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Published on: December 18, 2016
Prevalence and Risk Factors of Cerebral Microbleeds: Analysis From the UK Biobank
Dongwei Lu1, Junfeng Liu2, Andrew D MacKinnon2
1From the Stroke Research Group, Department of Clinical Neurosciences (D.L., J.L., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (D.L.), Zhongnan Hospital, Wuhan University; Department of Neurology (J.L.), West China Hospital, Sichuan University, China; and Department of Neuroradiology (A.D.M.), Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, UK. 2008302180101@whu.edu.cn.
Background And Objectives:
To determine the prevalence of and risk factors for cerebral microbleeds (CMBs) at different locations in a large healthy community population.
Methods:
A total of 8,159 participants from the UK Biobank with MRI scans suitable for CMB analysis were included. Brain susceptibility-weighted imaging data were acquired on 2 identical 3.0T scanners. The Microbleed Anatomical Rating Scale was used to identify definite CMBs. Generalized linear models were used to determine independent associations with all CMBs and lobar, deep, and infratentorial CMBs.
Results:
The mean age at scan was 62.1 ± 7.4 years. One or more definite CMBs were detected in 572 (7.0%) participants. Of those with CMBs, 439 (76.7%) had lobar CMBs, 103 (18.0%) had deep CMBs, and 83 (14.5%) had infratentorial CMBs. Age was an independent risk factor for CMBs in all locations. APOE4 and male sex were positively associated and higher body mass index was negatively associated with lobar CMBs. Hypertension, smoking, and alcohol consumption were associated with deep CMBs, but not with lobar CMBs. Only age was associated with infratentorial CMBs. The associations were unchanged after controlling for white matter hyperintensity lesion volume as a marker of small vessel disease severity.
Discussion:
In this large population-based study, CMB prevalence detected using a low sensitivity and high specificity system was 7%. There were distinct risk factor profiles for CMBs in lobar and deep locations consistent with different underlying pathophysiologic processes.
Trial Registration Information:
Clinical Trial registration number: UK Biobank application number 19463.
Insights
Cerebral microbleeds (CMBs) affect 7% of healthy adults, with distinct risk factors for lobar and deep locations. Age is a universal risk factor for CMBs across all brain regions.
Area of Science:
- Neuroimaging
- Neurology
- Epidemiology
Background:
- Cerebral microbleeds (CMBs) are markers of small vessel disease.
- Understanding CMB prevalence and risk factors is crucial for neurological health.
- Community-based data on CMBs are limited.
Purpose of the Study:
- To determine the prevalence of cerebral microbleeds (CMBs) in a large, healthy community population.
- To identify distinct risk factors associated with CMBs in lobar, deep, and infratentorial locations.
- To investigate the relationship between CMBs and demographic and lifestyle factors.
Main Methods:
- Utilized UK Biobank data from 8,159 participants with susceptibility-weighted imaging.
- Employed the Microbleed Anatomical Rating Scale for definite CMB identification.
- Applied generalized linear models to assess associations with CMBs and their locations.
Main Results:
- Prevalence of one or more definite CMBs was 7.0% (572/8159).
- Lobar CMBs were most common (76.7%), followed by deep (18.0%) and infratentorial (14.5%).
- Age was a universal risk factor; APOE4, male sex, and BMI were associated with lobar CMBs; hypertension, smoking, and alcohol with deep CMBs.
Conclusions:
- CMB prevalence in this population was 7%, with varied risk factor profiles for different locations.
- Distinct pathophysiological processes likely underlie lobar versus deep CMBs.
- Findings highlight the importance of location-specific risk factor analysis for CMBs.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Cerebral Edema ll: Pathophysiology

