Use of Antithrombotic Drugs and the Presence of Cerebral Microbleeds

Vernooij, Meike W.; Haag, Mendel; Lugt, Aad van der; Hofman, Albert; Krestin, Gabriël P.; Stricker, Bruno H.; Breteler, Monique M.B.

doi:10.1001/archneurol.2009.42

Cited by 213 publications

(148 citation statements)

References 35 publications

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“…Age, history of previous stroke, antiplatelet medications, low total serum cholesterol and high HDL-cholesterol concentrations, and LV mass index were also associated with a high prevalence or number of cerebral microbleeds in previous studies [34,35]. In univariate analyses of our results, age, hypertension, LV mass index, and history of previous stroke were significantly associated with the prevalence of cerebral microbleeds.…”

Section: Discussionsupporting

confidence: 66%

Correlations between left ventricular mass index and cerebrovascular lesion

Kang

Lee²,

Kim³

et al. 2011

Open Medicine

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AbstractLeft ventricular (LV) mass and LV geometry are well-established measures of hypertension chronicity and severity, have a prognostic value on cardiovascular morbidity and mortality, and are related to asymptomatic cerebral small-artery disease (SAD) and largeartery disease (LAD). The aim of the present study was to clarify the different effects of LV mass and LV geometry on underlying SAD compared with its effects on underlying LAD in ischemic stroke patients. Four hundred three ischemic stroke patients underwent echocardiography to determine LV mass index and relative wall thickness. Brain magnetic resonance imaging, angiography, and carotid magnetic resonance angiography were preformed to detect LAD (≥50% stenosis) and SAD (leukoaraiosis, microbleeds, and old lacunar infarction) in the brain. Multivariate analyses showed that the LV mass index was highly associated with underlying SAD but not with underlying LAD. Among the various subtypes of SAD, only cerebral microbleeds were closely related to the LV mass index. Concentric LV hypertrophy was not related to the presence of either SAD or LAD. Subgroup analyses revealed that, among the various subtypes of SAD, only cerebral microbleeds were associated with concentric LV hypertrophy. In conclusion, cerebral microbleeds may imply more advanced target organ damage than underlying LAD and ischemic subtypes of SAD.

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Section: Discussionsupporting

confidence: 66%

Correlations between left ventricular mass index and cerebrovascular lesion

Kang

Lee²,

Kim³

et al. 2011

Open Medicine

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“…Demographic, cardiovascular, and brain pathologic factors may confound the association of microvascular le- 36 : a strict lobar distribution and separately those in the deep hemispheric or infratentorial regions.…”

Section: Cognitive Function Three Domains Of Cognitive Functionmentioning

confidence: 99%

Cerebral microbleeds, retinopathy, and dementia

Qiu

Cotch²,

Sigurðsson³

et al. 2010

Neurology

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Objective: To determine whether microvascular damage, indicated by cerebral microbleeds (CMBs) and retinal microvascular signs, is associated with cognitive function and dementia in older persons.Methods: This is a cross-sectional study of 3,906 participants (mean age 76 years; 58% women) in the AGES-Reykjavik Study (2002)(2003)(2004)(2005)(2006). We assessed CMBs on MRI and retinal microvascular signs on digital retinal images. Composite Z scores of memory, processing speed, and executive function were derived from a battery of neurocognitive tests. Dementia and subtypes were diagnosed following international criteria. Regression models were used to relate cognitive Z scores and dementia to CMBs and retinal microvascular signs, adjusting for demographics, cardiovascular factors, and brain ischemic lesions. Results:People with multiple (Ն2) CMBs had lower Z scores on tests of processing speed (␤-coefficient Ϫ0.16; 95% confidence interval Ϫ0.26 to Ϫ0.05) and executive function (Ϫ0.14; Ϫ0.24 to Ϫ0.04); results were strongest for having multiple CMBs located in the deep hemispheric or infratentorial areas. The odds ratio of vascular dementia was 2.32 (95% confidence interval 1.02 to 5.25) for multiple CMBs and 1.95 (1.04 to 3.62) for retinopathy. Having both CMBs and retinopathy, compared to having neither, was significantly associated with markedly slower processing speed (Ϫ0.25; Ϫ0.37 to Ϫ0.12), poorer executive function (Ϫ0.19; Ϫ0.31 to Ϫ0.07), and an increased odds ratio of vascular dementia (3.10; 1.11 to 8.62). Conclusion:Having multiple CMBs or concomitant CMBs and retinopathy is associated with a profile of vascular cognitive impairment. These findings suggest that microvascular damage, as indicated by CMBs and retinopathy lesions, has functional consequences in older men and women living in the community. Neurology ® 2010;75:2221-2228 GLOSSARY AD ϭ Alzheimer disease; AGES ϭ Age, Gene/Environment Susceptibility; CAA ϭ cerebral amyloid angiopathy; CI ϭ confidence interval; CMB ϭ cerebral microbleed; DSM-IV ϭ Diagnostic and Statistical Manual of Mental Disorders, 4th edition; DSST ϭ Digit Symbol Substitution Test; FA ϭ flip angle; FLAIR ϭ fluid-attenuated inversion recovery; FOV ϭ field of view; FSE ϭ fast spin-echo; MR ϭ magnetic resonance; OR ϭ odds ratio; PD ϭ proton density; TE ϭ echo time; TR ϭ repetition time; VaD ϭ vascular dementia; VCI ϭ vascular cognitive impairment; WMH ϭ white matter hyperintensity.

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“…In our study, there was no significant association of antithrombotic therapy with presence of CMBs. The population‐based Rotterdam Scan study found that antiplatelet agent was related to the presence of CMBs, but anticoagulation was not (Darweesh et al., 2013; Vernooij et al., 2009). A systematic review including ICH and ischemic stroke/TIA found that both antiplatelet and warfarin were associated with presence of CMBs (Lovelock et al., 2010).…”

Section: Discussionmentioning

confidence: 99%

Background and distribution of lobar microbleeds in cognitive dysfunction

et al. 2017

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ObjectivesCerebral microbleeds (CMBs) are often observed in memory clinic patients. It has been generally accepted that deep CMBs (D‐CMBs) result from hypertensive vasculopathy (HV), whereas strictly lobar CMBs (SL‐CMBs) result from cerebral amyloid angiopathy (CAA) which frequently coexists with Alzheimer's disease (AD). Mixed CMBs (M‐CMBs) have been partially attributed to HV and also partially attributed to CAA. The aim of this study was to elucidate the differences between SL‐CMBs and M‐CMBs in terms of clinical features and regional distribution.MaterialsWe examined 176 sequential patients in our memory clinic for clinical features and CMB location using susceptibility‐weighted images obtained on a 3T‐MRI. The number of lobar CMBs in SL‐CMBs and M‐CMBs was counted in each cerebral lobe and their regional density was adjusted according to the volume of each lobe.ResultsOf the total 176 patients, 111 patients (63.1%) had CMBs. Within the patients who had CMBs, M‐CMBs were found in 54 patients (48.6%), followed by SL‐CMBs in 35 (31.5%) and D‐CMBs in 19 (17.1%). The SL‐CMB group showed a significantly higher prevalence of family history of dementia, whereas the M‐CMB group showed an increasing trend toward hypertension and smoking. The prevalence of AD was significantly higher in the SL‐CMBs group, whereas the prevalence of AD with cerebrovascular disease was higher in the M‐CMBs group. The regional density of lobar CMBs was significantly higher in the occipital lobe in the M‐CMB group, whereas the SL‐CMB group showed higher regional density between regions an increasing tendency in the parietal and occipital lobe.ConclusionThe between‐group differences in clinical features and regional distribution indicate there to be an etiological relationship of SL‐CMBs to AD and CAA, and M‐CMBs to both HV and CAA.

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Use of Antithrombotic Drugs and the Presence of Cerebral Microbleeds

Cited by 213 publications

References 35 publications

Correlations between left ventricular mass index and cerebrovascular lesion

Correlations between left ventricular mass index and cerebrovascular lesion

Cerebral microbleeds, retinopathy, and dementia

Background and distribution of lobar microbleeds in cognitive dysfunction

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