Cerebral microbleeds, cognitive impairment, and MRI in patients with diabetes mellitus

Zhou, Hong; Yang, Juan; Xie, Peihan; Dong, Yulan; You, Yong; Liu, Jincai

doi:10.1016/j.cca.2017.04.019

Cited by 23 publications

(22 citation statements)

References 68 publications

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“…First, as the present study was a cross-sectional study, causeeffect relationship was unclear. Second, in addition to LCI and WMH, cerebral microbleeds is also a form of cerebral small vessel disease, which is reported to be highly prevalent in memory clinic patients and those with Alzheimer's disease (16,17) . Third, the precise cause of cognitive impairment was not characterized in this study using molecular ligands or pathological con rmation.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal Blood Pressure Rise as A Predictor of Cognitive Impairment Among the Elderly：A Retrospective Cohort Study

Xing

Sun

Wang

et al. 2020

Preprint

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Background: This study investigated the relationship between ambulatory blood pressure monitoring (ABPM), cognitive function and cerebral Magnetic Resonance Imaging (MRI) among elderly patients to assess effective hypertension management for preventing the progression of cognitive impairment. Methods: Participants comprised 305 elderly patients aged ≥ 65 years, who were divided into the cognitive impairment group (CI, n=130), and the non-cognitive impairment group (NCI, n=175), according to MMSE score. All participants underwent ABPM for the evaluation of possible hypertensive disorder and cerebral MRI for the evaluation of cerebral small vessel disease. Follow-up was performed by telephone or medical records. Results: Of the 305 participants, 130 (42.6%) were identified with cognitive impairment (CI), with the average systolic blood pressure (BP) of 127 mmHg and diastolic BP of 66 mmHg. According to ABPM, only 13.1% had dipper pattern, 45.6% had nocturnal BP rise, while 41.3% had non-dipper pattern. Compared with NCI patients, the CI group had significantly higher night-time systolic BP (130.0±18.2 vs. 123.9±15.1, p=0.011), and more participants had nocturnal BP rise (52.3% vs. 40.6%, p=0.042). Nocturnal BP rise was associated with greater white matter hyperintensities (WMH) (p=0.013). After 2.03 years of follow-up, there were 35 all-cause deaths, and 33 cases of major adverse cardiac and cerebrovascular events (MACCE). CI was independently associated with all-cause mortality during long-term observation (p<0.01). Nocturnal BP rise had no significant predictive ability for all-cause mortality in the elderly patients (p =0.178).Conclusions: Nocturnal BP rise contributed to greater WMH volumes and cognitive impairment in the elderly patients. To prevent the progression of cognitive dysfunction, it is critical to control BP based on ABPM.

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Section: Discussionmentioning

confidence: 99%

Nocturnal Blood Pressure Rise as A Predictor of Cognitive Impairment Among the Elderly：A Retrospective Cohort Study

Xing

Sun

Wang

et al. 2020

Preprint

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“…Particularly, there is strong evidence that higher number of CMBs is associated with a more severe cognitive dysfunction, which comprises impaired executive function, and decreased attention and processing speed [7,11,34]. The development of novel imaging technique and large prospective studies is expected to better understand the pathogenesis of CMBs and the clinical implication of this currently underdiagnosed clinical entity.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, with the introduction of susceptibilityweighted imaging sequences, and with the wider availability of 3T MR units, there was an increased sensitivity of detection of small cerebral microbleeds [7,8,19].…”

Section: Discussionmentioning

confidence: 99%

“…In these patients, CMBs represent an important marker of the cerebral small vessel pathology [7,16,17]. Moreover, the presence of CMBs is an independent risk factor for subsequent larger intracerebral hemorrhages, and they are also associated with higher incidence of cognitive decline [18,19].…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, the introduction of susceptibilityweighted imaging (SWI) MR sequences has improved CMBs detection of previously undetected small intracerebral 1 3 hemorrhages (< 5-10 mm in diameter) compared to the GRE MR sequences [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure

Sparacia

Cannella

et al. 2018

Radiol med

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Purpose Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. Materials and methods Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (c) end-stage liver failure undergoing liver transplantation (n = 6). The MR exams were performed on a 3T MR unit and the SWI sequence was used for the detection of CMBs. CMBs were subdivided in supratentorial lobar distributed, supratentorial non-lobar distributed, and infratentorial distributed. Results A total of 91 microbleeds were observed in 15 patients. Fifty-nine CMBs lesions (64.8%) had supratentorial lobar distribution, 17 CMBs lesions (18.8%) had supratentorial non-lobar distribution and the remaining 15 CMBs lesions (16.4%) were infratentorial distributed. An overall predominance of supratentorial multiple lobar localizations was found in all types of end-stage organ failure. The presence of CMBs was significantly correlated with age, hypertension, and specific end-stage organ failure risk factors (p < 0.001). Conclusions CMBs are mostly founded in supratentorial lobar localization in end-stage organ failure. The improved detection of CMBs with SWI sequences may contribute to a more accurate identification of patients with cerebral risk factors to prevent complications during or after the organ transplantation.

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A promising structural magnetic resonance imaging assessment in patients with preclinical cognitive decline and diabetes mellitus

Dong

Wang²,

Yao

et al. 2019

Journal Cellular Physiology

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Subjective cognitive decline (SCD) is frequently reported in diabetic patients. Diabetes mellitus (DM) is associated with changes in the microstructure of the brain arise in diabetic patients, including changes in gray matter volume (GMV). However, the underlying mechanisms of changes in GMV in DM patients with cognitive impairment remain uncertain. Here, we present an overview of amyloid‐β‐dependent cognitive impairment in DM patients with SCD. Moreover, we review the evolving insights from studies on the GMV changes in GMV and cognitive dysfunction to which provide the mechanisms of cognitive impairment in T2DM. Ultimately, the novel structural magnetic resonance imaging (MRI) protocol was used for detecting neuroimaging biomarkers that can predict the clinical outcomes in diabetic patients with SCD. A reliable MRI protocol would be helpful to detect neurobiomarkers, and to understand the pathological mechanisms of preclinical cognitive impairment in diabetic patients.

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Cerebral microbleeds, cognitive impairment, and MRI in patients with diabetes mellitus

Cited by 23 publications

References 68 publications

Nocturnal Blood Pressure Rise as A Predictor of Cognitive Impairment Among the Elderly：A Retrospective Cohort Study

Nocturnal Blood Pressure Rise as A Predictor of Cognitive Impairment Among the Elderly：A Retrospective Cohort Study

Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure

A promising structural magnetic resonance imaging assessment in patients with preclinical cognitive decline and diabetes mellitus

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