Background and distribution of lobar microbleeds in cognitive dysfunction

Matsuyama, Hirofumi; Yuichiro,; Maeda, Masayuki; Umino, Maki; Ueda, Yukito; Tabei, Ken-ichi; Kida, Hirotaka; Satoh, Masayuki; Shindo, Akihiro; Taniguchi, Akira; Takahashi, Ryōsuke; Tomimoto, Hidekazu

doi:10.1002/brb3.856

Cited by 12 publications

(10 citation statements)

References 51 publications

(74 reference statements)

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“…Preclinical research on post haemorrhage neuronal damage: novel insights Recent clinical evidence suggests that the occurrence of microbleeds leads to a greater cognitive decline in vascular dementia and AD [102][103][104]. In the Rotterdam Study, higher levels of plasma Ab were associated with increasing lacunar and microbleed counts [105].…”

Section: Immunological Mechanisms Potentially Contributing To Vasculamentioning

confidence: 99%

Current and emerging avenues for Alzheimer's disease drug targets

et al. 2019

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Loera-Valencia R, Cedazo-Minguez A, ). Current and emerging avenues for Alzheimer's disease drug targets (Review). J Intern Med 2019; 286: 398-437.Alzheimer's disease (AD), the most frequent cause of dementia, is escalating as a global epidemic, and so far, there is neither cure nor treatment to alter its progression. The most important feature of the disease is neuronal death and loss of cognitive functions, caused probably from several pathological processes in the brain. The main neuropathological features of AD are widely described as amyloid beta (Ab) plaques and neurofibrillary tangles of the aggregated protein tau, which contribute to the disease. Nevertheless, AD brains suffer from a variety of alterations in function, such as energy metabolism, inflammation and synaptic activity. The latest decades have seen an explosion of genes and molecules that can be employed as targets aiming to improve brain physiology, which can result in preventive strategies for AD. Moreover, therapeutics using these targets can help AD brains to sustain function during the development of AD pathology. Here, we review broadly recent information for potential targets that can modify AD through diverse pharmacological and nonpharmacological approaches including gene therapy. We propose that AD could be tackled not only using combination therapies including Ab and tau, but also considering insulin and cholesterol metabolism, vascular function, synaptic plasticity, epigenetics, neurovascular junction and blood-brain barrier targets that have been studied recently. We also make a case for the role of gut microbiota in AD. Our hope is to promote the continuing research of diverse targets affecting AD and promote diverse targeting as a near-future strategy. ReviewInsoluble Ab fibrils are taken into consideration as the main responsible for spine pathology. On the other hand, in both transgenic mouse models of AD and human AD brain, synapse defects and memory loss correlate weakly with the presence of Ab Current and novel Alzheimer´s disease therapy targets / R. Loera-Valencia et al.

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Section: Immunological Mechanisms Potentially Contributing To Vasculamentioning

confidence: 99%

Current and emerging avenues for Alzheimer's disease drug targets

et al. 2019

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“…CMBs were detected in older patients, and this was proven as a consistent risk factor across different studies [12,22]. They attributed the effect of age on accumulation of other vascular risk factors that lead to CMB pathology.…”

Section: Discussionmentioning

confidence: 86%

Do cerebral microbleeds affect cognition in patients with symptomatic small vessel disease?

Abdullah

Zakieldin

Bayomy

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Dementia and cognitive impairment are becoming increasingly a major health problem, pronounced by increased life expectancy. Cerebral small vessel disease (cSVD) is among the major causes of cognitive deterioration, yet cerebral microbleeds (CMBs) which are a common association of cSVD are still not sure to be related to cognition. Aim of the study: The study aims to determine whether the number and localization of CMBs correlate with cognition in patients with symptomatic small vessel disease (SVD), according to Montreal Cognitive Assessment (MoCA) test. Subjects and methods: This cross-sectional study included 85 Egyptian patients with symptomatic SVD, from the neuropsychiatry clinic of the Main Suez Hospital in Suez City, in the period between February 2017 and February 2018. Subjects were classified according to CMB presence into CMB-positive and CMB-negative groups. Both groups are assessed using MRI imaging and MoCA test for cognitive function. Results: In our study, CMBs recorded a high prevalence rate of SVD patients. Subjects with MBs were mainly males and significantly older, with higher white matter lesion volume and more lacunar infarcts. MoCA test detected significant impairment in visuospatial/executive function, attention, and total scores in CMB-positive group. Both frontal and parietal MBs showed independent association with visuospatial/executive impairment. Deep MBs in the basal ganglia were proved to be independent risk factor for attention affection. Conclusion: Number and localization of MBs proved to be important in determining cognitive consequences. The relations with cognitive performance were mainly driven by frontal, parietal, and deep located MBs in the basal ganglia. Memory affection in frontal MBs was dependent to severe white matter intensities and lacunes.

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“…This could be because lobar microbleeds indicate the presence of subclinical neurodegenerative pathomechanisms such as AD-related cerebral amyloid angiopathy. 23,24 The prevalence of cerebral amyloid pathology, detected using positron emission tomography (PET), was approximately 10% in patients with ischemic stroke 25 and approximately 20% in patients with PSCI. 26 The prevalence of a positive amyloid PET result in patients with PSCI was not higher than that in patients without PSCI.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the presence of lobar microbleeds, even those that were not severe, was associated with PSCI in the current study. This could be because lobar microbleeds indicate the presence of subclinical neurodegenerative pathomechanisms such as AD‐related cerebral amyloid angiopathy 23,24 . The prevalence of cerebral amyloid pathology, detected using positron emission tomography (PET), was approximately 10% in patients with ischemic stroke 25 and approximately 20% in patients with PSCI 26 .…”

Section: Discussionmentioning

confidence: 99%

Impaired cerebral autoregulation is associated with poststroke cognitive impairment

Chi

Chan

et al. 2020

Ann Clin Transl Neurol

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Objective: To investigate whether dynamic cerebral autoregulation (CA) and neuroimaging characteristics are determinants of poststroke cognitive impairment (PSCI). Methods: Eighty patients within 7 days of acute ischemic stroke and 35 age-and sex-matched controls were enrolled. In the patients with stroke, brain magnetic resonance imaging and dynamic CA were obtained at baseline, and dynamic CA was followed up at 3 months and 1 year. Montreal Cognitive Assessment (MoCA) was performed at 3 months and 1 year. Patients with a MoCA score <23 at 1 year were defined as having PSCI, and those with a MoCA score that decreased by 2 points or more between the 3-month and 1year assessments were defined as having progressive cognitive decline. Results: In total, 65 patients completed the study and 16 developed PSCI. The patients with PSCI exhibited poorer results for all cognitive domains than did those without PSCI. The patients with PSCI also had poorer CA (lower phase shift between cerebral blood flow and blood pressure waveforms in the very low frequency band) compared with that of the patients without PSCI and controls at baseline and 1 year. CA was not different between the patients without PSCI and controls. In the multivariate analysis, low education level, lobar microbleeds, and impaired CA (very low frequency phase shift [≤46°] within 7 days of stroke), were independently associated with PSCI. In addition, impaired CA was associated with progressive cognitive decline. Interpretation: Low education level, lobar microbleeds, and impaired CA are involved in the pathogenesis of PSCI.

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Background and distribution of lobar microbleeds in cognitive dysfunction

Cited by 12 publications

References 51 publications

Current and emerging avenues for Alzheimer's disease drug targets

Current and emerging avenues for Alzheimer's disease drug targets

Do cerebral microbleeds affect cognition in patients with symptomatic small vessel disease?

Impaired cerebral autoregulation is associated with poststroke cognitive impairment

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