Exploring the spatial covariance of cerebral vascular density and amyloid burden in Alzheimer's disease

INTRODUCTION Regional patterns of amyloid beta (Aβ) deposition in Alzheimer's disease (AD) may be influenced by cerebrovascular architecture. We examined the relationship between normative arterial and venous density maps and cortical Aβ burden. METHODS Seventy‐four amyloid‐positive AD patients underwent amyloid positron emission tomography (PET) and magnetic resonance imaging. Regional Aβ uptake was quantified; spatial associations with normative arterial (time‐of‐flight magnetic resonance angiography) and venous (susceptibility‐weighted imaging) density maps were assessed using correlation analyses and partial least squares (PLS) regression, controlling for early‐frame PET as a proxy for perfusion. RESULTS Higher arterial density was associated with lower Aβ uptake ( r = −0.68, p < 0.001), independent of venous density and perfusion. PLS explained 71% of regional variance, highlighting temporo‐limbic regions. Subject‐level analyses showed heterogeneous vascular–amyloid coupling, related to education and global Aβ burden. DISCUSSION Arterial architecture may contribute to regional amyloid vulnerability through vascular clearance mechanisms.