Instead, we hypothesize that WMH in the context of Alzheimer’s disease (and in the relative absence of vascular risk factors) reflect inflammatory changes at the level of the endothelium, which could contribute to the weakening of the vessel walls and increased risk for other vascular lesions, like microbleeds, as well as the downstream tau abnormalities we observed. This evidence concerns the gene MAPT and early-onset autosomal dominant Alzheimer disease.