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Female vulnerability to microvascular transport dysfunction emerges early across the Alzheimer's disease continuum.

Overview

Authors: Manxi Xu1,2,3, Yian Gao1, Peiling Ou1, Haoyu Yang1, Jia Wang1, Wulong Liu1, Ni Shu4, Yu Sun5, Liping Fu6, Lidia Glodzik7, Tracy A Butler7, Gloria C Chaing7, Yi Li7, Yi Wang3, Liangdong Zhou7, Guolin Ma1,2
ORCID iDs: Liangdong Zhou
  1. Department of Radiology China‐Japan Friendship Hospital Beijing China
  2. Peking University China‐Japan Friendship School of Clinical Medicine Beijing China
  3. Department of Radiology MRI Research Institute (MRIRI) Weill Cornell Medicine New York New York USA
  4. State Key Laboratory of Cognitive Neuroscience and Learning Beijing Normal University Beijing China
  5. Department of Neurology China‐Japan Friendship Hospital Beijing China
  6. Department of Nuclear Medicine, China‐Japan Friendship Hospital Beijing China
  7. Department of Radiology Brain Health Imaging Institute (BHII) Weill Cornell Medicine New York New York USA
Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association, volume 22, issue 9, article e71811
Dates: received 24 April 2026; accepted 6 August 2026; published online 31 August 2026; in print September 2026
Type: Research article · Language: English
License: CC BY-NC
Identifiers: DOI 10.1002/alz.71811 · PMID 42675347 · PMCID PMC13529826 · OpenAlex W7204827941
Open access: hybrid, a free copy (OpenAlex)
Status: code on request
Categories: structural MRI / diffusion (modality), other (modality), human (organism), Alzheimer's / dementia (population), stroke (population), clinical / translational (subfield)
Methods: Statistics, Connectivity, fMRI & imaging
Keywords: Alzheimer's disease, cerebral blood flow, female‐specific cerebrovascular risk, microvasculature alteration, neurovascular dysfunction, plasma biomarkers, quantitative transport mapping, sex differences
MeSH: Alzheimer Disease*, Brain*, Cerebrovascular Circulation*, Cognitive Dysfunction*, Microvessels*, Aged, Aged, 80 and over, Biomarkers, Female, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Sex Characteristics (* major topic)
Topic: Advanced MRI Techniques and Applications (Radiology, Nuclear Medicine and Imaging, Medicine), according to OpenAlex
Funding: Brain Science and Brain-like Intelligence Technology—National Science and Technology Major Project (2022ZD0213300); National Natural Science Foundation of China (82271953, U25A20136); National Institute on Aging (R01 AG057848‐02, R01AG077576‐01A); U.S. Department of Health & Human Services | NIH | National Institute of Neurological Disorders and Stroke (NINDS) (R01NS104364‐02)
Citations: not cited yet (Europe PMC); 65 references in the paper

Abstract

INTRODUCTION: We tested whether quantitative transport mapping (QTM)‐derived perfusion velocity would detect earlier and more sex‐specific microvascular alterations than cerebral blood flow (CBF) across the Alzheimer's disease (AD) continuum.

METHODS: In 182 participants (cognitively normal = 53, subjective cognitive decline [SCD] = 48, mild cognitive impairment [MCI] = 31, AD = 50), seven‐delay arterial spin labeling was used to derive CBF and QTM velocity. Age/sex‐adjusted models assessed diagnostic and sex effects, associations with plasma biomarkers and Mini‐Mental State Examination (MMSE), and mediation of the hippocampal volume–cognition relationship.

RESULTS: QTM velocity was reduced already in SCD, including the hippocampus, whereas CBF declined mainly in MCI/AD. Sex × Diagnosis interactions were significant for QTM in gray and white matter, but not for CBF. QTM, especially in females, was inversely associated with plasma NfL/GFAP, related to MMSE, and parietal QTM partially mediated the hippocampal volume–MMSE association.

DISCUSSION: QTM is a non‐invasive biomarker more sensitive than CBF to early, female‐biased microvascular transport dysfunction in AD.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

The paper's code and data availability statement is in the Data section.

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Data

No dataset and no data link were found in the paper.

Data availability

The raw data and analytical code that support the findings of this study are available on request from the corresponding author.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

Versions

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 16 authors, 8 keywords, 14 MeSH terms, 4 funders, 65 references.

Cite

This paper

Xu, M., Gao, Y., Ou, P., Yang, H., Wang, J., Liu, W., Shu, N., Sun, Y., Fu, L., Glodzik, L., Butler, T. A., Chaing, G. C., Li, Y., Wang, Y., Zhou, L., & Ma, G. (2026). Female vulnerability to microvascular transport dysfunction emerges early across the Alzheimer's disease continuum. Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(9), e71811. https://doi.org/10.1002/alz.71811

BibTeX

@article{xu2026female,
author = {Xu, Manxi and Gao, Yian and Ou, Peiling and Yang, Haoyu and Wang, Jia and Liu, Wulong and Shu, Ni and Sun, Yu and Fu, Liping and Glodzik, Lidia and Butler, Tracy A and Chaing, Gloria C and Li, Yi and Wang, Yi and Zhou, Liangdong and Ma, Guolin},
title = {{Female vulnerability to microvascular transport dysfunction emerges early across the Alzheimer's disease continuum}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2026},
month = sep,
volume = {22},
number = {9},
pages = {e71811},
publisher = {Wiley},
issn = {1552-5260},
doi = {10.1002/alz.71811},
url = {https://doi.org/10.1002/alz.71811},
pmid = {42675347},
pmcid = {PMC13529826}
}

RIS

TY - JOUR
AU - Xu, Manxi
AU - Gao, Yian
AU - Ou, Peiling
AU - Yang, Haoyu
AU - Wang, Jia
AU - Liu, Wulong
AU - Shu, Ni
AU - Sun, Yu
AU - Fu, Liping
AU - Glodzik, Lidia
AU - Butler, Tracy A
AU - Chaing, Gloria C
AU - Li, Yi
AU - Wang, Yi
AU - Zhou, Liangdong
AU - Ma, Guolin
TI - Female vulnerability to microvascular transport dysfunction emerges early across the Alzheimer's disease continuum
T2 - Alzheimer's & dementia : the journal of the Alzheimer's Association
J2 - Alzheimers Dement
PY - 2026
DA - 2026/09/01
VL - 22
IS - 9
SP - e71811
SN - 1552-5260
PB - Wiley
DO - 10.1002/alz.71811
UR - https://doi.org/10.1002/alz.71811
LA - en
ER -

CSL-JSON

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