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Cerebral amyloid angiopathy (CAA) associates with neuritic plaques (NPs) to exacerbate NFT accumulation. We aim to study how these co\u2010pathologies affect WM integrity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We performed a cross\u2010sectional study of\n                      <jats:italic>ante mortem<\/jats:italic>\n                      diffusion tensor imaging (DTI) data according to participants\u2019\n                      <jats:italic>post mortem<\/jats:italic>\n                      NFT, NP, and CAA neuropathology, from the National Alzheimer's Coordinating Center dataset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We found asymmetric DTI changes in several WM regions between Braak NFT stages II and IV and V\/VI, and across CAA pathological burden, with increased mean, radial, and axial diffusivities. CAA\u2010NFT co\u2010pathology effects were observed mainly in the splenium of the corpus callosum. DTI metrics were associated with cognitive function and hippocampal volumes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Our results suggest that WM integrity is differentially impacted by AD neuropathology, with CAA and NFTs influencing each other's effects on WM microstructure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Diffusion tensor imaging (DTI) changes were observed in several white matter (WM) regions between advanced Braak stages and across cerebral amyloid angiopathy (CAA).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CAA demonstrated a greater WM impact on the right hemisphere, while neurofibrillary tangles (NFTs) had greater impact on the left.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CAA\u2013NFT concurrent effects were mainly noticed in the splenium of the corpus callosum.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>WM DTI metrics were associated with cognition and hippocampal volumes.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70637","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T13:45:09Z","timestamp":1760449509000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["White matter microstructure is differentially impacted by cerebral amyloid angiopathy, neurofibrillary tangles, and neuritic plaque co\u2010pathology"],"prefix":"10.1002","volume":"21","author":[{"given":"Alexandra","family":"Santos","sequence":"first","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho  Gualtar Portugal"},{"name":"ICVS\/3B's\u2014PT Government Associate Laboratory  Gualtar Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco C.","family":"Almeida","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho  Gualtar Portugal"},{"name":"ICVS\/3B's\u2014PT Government Associate Laboratory  Gualtar Portugal"},{"name":"Department of Neuroradiology Centro Hospitalar Universit\u00e1rio do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Gauthreaux","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Alzheimer's Coordinating Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles N.","family":"Mock","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Alzheimer's Coordinating Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter A.","family":"Kukull","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Alzheimer's Coordinating Center University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Crary","sequence":"additional","affiliation":[{"name":"Neuropathology Brain Bank &amp; Research Core, Department of Pathology, Nash Family Department of Neuroscience, Department of Artificial Intelligence &amp; Human Health, Friedman Brain Institute, Ronald M. 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