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Updated: Oct 5, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebral Microbleeds Are Associated With Increased Brain Iron and Cognitive Impairment in Patients With Cerebral
Jing Li1, Thanh D Nguyen2, Qihao Zhang2
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Beijing, 10050, China.
Background:
Cerebral microbleeds (CMBs) have been recognized to play an important role in cognitive impairment of cerebral small vessel disease (CSVD) patients. However, the mechanism of this effect is still unclear.
Purpose:
Comparing the susceptibility values in the selected subcortical gray matter structures of CSVD patients without CMBs (CSVD-N) and with CMBs (CSVD-C) as well as healthy controls (HCs).
Study Type:
Prospective.
Subjects:
Sixty-nine CSVD patients and 28 HCs were included; 24 CSVD patients (34.78%) had CMBs and 45 CSVD patients (65.22%) had no CMBs.
Field Strength/Sequence:
All subjects were imaged on a 3.0 T MR scanner. The protocol consisted of a three-dimensional (3D) T1-weighted sequence and a 3D multi-echo gradient echo (mGRE) sequence. Brain QSM maps were computed from mGRE data using the morphology-enabled dipole inversion with automatic uniform cerebrospinal fluid zero reference algorithm (MEDI+0).
Assessment:
The mean susceptibility value within each region of interest was recorded. All participants underwent the cognitive assessment. Brain iron deposition burden of CMB lesions of every CSVD-C patient was computed.
Statistical Tests:
One-way analysis of variance test followed by Tukey's honest significance test and Kruskal-Wallis test were used with significance level of 0.05. Stepwise multivariate linear analysis was used to explore the factors influencing cognitive scores.
Results:
Montreal cognitive assessment (MoCA), trail-making test (TMT)-A and TMT-B scores in the three groups were significantly different (all P < 0.05). Stepwise multivariate linear regression analysis revealed that the factors influenced MoCA scores were having CMBs (P < 0.05), white matter hyperintensities (P < 0.05), lacunes (P < 0.05) in brain, and the brain iron deposition burden of CMB lesions (P < 0.05) and for TMT scores (TMT-A + TMT-B), the influencing factors were age (P < 0.05), education years (P < 0.05), and the brain iron deposition burden of CMB lesions (P < 0.05).
Data Conclusion:
The higher iron deposition burden of CMB lesions in brain may be an imaging quantitative marker of cognitive decline in patients with CSVD-C.
Level Of Evidence:
1 TECHNICAL EFFICACY: Stage 2.
Insights
Cerebral microbleeds (CMBs) contribute to cognitive impairment in cerebral small vessel disease (CSVD). Higher iron deposition in CMB lesions may serve as a marker for cognitive decline in CSVD patients.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cerebral microbleeds (CMBs) are linked to cognitive impairment in cerebral small vessel disease (CSVD) patients.
- The exact mechanism by which CMBs affect cognition in CSVD remains unclear.
Purpose of the Study:
- To compare susceptibility values in subcortical gray matter structures.
- To investigate differences between CSVD patients with and without CMBs, and healthy controls.
Main Methods:
- Prospective study involving 69 CSVD patients and 28 healthy controls.
- 3.0T MRI with 3D T1-weighted and 3D multi-echo gradient echo (mGRE) sequences.
- Quantitative Susceptibility Mapping (QSM) was used to assess iron deposition; cognitive assessments were performed.
Main Results:
- Cognitive scores (MoCA, TMT) differed significantly across the three groups.
- CMBs, white matter hyperintensities, lacunes, and CMB iron burden influenced MoCA scores.
- Age, education, and CMB iron burden affected TMT scores.
Conclusions:
- Higher iron deposition burden in CMB lesions may indicate cognitive decline in CSVD patients.
- Iron deposition in CMBs could be a quantitative imaging marker for cognitive impairment in CSVD.
