Related Experiment Video
Updated: Aug 4, 2026

Sub-acute Cerebral Microhemorrhages Induced by Lipopolysaccharide Injection in Rats
Published on: October 17, 2018
Correlation of Cerebral Microbleed Distribution to Amyloid Burden in Patients with Primary Intracerebral Hemorrhage
Hsin-Hsi Tsai1, Li-Kai Tsai1, Ya-Fang Chen2
1Departments of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Abstract:
The underlying pathology of cerebral microbleeds (CMBs) with mixed lobar and deep distribution remains contentious. The aim of this study was to correlate CMBs distribution to β-amyloid burden in patients with primary intracerebral hemorrhage (ICH). Fourty-seven ICH patients underwent magnetic resonance susceptibility-weighted imaging and 11C-Pittsburgh Compound B positron emission tomography. The amyloid burden was expressed as standardized uptake value ratio with reference to cerebellum, and presented as median (interquartile range). Patients were categorized into the lobar, mixed (both lobar and deep regions), and deep types of CMB. Comparing the lobar (17%), mixed (59.6%) and deep (23.4%) CMB types, the global amyloid burden was significantly higher in the mixed type than the deep type (1.10 [1.03-1.25] vs 1.00 [0.97-1.09], p = 0.011), but lower than in the lobar type (1.48 [1.18-1.50], p = 0.048). On multivariable analysis, the ratio of lobar to deep CMB number was positively correlated with global (p = 0.028) and occipital (p = 0.031) amyloid burden. In primary ICH, patients with lobar and mixed CMB types are associated with increased amyloid burden than patients with deep type. The ratio of lobar to deep CMB number is an independent indicator of cerebral β-amyloid deposition.
Insights
Cerebral microbleeds (CMBs) in patients with intracerebral hemorrhage (ICH) are linked to amyloid burden. Mixed and lobar CMB types show higher amyloid levels than deep CMB types, indicating amyloid deposition.
Area of Science:
- Neurology
- Neuroimaging
- Biomarkers
Background:
- Cerebral microbleeds (CMBs) are small hemorrhages in the brain.
- The distribution of CMBs (lobar, deep, or mixed) can indicate underlying pathologies.
- Understanding the link between CMBs and β-amyloid is crucial for diagnosing and managing conditions like Alzheimer's disease and intracerebral hemorrhage (ICH).
Purpose of the Study:
- To investigate the correlation between the distribution patterns of CMBs and the burden of β-amyloid in patients diagnosed with primary intracerebral hemorrhage (ICH).
- To determine if CMB distribution can serve as a predictive marker for cerebral β-amyloid deposition.
Main Methods:
- Magnetic resonance (MR) susceptibility-weighted imaging was used to identify and categorize CMBs in 47 ICH patients.
- 11C-Pittsburgh Compound B positron emission tomography (PET) was employed to quantify global and regional amyloid burden.
- Patients were classified into lobar, mixed (lobar and deep), and deep CMB groups.
Main Results:
- The mixed CMB type exhibited significantly higher global amyloid burden compared to the deep CMB type.
- The lobar CMB type showed the highest global amyloid burden, significantly greater than the deep CMB type.
- A higher ratio of lobar to deep CMBs was independently correlated with increased global and occipital amyloid burden.
Conclusions:
- In primary ICH, lobar and mixed CMB types are associated with a greater cerebral β-amyloid burden compared to the deep CMB type.
- The ratio of lobar to deep CMBs is a significant independent indicator of β-amyloid deposition in the brain.
- These findings highlight the potential of CMB distribution patterns as biomarkers for amyloid pathology in ICH patients.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Cerebral Edema ll: Pathophysiology

