White matter abnormalities in Alzheimer's disease: Implications for pathophysiology, diagnosis, and treatment.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analytic data.
PubMed 42402307 · doi:10.1016/j.arr.2026.103229
What was done
Narrative review evaluating the mechanistic role, diagnostic utility (via advanced neuroimaging such as diffusion tensor imaging), and therapeutic relevance of white matter abnormalities in Alzheimer's disease pathogenesis.
What was found
The abstract reports no quantitative data or specific numerical metrics. It summarizes qualitative concepts, noting that microstructural white matter changes frequently precede overt gray matter atrophy and cognitive decline, and frames white matter degradation as an active contributor to amyloid-beta and tau pathology, neuroinflammation, and impaired plasticity rather than a passive downstream outcome.
Why it matters
Highlights the paradigm shift toward viewing white matter degeneration as an early, active driver of Alzheimer's disease, pointing toward myelin protection and regeneration as potential disease-modifying therapeutic strategies.
Limits
The abstract contains no original empirical data, sample sizes, or systematic review methodology. Specific clinical effect sizes, diagnostic accuracy values, and outcomes of white matter-targeted interventions are not reported.
Cited by
- supports Age-related degradation of white matter structure is one of the strongest predictors of age-related cognitive decline.