Relationship between Cerebral Microbleeds and Liver Stiffness Determined by Transient Elastography

Area of Science:

• Neurology
• Hepatology
• Radiology

Background:

• Liver fibrosis is a chronic liver condition that can impact brain health.
• Cerebral small vessel diseases (SVDs), including cerebral microbleeds (CMBs), are associated with liver fibrosis.
• Transient elastography is a non-invasive method to assess liver stiffness (LS), a marker of liver fibrosis.

Purpose of the Study:

• To investigate the association between liver stiffness (LS) values and the presence and burden of SVDs.
• To determine if liver fibrosis is an independent predictor of SVDs, specifically CMBs, leukoaraiosis, and silent infarctions.

Main Methods:

• 300 healthy participants underwent transient elastography to measure LS and brain MRI to identify SVDs.
• Liver stiffness values were categorized as mild (>5.6 kPa) and significant (>8.0 kPa) fibrosis.
• SVDs were assessed using FLAIR, GRE, T1-, and T2-weighted MRI sequences.

Main Results:

• The presence and number of CMBs were positively associated with higher LS values (p<0.001).
• Significant liver fibrosis (>8.0 kPa) was an independent predictor of CMBs (OR 6.079, p=0.012).
• Leukoaraiosis and silent infarctions showed no significant association with LS values (p>0.05).

Conclusions:

• Liver fibrosis, assessed by transient elastography, is independently associated with CMBs in asymptomatic individuals.
• This finding highlights a potential link between liver health and brain microvascular integrity.
• Further research into the brain-liver axis may elucidate the pathomechanisms of CMBs.