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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Cerebral microbleeds are associated with worse cognitive function in the nondemented elderly with small vessel

Kazuo Yamashiro, Ryota Tanaka, Yasuyuki Okuma

    Cerebrovascular Diseases Extra
    |January 20, 2015
    PubMed
    Abstract

    Insights

    Cerebral microbleeds (CMBs) in elderly individuals with small vessel disease (SVD) are linked to poorer executive and global cognitive function, independent of other SVD markers. CMBs may indicate hypertensive microangiopathy and impact cognition.

    Area of Science:

    • Neurology
    • Geriatrics
    • Neuroimaging

    Background:

    • Cerebral small vessel disease (SVD) is a primary cause of cognitive decline in older adults.
    • Cerebral microbleeds (CMBs) are a key indicator of SVD, alongside lacunar infarcts and white matter lesions (WMLs).
    • The relationship between CMBs and cognitive function, independent of other SVD markers, requires further investigation.

    Purpose of the Study:

    • To determine if the presence and location of CMBs in elderly individuals with SVD are associated with cognitive function.
    • To assess cognitive function using executive function (Frontal Assessment Battery - FAB) and global cognition (Mini-Mental State Examination - MMSE) measures.
    • To differentiate the impact of CMBs from lacunar infarcts and WMLs on cognitive performance.

    Main Methods:

    • Magnetic resonance imaging (MRI) was used to identify SVD markers in 148 non-demented elderly participants.
    • Participants were categorized as CMB-positive or CMB-negative.
    • Cognitive scores were analyzed for differences between groups, with adjustments for age, education, brain volume, and other SVD indicators.

    Main Results:

    • CMBs were present in 32% of subjects, with most located in deep or infratentorial regions.
    • The presence of CMBs was significantly associated with lower FAB and MMSE scores, even after adjusting for confounders.
    • CMBs in basal ganglia, thalamus, or lobar regions correlated with FAB scores, while lobar CMBs correlated with MMSE scores.

    Conclusions:

    • In non-demented elderly individuals with SVD, CMBs are independently associated with diminished executive and global cognitive function.
    • CMBs may serve as a marker of hypertensive microangiopathy in this population.
    • The location of CMBs, particularly in lobar regions, appears significant for specific cognitive functions.
    Keywords:
    Cerebral microbleedsCognitionSmall vessel disease

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