Arachnoid Granulation Characterization in Dutch-type hereditary Cerebral Amyloid Angiopathy

Motivation: Arachnoid granulations (AGs) have been largely understudied, despite their potential role in cerebrospinal fluid clearance and glymphatic-lymphatic coupling, which may be disrupted in Cerebral Amyloid Angiopathy (CAA). Goal(s): This study aims to explore the role of AGs in Dutch-type CAA by characterizing their volume and count across different clinical stages. Approach: AGs were segmented and analyzed in healthy controls, presymptomatic, and symptomatic D-CAA patients using high resolution MRI to assess changes in AG characteristics. Results: AGs connected to cranial bone showed significant increases in both volume and count in symptomatic D-CAA patients, suggesting a potential role in disease-related clearance/neuroimmune disruptions. Impact: This study highlights the role of arachnoid granulations connected to cranial bone in Dutch-type cerebral amyloid angiopathy, suggesting they may serve as biomarkers for disease progression. It opens new avenues for investigating arachnoid granulations in glymphatic-lymphatic coupling.