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Distributional impact of brain microbleeds on global cognitive function in adults without neurological disorder

Yusuke Yakushiji1, Tomoyuki Noguchi, Megumi Hara

  • 1Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan. yakushij@cc.saga-u.ac.jp

Stroke
|May 15, 2012
PubMed
Abstract

Insights

Brain microbleeds (MBs) linked to cognitive decline show distinct patterns. Deep microbleeds, associated with hypertension, significantly impact cognitive function, unlike lobar microbleeds linked to cerebral amyloid angiopathy.

Area of Science:

  • Neurology
  • Neuroimaging
  • Cognitive Science

Background:

  • Brain microbleeds (MBs) are associated with cognitive decline.
  • MBs can be classified pathologically and topographically: cerebral amyloid angiopathy-related (lobar) and hypertensive microangiopathy-related (deep).

Purpose of the Study:

  • To investigate if different distributions of MBs have varying effects on global cognitive function.

Main Methods:

  • Prospective study of 1279 adults without neurological disorders.
  • Subjects categorized into four groups: without MBs, lobar MBs, deep MBs, and diffuse MBs (both areas).
  • Global cognitive function assessed using the Mini-Mental State Examination (MMSE), with scores <27 indicating subnormal function.

Main Results:

  • MBs detected in 98 subjects (8%).
  • Subnormal MMSE scores found in 5.9% of subjects, associated with age, education, hypertension, white matter hyperintensities, and MB distribution/number.
  • Logistic regression showed deep MBs (OR, 2.79) significantly associated with subnormal scores, while lobar MBs (OR, 0.77) were not. Diffuse MBs showed a non-significant trend (OR, 5.01).
  • The deep and diffuse MB groups exhibited significantly lower total MMSE and attention/calculation scores compared to the without-MBs group.

Conclusions:

  • Global cognitive dysfunction related to MBs appears more strongly linked to hypertensive pathogenesis than cerebral amyloid angiopathy.
  • Hypertensive microangiopathy-related MBs (deep) are significantly associated with cognitive impairment.

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