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Background and distribution of lobar microbleeds in cognitive dysfunction

Hirofumi Matsuyama1, Yuichiro Ii1, Masayuki Maeda2

  • 1Department of Neurology Mie University Graduate School of Medicine Tsu Mie Japan.

Brain and Behavior
|December 5, 2017
PubMed
Abstract

Insights

Strictly lobar cerebral microbleeds (SL-CMBs) are linked to Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA), while mixed CMBs (M-CMBs) are associated with both HV and CAA in memory clinic patients.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Cerebral microbleeds (CMBs) are common in memory clinic patients.
  • Deep CMBs (D-CMBs) are typically linked to hypertensive vasculopathy (HV), while strictly lobar CMBs (SL-CMBs) are associated with cerebral amyloid angiopathy (CAA), often co-occurring with Alzheimer's disease (AD).
  • Mixed CMBs (M-CMBs) are thought to result from both HV and CAA.

Purpose of the Study:

  • To differentiate between SL-CMBs and M-CMBs based on clinical characteristics and anatomical distribution.
  • To investigate the etiological underpinnings of different CMB subtypes.

Main Methods:

  • Analysis of 176 memory clinic patients using 3T-MRI with susceptibility-weighted imaging.
  • Quantification and regional density adjustment of lobar CMBs in SL-CMB and M-CMB groups.
  • Correlation of CMB location with clinical features, including dementia history, hypertension, smoking, AD, and cerebrovascular disease.

Main Results:

  • CMBs were present in 63.1% of patients; M-CMBs were most frequent (48.6%), followed by SL-CMBs (31.5%).
  • SL-CMB patients showed higher dementia history prevalence and AD, while M-CMB patients had trends toward hypertension, smoking, and co-existing AD with cerebrovascular disease.
  • M-CMBs had higher regional density in the occipital lobe, whereas SL-CMBs showed increased density in parietal and occipital lobes.

Conclusions:

  • Clinical and regional distribution differences support an etiological link between SL-CMBs and AD/CAA.
  • M-CMBs appear to be associated with both hypertensive vasculopathy (HV) and cerebral amyloid angiopathy (CAA).
  • These findings aid in understanding the distinct pathologies underlying different CMB presentations.
Keywords:
cerebral amyloid angiopathycerebral microbleedshypertensive vasculopathymagnetic resonance imagingmemory clinic

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