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Cerebral microbleeds: prevalence and associations with cardiovascular risk factors in the Framingham Study
Tom Jeerakathil1, Philip A Wolf, Alexa Beiser
1Department of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton.
Background And Purpose:
Cerebral microbleeds (CMBs) are areas of low signal intensity on gradient echo T2*-weighted magnetic resonance imaging (T2*MRI) corresponding to hemosiderin deposits in the perivascular space. Microangiopathy from atherosclerosis or amyloid angiopathy might lead to the formation of these lesions; therefore, there may be associations between CMBs and cardiovascular risk factors, APOE allele status, and brain morphology. We examined these relationships in the Framingham Study (FHS).
Methods:
In 472 subjects from the FHS Offspring and Cohort, we related CMB status to age, sex, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels, smoking, diabetes, total hemispheric brain volume, white matter hyperintensity volume (WMHV), and APOE allele status.
Results:
Overall prevalence of CMBs was 4.7%, but CMBs were more prevalent with advanced age and male sex. Blood pressure, brain volume, and WMHV were related to CMBs in crude analysis but not after adjustment for age and sex. There were no significant relationships demonstrated between CMBs and APOE allele status, cholesterol, smoking, or diabetes.
Conclusions:
There is a low prevalence of CMBs in the community and a strong relationship with increasing age and male sex. We found no independent relationships with cardiovascular risk factors, APOE status, brain volumes, or WMH.
Insights
Cerebral microbleeds (CMBs) are uncommon in the general population and primarily linked to older age and male sex. This study found no independent associations with cardiovascular risk factors, APOE status, or brain morphology.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Medicine
Background:
- Cerebral microbleeds (CMBs) are hemosiderin deposits in perivascular spaces, visible on T2*-weighted MRI.
- Potential causes include microangiopathy from atherosclerosis or amyloid angiopathy.
- Associations with cardiovascular risk factors, APOE status, and brain morphology are hypothesized.
Purpose of the Study:
- To investigate the relationships between cerebral microbleeds (CMBs) and cardiovascular risk factors, APOE allele status, and brain morphology.
- To examine these associations within the Framingham Study (FHS) cohort.
Main Methods:
- Analysis of 472 subjects from the FHS Offspring and Cohort.
- Relating CMB status to age, sex, systolic blood pressure, cholesterol levels, smoking, diabetes, brain volume, white matter hyperintensity volume (WMHV), and APOE allele status.
Main Results:
- Overall CMB prevalence was 4.7%, increasing with age and in males.
- Crude analyses showed relationships with blood pressure, brain volume, and WMHV, but these were not significant after age and sex adjustment.
- No significant associations were found between CMBs and APOE allele status, cholesterol, smoking, or diabetes.
Conclusions:
- CMBs have a low prevalence in the community.
- Increasing age and male sex are strongly associated with CMBs.
- No independent relationships were identified with cardiovascular risk factors, APOE status, brain volumes, or white matter hyperintensities.
