Cerebral Microbleeds: Different Prevalence, Topography, and Risk Factors Depending on Dementia Diagnosis—The Karolinska Imaging Dementia Study

Shams, Sara; Martola, Juha; Granberg, Tobias; Li, X.; Shams, Mana; Fereshtehnejad, Seyed‐Mohammad; Cavallin, Lena; Aspelin, Peter; Wiberg, Maria Kristoffersen; Wahlund, Lars‐Olof

doi:10.3174/ajnr.a4176

Cited by 111 publications

(130 citation statements)

References 31 publications

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“…Two of the 3 studies were excluded, 25,26 and the only study meeting our selection criteria 27 was added to the remaining of studies. To avoid investigator bias, we also performed analyses of the added new article separately.…”

Section: Literature Updatementioning

confidence: 99%

Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques

Sepehry¹,

Lang

Hsiung³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The literature on the prevalence of Alzheimer disease-associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease.

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Section: Literature Updatementioning

confidence: 99%

Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques

Sepehry¹,

Lang

Hsiung³

et al. 2015

AJNR Am J Neuroradiol

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“…Microbleeds were only rated as present or absent. 11 Microbleeds were distinguished from cross-sectioned vessels by looking at the T2-weighted image in multiple planes. Mineralizations in the globus pallidus were not rated.…”

Section: Image Analysismentioning

confidence: 99%

“…We hypothesized that CMBs in lobar regions would be associated with lower Ab42 levels, and possibly also higher T-tau and P-tau levels in the continuum of cognitive impairment. We also hypothesized that lobar, and especially occipital CMBs, being one of the most frequent locations of CAA and CMBs in Alzheimer's disease, [11][12][13][14] would be mostly associated with dementia pathology, and thus reflected by altered CSF biomarkers.…”

Section: Introductionmentioning

confidence: 99%

Cerebral microbleeds topography and cerebrospinal fluid biomarkers in cognitive impairment

Shams

Granberg

Martola

et al. 2016

J Cereb Blood Flow Metab

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Cerebral microbleeds, a marker of small vessel disease, are thought to be of importance in cognitive impairment. We aimed to study topographical distribution of cerebral microbleeds, and their involvement in disease pathophysiology, reflected by cerebrospinal fluid biomarkers; 1039 patients undergoing memory investigation underwent lumbar puncture and a brain magnetic resonance imaging scan. Cerebrospinal fluid samples were analyzed for amyloid b(Ab)42, total tau(T-tau), tau phosphorylated at threonine 18(P-tau) and cerebrospinal fluid/serum albumin ratios. Magnetic resonance imaging sequences were evaluated for small vessel disease markers, including cerebral microbleeds, white matter hyperintensities and lacunes. Low Ab42 levels were associated with lobar cerebral microbleeds in the whole cohort and Alzheimer's disease (P < 0.001). High cerebrospinal fluid/serum albumin ratios were seen with increased number of cerebral microbleeds in the brainstem (P < 0.001). There were tendencies for increased Ab42 levels and decreased Tau levels with deep and infratentorial cerebral microbleeds (P < 0.05). Lobar cerebral microbleeds were associated with white matter hyperintensities and lacunes (P < 0.001). Probable cerebral amyloid angiopathy-related cerebral microbleeds were associated with low Ab42 levels and lacunes, whereas probable cerebral amyloid angiopathy-unrelated cerebral microbleeds were associated with white matter hyperintensities (P < 0.001). Our findings show that cerebral microbleed distribution is associated with different patterns of cerebrospinal fluid biomarkers, supporting different pathogenesis of deep/infratentorial and lobar cerebral microbleeds.

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“…131 Inhibition of this process is linked to more rapid disease progression. 132 Their increasing prevalence with an increasing number of risk factors (hypertension, hyperlipidemia, diabetes, male sex and advanced age) 133,134 and lower levels of TIMPs in Alzheimer's disease patients with microbleeds suggest less MMP inhibition in patients with concurrent cerebral microbleeds.…”

mentioning

confidence: 99%

Age-associated physiological and pathological changes at the blood–brain barrier: A review

Erdő

Dénès

Lange

2016

J Cereb Blood Flow Metab

351

260

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The age-associated decline of the neurological and cognitive functions becomes more and more serious challenge for the developed countries with the increasing number of aged populations. The morphological and biochemical changes in the aging brain are the subjects of many extended research projects worldwide for a long time. However, the crucial role of the blood-brain barrier (BBB) impairment and disruption in the pathological processes in age-associated neurodegenerative disorders received special attention just for a few years. This article gives an overview on the major elements of the blood-brain barrier and its supporting mechanisms and also on their alterations during development, physiological aging process and age-associated neurodegenerative disorders (Alzheimer's disease, multiple sclerosis, Parkinson's disease, pharmacoresistant epilepsy). Besides the morphological alterations of the cellular elements (endothelial cells, astrocytes, pericytes, microglia, neuronal elements) of the BBB and neurovascular unit, the changes of the barrier at molecular level (tight junction proteins, adheres junction proteins, membrane transporters, basal lamina, extracellular matrix) are also summarized. The recognition of new players and initiators of the process of neurodegeneration at the level of the BBB may offer new avenues for novel therapeutic approaches for the treatment of numerous chronic neurodegenerative disorders currently without effective medication. KeywordsAging, blood-brain barrier, endothelial cells, neurodegenerative disorders, transport systems Structure of the blood-brain barrier (BBB)Homeostasis of the extracellular microenvironment in the neural tissue of the brain as well as its protection against neurotoxic compounds and variations in the composition of the blood are important for normal function of the neurons. It is warranted by a structure formed between blood and brain, which is therefore called the BBB.1 Clear evidence for the existence of this permeability barrier in the brain emerged in 1909 with the demonstration by Edwin Goldman (a South African-German) that a dye injected into the blood stream of a rat stained the whole body -except for the brain and spinal cord. The opposite was also true: injection of the dye into the cerebral ventricles stained the brain and spinal cord but not the rest of the body. 2,3 This occurs because most organs of the body are perfused by capillaries lined with endothelial cells (ECs) that have small pores (fenestrations) to allow for the rapid movement of small molecules into the organ interstitial fluid from the circulation. However, the capillary endothelium of the brain and spinal cord lack these pores because the ECs of brain capillary are connected to each other by continuous tight junctions (TJs), produced by the interaction of several transmembrane proteins that project into and seal the paracellular pathway.3-5 The interaction of these junctional proteins effectively blocks the free diffusion of

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Cerebral Microbleeds: Different Prevalence, Topography, and Risk Factors Depending on Dementia Diagnosis—The Karolinska Imaging Dementia Study

Cited by 111 publications

References 31 publications

Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques

Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques

Cerebral microbleeds topography and cerebrospinal fluid biomarkers in cognitive impairment

Age-associated physiological and pathological changes at the blood–brain barrier: A review

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