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Cerebral Microbleeds, Vascular Risk Factors, and Magnetic Resonance Imaging Markers: The Northern Manhattan Study
Michelle R Caunca1, Victor Del Brutto2, Hannah Gardener1
1Evelyn F. McKnight Brain Institute and the Neuroscience Program, University of Miami, Miami, FL Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
Background:
Cerebral microbleeds (CMBs) represent intracerebral hemorrhages due to amyloid angiopathy or exposure to modifiable risk factors. Few community-based stroke-free studies including blacks and Hispanics have been done.
Methods And Results:
The Northern Manhattan Study (NOMAS) is a stroke-free, racially and ethnically diverse cohort study. Brain MRI was performed in 1290 participants, 925 of whom had available T2* gradient-recall echo data. We used multivariable logistic regression to examine the association of sociodemographics, vascular risk factors, apolipoprotein E (APOE) genotype, and brain MRI markers with CMB presence and location. The prevalence of CMBs in our cohort was 5%. Of the 46 participants with CMBs, 37% had only deep CMBs, 48% had only lobar CMBs, and 15% had CMBs in both locations. The difference in CMB distribution was not statistically significant across race/ethnic group or APOE genotype. In multivariable analyses, age (OR [95% CI]: 1.09 [1.04, 1.15]) and SBIs (2.58 [1.01, 6.59]) were positively associated with CMB presence, and diabetes medication use was negatively associated (0.25 [0.07, 0.86]).
Conclusions:
CMBs may represent the severity of vascular disease in this racially and ethnically diverse cohort. Larger studies are needed to elucidate the association between diabetes medication use and CMB presence.
Insights
Cerebral microbleeds (CMBs) are linked to aging and stroke burden in diverse populations. Diabetes medication use may reduce CMB risk, warranting further investigation.
Area of Science:
- Neurology
- Radiology
- Epidemiology
Background:
- Cerebral microbleeds (CMBs) are small hemorrhages linked to amyloid angiopathy and risk factors.
- Limited community-based, stroke-free studies exist for diverse populations, including Black and Hispanic individuals.
Purpose of the Study:
- To investigate the prevalence and correlates of CMBs in a diverse, stroke-free cohort.
- To examine associations between sociodemographics, vascular risk factors, APOE genotype, and CMBs.
Main Methods:
- Utilized T2* gradient-recall echo MRI data from 925 participants in the Northern Manhattan Study (NOMAS).
- Employed multivariable logistic regression to analyze associations with CMB presence and location.
- Assessed sociodemographics, vascular risk factors, and apolipoprotein E (APOE) genotype.
Main Results:
- Prevalence of CMBs was 5% (46 participants).
- CMB distribution (lobar vs. deep) did not significantly differ by race/ethnicity or APOE genotype.
- Age (OR 1.09 [1.04, 1.15]) and prior silent brain infarcts (SBIs) (OR 2.58 [1.01, 6.59]) were associated with increased CMB presence.
- Diabetes medication use was associated with decreased CMB presence (OR 0.25 [0.07, 0.86]).
Conclusions:
- CMBs may reflect vascular disease severity in diverse populations.
- Further research is needed to clarify the relationship between diabetes medication use and CMBs.
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