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Patients with Alzheimer disease with multiple microbleeds: relation with cerebrospinal fluid biomarkers and cognition

Jeroen D C Goos1, M I Kester, Frederik Barkhof

  • 1Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands. j.goos@vumc.nl

Stroke
|September 19, 2009
PubMed
Abstract

Insights

Multiple microbleeds (MBs) in Alzheimer disease correlate with worse cognitive function and higher levels of tau biomarkers. This suggests microbleeds may play a role in Alzheimer disease progression.

Area of Science:

  • Neuroimaging and Neuropathology
  • Alzheimer Disease Research
  • Biomarker Discovery

Background:

  • Microbleeds (MBs) are common in Alzheimer disease (AD), with a subset of patients exhibiting multiple MBs.
  • The clinical and biomarker associations of multiple MBs in AD remain incompletely understood.

Purpose of the Study:

  • To investigate the associations between multiple MBs and clinical characteristics, MRI findings, and cerebrospinal fluid (CSF) biomarkers in patients with Alzheimer disease.

Main Methods:

  • Matched case-control study comparing AD patients with multiple MBs (>=8) to those without MBs using T2*-weighted MRI.
  • Clinical severity assessed by Mini-Mental State Examination (MMSE) and neuropsychological tests.
  • Brain atrophy, white matter hyperintensities (WMH), apolipoprotein E genotype, and CSF biomarkers (Abeta42, total tau, p-tau181) were analyzed.

Main Results:

  • Patients with multiple MBs showed significantly worse MMSE scores and increased WMH compared to those without MBs.
  • After adjusting for covariates, multiple MBs were associated with poorer performance on specific cognitive tests.
  • Lower CSF Abeta42 and higher total tau and p-tau181 levels were observed in patients with multiple MBs.

Conclusions:

  • Microbleeds in Alzheimer disease are linked to clinical decline and specific biochemical markers.
  • These findings suggest that microbleeds may contribute to the underlying pathology and progression of Alzheimer disease.

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