Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder

Yakushiji, Yusuke; Nishiyama, Masanori; Yakushiji, Satomi; Hirotsu, Tatsumi; Uchino, Akira; Nakajima, Junko; Eriguchi, Makoto; Nanri, Yasuhiro; Hara, Megumi; Horikawa, Etsuo; Kuroda, Yasuo

doi:10.1161/strokeaha.108.516112

Cited by 128 publications

(100 citation statements)

References 48 publications

(42 reference statements)

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“…However, links between CMBs and cognitive function have been inconsistent, probably because of the great variability in populations, MRI techniques, and cognitive rating instruments used. 4,5,7,8,[20][21][22][23] Nevertheless, consistent with our findings, a large recent study in community-based elderly subjects showed that CMBs were independently associated with lower scores in processing speed and executive functions. 20 Another study in a large European population-based cohort 22 reported robust associations between strictly lobar CMBs and cognitive function (information processing speed and motor speed), but only weak associations for deep or infratentorial CMBs.…”

Section: Discussionsupporting

confidence: 90%

“…3 Recent evidence suggests that CMBs are linked to cognitive impairment 4,5 particularly executive function or processing speed. [6][7][8] There is indirect evidence that CMB location reflects the underlying small vessel disease process (strictly lobar CMBs being a marker for CAA; deep CMBs for hypertensive arteriopathy), 9 but the importance of CMB location with regard to cognition remains uncertain.…”

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confidence: 99%

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Strictly Lobar Microbleeds Are Associated With Executive Impairment in Patients With Ischemic Stroke or Transient Ischemic Attack

Grégoire

Scheffler

Jäger

et al. 2013

Stroke

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Background and Purpose-Cerebral microbleeds (CMBs) are a marker of small vessel diseases, including hypertensive arteriopathy and cerebral amyloid angiopathy, and may be associated with cognitive impairment. The relationship between CMBs and cognitive function in ischemic cerebrovascular disease remains uncertain. We, therefore, investigated the cognitive impact of CMBs in a cohort of patients with ischemic stroke or transient ischemic attack. Methods-All patients underwent detailed and comprehensive neuropsychological testing and standardized MRI, including fluid attenuation inversion recovery, T1, T2, and gradient-recalled echo T2*-weighted sequences. CMBs, white matter changes, lacunes, and territorial cortical infarcts (defined by standardized criteria) were identified, and associations with cognition assessed. Results-Three hundred twenty patients with a diagnosis of ischemic stroke or transient ischemic attack were included. Of these, 72 (22.5%) had at least 1 CMB. Of all the cognitive domains tested, only executive impairment was more prevalent in patients with CMBs than without (38% versus 25%; P=0.039). In univariate analysis, the presence of strictly lobar (but not deep) CMBs was associated with executive impairment (odds ratio, 2.49; 95% confidence interval, 1.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

Strictly Lobar Microbleeds Are Associated With Executive Impairment in Patients With Ischemic Stroke or Transient Ischemic Attack

Grégoire

Scheffler

Jäger

et al. 2013

Stroke

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“…The same system of health screening tests of the brain was described in previous studies. 14,15 These individuals were considered potential study subjects. To be included, subjects had to meet the following criteria: (1) age X30 years; (2) no disability in instrumental activities of daily living; (3) ability to independently attend visits for health screening tests of the brain; and (4) voluntary provision of written, informed consent.…”

Section: Methods Subjectsmentioning

confidence: 99%

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Yakushiji

Nanri

Hirotsu³

et al. 2010

Hypertens Res

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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.

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“…CMBs have also been observed in elderly patients without known underlying pathology [13,14], as well as in other degenerative central nervous system conditions, including cerebral amyloid angiopathy (CAA) associated with Alzheimer's disease and vascular cognitive impairment [11], where they have been linked to cognitive dysfunction [15][16][17][18]. Thus, quantification of CMB characteristics may serve as a valuable metric for radiation-induced vasculopathy and resultant cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Radiation Dose and Microbleed Formation in Patients With Malignant Glioma

Wahl

Anwar

Hess

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Background: Cranial irradiation is associated with long-term cognitive changes. Cerebral microbleeds (CMBs) have been identified on susceptibility-weighted MRI (SWI) in patients who have received prior cranial radiation, and serve as radiographic markers for microvascular injury thought to contribute to late cognitive decline. The relationship between CMB formation and radiation dose has not previously been quantified. Methods: SWI was performed on 13 patients with stable WHO grade III-IV gliomas between 2 and 4 years after chemoradiotherapy to 60 Gy. The median age at the time of treatment was 41 years (range 25 -74 years). CMBs were identified as discrete foci of susceptibility on SWI that did not correspond to vessels. CMB density for low (<30 Gy), median (30-45 Gy), and high (>45 Gy) dose regions was computed. Results: Twelve of 13 patients exhibited CMBs. The number of CMBs was significantly higher for late (>3 years from treatment) compared to early (<3 years) timepoints (early median 6 CMBs; late median 27 CMBs; p = 0.001), and there were proportionally more CMBs at lower doses for late scans (p = 0.006). 88% of all CMBs were observed in regions receiving at least 30 Gy, but the CMB density within medium and high dose regions was not significantly different (p = 0.33 and p = 0.9, respectively, for early and late time points). Conclusions: CMBs predominantly form in regions receiving at least 30 Gy, but form in lower dose regions with longer follow-up. We do not observe a clear dose-response relationship at doses above 30 Gy. These findings provide important information to assess the risk of late microvascular sequelae from cranial irradiation.

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Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder

Cited by 128 publications

References 48 publications

Strictly Lobar Microbleeds Are Associated With Executive Impairment in Patients With Ischemic Stroke or Transient Ischemic Attack

Strictly Lobar Microbleeds Are Associated With Executive Impairment in Patients With Ischemic Stroke or Transient Ischemic Attack

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Relationship Between Radiation Dose and Microbleed Formation in Patients With Malignant Glioma

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