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Updated: Mar 15, 2026
Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases
Published on: December 6, 2016
Synergistic effects of longitudinal amyloid and vascular changes on lobar microbleeds
Yeo Jin Kim1, Hee Jin Kim1, Jae-Hyun Park1
1From the Department of Neurology (Y.J.K.), Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon; Departments of Neurology (H.J.K., D.L.N., S.W.S.) and Nuclear Medicine (Y.S.C., K.-H.L., S.H.M.), Sungkyunkwan University School of Medicine, and Neuroscience Center (H.J.K., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (J.-H.P.), Semyeong Christianity Hospital, Pohang; Biostatistics Team (S.K., S.-Y.W.), Samsung Biomedical Research Institute; Department of Biomedical Engineering (K.-C.K., J.M.L.), Hanyang University, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan; Departments of Nuclear Medicine (J.S.K.) and Neurology (J.-H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul; Department of Neurology (Y.J.K.), Ilsong Institute of Life Science, Hallym University, Anyang, Korea; Stroke Research Centre (D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK; and Departments of Health Sciences and Technology (D.L.N.) and Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea.
Objective:
To determine whether amyloid and hypertensive cerebral small vessel disease (hCSVD) changes synergistically affect the progression of lobar microbleeds in patients with subcortical vascular mild cognitive impairment (svMCI).
Methods:
Among 72 patients with svMCI who underwent brain MRI and [11C] Pittsburgh compound B (PiB)-PET, 52 (72.2%) completed the third year of follow-up. These patients were evaluated by annual neuropsychological testing, brain MRI, and follow-up PiB-PET.
Results:
Over 3 years, 31 of 52 patients (59.6%) had incident cerebral microbleeds (CMBs) in the lobar and deep regions. Both baseline and longitudinal changes in lacune numbers were associated with increased numbers of lobar and deep microbleeds, while baseline and longitudinal changes in PiB uptake ratio were associated only with the progression of lobar microbleeds, especially in the temporal, parietal, and occipital areas. Regional white matter hyperintensity severity was also associated with regional lobar CMBs in the parietal and occipital regions. There were interactive effects between baseline and longitudinal lacune number and PiB retention on lobar microbleed progression. Increased lobar, but not deep, CMBs were associated with decreased scores in the digit span backward task and Rey-Osterrieth Complex Figure Test.
Conclusions:
Our findings suggest that amyloid-related pathology and hCSVD have synergistic effects on the progression of lobar microbleeds, providing new clinical insight into the interaction between amyloid burden and hCSVD on CMB progression and cognitive decline with implications for developing effective prevention strategies.
Insights
Amyloid pathology and hypertensive cerebral small vessel disease (hCSVD) interact to worsen lobar microbleeds in mild cognitive impairment. This suggests combined strategies may be needed for prevention.
Area of Science:
- Neurology
- Neuroimaging
- Gerontology
Background:
- Subcortical vascular mild cognitive impairment (svMCI) is associated with amyloid and hypertensive cerebral small vessel disease (hCSVD).
- The interplay between these pathologies in driving microbleed progression is not fully understood.
Purpose of the Study:
- To investigate the synergistic effects of amyloid burden and hCSVD on the progression of lobar microbleeds in svMCI patients.
- To explore the relationship between microbleed progression and cognitive decline.
Main Methods:
- Longitudinal analysis of 72 svMCI patients over 3 years.
- Utilized brain MRI and [11C] Pittsburgh compound B (PiB)-PET for amyloid imaging.
- Assessed annual neuropsychological testing and MRI for microbleed and hCSVD changes.
Main Results:
- Incident cerebral microbleeds (CMBs) occurred in 59.6% of patients.
- Both lacune changes and PiB retention were linked to microbleed progression, particularly in lobar regions.
- Amyloid and hCSVD showed synergistic effects on lobar microbleed progression and were associated with cognitive decline.
Conclusions:
- Amyloid pathology and hCSVD synergistically accelerate lobar microbleed progression in svMCI.
- Findings offer insights into the combined impact of amyloid and hCSVD on CMBs and cognitive decline.
- Suggests potential for combined prevention strategies targeting both pathologies.
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