{
  "abstract": "IMPORTANCE: Predictors of decline and of amyloid-related imaging abnormalities (ARIA) during anti-amyloid β therapy in routine care are undefined.\n\nOBJECTIVE: To identify baseline predictors of cognitive, functional, and safety outcomes.\n\nDESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort of 161 consecutive patients initiating anti-amyloid β therapy at a Tokyo dementia center, 2024 to 2026 (lecanemab, 89; donanemab, 72).\n\nEXPOSURES: Lecanemab or donanemab.\n\nMAIN OUTCOMES AND MEASURES: Change in MMSE and CDR-Sum of Boxes (CDR-SB); baseline medial temporal atrophy (VSRAD Z score), amyloid PET burden, and microbleeds; ARIA.\n\nRESULTS: With lecanemab, MMSE and CDR-SB declined significantly at every assessment (CDR-SB +0.79, +1.10, +1.60 at 6, 12, 18 months); memory and orientation declined while language was preserved. Greater baseline medial temporal atrophy was associated with greater 12-month CDR-SB worsening (r = 0.39; P = .01; n = 40); patients in the most severe standard category (Z ≥ 3) worsened by 2.62 versus 0.64 points (adjusted β = +2.18; P < .001). Atrophy was associated with older age (r = 0.19; P = .03) and with baseline memory-related measures — ADAS-Cog score (r = 0.32; P < .001) and the MMSE subdomains of delayed recall (β = −0.25; P = .006) and time orientation (β = −0.30; P = .04) — but not MMSE total score. Amyloid PET burden showed no significant association at most time points. All ARIA events were asymptomatic; ARIA-H occurred in 6 of 25 with microbleeds versus 3 of 136 without (odds ratio, 14.0; P < .001). Donanemab follow-up was 6 months.\n\nCONCLUSIONS AND RELEVANCE: Baseline medial temporal atrophy was associated with functional decline and microbleeds with ARIA-H. Pretreatment MRI may provide prognostic and safety information during anti-amyloid β therapy.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Care Coordination Office, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Neuropsychology Unit, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Department of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan",
    "Department of Radiology, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Memory Center, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan",
    "Department of Cardiology, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Department of Neurosurgery, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Department of Psychiatry, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan",
    "Department of Gastroenterological Surgery, Tachikawa Hospital, Tachikawa-shi, Tokyo, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yuki Kujuro"
    },
    {
      "affs": [
        0
      ],
      "name": "Marina Saito"
    },
    {
      "affs": [
        0
      ],
      "name": "Manami Maruko"
    },
    {
      "affs": [
        1
      ],
      "name": "Kazuko Kamiyama"
    },
    {
      "affs": [
        2
      ],
      "name": "Aya Nakano"
    },
    {
      "affs": [
        3
      ],
      "name": "Emi Qian"
    },
    {
      "affs": [
        4
      ],
      "name": "Teppei Okamura"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Daisuke Ito"
    },
    {
      "affs": [
        6
      ],
      "name": "Toshimi Kageyama"
    },
    {
      "affs": [
        7
      ],
      "name": "Ichiro Sugiyama"
    },
    {
      "affs": [
        7
      ],
      "name": "Eriko Ishihara"
    },
    {
      "affs": [
        8
      ],
      "name": "Tatsuro Kuwahara"
    },
    {
      "affs": [
        6
      ],
      "name": "Kazunori Moritani"
    },
    {
      "affs": [
        9
      ],
      "name": "Hitoshi Katai"
    },
    {
      "affs": [
        0
      ],
      "name": "Hidenori Hattori"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1s6ty2zrp4b8a.bib",
  "cited_by": 0,
  "doi": "10.1016/j.tjpad.2026.100686",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696334/",
  "id": "1s6ty2zrp4b8a",
  "issns": [
    "2274-5807",
    "2426-0266"
  ],
  "landing_url": "https://doi.org/10.1016/j.tjpad.2026.100686",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2737|Alzheimer's disease research and treatments"
    ]
  ],
  "openalex": "W7222823532",
  "pdf_url": "https://europepmc.org/articles/PMC13696334?pdf=render",
  "pmcid": "PMC13696334",
  "pmid": "42892274",
  "published": "2026-10-17",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/1s6ty2zrp4b8a.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:42Z",
      "native_id": "PMC13696334",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.tjpad.2026.100686"
    },
    {
      "first_seen": "2026-10-30T12:18:46Z",
      "native_id": "MED:42892274",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42892274"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Alzheimer's disease research and treatments",
      "subfield": "physiology"
    }
  ],
  "title": "Baseline MRI markers and clinical outcomes during anti-amyloid β therapy: A real-world study in a Japanese dementia center",
  "title_text": "Baseline MRI markers and clinical outcomes during anti-amyloid β therapy: A real-world study in a Japanese dementia center",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:41Z",
  "url": "https://research.draconitic.com/paper/1s6ty2zrp4b8a",
  "venue": "The Journal of Prevention of Alzheimer's Disease",
  "versions": []
}