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Published on: June 8, 2017
Association between infectious burden and cerebral microbleeds: a pilot cross-sectional study
Fan Fan1,2, Cui Yang2,3,4, Xiaoyan Zhu5
1Department of Neurology, Huanggang Central Hospital, Huanggang, Hubei, China.
Objective:
Cerebral microbleeds (CMBs) is a subtype of cerebral small vessel disease. Their underlying pathogenesis remains unclear. The aim of this study was to investigate the association between infectious burden (IB) and CMBs.
Methods:
Seven hundred and seventy-three consecutive patients who were hospitalized in the Department of Neurology in General Hospital of Western Theater Command without severe neurological symptoms were recruited and selected in this pilot cross-sectional study. CMBs were assessed using the susceptibility-weighted imaging sequence of magnetic resonance imaging. Immunoglobulin G antibodies against common pathogens, including herpes simplex virus (HSV)-1, HSV-2, cytomegalovirus (CMV), Chlamydia pneumoniae (C. pneumoniae), Mycoplasma pneumoniae (M. pneumoniae), Epstein-Barr virus (EBV), Helicobacter pylori (HP), and Borrelia burgdorferi (B. burgdorferi), were measured by commercial ELISA assays. IB was defined as a composite serologic measure of exposure to these common pathogens.
Results:
Patients with and without CMBs were defined as the CMBs group (n = 76) and the non-CMBs group (n = 81), respectively. IB was significantly different between the CMBs and non-CMBs groups. After adjusted for other risk factors, the increased IB was independently associated with the presence of CMBs (P = 0.031, OR = 3.00, 95% CI [1.11-8.15]). IB was significantly positively associated with the number of CMBs (Spearman ρ = 0.653, P < 0.001). The levels of serum inflammatory markers were significantly different between the CMBs and non-CMBs groups and among the categories of IB.
Interpretation:
IB consisting of HSV-1, HSV-2, CMV, C. pneumoniae, M. pneumoniae, EBV, HP, and B. burgdorferi was associated with CMBs. All the findings suggested that pathogen infection could be involved in the pathogenesis of CMBs.
Insights
Increased infectious burden (IB) from common pathogens is linked to cerebral microbleeds (CMBs), a type of small vessel disease. This suggests infections may play a role in CMB development.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Cerebral microbleeds (CMBs) are a subtype of cerebral small vessel disease with unclear pathogenesis.
- Investigating potential contributing factors like infectious burden is crucial for understanding CMBs.
Purpose of the Study:
- To investigate the association between infectious burden (IB) and the presence of CMBs.
- To explore the role of common pathogen infections in the pathogenesis of CMBs.
Main Methods:
- A cross-sectional study of 773 patients hospitalized in Neurology.
- CMBs assessed via magnetic resonance imaging (MRI) susceptibility-weighted imaging.
- Immunoglobulin G antibodies against common pathogens (HSV-1, HSV-2, CMV, C. pneumoniae, M. pneumoniae, EBV, HP, B. burgdorferi) measured by ELISA to determine IB.
Main Results:
- Patients with CMBs (n=76) showed a significantly different IB compared to those without CMBs (n=81).
- Increased IB was independently associated with the presence of CMBs (OR=3.00, P=0.031).
- IB positively correlated with the number of CMBs (Spearman ρ=0.653, P<0.001), and inflammatory markers differed between groups.
Conclusions:
- Infectious burden, encompassing infections like HSV-1, HSV-2, CMV, C. pneumoniae, M. pneumoniae, EBV, HP, and B. burgdorferi, is associated with CMBs.
- Findings suggest that pathogen infections may contribute to the pathogenesis of cerebral microbleeds.
