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Cerebral microbleeds are associated with deficits in cognitive processing speed and executive functions in

Iiris Kyläheiko1, Aleksi Tarkkonen2, Linda Kuusela3

  • 1Department of Psychology, Faculty of Medicine, University of Helsinki, PO Box 21 (Haartmaninkatu 3) 00014 Helsinki, Finland; Department of Neurology, Kymenlaakso Central Hospital, Kotkantie 41, 48210 Kotka, Finland; Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2U, Tukholmankatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, University of Helsinki, Biomedicum Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland.

Diabetes Research and Clinical Practice
|January 4, 2026
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) in adults with type 1 diabetes are linked to cognitive decline, particularly in processing speed and executive functions. White matter hyperintensities (WMHs) showed no independent cognitive impact.

Area of Science:

  • Neurology
  • Endocrinology
  • Neuroimaging

Background:

  • Type 1 diabetes (T1D) increases risk for cerebral small vessel disease (cSVD)-related brain changes in midlife adults.
  • The impact of cSVD markers like cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs) on cognition in T1D is not well understood.

Purpose of the Study:

  • To investigate the association between CMBs, WMHs, and cognitive functions in neurologically asymptomatic adults with T1D.
  • To determine if CMB burden and location, or WMH volume, correlate with cognitive performance.

Main Methods:

  • Cross-sectional study of 167 adults (mean age 46.4 years) with T1D.
  • Clinical, biochemical, brain MRI (evaluating CMBs and WMHs), and neuropsychological assessments were performed.
  • CMB number and topography, and WMH volume were quantified.

Main Results:

  • Higher CMB burden (≥3) was independently associated with poorer processing speed and executive functions, but not episodic memory.
  • Mild WMHs did not show independent associations with cognitive measures.
  • Mixed CMB location was more frequently linked to negative cognitive outcomes.

Conclusions:

  • CMBs are associated with subtle but consistent cognitive impairments in adults with T1D.
  • Early cSVD-related cognitive changes occur in midlife T1D, indicating an elevated risk for cognitive decline.
Keywords:
Cerebral microbleedsCerebrovascular diseaseCognitionMRIType 1 Diabetes

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