Chih-Ping Chung1, Kun-Hsien Chou1, Wei-Ta Chen1, Li-Kuo Liu1, Wei-Ju Lee1, Liang-Kung Chen1, Ching-Po Lin1, Pei-Ning Wang2. 1. From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.). 2. From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.). pnwang@vghtpe.gov.tw.
Abstract
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 cognitive impairment.
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 cognitive impairment.
Authors: Gianvincenzo Sparacia; Francesco Agnello; Giuseppe La Tona; Alberto Iaia; Federico Midiri; Benedetta Sparacia Journal: Neuroradiol J Date: 2017-05-02
Authors: Gargi Banerjee; Roxana Carare; Charlotte Cordonnier; Steven M Greenberg; Julie A Schneider; Eric E Smith; Mark van Buchem; Jeroen van der Grond; Marcel M Verbeek; David J Werring Journal: J Neurol Neurosurg Psychiatry Date: 2017-08-26 Impact factor: 10.154