Aducanumab Removes Superficial Cortical Amyloid but Associates with Local Vascular Injury and ARIA: Clinicopathological Evidence from a Retrospective Case–Control Study

Highlights

– Autopsy study of five aducanumab-treated Alzheimer’s cases shows disproportionate clearance of Aβ from superficial cortical layer I with limited clearance in deeper layers, despite PET Centiloid reductions of up to 81%.

– Regions corresponding to ARIA on MRI contained microinfarcts with haemosiderin, complement activation, and CD68-positive vessel-wall changes arising from Aβ-laden leptomeningeal and penetrating vessels.

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