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Updated: Aug 8, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Increase in cerebral microbleeds and cognitive decline
Shingo Mitaki1, Masahiro Takamura2, Shuhei Yamaguchi3
1Department of Neurology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan. shingomi@med.shimane-u.ac.jp.
Background:
In spite of increasing evidence of the clinical importance of cerebral microbleeds (CMBs), the relationship between CMBs and cognitive impairment is still controversial. In addition, there are very limited prior data regarding the prospective association of additional CMBs over time with a decline in cognitive function. This study thus aimed to investigate the effects of newly detected CMBs on cognitive decline in a Japanese health examination cohort.
Patients And Methods:
We performed a prospective cohort study involving 769 Japanese participants (mean age, 61.6 years) with a mean follow-up of 7.3 ± 3.5 years. CMBs were classified according to their locations. Cognitive functions were evaluated using Okabe's Intelligence Scale, Koh's block design test, and the Wisconsin Card Sorting Test. Multiple linear regression analyses were performed to examine the relationship between the newly detected CMBs and cognitive decline.
Results:
Fifty-six (7.3%) participants (16 had new strictly lobar cerebral microbleeds and 40 had new deep or infratentorial cerebral microbleeds) developed new CMBs during the follow-up period. In multivariable analysis, newly detected strictly lobar CMBs were associated with a greater decline in the Wisconsin Card Sorting Test in the categories achieved (β: - 0.862 [95% CI: - 1.325, - 0.399]; P < 0.0001), greater increase in perseverative errors of Nelson (β: 0.603 [95% CI: 0.023, 1.183]; P = 0.04), and greater increase in the difficulty with maintaining set (β: 1.321 [95% CI: 0.801, 1.842]; P < 0.0001).
Conclusions:
Strictly lobar CMBs over time were associated with a decline in executive function.
Insights
Newly detected strictly lobar cerebral microbleeds (CMBs) are linked to cognitive decline. This prospective study in a Japanese cohort found these microbleeds impact executive function over time.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Cerebral microbleeds (CMBs) are increasingly recognized for their clinical importance.
- The link between CMBs and cognitive impairment remains controversial.
- Limited data exist on the prospective association of new CMBs with cognitive decline.
Purpose of the Study:
- To investigate the impact of newly detected CMBs on cognitive decline.
- To analyze the association between new CMBs and changes in cognitive function in a Japanese health examination cohort.
Main Methods:
- Prospective cohort study of 769 Japanese participants (mean age 61.6 years) with a 7.3-year follow-up.
- CMBs classified by location; cognitive functions assessed using standardized tests.
- Multiple linear regression analyses used to determine relationships between new CMBs and cognitive decline.
Main Results:
- 56 participants (7.3%) developed new CMBs; 16 had strictly lobar CMBs.
- Newly detected strictly lobar CMBs correlated with significant decline in executive function.
- Specifically, associations found with Wisconsin Card Sorting Test performance and increased perseverative errors.
Conclusions:
- Strictly lobar cerebral microbleeds detected over time are associated with a decline in executive function.
- This finding contributes to understanding the role of CMBs in cognitive impairment progression.
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