Lecanemab in the treatment of early Alzheimer's disease: An observational study based on 7.0T ultra‐high field MRI
Bibliographic record
Abstract
BACKGROUND: Previous research has demonstrated the effectiveness of lecanemab in treating early Alzheimer's disease (AD). However, its validation in the Hunan region of China remains limited. Traditional evaluation methods lack precision, particularly in brain imaging technologies. To address this gap, this study utilizes 7.0-tesla ultra-high-field magnetic resonance imaging (MRI) and its sensitive susceptibility-weighted imaging (SWI) sequence, which effectively detects microbleeds. Additionally, diffusion tensor imaging (DTI) analysis, in combination with the along the perivascular spaces (ALPS) index, is employed to evaluate glymphatic function. This study aims to assess the efficacy and safety of lecanemab in AD treatment, focusing on its impact on brain microstructure, glymphatic function, and amyloid-β (Aβ) clearance. METHOD: Beginning on June 28, 2024, 27 patients diagnosed with AD were enrolled in the study and commenced treatment with lecanemab. Comprehensive baseline data collection, clinical screening, and cognitive assessments were completed. Each patient underwent SWI and DTI imaging using a 7.0T Siemens Terra MRI scanner equipped with a 32-channel head coil and parallel transmission (pTX) system, both pre- and post-treatment. RESULT: Of the 27 participants (mean age 61.67±7.30 years; 9 male), two patients (7.4%; 1 male) experienced flu-like symptoms following their initial lecanemab injection. No new cortical or subcortical microhemorrhages were detected via 7.0T MRI SWI sequences during treatment. Additionally, there were no instances of ARIA-E or ARIA-H among participants. Cognitive function, evaluated through the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), showed no significant decline during the observation period (p >0.05). Among the 27 patients, 9 (mean age 63.56±8.90 years; 4 male) completed observation for their seventh medication dose. Paired t-tests revealed a statistically significant increase in left DTI-ALPS index values post-treatment (t = -2.781, p = 0.024), suggesting improvements in glymphatic function. CONCLUSION: 1. Lecanemab treatment in AD patients from Hunan, China, is generally safe, though its long-term efficacy requires further investigation. 2. The use of 7.0T MRI, particularly its SWI sequence, enhances monitoring of microbleeds and improves safety surveillance. Furthermore, DTI-ALPS, which reflects the glymphatic function, presents as a potential imaging marker for assessing treatment efficacy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".