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MRI evaluation of cerebral perivascular spaces predicts amyloid-related imaging abnormalities risk in preclinical Alzheimer's disease
Bigjahan B, Cavallari M, Barisano G.. Frontiers in dementia, 2026-04-09
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Background and purpose Amyloid-related imaging abnormalities (ARIA) are radiographic findings observed in the natural course of Alzheimer's disease and have been reported at higher rates in patients receiving anti-amyloid monoclonal antibody therapy. Identifying novel radiographic factors predicting ARIA risk may help prevent its occurrence, improve patient stratification, and provide insight on the underlying biological mechanisms. It remains unclear whether cerebral perivascular spaces (PVS) along with other quantitative radiographic markers of cerebral small vessel disease may help predict the risk of incident ARIA in patients diagnosed with preclinical Alzheimer's disease. Methods Participants from the A4 study were included. PVS and white matter hyperintensities (WMH) were segmented with robust fully-automated methods on T1-weighted and FLAIR images, respectively. Number of microhemorrhages and subcortical infarcts were previously recorded by expert radiologists. Baseline measurements of these markers were used in Cox proportional-hazards models to predict ARIA risk controlling for relevant demographic, clinical, and radiographic factors. Results Among 6,028 brain MRI from 1,088 participants (median age: 71-y.o.; 59.4% women), 356 ARIA were diagnosed (median study follow-up: 5.4 years). The volume fraction of PVS and WMH, and the number of microhemorrhages at baseline predicted higher ARIA risk (adjusted hazard ratio ranges: 1.32-1.55; adjusted p -values all <0.05). Importantly, the effect of PVS on ARIA with microhemorrhages risk was observed in individuals considered at low risk of ARIA according to current guidelines, i.e., APOE-ε4 non-carriers, low WMH burden, or no microhemorrhages. Conclusions These results support the use of quantitative measurements of PVS in addition to WMH and microhemorrhages to assist clinicians in estimating an individual's risk of ARIA.
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APA 7th
Bigjahan, B., Cavallari, M., & Barisano, G. (2026). MRI evaluation of cerebral perivascular spaces predicts amyloid-related imaging abnormalities risk in preclinical Alzheimer's disease. Frontiers in dementia. https://doi.org/10.3389/frdem.2026.1719740
Vancouver
Bigjahan B, Cavallari M, Barisano G. MRI evaluation of cerebral perivascular spaces predicts amyloid-related imaging abnormalities risk in preclinical Alzheimer's disease. Frontiers in dementia. 2026. doi:10.3389/frdem.2026.1719740. PMID: 42040755.
BibTeX
@article{bigjahan2026-42040755,
author = {Bigjahan, B. and Cavallari, M. and Barisano, G.},
title = {{MRI evaluation of cerebral perivascular spaces predicts amyloid-related imaging abnormalities risk in preclinical Alzheimer's disease}},
journal = {Frontiers in dementia},
year = {2026},
doi = {10.3389/frdem.2026.1719740},
pmid = {42040755},
url = {https://doi.org/10.3389/frdem.2026.1719740}
}
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Key findings
- Results Among 6,028 brain MRI from 1,088 participants (median age: 71-y.o.; 59.4% women), 356 ARIA were diagnosed (median study follow-up: 5.4 years).
- Conclusions These results support the use of quantitative measurements of PVS in addition to WMH and microhemorrhages to assist clinicians in estimating an individual's risk of ARIA.
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Study details
- Participants1,088
- Effect size59.4%
- Evidence strengthLow
How this study scored 60/100
Published in a peer-reviewed journal. Scored zero for study design and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 35 of the 58 points we could judge it on, which is 60 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Frontiers in dementia) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,088 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42040755) |
| Free to read | 2 / 2 | Free to read |
| Points | 35 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 35 of the 58 points we could judge it on is 60 out of 100. |
| Total | 60 / 100 | — |
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