Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Alzheimer Disease Patients

Strategic Insights -

New research has shed light on the relationship between deep white matter hyperintensities (DWMH) and amyloid-related imaging abnormalities (ARIA) in patients with Alzheimer Disease (AD) treated with lecanemab. Investigators have identified DWMH as a potential imaging biomarker for ARIA risk stratification, suggesting that a higher burden of DWMH, as quantified by the Fazekas score, is significantly associated with ARIA risk.

Key Takeaways:

  • The study included 27 ARIA-positive patients and 27 age- and sex-matched ARIA-negative controls, all of whom were treated with lecanemab.
  • ARIA-positive patients had significantly higher Fazekas scores compared to ARIA-negative patients (1.37 vs. 1.0; p = 0.0262), indicating a greater DWMH burden.
  • Simple logistic regression identified the Fazekas score as a significant predictor of ARIA (OR: 2.812; 95% CI, 1.076-8.438; p = 0.0343).
  • The research suggests that DWMH may serve as a potential imaging biomarker for ARIA risk stratification in patients with AD treated with lecanemab.
  • Larger studies incorporating additional vascular biomarkers, including cerebral amyloid angiopathy markers, are warranted to refine risk prediction models.
  • The study highlights the importance of considering DWMH as a potential risk factor for ARIA in patients with AD treated with lecanemab.

Statistics:

  • The study included 54 patients, with 27 ARIA-positive patients and 27 ARIA-negative controls.
  • ARIA-positive patients had a higher Fazekas score (1.37) compared to ARIA-negative patients (1.0).
  • The area under the receiver operating characteristic curve for the model was 0.640 (95% CI, 0.492-0.788; p = 0.078).
  • The study identified the Fazekas score as a significant predictor of ARIA (OR: 2.812; 95% CI, 1.076-8.438; p = 0.0343).

Sources:

  • NewsRx. New Findings from Saurabh Rohatgi and Colleagues Has Provided New Data on Alzheimer Disease (Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab?). Immunotherapy Weekly. October 15, 2025; p 3093.
  • American Journal of Neuroradiology. Are Deep White Matter Hyperintensities Associated with Amyloid-Related Imaging Abnormalities in Patients with Alzheimer Disease Treated with Lecanemab?