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Published on: April 23, 2021
The performance of patients with cerebral microbleeds in different cognitive tests: A cross-sectional study
Xuanting Li1, Shuna Yang1, Yue Li1
1Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Background:
The clinical features and pathological process of cerebral microbleed (CMB)-related cognitive impairment are hot topics of cerebral small vessel disease (CSVD). However, how to choose a more suitable cognitive assessment battery for CMB patients is still an urgent issue to be solved. This study aimed to analyze the performance of CMB patients on different cognitive tests.
Methods:
This study was designed as a cross-sectional study. The five main markers of CSVD (including the CMB, white matter hyperintensities, perivascular spaces, lacunes and brain atrophy) were assessed according to magnetic resonance imaging. The burden of CMB was categorized into four grades based on the total number of lesions. Cognitive function was assessed by Mini-Mental State Examination (MMSE), Trail-Making Test (TMT, Part A and Part B), Stroop color-word test (Stroop test, Part A, B and C), Verbal Fluency Test (VF, animal), Digit-Symbol Substitution Test (DSST), Digit Cancellation Test (DCT) and Maze. Multiple linear regression analysis was conducted to analyze the association between CMB and cognitive findings.
Results:
A total of 563 participants (median age of 69 years) were enrolled in this study, including 218 (38.7%) CMB patients. CMB patients showed worse performance than non-CMB subjects in each cognitive test. Correlation analysis indicated the total number of CMB lesions had positive correlations with the time of TMT, Maze and Stroop test, and negative correlations with the performance of MMSE, VF, DSST, and DCT. After the adjustment for all the potential confounders by linear regression, the CMB burden grade was correlated with the performance of VF, Stroop test C, Maze and DCT.
Conclusion:
The presence of CMB lesions was associated with much worse cognitive performances. In VF, Stroop test C, Maze and DCT, the correlations between CMB severity and assessment results were more significant. Our study further confirmed that the attention/executive function domain was the most commonly evaluated in CMB, which provided a picture of the most utilized tools to analyze the prognostic and diagnostic value in CMB.
Insights
Cerebral microbleed (CMB) patients exhibit poorer cognitive function across various tests. Higher CMB burden correlates with deficits in attention and executive functions, particularly in Verbal Fluency, Stroop C, Maze, and Digit Cancellation tests.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Cerebral microbleeds (CMBs) are a key marker of cerebral small vessel disease (CSVD).
- CMB-related cognitive impairment is a significant clinical concern within CSVD research.
- Optimal cognitive assessment strategies for CMB patients remain an area needing clarification.
Purpose of the Study:
- To evaluate the performance of patients with cerebral microbleeds (CMBs) on a comprehensive battery of cognitive tests.
- To identify specific cognitive domains and tests most affected by CMBs.
- To inform the selection of appropriate cognitive assessments for CMB patients.
Main Methods:
- A cross-sectional study involving 563 participants (218 with CMBs) was conducted.
- Cerebral small vessel disease markers, including CMBs, were assessed using magnetic resonance imaging.
- Cognitive function was evaluated using MMSE, TMT, Stroop test, VF, DSST, DCT, and Maze, with CMB burden graded by lesion count.
Main Results:
- Participants with CMBs demonstrated significantly worse performance on all cognitive tests compared to non-CMB subjects.
- CMB lesion count correlated positively with TMT and Maze completion times and negatively with MMSE, VF, DSST, and DCT scores.
- After adjusting for confounders, CMB burden grade was significantly associated with performance in VF, Stroop test C, Maze, and DCT.
Conclusions:
- The presence of CMBs is strongly associated with diminished cognitive performance.
- Verbal Fluency, Stroop test C, Maze, and Digit Cancellation tests showed the most significant correlations with CMB severity.
- Attention and executive function domains are most frequently assessed in CMB patients, highlighting key areas for prognostic and diagnostic evaluation.
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