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Updated: May 29, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Frontal and temporal microbleeds are related to cognitive function: the Radboud University Nijmegen Diffusion Tensor
Anouk G W van Norden1, Heleen A C van den Berg, Karlijn F de Laat
1Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Neurology, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen, the Netherlands.
Background And Purpose:
Cerebral small vessel disease, including white matter lesions and lacunar infarcts, is related to cognitive impairment. Cerebral microbleeds (MBs) are increasingly being recognized as another manifestation of small vessel disease and are also related to cognitive function. However, it remains unclear whether this relation is independent of white matter lesions and lacunar infarcts and if location of MB plays a role. We investigated the relation between the presence, number, and location of MB and cognitive performance adjusted for white matter lesions and lacunar infarcts.
Methods:
Presence, number, and location of MB were rated on a gradient echo T2*-weighted MRI in 500 nondemented elderly patients with small vessel disease. Cognitive performance was assessed in different domains. Analyses were adjusted for age, sex, education, depressive symptoms, total brain volume, white matter lesion volume, and lacunar and territorial infarcts.
Results:
Mean age was 65.6 years (SD 8.8) and 57% were male. MBs were present in 10.4% of the participants. Subjects with MBs were significantly older, had a higher white matter lesion volume, and more lacunar infarcts (P<0.001). Presence and number of MBs were related to global cognitive function (β-0.10, P=0.008; β-0.20, P=0.002), psychomotor speed (β-0.10, P=0.012; β-0.19, P=0.006), and attention (β-0.10, P=0.02; β-0.205, P=0.001). The relations with cognitive performance were mainly driven by frontal, temporal, and strictly deep located MB.
Conclusions:
Frontal and temporal located MBs correlate with cognitive performance in nondemented elderly patients independent of coexisting other small vessel disease-related lesions. MBs are clinically not silent and may help to understand the role of vascular disease in cognitive decline.
Insights
Cerebral microbleeds (MBs) are linked to cognitive decline in elderly individuals, particularly when located in the frontal and temporal lobes. These findings suggest MBs are not silent and contribute to understanding vascular disease
Area of Science:
- Neurology
- Radiology
- Gerontology
Background:
- Cerebral small vessel disease (SVD) encompasses white matter lesions and lacunar infarcts, both linked to cognitive impairment.
- Cerebral microbleeds (MBs) are an emerging SVD manifestation also associated with cognitive function.
- The independent contribution of MBs and the role of their location in cognitive impairment remain unclear.
Purpose of the Study:
- To investigate the relationship between the presence, number, and location of MBs and cognitive performance.
- To adjust for confounding factors including white matter lesions and lacunar infarcts in elderly patients with SVD.
Main Methods:
- Gradient echo T2*-weighted MRI was used to assess MBs in 500 non-demented elderly patients with SVD.
- Cognitive performance was evaluated across multiple domains.
- Statistical analyses controlled for age, sex, education, depressive symptoms, brain volume, white matter lesion volume, and infarcts.
Main Results:
- MBs were present in 10.4% of participants, who were older and had greater SVD burden.
- The presence and number of MBs correlated with global cognitive function, psychomotor speed, and attention.
- Cognitive associations were primarily driven by frontal, temporal, and deep-seated MBs.
Conclusions:
- Frontal and temporal MBs correlate with cognitive performance in non-demented elderly patients, independent of other SVD lesions.
- MBs are not clinically silent and play a role in vascular contributions to cognitive decline.
