Alzheimer’s Association (ALZ.org)
Browse Professional Information, tools, and resources for those working in the field of Alzheimer’s disease and dementia care.ALZ.org
Detection and Management of Amyloid-Related Imaging Abnormalities in Patients with Alzheimer's Disease Treated with Anti-Amyloid Beta Therapy.
- Literature on ARIA from anti-amyloid β therapy studies about potential risk factors, detection, and management is summarized.
- ARIA may be related to binding of antibodies to accumulated Aβ in both the cerebral parenchyma and vasculature, resulting in loss of vessel wall integrity and increased leakage into surrounding tissues.
- ARIA-E is identified as vasogenic edema in the brain parenchyma or sulcal effusions in the leptomeninges/sulci.
- ARIA tends to be transient and asymptomatic, typically occurring early during treatment, with the risk decreasing later in treatment.
Amyloid-Related Imaging Abnormalities with Emerging Alzheimer Disease Therapeutics: Detection and Reporting Recommendations for Clinical Practice.
- Monoclonal antibodies are emerging disease-modifying therapies for Alzheimer disease that require brain MR imaging for eligibility assessment as well as for monitoring for ARIA.
- ARIA with edema or effusion are transient, treatment-induced edema or sulcal effusion, identified on T2-FLAIR.
- ARIA with hemorrhage are treatment-induced microhemorrhages or superficial siderosis identified on T2* gradient recalled-echo.
- As monoclonal antibodies become more widely available, treatment screening and monitoring brain MR imaging examinations may increase neuroradiology practice volumes.
- Radiologists must become familiar with the imaging appearance of ARIA, how to select an appropriate imaging protocol, and report findings in clinical practice.
Amyloid-related imaging abnormalities in amyloid-modifying therapeutic trials: recommendations from the Alzheimer's Association Research Roundtable Workgroup.
- In response to concerns raised by the Food and Drug Administration, the Alzheimer's Association Research Roundtable convened a working group to review publicly available trial data.
- The etiology of ARIA remains unclear but the prevailing data support vascular amyloid as a common pathophysiological mechanism leading to increased vascular permeability.
- The workgroup proposes recommendations for the detection and monitoring of ARIA in ongoing AD clinical trials, as well as directions for future research.
Amyloid-Related Imaging Abnormalities and β-Amyloid-Targeting Antibodies: A Systematic Review.
- Available evidence on ARIAs from RCTs testing anti-β-amyloid mAbs in patients with AD was summarized to provide a comprehensive update about risk factors, clinical correlates, and implications for withholding and reinitiating treatment.
- Evidence suggests that ARIAs are frequent, mostly asymptomatic collateral events of amyloid-modifying therapies, highlighting the need for standardized clinical and neuroradiological management protocols in real-world clinical settings.
Cerebral amyloid angiopathy and Alzheimer disease - one peptide, two pathways.
- The pathogenic pathways of CAA and AD intersect at the levels of Aβ generation, its circulation within the interstitial fluid and perivascular drainage pathways and its brain clearance but diverge in their mechanisms of brain injury and disease presentation.
Continuing Medical Education
Alzheimer’s Association (ALZ.org)
An Introduction to Amyloid-Related Imaging Abnormalities (ARIA) and Its Management (75-minute continuous webinar)Link
American Society for Neuroradiology (ASNR)
Alzheimer’s Webinar Series and link to directory of ARIA Educated PractitionersLink
These links are provided for informational purposes and the presence of this content on UnderstandingARIA.com (“Website”) does not constitute the review, approval, or endorsement by these organizations of this Website.