Peak Width of Skeletonized Mean Diffusivity Predicts Alzheimer's Clinical Progression Independently of Amyloid

In amyloid-positive individuals, higher white matter injury marker PSMD conferred increased risk of clinical progression, adding independent prognostic value beyond amyloid status (two-cohort study).

• Retrospective survival analysis of 344 subjects from DDI and ADNI cohorts; external validation across datasets.
• Higher PSMD linked to slower processing speed and executive dysfunction, not memory decline.
• Exact hazard ratios not reported; requires prospective validation in broader populations.

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