Multiple Approaches to Diffusion Magnetic Resonance Imaging in Hereditary Cerebral Amyloid Angiopathy Mutation Carriers

Background Cerebral amyloid angiopathy (CAA) is a major cause of lobar intracerebral hemorrhage in elderly adults; however, presymptomatic diagnosis of CAA is difficult. Hereditary cerebral hemorrhage with amyloidosis–Dutch type (HCHWA‐D) is a rare autosomal‐dominant disease that leads to pathology similar to sporadic CAA. Presymptomatic HCHWA‐D mutation carriers provide a unique opportunity to study CAA‐related changes before any symptoms have occurred. In this study we investigated early CAA‐related alterations in the white matter. Methods and Results We investigated diffusion magnetic resonance imaging (dMRI) data for 15 symptomatic and 11 presymptomatic HCHWA‐D mutation carriers and 30 noncarrier control participants using 4 different approaches. We looked at (1) the relation between age and global dMRI measures for mutation carriers versus controls, (2) voxel‐wise dMRI, (3) independent component‐clustered dMRI measures, and (4) structural connectomics between presymptomatic or symptomatic carriers an...