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Microbleeds in vascular dementia: clinical aspects

Wiesje M Van der Flier1, Charlotte Cordonnier

  • 1Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands. wm.vdflier@vumc.nl

Experimental Gerontology
|July 25, 2012
PubMed

Insights

Microbleeds, small lesions on MRI, are common in vascular dementia. Their presence is linked to cognitive decline and may predict disease progression.

Area of Science:

  • Neurology
  • Neuroradiology
  • Geriatrics

Background:

  • Microbleeds are hypointensities on T2*-weighted MRI, indicative of small vessel disease.
  • They are frequently observed in vascular dementia (35-85% prevalence).
  • Associated with lacunes and white matter hyperintensities (WMH).

Purpose of the Study:

  • To explore the role of microbleeds in vascular dementia.
  • To investigate the potential causes and implications of microbleeds in cognitive impairment.

Main Methods:

  • Review of MRI findings, specifically gradient echo and T2*-weighted sequences.
  • Analysis of microbleed prevalence and association with cognitive function.

Main Results:

  • Microbleeds are common in vascular dementia, linked to hypertensive vasculopathy, neurodegeneration, and cerebral amyloid angiopathy.
  • Multiple microbleeds correlate with poorer cognitive performance, especially in psychomotor speed and executive functions.
  • Microbleeds may predict dementia development, mortality, and disability.

Conclusions:

  • Microbleeds are significant markers in vascular dementia and vascular cognitive impairment.
  • Current diagnostic criteria for vascular dementia need revision to include microbleeds.
  • Further research is needed on stroke and post-stroke dementia in patients with microbleeds.

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