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Md Tahmid Yasar1, Grant Nikseresht1, Abdur Raquib Ridwan2

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Cerebral microbleeds (CMBs) detected in vivo persist postmortem and are visible on ex vivo MRI. Higher CMB counts correlate with cognitive decline and cerebral amyloid angiopathy (CAA).

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Area of Science:

  • Neuroimaging
  • Neuropathology
  • Gerontology

Background:

  • Cerebral microbleeds (CMBs) are small hemorrhages common in older adults.
  • CMBs are associated with cognitive decline, reduced brain volume, and increased risk of stroke and mortality.
  • This study investigates CMBs detected in vivo and ex vivo, correlating findings with clinical and pathological data.

Purpose of the Study:

  • To determine if cerebral microbleeds (CMBs) detected in vivo can be identified postmortem using ex vivo MRI.
  • To assess the relationship between in vivo and ex vivo CMB findings and clinical evaluations.
  • To investigate the association of CMBs with neuropathologies, including cerebral amyloid angiopathy (CAA).

Main Methods:

  • A longitudinal study of 37 community-dwelling older adults involving annual cognitive testing and brain MRI.
  • In vivo MRI (3D-T1w MPRAGE, ME-GRE) and ex vivo MRI (3D ME-SE, ME-GRE) were acquired.
  • Neuropathologic assessment included cerebrovascular pathologies; CMBs were annotated and compared between in vivo and ex vivo scans.

Main Results:

  • 59% of participants had at least one CMB on ex vivo MRI.
  • 65% of in vivo CMBs were exactly matched with ex vivo CMBs.
  • Ex vivo CMB counts were higher than in vivo counts, particularly in individuals with greater cognitive impairment and cerebral amyloid angiopathy (CAA).

Conclusions:

  • Cerebral microbleeds (CMBs) observed during life persist in the brain and are detectable via ex vivo MRI.
  • The number of CMBs increases over time in individuals experiencing cognitive impairment and cerebral amyloid angiopathy (CAA).
  • This study validates ex vivo MRI as a tool for detecting persistent CMBs and their association with neurodegenerative conditions.