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50/100

✓ Peer-reviewed alzhub usefulness score 50 out of 100. Prevention and risk

Topic: Amyloid, tau and blood-test diagnosis

Importance Current hypothetical models emphasize the importance of β-amyloid in Alzheimer disease (AD) pathogenesis, although amyloid alone is not sufficient to account for the dementia syndrome. The impact of small-vessel cerebrovascular disease, visualized as white matter hyperintensities (WMHs) on magnetic resonance imaging scans, may be a key factor that contributes independently to AD presentation. Objective To determine the impact of WMHs and Pittsburgh Compound B (PIB) positron-emission tomography-derived amyloid positivity on the clinical expression of AD. Design Baseline PIB-positron-emission tomography values were downloaded from the Alzheimer's Disease Neuroimaging Initiative database. Total WMH volume was derived on accompanying structural magnetic resonance imaging data. We examined whether PIB positivity and total WMHs predicted diagnostic classification of patients with AD (n = 20) and control subjects (n = 21). A second analysis determined whether WMHs discriminated between those with and without the clinical diagnosis of AD among those who were classified as PIB positive (n = 28). A third analysis examined whether WMHs, in addition to PIB status, could be used to predict future risk for AD among subjects with mild cognitive impairment (n = 59). Setting The Alzheimer's Disease Neuroimaging Initiative public database. Participants The study involved data from 21 normal control subjects, 59 subjects with mild cognitive impairment, and 20 participants with clinically defined AD from the Alzheimer Disease's Neuroimaging Initiative database. Main outcome measures Clinical AD diagnosis and WMH volume. Results Pittsburgh Compound B positivity and increased total WMH volume independently predicted AD diagnosis. Among PIB-positive subjects, those diagnosed as having AD had greater WMH volume than normal control subjects. Among subjects with mild cognitive impairment, both WMH and PIB status at baseline conferred risk for future diagnosis of AD. Conclusions and relevance White matter hyperintensities contribute to the presentation of AD and, in the context of significant amyloid deposition, may provide a second hit necessary for the clinical manifestation of the disease. As risk factors for the development of WMHs are modifiable, these findings suggest intervention and prevention strategies for the clinical syndrome of AD.

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APA 7th

Provenzano, F. A., Muraskin, J., Tosto, G., Narkhede, A., Wasserman, B. T., Griffith, E. Y., et al. (2013). White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease? JAMA neurology. https://doi.org/10.1001/jamaneurol.2013.1321

Vancouver

Provenzano FA, Muraskin J, Tosto G, Narkhede A, Wasserman BT, Griffith EY, et al. White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease? JAMA neurology. 2013. doi:10.1001/jamaneurol.2013.1321. PMID: 23420027.

BibTeX

@article{provenzano2013-23420027,
  author  = {Provenzano, F. A. and Muraskin, J. and Tosto, G. and Narkhede, A. and Wasserman, B. T. and Griffith, E. Y. and Guzman, V. A. and Meier, I. B. and others},
  title   = {{White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease?}},
  journal = {JAMA neurology},
  year    = {2013},
  doi     = {10.1001/jamaneurol.2013.1321},
  pmid    = {23420027},
  url     = {https://doi.org/10.1001/jamaneurol.2013.1321}
}

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Key findings

Results Pittsburgh Compound B positivity and increased total WMH volume independently predicted AD diagnosis.
Conclusions and relevance White matter hyperintensities contribute to the presentation of AD and, in the context of significant amyloid deposition, may provide a second hit necessary for the clinical manifestation of the disease.
As risk factors for the development of WMHs are modifiable, these findings suggest intervention and prevention strategies for the clinical syndrome of AD.

Why it matters

This study found that amyloid positivity and increased white matter hyperintensity volume independently predicted an Alzheimer's disease diagnosis, and that white matter hyperintensities may provide a second hit needed for the clinical manifestation of the disease. Because risk factors for white matter hyperintensities are modifiable, the authors suggest this points to possible intervention and prevention strategies, though this was not tested.

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Study details

Participants20
Evidence strengthLow

How this study scored 50/100

Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA neurology)
Journal's citation record	2 / 4	JAMA Neurology: journal h-index 235 (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	1 / 5	2013 — within 20 year(s) of the newest study here
Sample size	1 / 4	20 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
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	5 / 7	Cited 194 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	12.9 citations a year over 15 year(s) since 2013
Impact for its field and year	4 / 6	Cited 15.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 11 other studies in this library
Still being cited	2 / 4	Cited 19 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	1 / 4	Last-listed author for the Alzheimer’s Disease Neuroimaging Initiative: h-index 12 (OpenAlex, whole career)
Institution's track record	2 / 3	Columbia University: institution h-index 1,824 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 23420027)
Free to read	0 / 2	Behind a paywall — scores zero
Total	50 / 100	—

What each of these 20 components measures, and what this score is not →

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