Brain microbleeds: Epidemiology and clinical implications

Boyano, Inmaculada; Bravo, Nicolás; Miranda, Jesús García de Madariaga; Gil-Gregorio, Pedro; Olazarán, Javier

doi:10.1016/j.nrleng.2016.04.013

Cited by 4 publications

(14 citation statements)

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“…Brain microbleeds are often associated with the aging process, AD, and hemorrhagic or ischemic strokes. 53 The data evaluated together for MCI (►Table 1), VD (►Table 2), and AD (►Table 3) indicate an increase in homocysteine levels, which is a marker of impairment in vitamin B12 and folate metabolism but also strongly correlated with endothelial damage. 54,55 Folate and vitamin B12 deficiencies promote an elevated level of homocysteine, possibly leading to endothelial and neuronal injury.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis

Loures

Duarte

Silva

et al. 2019

Semin Thromb Hemost

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Alzheimer's disease (AD) is considered the most frequent cause of dementia. It is known that vascular risk factors play an important role in the development and progression of this condition. Alterations in vascular walls represent documented findings in patients with AD and other dementias affecting elderly people. The authors performed a systematic review and meta-analysis, aiming to synthesize observational studies that evaluated how the hemostatic system may contribute to cognitive decline in the elderly, using papers published until April 2018 and as indexed in Medline (PubMed), Scopus, Web of Science, ScienceDirect, Lilacs, Cinahl, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Among 5,278 studies identified, 32 were included in the final synthesis, and these included 485 patients with mild cognitive impairment, 568 with vascular dementia (VD), 1,781 with AD, and 2,855 participants without dementia. AD patients had increased plasma von Willebrand factor (VWF) (standardized mean difference [SMD]: 2.53; 95% confidence interval [CI]: 0.10–4.95), D-dimer (SMD: 0.50; 95% CI: 0.35–0.66), plasminogen activator inhibitor-1 (SMD: 3.34; 95% CI: 1.01–5.67), thrombomodulin (SMD: 1.08; 95% CI: 0.53–1.62), and homocysteine levels (SMD: 0.65; 95% CI: 0.15–1.15). In contrast, the VD group showed increased fibrinogen levels (SMD: 0.77; 95% CI: 0.13–1.41), activated factor VII (SMD: 0.36; 95% CI: 0.05–0.67), factor VIII (SMD: 0.57; 95% CI: 0.22–0.91), VWF (SMD: 2.34; 95% CI: 0.38–4.29), D-dimer (SMD: 1.14; 95% CI: 0.51–1.78), and homocysteine (SMD: 2.17; 95% CI: 1.67–2.68). AD showed an elevation in some markers of endothelial dysfunction, whereas VD presented mostly an involvement of coagulation cascade components.

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Section: Discussionmentioning

confidence: 99%

Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis

Loures

Duarte

Silva

et al. 2019

Semin Thromb Hemost

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“…Cerebral microbleeds (CMBs), a typical imaging marker of CSVD (Wardlaw et al, 2013 ), have an incidence of 5–35% in individuals aged older than 45 years (Haller et al, 2018 ). The proportion of CMBs is 16–45% and up to 86% in patients with cognitive impairment and vascular dementia, respectively (Boyano et al, 2018 ). A high CMB count might increase the risk of cognitive decline, even dementia, and the location of CMBs might involve the different impaired cognitive domains (Akoudad et al, 2016 ; Ding et al, 2017 ; Li et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Iron deposition in the precuneus is correlated with mild cognitive impairment in patients with cerebral microbleeds: A quantitative susceptibility mapping study

Yan

Liu

et al. 2022

Front. Neurosci.

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PurposeThe purpose of this study was to define whether mild cognitive impairment (MCI) is associated with iron deposition in rich-club nodes distant from cerebral microbleeds (CMBs) in patients with cerebral small vessel disease (CSVD).MethodsA total of 64 participants underwent magnetic resonance imaging (MRI) scanning and were separated into three groups, namely, CMB(+), CMB(–), and healthy controls (HCs). We compared their characteristics and susceptibility values of rich-club nodes [e.g., superior frontal gyrus (SFG), precuneus, superior occipital gyrus (SOG), thalamus, and putamen]. We then divided the CMB(+) and CMB(–) groups into subgroups of patients with or without MCI. Then, we analyzed the relationship between iron deposition and MCI by comparing the susceptibility values of rich-club nodes. We assessed cognitive functions using the Montreal Cognitive Assessment (MoCA) and quantified iron content using quantitative susceptibility mapping (QSM).ResultsIn the putamen, the CMB(+) and CMB(–) groups had significantly different susceptibility values. Compared with the HCs, the CMB(+) and CMB(–) groups had significantly different susceptibility values for the SFG and SOG. In addition, we found significant differences in the putamen susceptibility values of the CMB(+)MCI(+) group and the two CMB(–) groups. The CMB(+)MCI(+) and CMB(+)MCI(–) groups had significantly different precuneus susceptibility values. The binary logistic regression analysis revealed that only higher susceptibility values of precuneus were associated with a cognitive decline in patients with CMBs, and it indicated statistical significance.ConclusionIron deposition in the precuneus is an independent risk factor for MCI in patients with CMBs. CMBs might influence iron content in remote rich-club nodes and be relevant to MCI.

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“…They are seen on blood-sensitive MRI sequences such as T2*-weighted gradient-recalled echo (T2*-GRE) or susceptibility-weighted imaging (SWI) 1,2,3,4,5,6 . They are small (usually <5 mm in diameter), rounded or oval lesions of low signal intensity in the brain parenchyma 1,2,3,4,7,8 . CMBs represent haemosiderin deposits contained within macrophages in the microvascular perivascular spaces on histopathological examinations 1,2,3,4,9 , and develop as a result of leakage of red blood cells secondary to rupture of the walls of small arteries, arterioles or capillaries 1,2,10 .…”

mentioning

confidence: 99%

“…They are small (usually <5 mm in diameter), rounded or oval lesions of low signal intensity in the brain parenchyma 1,2,3,4,7,8 . CMBs represent haemosiderin deposits contained within macrophages in the microvascular perivascular spaces on histopathological examinations 1,2,3,4,9 , and develop as a result of leakage of red blood cells secondary to rupture of the walls of small arteries, arterioles or capillaries 1,2,10 . Whether the rupture of a small vessel results in a microbleed or a larger macrobleed is believed to depend on different vasculopathic features and environmental exposure 5,7 .…”

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confidence: 99%

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Cerebral microbleeds and stroke: more questions than answers

Ranawaka

2021

Sri Lanka J. Neurology

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CMBs are a radiological biomarker of cerebral small vessel disease. They are seen on blood-sensitive MRI sequences such as T2*-weighted gradient-recalled echo (T2*-GRE) or susceptibility-weighted imaging (SWI) 1,2,3,4,5,6 . They are small (usually <5 mm in diameter), rounded or oval lesions of low signal intensity in the brain parenchyma 1,2,3,4,7,8 . CMBs represent haemosiderin deposits contained within macrophages in the microvascular perivascular spaces on histopathological examinations 1,2,3,4,9 , and develop as a result of leakage of red blood cells secondary to rupture of the walls of small arteries, arterioles or capillaries 1,2,10 . Whether the rupture of a small vessel results in a microbleed or a larger macrobleed is believed to depend on different vasculopathic features and environmental exposure 5,7 . Two distinct patterns of microangiopathy are noted on histopathological testing in the blood vessels located near CMBs: lipohyalinosis and cerebral amyloid angiopathy (CAA). The pattern of microangiopathy appears to determine the pattern of anatomical distribution of CMBs;

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Brain microbleeds: Epidemiology and clinical implications

Cited by 4 publications

References 70 publications

Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis

Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis

Iron deposition in the precuneus is correlated with mild cognitive impairment in patients with cerebral microbleeds: A quantitative susceptibility mapping study

Cerebral microbleeds and stroke: more questions than answers

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