biostudies-literatureUnknown16(1)Li J<h4>Background</h4>Early detection of Alzheimer's disease (AD) remains challenging due to limited biomarkers. This retrospective longitudinal study evaluated whether alterations in the deep medullary veins (DMVs) predict cognitive decline.<h4>Methods</h4>We analyzed 170 participants from the Open Access Series of Imaging Studies-3 (OASIS-3) database [95 cognitive normal (CN), 36 mild cognitive impairment (MCI), and 39 AD]. DMVs were scored on susceptibility-weighted imaging (SWI). Cox proportional hazard models assessed the association between DMVs and longitudinal cognitive decline. Mediation analysis tested whether amyloid-β (Aβ) partially mediates the effect of DMVs on cognition.<h4>Results</h4>DMVs scores increased across groups {7 [6, 8] in CN, 13 [8.25, 15] in MCI, and 14 [13, 15] inQuantitative imaging in medicine and surgery27https://www.ebi.ac.uk/biostudies/studies/S-EPMC12780641biostudies-literatureDeep medullar veins: predictors of clinical progression in Alzheimer's disease.PMC12780641Xu LShao XLi JZeng MLin JLiu SChen CWang JCheng XLiu FfalseDeep medullar veins: predictors of clinical progression in Alzheimer's disease.<h4>Background</h4>Early detection of Alzheimer's disease (AD) remains challenging due to limited biomarkers. This retrospective longitudinal study evaluated whether alterations in the deep medullary veins (DMVs) predict cognitive decline.<h4>Methods</h4>We analyzed 170 participants from the Open Access Series of Imaging Studies-3 (OASIS-3) database [95 cognitive normal (CN), 36 mild cognitive impairment (MCI), and 39 AD]. DMVs were scored on susceptibility-weighted imaging (SWI). Cox proportional hazard models assessed the association between DMVs and longitudinal cognitive decline. Mediation analysis tested whether amyloid-β (Aβ) partially mediates the effect of DMVs on cognition.<h4>Results</h4>DMVs scores increased across groups {7 [6, 8] in CN, 13 [8.25, 15] in MCI, and 14 [13, 15] in2026-01-01T00:00:00Z2026 Jan2026-06-06T12:42:44.77Z2026-05-30T03:11:14.006ZS-EPMC127806414152203810.21037/qims-2025-737