Association between infectious burden and cerebral microbleeds: a pilot cross‐sectional study

Abstract

Objective Cerebral microbleeds (CMBs) is a subtype of cerebral small vessel disease. Their underlying pathogenesis remains unclear. The aim of this study was to investigate the association between infectious burden (IB) and CMBs. Methods Seven hundred and seventy‐three consecutive patients who were hospitalized in the Department of Neurology in General Hospital of Western Theater Command without severe neurological symptoms were recruited and selected in this pilot cross‐sectional study. CMBs were assessed using the susceptibility‐weighted imaging sequence of magnetic resonance imaging. Immunoglobulin G antibodies against common pathogens, including herpes simplex virus (HSV)‐1, HSV‐2, cytomegalovirus (CMV), Chlamydia pneumoniae (C. pneumoniae), Mycoplasma pneumoniae (M. pneumoniae), Epstein‐Barr virus (EBV), Helicobacter pylori (HP), and Borrelia burgdorferi (B. burgdorferi), were measured by commercial ELISA assays. IB was defined as a composite serologic measure of exposure to these common pathogens. Results Patients with and without CMBs were defined as the CMBs group (n = 76) and the non‐CMBs group (n = 81), respectively. IB was significantly different between the CMBs and non‐CMBs groups. After adjusted for other risk factors, the increased IB was independently associated with the presence of CMBs (P = 0.031, OR = 3.00, 95% CI [1.11–8.15]). IB was significantly positively associated with the number of CMBs (Spearman ρ = 0.653, P < 0.001). The levels of serum inflammatory markers were significantly different between the CMBs and non‐CMBs groups and among the categories of IB. Interpretation IB consisting of HSV‐1, HSV‐2, CMV, C. pneumoniae, M. pneumoniae, EBV, HP, and B. burgdorferi was associated with CMBs. All the findings suggested that pathogen infection could be involved in the pathogenesis of CMBs.

Baseline Infection Burden and Cognitive Function in Elders with Essential Tremor

“…Additional limitations of this instrument include the level of knowledge needed to identify several infectious diseases increasing the possibility of underreport [ 31 ]. Hence, the literature favors alternative approaches to measure infection burden such as antibody titers and disability adjusted life years (DALY) [ 21 52 53 54 55 ]. Nevertheless, self-report questionnaires are considered reliable and valid and are frequently used in epidemiological studies to complement objective data [ 48 56 57 ].…”

Dysfunction of the Blood-brain Barrier in Cerebral Microbleeds: from Bedside to Bench

“…Inflammation exerts the role as an essential part of CMBs pathogenesis and one of CMBs’ most significant risk factors. A pilot cross-sectional study showed an association between the presence of CMBs and infection with multiple pathogens, such as herpes simplex virus (HSV)-1 and HSV-2 [ 178 ]. Histopathological evidence demonstrated that hemosiderin deposits at the lesion site of CMBs are often surrounded by macrophages, a type of immune cells that further initiate inflammatory responses.…”

De novo appearance of cerebral microbleeds in community-dwelling older adults. Neuroimaging and clinical correlates

“…However, other pathologies (traumatic brain injuries, chronic kidney disease, and chronic infections) may account for their occurrence. 3–5 In addition, CMB have been reported after radiation therapy, certain endovascular procedures and with the use of some medications. 6–8…”

“…However, other pathologies (traumatic brain injuries, chronic kidney disease, and chronic infections) may account for their occurrence. [3][4][5] In addition, CMB have been reported after radiation therapy, certain endovascular procedures and with the use of some medications. [6][7][8] Several cross-sectional studies have addressed CMB prevalence, which varies from 3% to >30% according to age and other characteristics of the study population.…”