{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:06:55Z","timestamp":1789103215452,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify MRI predictors of relapse and quantify relapse and mortality risk in cerebral amyloid angiopathy\u2013related inflammation (CAA\u2010RI). A secondary objective was to assess the association between mycophenolate mofetil use and relapse risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of 36 patients with CAA\u2010RI treated at the Cleveland Clinic from January 2020 to December 2024. Relapse was defined as recurrent vasogenic edema on MRI after corticosteroid treatment. Edema was classified as focal (1 lobar region), multifocal (2\u20133 regions), or diffuse (\u2265\u20094 regions). Cause\u2010specific Cox models and Gray's test evaluated predictors of relapse and mortality, and the effect of mycophenolate on relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 36 patients (mean age 71.6\u2009\u00b1\u20098.2\u2009years; 66.7% female), 11 (30.6%) relapsed, 9 (25.0%) died without having relapse, and 16 (44.4%) had neither event after a median prednisone taper of 4.5\u2009months. 31 patients had follow\u2010up data for time\u2010to\u2010event analyses, with a median follow\u2010up time of 18.7\u2009months. Cumulative relapse rates were 22.4%, 26.3%, and 44.0% at 6, 12, and 24\u2009months, respectively. Diffuse edema strongly predicted relapse (hazard ratio [HR]\u2009=\u200912.26; 95% confidence interval [CI]\u2009=\u20091.95\u201376.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Mycophenolate was used in 11 patients; relapse occurred in 18.2% versus 30.0% without mycophenolate treatment. Initiation of mycophenolate at steroid taper in high\u2010relapse\u2010risk patients was associated with a statistically nonsignificant reduction in relapse risk (HR\u2009=\u20090.36; 95% CI\u2009=\u20090.07\u20131.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.231).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Relapse in CAA\u2010RI is common and extends beyond the early post\u2010treatment phase. Diffuse edema on baseline MRI strongly predicts recurrence, enabling effective risk stratification. Mycophenolate shows promise as a steroid\u2010sparing therapy for preventing relapse in high\u2010risk patients and merits prospective evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70525","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:21:55Z","timestamp":1789100515000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diffuse\n                    <scp>MRI<\/scp>\n                    Edema Predicts Relapse in Cerebral Amyloid Angiopathy\u2013Related Inflammation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-1028","authenticated-orcid":false,"given":"G. Abbas","family":"Kharal","sequence":"first","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gowtham","family":"Yerneni","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim J.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Lerner Research Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"Center for Outcomes Research and Evaluation, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9468-4172","authenticated-orcid":false,"given":"Ken","family":"Uchino","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9006-7780","authenticated-orcid":false,"given":"Irene","family":"Katzan","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"Center for Outcomes Research and Evaluation, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolora","family":"Wisco","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Farrag","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayashree","family":"Sundarajan","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Russman","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Shazam","family":"Hussain","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ANA.10810"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANEUROL.2015.4078"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ACN3.52169"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.13826"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ANA.23857;WGROUP:STRING:PUBLICATION"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ANA.27162"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JNS.2021.117425"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040671"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010150070"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JSTROKECEREBROVASDIS.2015.04.015\/ATTACHMENT\/F6066F56\u20103157\u20104DAD\u2010A193\u2010EF69AC5C8AAB\/MMC1.XLSX"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/PRACTNEUROL\u20102017\u2010001599"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nan.12946"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003613"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209647"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JSTROKECEREBROVASDIS.2023.107436"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANEUROL.2020.1782"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000001427"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/JCM11226731"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0339757"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/BRAINSCI13050747"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/FIMMU.2024.1463429\/TEXT"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/S40744\u2010023\u201000572\u2010Y"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012778"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(22)00208\u20103"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.54.SUPPL_1.TP22"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/RMDOPEN\u20102014\u2010000014"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3174\/AJNR.A7759"}],"container-title":["Annals of Clinical and Translational Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.70525","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acn3.70525","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.70525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:21:56Z","timestamp":1789100516000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/acn3.70525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":27,"alternative-id":["10.1002\/acn3.70525"],"URL":"https:\/\/doi.org\/10.1002\/acn3.70525","archive":["Portico"],"relation":{},"ISSN":["2328-9503","2328-9503"],"issn-type":[{"value":"2328-9503","type":"print"},{"value":"2328-9503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"assertion":[{"value":"2026-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acn3.70525"}}