Unraveling the potential co-contributions of cerebral small vessel vasculopathy to the pathogenesis of Alzheimer’s dementia

Emerging evidence for the potential co-contributions of small vessel vasculopathy to dementia has resulted in a more nuanced view of Alzheimer’s disease (AD) pathogenesis. Although cerebral small vessel disease, visualized on magnetic resonance imaging as hyperintense signal abnormalities, independently predicts the incidence and clinical progression of dementia, the relationships between AD pathology, white matter hyperintensity volume, genotype, and cognitive decline in AD remain unclear. The study by Morgen and colleagues, recently published in Alzheimer’s Research & Therapy, presents important new findings on the associations between apolipoprotien E ε4 genotype, white matter hyperintensities, and cognition, independent of vascular risk, in a cohort of AD patients.