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Location of Cerebral Microbleeds And Their Association with Carotid Intima-media Thickness: A Community-based Study
Chih-Ping Chung1,2, Kun-Hsien Chou3,4, Wei-Ta Chen1,5,4,2
1Department of Neurology, National Yang Ming University, Taipei City, Taiwan.
Insights
High carotid intima-media thickness (CIMT), a marker of atherosclerosis, is linked to deep or infratentorial cerebral microbleeds (CMBs). This association suggests distinct pathways for different types of microbleeds.
Area of Science:
- Neurology
- Cardiovascular Science
- Radiology
Background:
- Cerebral microbleeds (CMBs) are small vascular lesions in the brain.
- Carotid intima-media thickness (CIMT) is a non-invasive marker of systemic atherosclerosis.
- The relationship between CIMT and CMBs, particularly different subtypes, requires further investigation.
Purpose of the Study:
- To investigate the association between high CIMT and the presence of CMBs.
- To explore potential differences in this association based on CMB location (deep/infratentorial vs. strictly lobar).
Main Methods:
- Cross-sectional study of 962 participants from the I-Lan Longitudinal Aging Study.
- CIMT measured by ultrasonography; CMBs assessed by 3T MRI susceptibility-weighted imaging.
- Analysis adjusted for age, sex, cardiovascular risk factors, and other cerebral small vessel diseases.
Main Results:
- CMBs were found in 14.0% of subjects.
- Hypertension, hyperlipidemia, obesity, and higher triglycerides correlated with deep/infratentorial (DI) CMBs, but not strictly lobar (SL) CMBs.
- High CIMT (top quartile) significantly predicted DI CMBs (OR=2.1, 95% CI=1.3-3.4), independent of other factors. No association was found between CIMT and SL CMBs.
Conclusions:
- High CIMT is an independent predictor of deep or infratentorial cerebral microbleeds.
- The findings suggest distinct underlying pathologies for DI and SL CMBs.
- CIMT may serve as a potential indicator for DI CMBs in clinical practice.
Abstract:
To assess whether high cerebral microbleeds (CMBs) are associated with carotid intima-media thickness (CIMT), a marker of systemic atherosclerosis, we cross-sectionally evaluated participants from a community-based study, the I-Lan Longitudinal Aging Study. The participants' demographics and cardiovascular risk factors were determined by questionnaire and/or laboratory measurements. CIMT was measured by ultrasonography. CMBs were assessed by susceptibility-weighted-imaging on 3 T MRI. Of the 962 subjects [62.5(8.6) years, 44.2% men] included, CMBs were found in 134(14.0%) subjects. Among the subjects with identified CMB's, 85(63.4%) had deep or infratentorial (DI) and 49(36.6%) had strictly lobar(SL) CMBs. After the results were adjusted for age and sex, the analysis revealed that hypertension, hyperlipidemia, obesity, and higher triglyceride levels correlated with DI but not SL CMBs. The subjects with DI CMBs also had a higher mean CIMT and higher prevalence of top quartile CIMT. The multivariate analysis demonstrated that high CIMT (top quartile) significantly predicted the presence of DI CMBs (odds ratio = 2.1; 95% confidence interval = 1.3-3.4; P = 0.004), independent of age, sex, cardiovascular risk factors, and other cerebral small vessel diseases, lacune, and white matter hyperintensity. There was no association between CIMT and SL CMBs. Our results support that there are distinct pathogenesis in DI and SL CMBs.
