Home › Research › Treatments
Changes of a Cerebral Cavernous Malformation Associated With Lecanemab Therapy in a Patient With Alzheimer Disease
Nicholas U. Schwartz, Connor D. Dietz, Igor Prufer Araújo, Javier E. Villanueva-Meyer, Winston Chiong, Courtney Lane‐Donovan, Lawren A. VandeVrede, Peter Alexander Ljubenkov et al.. Neurology Clinical Practice, 2025-06-20
Topic: Brain proteins, microglia and lab models
ε4 heterozygous woman with mild cognitive impairment and CSF biomarker evidence of AD underwent treatment with intravenous lecanemab. Baseline MRI revealed 3 lobar microhemorrhages and an asymptomatic left orbitofrontal cavernous malformation. This cavernous malformation exhibited gross radiologic stability at surveillance brain MRI before the 5th and 7th infusions, but on surveillance MRI after infusion 13 exhibited an asymptomatic increase in size with subacute blood products without additional new amyloid-related imaging abnormalities (ARIA), resulting in treatment discontinuation. Lecanemab therapy was associated with asymptomatic expansion of an incidental cavernous malformation in a patient with AD and without evidence of ARIA.
Key findings
- ε4 heterozygous woman with mild cognitive impairment and CSF biomarker evidence of AD underwent treatment with intravenous lecanemab.
- Baseline MRI revealed 3 lobar microhemorrhages and an asymptomatic left orbitofrontal cavernous malformation.
- This cavernous malformation exhibited gross radiologic stability at surveillance brain MRI before the 5th and 7th infusions, but on surveillance MRI after infusion 13 exhibited an asymptomatic increase in size with subacute blood products without additional new amyloid-related imaging abnormalities (ARIA), resulting in treatment discontinuation.
- Lecanemab therapy was associated with asymptomatic expansion of an incidental cavernous malformation in a patient with AD and without evidence of ARIA.
Why it matters
In one patient with Alzheimer disease, an incidental cavernous malformation in the brain grew larger on MRI after 13 lecanemab infusions, without new amyloid-related imaging abnormalities, and treatment was stopped. This is a single case report, so it cannot show how often such changes occur or whether lecanemab caused them.
New to this subject? Start with our plain-English guide: Treatments →
Study details
- Evidence strengthLow
How this study scored 35/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neurology Clinical Practice) |
| Journal's citation record | 0 / 4 | Neurology Clinical Practice: journal h-index 60 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” 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 | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| 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 | 0 / 6 | No other study in this library cites it |
| 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 Julio C. Rojas: h-index 41 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40584633) |
| Free to read | 2 / 2 | Free to read |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/cpj.0000000000200508
- PubMed: 40584633
- Original source →
- Free full text: eScholarship (California Digital Library) →
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
Schwartz, N. U., Dietz, C. D., Araújo, I. P., Villanueva-Meyer, J. E., Chiong, W., Lane‐Donovan, C., et al. (2025). Changes of a Cerebral Cavernous Malformation Associated With Lecanemab Therapy in a Patient With Alzheimer Disease. Neurology Clinical Practice. https://doi.org/10.1212/cpj.0000000000200508
Vancouver
Schwartz NU, Dietz CD, Araújo IP, Villanueva-Meyer JE, Chiong W, Lane‐Donovan C, et al. Changes of a Cerebral Cavernous Malformation Associated With Lecanemab Therapy in a Patient With Alzheimer Disease. Neurology Clinical Practice. 2025. doi:10.1212/cpj.0000000000200508. PMID: 40584633.
BibTeX
@article{schwartz2025-40584633,
author = {Schwartz, Nicholas U. and Dietz, Connor D. and Araújo, Igor Prufer and Villanueva-Meyer, Javier E. and Chiong, Winston and Lane‐Donovan, Courtney and VandeVrede, Lawren A. and Ljubenkov, Peter Alexander and others},
title = {{Changes of a Cerebral Cavernous Malformation Associated With Lecanemab Therapy in a Patient With Alzheimer Disease}},
journal = {Neurology Clinical Practice},
year = {2025},
doi = {10.1212/cpj.0000000000200508},
pmid = {40584633},
url = {https://doi.org/10.1212/cpj.0000000000200508}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Related studies in Treatments
Also tagged “double-blind”
783 studies in the library carry the topic tag “double-blind”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 783 tagged studies.