In our group’s previous studies, lobar CMBs were identified as associated with cognitive changes.4 Additionally, p-tau217 and GFAP levels have been associated with cognitive changes.20 Furthermore, patients with both Aβ-positive uptake on PET and lobar CMBs have shown faster cognitive deterioration than those with lobar CMBs alone.29 In our study, we suggest that lobar CMBs may be synergistically associated with cognitive changes along with downstream AD plasma biomarkers indicative of hyperphosphorylated tau and neuroinflammation, in addition to Aβ. Here, MAPT is linked to Alzheimer disease.