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Cerebral microbleeds: different prevalence, topography, and risk factors depending on dementia diagnosis—the

S Shams1, J Martola2, T Granberg2

  • 1Clinical Science, Intervention, and Technology (S.S., J.M., T.G., M.S., L.C., P.A., M.K.-W.), Division of Medical Imaging and Technology, Karolinska Institute, Stockholm, Sweden Department of Radiology (S.S., J.M., T.G., M.S., L.C., P.A., M.K.-W.) sara.shams@ki.se.

AJNR. American Journal of Neuroradiology
|December 20, 2014
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) prevalence and location differ across dementia types, reflecting underlying pathologies. Risk factors like hypertension significantly increase CMB occurrence, impacting treatment decisions for dementia patients.

Area of Science:

  • Neurology
  • Neuroimaging
  • Vascular Dementia Research

Background:

  • Cerebral microbleeds (CMBs) are associated with cerebral amyloid angiopathy in lobar regions and hypertensive arteriopathy in deep/infratentorial locations.
  • Understanding CMB topography and risk factors offers insights into dementia-related vascular and amyloid pathologies.

Purpose of the Study:

  • To investigate the topography and risk factors of cerebral microbleeds (CMBs) in patients with various dementia diagnoses.
  • To enhance comprehension of CMBs' role in the context of dementia.

Main Methods:

  • Analysis of 1504 dementia patients (mean age 63 ± 10 years) with 10 different dementia diagnoses.
  • Review of MR imaging and clinical parameters for all participating patients.

Main Results:

  • 22% of dementia patients exhibited CMBs, with predominantly lobar and occipital topography in Alzheimer disease.
  • CMB patients were older, more frequently male, had lower cognitive scores, and higher rates of hypertension.
  • Risk factors for CMBs varied by dementia diagnosis, with odds increasing with the number of factors (hypertension, hyperlipidemia, diabetes, male sex, age ≥65).

Conclusions:

  • CMB prevalence, topography, and risk factors are diagnosis-dependent, mirroring specific dementia pathologies.
  • Increasing CMB prevalence with multiple risk factors suggests considering these factors when initiating anticoagulant therapy in dementia patients.
  • CMBs may serve as predictors of intracerebral hemorrhage, highlighting the importance of risk factor assessment.

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