Risk Factors Associated With Incident Cerebral Microbleeds According to Location in Older People

Ding, Jie; Sigurðsson, Sigurður; García, Melissa; Phillips, Caroline L.; Eiríksdóttir, Guðný; Gudnason, Vilmundur; Buchem, Mark A. van; Launer, Lenore J.

doi:10.1001/jamaneurol.2015.0174

Cited by 106 publications

(104 citation statements)

References 39 publications

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“…Differences in population-based cohorts may explain why deep or lobar locations of MBs appear more prominently in different studies. Because the locations of the CMBs may reflect different mechanisms of action, 3,7,8 distinct underlying pathologies may mediate the relationship between CMBs and cognitive impairment. CAA, a common age-related condition, is characterized by a progressive deposition of amyloid-β in the media and adventitia of arterioles, capillaries, and venules in the cerebral cortex and the gray/white matter junction.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, DIs are usually attributed to hypertension vasculopathy, and SL CMBs are attributed to cerebral amyloid angiopathy (CAA). 3,7,8 The effects of CMBs on cognitive function in the general population have been evaluated in previous studies. However, there are inconsistent results regarding the location of CMBs that are associated with cognitive loss.…”

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confidence: 99%

“…3,7,8 The incidence of both CMB types increases with age. However, deep or infratentorial (DI) and strictly lobar (SL) CMBs have different risk factors.…”

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Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment

Chung

Chou

Chen

et al. 2016

Stroke

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2 In addition to being an age-related cerebrovascular abnormality, [3][4][5] CMBs are associated with dementia. The prevalence of CMBs is reported to be higher in patients with Alzheimer's disease (AD) and vascular dementia compared with the general population. 6 The mechanisms underlying CMBs and their effects on neuropsychological functions are subjects of active research.CMB in different locations might be related to different clinical manifestations. 3,7,8 The incidence of both CMB types increases with age. However, deep or infratentorial (DI) and strictly lobar (SL) CMBs have different risk factors. DI and SL CMBs are correlated with hypertension and APOE ɛ4 genotype, respectively. Therefore, DIs are usually attributed to hypertension vasculopathy, and SL CMBs are attributed to cerebral amyloid angiopathy (CAA). 3,7,8 The effects of CMBs on cognitive function in the general population have been evaluated in previous studies. However, there are inconsistent results regarding the location of CMBs that are associated with cognitive loss. In addition, only a few Asian CMB studies have evaluated the effects of CMBs on different cognitive domains. Therefore, the present study aimed to study the possible Background and Purpose-Different distributions of cerebral microbleeds (CMBs) are associated with distinct pathological mechanisms. Lobar CMBs are thought to be related to cerebral amyloid angiopathy, whereas deep or infratentorial CMBs are related to hypertensive vasculopathy. The present study aimed to evaluate the effects of CMBs and their locations on a variety of cognitive domains. Methods-Study subjects were selected from the community-based I-Lan Longitudinal Aging Study. We assessed cognitive domains, including verbal memory, language, visuospatial executive function, and verbal executive function. CMBs were evaluated using 3T susceptibility-weighted magnetic resonance imaging. Results-We studied 959 subjects (mean±SD, 62.5±8.6 years; 425 [44.3%] men). CMBs were found in 14.2% of the population. We classified subjects with CMBs into 2 different groups based on the locations of their CMBs: (1) deep or infratentorial (85 subjects, 8.8% of population) and (2) strictly lobar (49, 5.1%). Multivariate linear analysis showed that strictly lobar CMBs were significantly associated with deficits in global cognitive function (Mini-Mental State Examination) and visuospatial executive function, as determined by the copy test of the Taylor complex figure test and the clock drawing test. We adjusted our results for age, sex, years of education, cardiovascular risk factors, and other markers of cerebral small vessel disease, lacunes, and white matter hyperintensity. Deep or infratentorial CMBs were not associated with changes in cognitive function in our population. Conclusions-Strictly lobar, but not deep or infratentorial, CMBs are associated with changes in cognitive function, especially in visuospatial executive functions. Cerebral amyloid angiopathy may be the underlying pathology associated with CMB-related cognitiv...

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Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment

Chung

Chou

Chen

et al. 2016

Stroke

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“…We included available variables that were deemed clinically relevant a priori and have been investigated in previous studies. 11,12 Statistical analysis was performed using STATA software (Stata 14; Stata Corp, College Station, TX).…”

Section: Discussionmentioning

confidence: 99%

“…A population-based study in Iceland however found that 18.4% subjects developed new CMBs in 5 years. 11 It might therefore be of interest to follow up a patient cohort like ours for a longer period of time.…”

Section: Strokementioning

confidence: 98%

Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

Zerna

Modi

Bilston

et al. 2016

Stroke

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Background and Purpose-Transient focal neurological episodes occur in cerebral amyloid angiopathy (CAA) and can mimic transient ischemic attack (TIA). Risk factors and outcomes of minor ischemic stroke or TIA might differ in patients with and without cerebral microbleeds (CMBs), including CAA-consistent lobar CMB. Methods-Baseline magnetic resonance imaging (MRI) was analyzed for CMBs and cortical superficial siderosis in 416 patients in the prospective computed tomography and MRI in the CATCH study (Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients). Clinical symptoms, baseline characteristics, recurrence, and 90-day modified Rankin Scale were prospectively collected. MRI white-matter hyperintensity was measured using the Fazekas scale. Results-CMBs were detected in 65 (15.6%) and cortical superficial siderosis in 11 patients (2.6%). Lobar CMBs were present in 49 (11.8% Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

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Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia

et al. 2017

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IMPORTANCE With advancing age, an increased visibility of perivascular spaces (PVSs) on magnetic resonance imaging (MRI) is hypothesized to represent impaired drainage of interstitial fluid from the brain and may reflect underlying cerebral small vessel disease (SVD). However, whether large perivascular spaces (L-PVSs) (>3 mm in diameter) visible on MRI are associated with SVD and cognitive deterioration in older individuals is unknown.OBJECTIVE To examine whether L-PVSs are associated with the progression of the established MRI markers of SVD, cognitive decline, and increased risk of dementia.

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Risk Factors Associated With Incident Cerebral Microbleeds According to Location in Older People

Cited by 106 publications

References 39 publications

Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment

Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment

Cerebral Microbleeds and Cortical Superficial Siderosis in Patients Presenting With Minor Cerebrovascular Events

Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia

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