Functional Near‐Infrared Spectroscopy Reveals Lecanemab‐Induced Neural Changes During the Clock Drawing Test in Alzheimer's Disease
Year: 2025
Type: article
Abstract: BACKGROUND: Lecanemab, a monoclonal antibody targeting amyloid-beta (Aβ) aggregates, has shown efficacy in reducing Aβ burden in Alzheimer's disease (AD). However, its impact on brain function remains understudied. We employed functional near-infrared spectroscopy (fNIRS) during the Clock Drawing Test (CDT) to examine potential changes in brain function following lecanemab treatment. METHOD: Three patients with clinically diagnosed AD were recruited from the Memory Clinic of The First Affiliated Hospital of Chongqing Medical University. Each patient underwent fNIRS assessments during a CDT paradigm (task + 20 s rest blocks) at baseline and after 12 weeks of lecanemab therapy. Hemodynamic responses were analyzed using a generalized linear model (GLM) to extract β1 values. We further assessed functional connectivity (FC) among predefined regions of interest (ROIs). A paired t-test was conducted to compare CDT performance (15-point CLOX system) and fNIRS-derived metrics before and after treatment. RESULT: Two patients reported no adverse events; one experienced a mild headache following the first infusion. CDT scores did not show a statistically significant improvement after 12 weeks (p = 0.157). In contrast, fNIRS data revealed a significant increase in β1 values at channel 15 (right primary somatosensory cortex) (p < 0.05, FDR corrected). ROI-based FC analysis demonstrated enhanced connectivity between the right frontal (F.R) and left occipital (O.L) regions, as well as between the right parietal (P.R) and right occipital (O.R) regions (both p < 0.05, FDR corrected). Conversely, FC between the left frontal (F.L) and right parietal (P.R) regions decreased (p < 0.05, FDR corrected). CONCLUSION: Lecanemab therapy may induce notable changes in brain functional connectivity and neural activation patterns in AD, as evidenced by fNIRS during the CDT. The observed increase in frontal-occipital FC may indicate improved network coordination, whereas the decreased parietal-frontal connectivity could reflect compensatory reorganization. These findings underscore the potential of fNIRS for monitoring treatment-related neuronal changes in AD and warrant validation in larger cohorts.
Source: Alzheimer s & Dementia
Authors: Wenbo Zhang, Ming Chen, Qi Tian, Weihua Yu, Yang Lü
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7117319152
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