In a neurologically healthy cohort, the associations of PVS differ according to their topography. PVS distribution may be useful for the early detection and classification of small vessel disease.

Background and Purpose-Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships. Methods-A total of 518 consecutive adults without neurological disorder who had undergone health-screening tests of the brain were studied prospectively. Gradient-echo T2*-weighted MRI using a 1.5-T system was used to detect MBs. The Mini-Mental State Examination (MMSE) was administered to determine cognitive functions. MMSE scores Ͻ27 or Ͼ1.5 SDs below the age-related mean were regarded as subnormal. Results-MBs were found in 35 subjects (6.8%). MMSE score Ͻ27 was found in 25 subjects (4.8%), with MMSE score Ͼ1.5 SDs below the age-related mean in 34 subjects (6.6%). Univariate analysis showed presence and number of MBs, short duration of education, and severe white matter hyperintensities as significantly associated with subnormal scores.

Background and Purpose-Brain microbleeds (MBs) are considered to be associated with cognitive decline and can be pathologically and topographically classified as cerebral amyloid angiopathy-related (located in lobar regions) and hypertensive microangiopathy-related (located in deep regions). We examined whether different effects on global cognitive function might be seen with different distributions of MBs. Methods-A total of 1279 adults without neurological disorders were studied prospectively. Subjects were divided into 4 groups: without-MBs group; lobar group; deep group; and with in both areas (diffuse group). The Mini-Mental State Examination was administered to determine global cognitive functions, with scores Ͻ27 regarded as subnormal. Results-MBs were detected in 98 subjects (8%): 36 subjects (3%) classified as lobar group, 48 subjects (4%) as deep group, and 14 subjects (1%) as diffuse group. Subnormal scores were found in 76 subjects (5.9%), associated with age, education, hypertension, severe white matter hyperintensities, and distribution and number of MBs. In the final model of logistic regression analysis, the deep group (OR, 2.79; 95% CI, 1.14 -6.79) was associated with subnormal scores, whereas the lobar group (OR, 0.77; 95% CI, 0.17-3.44) was not. Trend for the diffuse group did not reach the level of significance (OR, 5.01; 95% CI,). These trends were also seen in analysis using another cut-off point for subnormal score. Scores for total Mini-Mental State Examination and attention and calculation were significantly lower in the deep group and the diffuse groups compared with the without-MBs group. Conclusions-ThisJapanese cross-sectional study demonstrated that MB-related global cognitive dysfunction seems to occur based on hypertensive pathogenesis rather than on cerebral amyloid angiopathy. (Stroke. 2012;43:1800-1805.)Key Words: microbleeds Ⅲ cognitive impairment Ⅲ hypertension Ⅲ cerebral amyloid angiopathy B rain microbleeds (MBs) on gradient-echo T2*-weighted magnetic resonance imaging (MRI), which are characterized histologically by the presence of hemosiderin around small vessels, are now accepted as a manifestation of cerebral small vessel pathologies, including hypertensive small vessel disease and cerebral amyloid angiopathy (CAA). 1,2 MBs are often detected in patients with stroke, 2,3 and are also reportedly associated with dementia disorders such as Alzheimer's disease, 4 and vascular dementia, 5 or memory loss, 6 as well as cognitive decline. 7-11 However, their pathological impacts on cognitive function remain uncertain.The pathological differences in MBs according to distribution is now well-known, with MBs in deep regions (deep MBs) considered to be associated with hypertensive microangiopathy, whereas strictly lobar MBs (lobar MBs) share risk factors with CAA. 12,13 According to this pathological and distributional concept, we assessed whether different effects on global cognitive function might be seen with different topographical distributions of MBs in a sample of independen...

The relationship between kidney dysfunction, such as chronic kidney disease (CKD), and brain morphology has attracted increasing attention, but the association between kidney dysfunction and cerebral atrophy has yet to be determined. The purpose of this study was to clarify the relationship between kidney function and a substantial degree of cerebral atrophy. A total of 610 consecutive Japanese adults without neurological disorders who had undergone health screening tests of the brain were studied prospectively. Magnetic resonance imaging was performed using a 1.5-T scanner. Using a computer-assisted processing system, the percentage of cerebrum atrophy (%Cerebrum atrophy) was calculated as an index of cerebral atrophy. Atrophy was defined as 42 s.d.s below the mean %Cerebrum atrophy. The glomerular filtration rate (GFR) was estimated using the revised equations for estimated GFR from serum creatinine in Japan. Kidney function variables included the GFR value and the prevalence of subjects with GFR o60 ml min À1 per 1.73 m 2 . Cerebral atrophy was found in 25 (4.1%) cases. Univariate analysis showed that age, male sex, hypertension, each kidney function variable, white matter hyperintensities and lacunae were associated with cerebral atrophy. On logistic regression analysis, GFR (odds ratio (OR), 0.64; 95% confidence interval (CI), 0.42-0.98) and GFR o60 ml min À1 per 1.73 m 2 (OR, 5.93; 95% CI,) were significantly associated with cerebral atrophy. On subanalysis, GFR o60 ml min À1 per 1.73 m 2 was significantly associated with cortical atrophy (OR, 3.23; 95% CI, 1.15-9.11). Decreased GFR was significantly associated with cerebral atrophy, indicating that treatment of CKD may control age-related degenerative processes of the brain.

Aim: Low plasma adiponectin levels have been demonstrated to be linked to obesity and insulin resistance. It has also been suggested that high molecular weight (HMW) adiponectin is more important for vascular protection than the total amount of adiponectin, although clinical data of HMW adiponectin are lacking. The purpose of this study was to investigate HMW adiponectin levels in Japanese rural residents and to elucidate their clinical significance. Methods: We measured plasma HMW adiponectin levels in 1,183 subjects (643 men) who participated in our annual health check program in Kashima-city, Saga, Japan. Results: The median plasma level of HMW adiponectin was significantly lower in men than women (2.6, 1.6 − 4.0 vs 6.5, 3.7 − 8.6 g/mL, p 0.001), respectively. Multivariate linear regression analysis showed that body weight, B-type natriuretic peptide (BNP) and high density lipoprotein cholesterol were independently associated with HMW adiponectin in both genders. Triglyceride and serum creatinine levels were associated with HMW adiponectin in men only. Conclusions: HMW adiponectin levels were lower in men than in women and were associated with BNP independently. A prospective follow-up of the subjects in this study is required to determine the usefulness of HMW adiponectin as a biomarker for predicting the development of cardiovascular disease. J Atheroscler