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Published on: April 23, 2021
Coexistence of Cerebral Microbleeds and Amyloid Pathology in Patients with Cognitive Complaints
Eun Ye Lim1, Seon Young Ryu2, Yong S Shim3
1Department of Neurology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Background And Purpose:
We investigated the prevalence of amyloid positivity and cerebral microbleeds (CMBs) in subjects with cognitive complaints with the aim of identifying differences in clinical parameters and cognitive function according to the pattern of coexistence.
Methods:
We retrospectively enrolled 200 subjects with memory impairment and applied both standardized ¹⁸F-florbetaben PET and brain MRI, including susceptibility-weighted imaging. The amyloid burden was visually classified as positive or negative, and the number and location of CMBs were also analyzed visually. Descriptive analysis was performed for the prevalence of amyloid positivity and CMBs. The relationship between the coexisting pattern of those two findings and clinical parameters including the results of neuropsychiatric tests was analyzed.
Results:
Positive amyloid PET scans were exhibited by 102 (51.5%) of the 200 patients, and 51 (25.5%) of them had CMBs, which were mostly located in lobar areas in the patients with positive amyloid scans. The patients with CMBs were older and had a higher burden of white-matter hyperintensities than the patients without CMBs. The patients with CMBs also performed worse in confrontation naming and frontal/executive function. When classified by topographical region, parietal CMBs (odds ratio=3.739, p=0.024) were significantly associated with amyloid positivity.
Conclusions:
The prevalence of CMBs was higher in patients with cognitive decline than in the general population. CMBs play distinctive roles in affecting clinical parameters and neuropsychological profiles according to the coexistence of amyloid pathology.
Insights
Cerebral microbleeds (CMBs) are more common in individuals with cognitive complaints and are linked to worse cognitive function, especially when co-occurring with amyloid positivity. Parietal CMBs specifically indicate a higher likelihood of amyloid positivity.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- Cognitive complaints are common in aging populations.
- Amyloid positivity and cerebral microbleeds (CMBs) are key neuropathological findings.
- Understanding their coexistence is crucial for diagnosing cognitive impairment.
Purpose of the Study:
- To determine the prevalence of amyloid positivity and CMBs in subjects with cognitive complaints.
- To identify differences in clinical parameters and cognitive function based on the co-occurrence of amyloid and CMBs.
- To explore the association between CMB location and amyloid positivity.
Main Methods:
- Retrospective analysis of 200 subjects with memory impairment.
- Standardized ¹⁸F-florbetaben PET for amyloid burden assessment.
- Brain MRI with susceptibility-weighted imaging for CMB detection and analysis.
Main Results:
- 51.5% of subjects had amyloid positivity; 25.5% had CMBs.
- CMBs were more prevalent in older patients with higher white-matter hyperintensity burden.
- Patients with CMBs showed poorer performance in naming and executive functions.
- Parietal CMBs were significantly associated with amyloid positivity (OR=3.739, p=0.024).
Conclusions:
- CMB prevalence is elevated in patients experiencing cognitive decline.
- CMBs influence clinical presentation and cognitive profiles, particularly when coexisting with amyloid pathology.
- The topographical distribution of CMBs provides insights into underlying amyloid pathology.
