2026 Volume 43 Issue 3 Pages 321-324
Brain dock, a health screening system unique to Japan, has traditionally focused on detecting asymptomatic cerebrovascular diseases. With the recent approval of anti–amyloid antibody therapies for early Alzheimer disease (AD), early identification of AD has become increasingly important.
MRI, a core examination in brain dock, allows evaluation of cerebral small vessel disease (SVD) burden, which is associated with cognitive decline. SVD includes type 1 SVD related to aging and hypertension and type 2 SVD characterized by cerebral amyloid angiopathy (CAA). MRI markers such as white matter hyperintensities, cerebral microbleeds, and cortical superficial siderosis may provide indirect evidence of these pathologies and contribute to AD risk assessment.
Although assessment of amyloid and tau pathology may enable detection of preclinical AD, such evaluations in asymptomatic individuals undergoing brain dock remain controversial because of limited therapeutic options and potential psychosocial and ethical concerns. Currently, MRI–based evaluation of SVD represents the most practical approach for AD risk assessment in brain dock.
