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Cerebral Microbleeds and Amyloid Pathology Estimates From the Amyloid Biomarker Study
Julie E Oomens1, Veerle van Gils1, Stephanie J B Vos1
1Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
JAMA Network Open
|January 22, 2025
Summary
Cerebral microbleeds (CMBs) prevalence increases with amyloid pathology and APOE ε4 gene presence in Alzheimer
Area of Science:
- Neurology
- Gerontology
- Biomarker Research
Background:
- Cerebral microbleeds (CMBs) and APOE ε4 allele copy number are established risk factors for amyloid-related imaging abnormalities.
- These abnormalities are a concern in Alzheimer disease (AD) patients undergoing therapies targeting amyloid-β plaque reduction.
Purpose of the Study:
- To determine the prevalence of cerebral microbleeds (CMBs) based on their number (any, no more than 4, or fewer than 2).
- To associate CMB prevalence with amyloid status, APOE ε4 allele copy number, and participant age.
Main Methods:
- Cross-sectional study utilizing pooled data from 15 research and memory clinic studies (Amyloid Biomarker Study initiative).
- Included 4080 participants with available data on age, cognitive status, amyloid status, and CMBs.
- CMBs assessed via MRI; amyloid pathology determined by cerebrospinal fluid Aβ42 levels or amyloid PET scans.
Main Results:
- Prevalence of CMBs varied significantly with age, amyloid status, and APOE ε4 copy number.
- In cognitively unimpaired individuals, amyloid and APOE ε4 were linked to lobar CMBs.
- In mild cognitive impairment or Alzheimer disease dementia groups, amyloid and APOE ε4 were associated with increased odds of any CMBs and no more than 4 CMBs.
Conclusions:
- CMB prevalence is associated with amyloid status, APOE ε4 copy number, and age in a large cohort.
- These prevalence estimates are crucial for assessing the safety of antiamyloid therapies in clinical trials for Alzheimer disease.
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