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Cerebral microbleeds in Binswanger's disease: a gradient-echo T2*-weighted magnetic resonance imaging study
Haruo Hanyu1, Yuriko Tanaka, Soichiro Shimizu
1Department of Geriatric Medicine, Tokyo Medical University, Tokyo 160-0023, Japan. hanyu@mb.kcom.ne.jp
Abstract:
We investigated the incidence and the number of microbleeds (MBs) on T2*-weighted gradient-echo magnetic resonance imaging in 30 Binswanger's disease (BD) patients with diffuse white matter lesions and a varying degree of lacunar infarction, 51 multiple lacunar stroke (MLS) patients with multiple lacunar infarction and no or mild white matter lesions, and 59 elderly controls. MBs were found in 23 (77%) patients with BD, 26 (51%) patients with MLS, and 5 (8%) controls, and the incidence and the number of MBs were significantly greater in the BD group compared with MLS and control groups. Patients with BD had a more widespread location of MBs. More specifically, MBs were commonly found in areas within or surrounded by white matter lesions of the patients with BD. When 81 patients from both the BD and MLS groups were analyzed, logistic regression analysis showed that number of lacunar infarct, severity of white matter hyperintensity, and use of antiplatelet agents were significantly associated with MBs. Patients with BD exhibited a high frequency and number of MBs, indicating advanced bleeding-prone microangiopathy within the brain, which should be taken into account in treatment and management.
Insights
Binswanger's disease (BD) patients show significantly more brain microbleeds (MBs) than multiple lacunar stroke (MLS) patients and controls. This indicates advanced microangiopathy in BD, influencing treatment strategies.
Area of Science:
- Neurology
- Neuroradiology
- Neuroimaging
Background:
- Binswanger's disease (BD) is characterized by diffuse white matter lesions and lacunar infarction.
- Multiple lacunar stroke (MLS) involves multiple lacunar infarctions with minimal white matter changes.
- Microbleeds (MBs) are indicative of cerebral small vessel disease.
Purpose of the Study:
- To compare the incidence and number of MBs in patients with BD, MLS, and elderly controls.
- To investigate the location and associations of MBs in these patient groups.
Main Methods:
- T2*-weighted gradient-echo magnetic resonance imaging (MRI) was used to detect MBs.
- A cohort of 30 BD patients, 51 MLS patients, and 59 elderly controls were analyzed.
- Logistic regression analysis identified factors associated with MBs in BD and MLS patients.
Main Results:
- MBs were detected in 77% of BD patients, 51% of MLS patients, and 8% of controls.
- The incidence and number of MBs were significantly higher in the BD group compared to MLS and control groups.
- MBs in BD patients were more widespread and often located within or adjacent to white matter lesions.
Conclusions:
- Patients with Binswanger's disease exhibit a high frequency and number of microbleeds, suggesting advanced bleeding-prone microangiopathy.
- Factors such as the number of lacunar infarcts, white matter hyperintensity severity, and antiplatelet agent use are associated with MBs.
- The findings underscore the importance of considering microbleeds in the treatment and management of Binswanger's disease.