ARIA

What Is ARIA?

ARIA stands for amyloid-related imaging abnormalities. It refers to specific changes seen in magnetic resonance imaging (MRI) brain scans of some patients with Alzheimer’s disease being treated with a class of medications called anti-amyloid therapies. These changes appear as tiny spots of bleeding (ARIA-H) and/or swelling (ARIA-E), which can only be detected via MRI.

How Does ARIA Occur?

When patients with Alzheimer’s disease are treated with medications that target amyloid plaques, the body’s process of removing amyloid from the brain may temporarily affect small blood vessels, leading to fluid leaks or tiny bleeds, which doctors can detect in their brain MRI scan. In most cases, ARIA doesn’t cause symptoms and resolves on its own within the first 6 months of treatment.

What are the Symptoms of ARIA?

Most people with ARIA do not have any visible symptoms. When symptoms do happen, they may be symptoms such as headache, confusion, visual disturbance, dizziness, nausea, and gait instability. If any of these symptoms occur, contact your treating doctor right away.

Who Is at Risk for ARIA?

ARIA can occur in any patient receiving anti-amyloid treatment, but the risk may be higher in people who carry a gene called apolipoprotein E (APOE) epsilon 4 (ε4) gene. Other risk factors include older age, small areas of bleeding in the brain (called microhemorrhages), damage in the brain’s white matter, use of antithrombotics/anticoagulants (medications used to prevent blood clots), and the dose of the drug. Your doctor may also discuss genetic testing and brain imaging before starting treatment.

What Questions Can I Ask My Doctor?

You can ask your doctor any questions you may have if you are concerned about ARIA. Here are some questions that can help you initiate the conversation with your doctor:

  • What is my/my loved one’s risk of ARIA?
  • What symptoms should I watch for?
  • How often are MRI scans repeated?
  • If ARIA is found, how will it affect the treatment?
  • If ARIA is detected, will the treatment have to be discontinued?
  • Who will provide the required support if ARIA is detected?

 Click here to download the “ARIA Appointment Discussion Guide” to carry with you for your doctor’s appointment. This will help you or your loved one make the most of the appointment.

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Scientific Council

Marc Agronin, MD

Chief Medical Officer
Frank C. and Lynn Scaduto MIND Institute and Behavioral Health
Miami Jewish Health
Miami, FL

Liana G. Apostolova, MD, MSc, FAAN

Associate Dean of Alzheimer’s Disease Research
Indiana University Distinguished Professor
Barbara and Peer Baekgaard Professor of Alzheimer's Disease Research
Professor in Neurology, Radiology, Medical and Molecular Genetics
Indiana University School of Medicine
Department of Neurology
Indianapolis, IN

Alireza Atri, MD, PhD

Chief Medical Officer, Banner Research
Banner Alzheimer’s and Research Institutes
Pheonix, Sun City, and Tucson, AZ
Director, Banner Sun Health Research Institute
Sun City, AZ

Frederik Barkhof

Professor of Neuroradiology
UCL Queen Square Institute of Neurology
UCL Hawkes Institute
London, United Kingdom

Sharon A. Brangman, MD, FACP, AGSF

Distinguished Service Professor
Chair, Department of Geriatrics
Director, Upstate Center of Excellence for Alzheimer’s Disease
SUNY Upstate Medical University
Syracuse, New York

Christopher Chen, BM BCh, MRCP, FAMS, FRCP

Associate Professor, Department of Pharmacology
Director, Memory Aging and Cognition Centre
Yong Loo Lin School of Medicine
National University of Singapore
Singapore

Natalie Christian, MD

Assistant Professor, Geriatrics
Program Director, Geriatric Medicine Fellowship
Tulane University School of Medicine
Southeast Louisiana Veterans Healthcare System
New Orleans, LA

Petrice M. Cogswell, MD, PhD

Associate Professor
Mayo Clinic
Rochester, Minnesota

Ariel F. Cole, MD, FAAFP

Program Director, AdventHealth Geriatric Fellowship
Winter Park, FL

Brad Dickerson, MD, MMSc, FAAN, FANPA

Professor of Neurology, Harvard Medical School
Director, Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital
Boston, MA

Bruno Dubois

Professor Emeritus of Neurology
Former Head, Department of Neurology
Pitié-Salpêtrière University Hospital
Sorbonne Université
Former Director, Institute for Memory and Alzheimer’s Disease (IM2A)
Paris, France

James M. Ellison, MD, MPH

Professor of Psychiatry and Human Behavior
Sidney Kimmel Medical College
Co-Director, Comprehensive Alzheimer’s Center
Vickie & Jack Farber Institute for Neuroscience
Thomas Jefferson University
Philadelphia, PA

Samuel Gandy, MD. PhD

Professor of Neurology & Psychiatry
Icahn School of Medicine at Mount Sinai
James J Peters VA Medical Center
New York, New York

Richard M. Dupee, MD, MACP, AGSF

Clinical Professor of Medicine
Tufts University School of Medicine
Clinical professor, Department of Public Health and Community Medicine, Tufts University
Chief, Geriatrics Service, Tufts Medical Center
Senior Physician, Pratt Diagnostic Center
Dean ex officio, Office of International Affairs, Tufts University School of Medicine
Boston, MA

James E. Galvin, MD, MPH

Professor of Neurology
University of Miami Miller School of Medicine
Miami, FL

David S. Geldmacher, MD

Professor and Director
Division of Memory Disorders and Behavioral Neurology
Department of Neurology
Heersink School of Medicine
University of Alabama at Birmingham
Birmingham, AL

George T. Grossberg, MD

Henry & Amelia Nasrallah Endowed Professor
Director of Geriatric Psychiatry
Department of Psychiatry & Behavioral Neuroscience
Saint Louis University School of Medicine
St. Louis, MO

Scott A. Kaiser, MD

Director of Geriatric Cognitive Health
Pacific Neuroscience Institute
Santa Monica, CA
Adjunct Professor
USC Leonard Davis School of Gerontology
Los Angeles, CA

Lynn E. Kassel, PharmD, BCPS

Associate Professor of Pharmacy Practice
Drake University College of Pharmacy & Health Sciences
Des Moines, IA

Diana R. Kerwin, MD, CPI

President, Kerwin Medical Center
Chief, Geriatric Medicine, Texas Health Presbyterian Hospital
Dallas, TX

Alka Khera, MD

Assistant Professor
UT Southwestern Neurology
Dallas, TX

Chi-Ying (Roy) Lin, MD, MPH, FAAN

Director, CurePSP Center of Care for PSP, CBD, and MSA
Assistant Professor of Neurology
Alzheimer's and Parkinson's Disease Centers
Baylor College of Medicine
Houston, TX

Catherine A. Madison, MD

Founding Director Ray Dolby Brain Health Center
San Francisco, CA

Scott McGinnis, MD

Assistant Professor of Neurology, Harvard Medical School
Center for Alzheimer Research and Treatment
Brigham and Women's Hospital
Frontotemporal Disorders Unit
Massachusetts General Hospital
Boston, MA

Mary Norman, MD

Geriatrician
Cedars-Sinai Medical Group
Los Angeles, CA

Kristin S. Meyer, PharmD, BCGP, FASCP

Professor of Pharmacy Practice
Drake University College of Pharmacy and Health Sciences
Des Moines, IA

Charles Montano, MD

Owner, Principal Investigator
CT Clinical Research
Cromwell, CT

Manisha Parulekar, MD, FACP, AGSF, CMD

Director, Division of Geriatrics
Co-director, Center for Memory Loss and Brain Health
Hackensack University Medical Center
Hackensack, NJ

Giulio Maria Pasinetti, MD, PhD

The Saunders Family Chair in Neurology, Professor in Neurology
Director, Mount Sinai Center in Advance Botanical Research in Molecular Integrative Neuroresilience
Icahn School of Medicine at Mount Sinai
New York, NY
Director, Basic and Biomedical Research and Training Program, Geriatric Research and Clinical Center
James J. Peters Department of Veterans Affairs Medical Center
Bronx, NY

Anton P. Porsteinsson, MD

William B. and Sheila Konar Professor of Psychiatry, Neurology,
Neuroscience, and Medicine
Director, Alzheimer’s Disease Care, Research and Education
Program (AD CARE)
University of Rochester School of Medicine and Dentistry
Rochester, NY

William D. Rhoades, DO, FACP

Chief Medical Officer
Advocate Good Samaritan Hospital
Downers Grove, IL

Barry W. Rovner, MD

Professor, Departments of Psychiatry & Neurology
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, PA

Marwan Noel Sabbagh, MD, FAAN, FANA

Moreno Family Chair for Alzheimer’s Research
Vice Chairman for Research and Professor
Department of Neurology
Barrow Neurological Institute
Phoenix, AZ

Martin J. Sadowski, MD, PhD

Zachary and Elizabeth M. Fisher Professor of Neurodegeneration and Alzheimer's Disease
Professor of Neurology, Psychiatry, and Biochemistry & Molecular Pharmacology
New York University Grossman School of Medicine Director, Fisher Center Alzheimer’s Clinical Trials Program
New York, NY

Stephen Salloway, MD, MS

Professor, Psychiatry and Human Behavior
Professor of Neurology, Alpert Medical School of Brown University
Providence, Rhode Island

Angela Sanford, MD, CMD

Associate Professor of Internal Medicine-Geriatrics
Saint Louis University School of Medicine
Ballwin, MO

Philip Scheltens, MD, PhD

Professor Emeritus of Neurology
Amsterdam University Medical Center
Head Dementia Fund at EQT Life Sciences
Amsterdam, Netherlands

Sharon J. Sha, MD, MS

Clinical Professor
Clinical Professor Neurology and Neurological Sciences Stanford University Chief, Stanford Memory Disorders Center Stanford Medicine Health Care
Palo Alto, CA

Paul E. Schulz, MD

Rick McCord Professor of Neurology
Umphrey Family Professor of Neurodegenerative Disorders
Director, Memory Disorders and Dementia Clinic
UTHealth Houston
Houston, TX

Neil Skolnik, MD

Professor of Family and Community Medicine
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, PA

Sandra Swantek, MD

Director, Section of Geriatric Psychiatry
RUSH University Medical Center
Chicago, IL

R. Scott Turner, PhD, MD

Professor of Neurology
Director of the Memory Disorders Program
Georgetown University
Washington, DC

Chuck Vega, MD, FAAFP

Health Sciences Clinical Professor
UC Irvine Department of Family Medicine
Director, UCI Program in Medical Education for the Latino Community
University of California Irvine
Irvine, CA

Geoffrey C. Wall, PharmD, FCCP, BCPS

John R. Ellis Distinguished Chair of Pharmacy Practice
Professor of Clinical Sciences
Director, Drake Drug Information Center
Drake University College of Pharmacy and Health Sciences
Internal Medicine Clinical Pharmacist
Iowa Methodist Medical Center
Des Moines, IA

David A. Wolk, MD, FAAN

Professor of Neurology
Director, Penn Alzheimer’s Disease Research Center
University of Pennsylvania
Philadelphia, PA