Effect of Cerebral Microbleeds on Cognitive Function and Quality of Life in Parkinson Disease

Abstract

Background This study aimed to investigate the risk factors and patterns of cerebral microbleeds (CMBs) in Parkinson disease (PD) and the impact of CMBs on cognitive function and quality of life (QoL). Material/Methods Patients with PD that underwent susceptibility-weighted imaging were recruited and divided into CMB-free, lobar-CMB, deep-CMB, and mixed-CMB groups according to CMB location. Motor function (MDS-UPDRS III), cognitive abilities (MoCA, MMSE), and QoL (PDQ-39) were compared among groups. The risk factors for CMBs in patients with PD and the association between CMBs and cognition and QoL were analyzed using multivariable logistic regression models and linear regression models. Results Among the 209 patients with PD, 42 (20.1%) had CMBs. Lobar, deep, and mixed CMBs were observed in 15 (35.7%), 17 (40.5%), and 10 (23.8%) patients, respectively. A higher frequency of hypertension was independently associated with deep CMBs (odds ratio [OR]=4.379, 95% CI: 1.405–13.643, P =0.011). The deep-CMB and mixed-CMB groups had lower MoCA scores and MMSE scores than the CMB-free group, especially in domains of naming, attention, and orientation ( P <0.05). Additionally, the presence of CMBs was associated with lower MMSE (R 2 =0.140, β=−0.301, P <0.001) and MoCA (R 2 =0.104, β=−0.289, P <0.001) and higher PDQ-39 (R 2 =0.052, β=0.227, P <0.05) scores, while the association between CMBs and PDQ-39 disappeared after adjustment of MMSE or MoCA as a covariate. Conclusions The results suggest that hypertension was associated with the occurrence of deep CMBs. Comorbidity with CMBs may impair cognitive function and indirectly reduce the QoL in patients with PD.

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

“…The majority of autopsy reports of PDD tried to evaluate the convergence and interactions between basic PD (Lewy) pathology and other cortical proteinopathies (αSyn, tau and Aβ) and their contribution to dementia pathogenesis [ 33 , 34 , 357 , 388 , 389 , 390 , 391 , 392 , 393 , 394 , 395 ] and the role of co-pathologies on cognition [ 203 , 389 , 395 , 396 , 397 ].…”

“…Lacunes were independently associated with worse attention and processing speed and may accelerate the course of PD [ 444 ]. Increased perivascular space in the basal ganglia and WMH was associated with cognitive decline in PD [ 203 , 445 ], as were cerebral microbleeds (CMB), which were both related to hypertension [ 397 ]. CMBs were significantly associated with PDD [ 396 , 443 ], while others associated PDD with amyloid-related CMBs and reduced hippocampal volume [ 446 ].…”