with lecanemab. These findings suggest that DWMH may serve as a potential imaging biomarker for ARIA risk stratification. Larger studies incorporating additional vascular biomarkers, including cerebral amyloid angiopathy markers, are warranted to refine risk prediction models.
Key findings
- ARIA-positive patients had significantly higher Fazekas scores compared with ARIA-negative patients (1.37 versus 1.0; P = .0262), indicating a greater DWMH burden.
- PVS grades in the basal ganglia were numerically higher in ARIA-positive patients (1.81 versus 1.56, P = .0733) but did not reach statistical significance.
- Simple logistic regression identified the Fazekas score as a significant predictor of ARIA (OR: 2.812; 95% CI, 1.076–8.438; P = .0343).
- The area under the receiver operating characteristic curve for the model was 0.640 (95% CI, 0.492–0.788; P = .078).
- Higher DWMH burden, as quantified by the Fazekas score, is significantly associated with ARIA risk in patients with AD treated with lecanemab.
Why it matters
In this cohort, patients who developed amyloid-related imaging abnormalities had higher deep white matter hyperintensity burden as measured by the Fazekas score, which was a significant predictor of ARIA. The authors say larger studies with more vascular biomarkers are needed before this can be used to stratify risk.
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Study details
- Study designcohort study
- Participants27
- Effect sizeOR: 2.812
- Evidence strengthModerate
How this study scored 56/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (American Journal of Neuroradiology) |
| Journal's citation record | 2 / 4 | American Journal of Neuroradiology: journal h-index 182 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 27 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Javier M. Romero: h-index 40 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41038644) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
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Read the original
- DOI: 10.3174/ajnr.a8822
- PubMed: 41038644
- Original source →
- Free full text: American Journal of Neuroradiology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Rohatgi, S., Zhu, S., Calle, E., Ford, J. N., Kozak, B. M., Chagui, O. G., et al. (2025). Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab? American Journal of Neuroradiology. https://doi.org/10.3174/ajnr.a8822
Vancouver
Rohatgi S, Zhu S, Calle E, Ford JN, Kozak BM, Chagui OG, et al. Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab? American Journal of Neuroradiology. 2025. doi:10.3174/ajnr.a8822. PMID: 41038644.
BibTeX
@article{rohatgi2025-41038644,
author = {Rohatgi, Saurabh and Zhu, Shenghua and Calle, Esteban and Ford, Jeremy N. and Kozak, Benjamin M. and Chagui, Odette Ganem and Vejdani‐Jahromi, Maryam and Griffin, Harry R. and others},
title = {{Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab?}},
journal = {American Journal of Neuroradiology},
year = {2025},
doi = {10.3174/ajnr.a8822},
pmid = {41038644},
url = {https://doi.org/10.3174/ajnr.a8822}
}
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